Why and how might genetic and phylogenetic diversity be reflected in the identification of key biodiversity areas?

PubMed

Brooks, T M; Cuttelod, A; Faith, D P; Garcia-Moreno, J; Langhammer, P; Pérez-Espona, S

2015-02-19

'Key biodiversity areas' are defined as sites contributing significantly to the global persistence of biodiversity. The identification of these sites builds from existing approaches based on measures of species and ecosystem diversity and process. Here, we therefore build from the work of Sgró et al. (2011 Evol. Appl. 4, 326-337. (doi:10.1111/j.1752-4571.2010.00157.x)) to extend a framework for how components of genetic diversity might be considered in the identification of key biodiversity areas. We make three recommendations to inform the ongoing process of consolidating a key biodiversity areas standard: (i) thresholds for the threatened species criterion currently consider a site's share of a threatened species' population; expand these to include the proportion of the species' genetic diversity unique to a site; (ii) expand criterion for 'threatened species' to consider 'threatened taxa' and (iii) expand the centre of endemism criterion to identify as key biodiversity areas those sites holding a threshold proportion of the compositional or phylogenetic diversity of species (within a taxonomic group) whose restricted ranges collectively define a centre of endemism. We also recommend consideration of occurrence of EDGE species (i.e. threatened phylogenetic diversity) in key biodiversity areas to prioritize species-specific conservation actions among sites.

Why and how might genetic and phylogenetic diversity be reflected in the identification of key biodiversity areas?

PubMed Central

Brooks, T. M.; Cuttelod, A.; Faith, D. P.; Garcia-Moreno, J.; Langhammer, P.; Pérez-Espona, S.

2015-01-01

‘Key biodiversity areas' are defined as sites contributing significantly to the global persistence of biodiversity. The identification of these sites builds from existing approaches based on measures of species and ecosystem diversity and process. Here, we therefore build from the work of Sgró et al. (2011 Evol. Appl. 4, 326–337. (doi:10.1111/j.1752-4571.2010.00157.x)) to extend a framework for how components of genetic diversity might be considered in the identification of key biodiversity areas. We make three recommendations to inform the ongoing process of consolidating a key biodiversity areas standard: (i) thresholds for the threatened species criterion currently consider a site's share of a threatened species' population; expand these to include the proportion of the species' genetic diversity unique to a site; (ii) expand criterion for ‘threatened species' to consider ‘threatened taxa’ and (iii) expand the centre of endemism criterion to identify as key biodiversity areas those sites holding a threshold proportion of the compositional or phylogenetic diversity of species (within a taxonomic group) whose restricted ranges collectively define a centre of endemism. We also recommend consideration of occurrence of EDGE species (i.e. threatened phylogenetic diversity) in key biodiversity areas to prioritize species-specific conservation actions among sites. PMID:25561678

10 CFR 960.3-2-3 - Recommendation of sites for characterization.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Recommendation of sites for characterization. 960.3-2-3... POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-3 Recommendation of sites... President not less than three candidate sites for such characterization. The recommendation decision shall...

10 CFR 960.3-1-4-3 - Site recommendation for characterization.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Site recommendation for characterization. 960.3-1-4-3... POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-4-3 Site recommendation for characterization. The evidence required to support the recommendation of a site as a candidate...

Could we do better? Behavioural tracking on recommended consumer health websites.

PubMed

Burkell, Jacquelyn; Fortier, Alexandre

2015-09-01

This study examines behavioural tracking practices on consumer health websites, contrasting tracking on sites recommended by information professionals with tracking on sites returned by Google. Two lists of consumer health websites were constructed: sites recommended by information professionals and sites returned by Google searches. Sites were divided into three groups according to source (Recommended-Only, Google-Only or both) and type (Government, Not-for-Profit or Commercial). Behavioural tracking practices on each website were documented using a protocol that detected cookies, Web beacons and Flash cookies. The presence and the number of trackers that collect personal information were contrasted across source and type of site; a second set of analyses specifically examined Advertising trackers. Recommended-Only sites show lower levels of tracking - especially tracking by advertisers - than do Google-Only sites or sites found through both sources. Government and Not-for-Profit sites have fewer trackers, particularly from advertisers, than do Commercial sites. Recommended sites, especially those from Government or Not-for-Profit organisations, present a lower privacy threat than sites returned by Google searches. Nonetheless, most recommended websites include some trackers, and half include at least one Advertising tracker. To protect patron privacy, information professionals should examine the tracking practices of the websites they recommend. © 2015 Health Libraries Group.

The Environmental Protection Agency's Safety Standards for Disposal of Spent Nuclear Fuel: Potential Path Forward in Response to the Report of the Blue Ribbon Commission on America's Nuclear Future - 13388

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

Forinash, Betsy; Schultheisz, Daniel; Peake, Tom

2013-07-01

Following the decision to withdraw the Yucca Mountain license application, the Department of Energy created a Blue Ribbon Commission (BRC) on America's Nuclear Future, tasked with recommending a national strategy to manage the back end of the nuclear fuel cycle. The BRC issued its final report in January 2012, with recommendations covering transportation, storage and disposal of spent nuclear fuel (SNF); potential reprocessing; and supporting institutional measures. The BRC recommendations on disposal of SNF and high-level waste (HLW) are relevant to the U.S. Environmental Protection Agency (EPA), which shares regulatory responsibility with the Nuclear Regulatory Commission (NRC): EPA issues 'generallymore » applicable' performance standards for disposal repositories, which are then implemented in licensing. For disposal, the BRC endorses developing one or more geological repositories, with siting based on an approach that is adaptive, staged and consent-based. The BRC recommends that EPA and NRC work cooperatively to issue generic disposal standards-applying equally to all sites-early in any siting process. EPA previously issued generic disposal standards that apply to all sites other than Yucca Mountain. However, the BRC concluded that the existing regulations should be revisited and revised. The BRC proposes a number of general principles to guide the development of future regulations. EPA continues to review the BRC report and to assess the implications for Agency action, including potential regulatory issues and considerations if EPA develops new or revised generic disposal standards. This review also involves preparatory activities to define potential process and public engagement approaches. (authors)« less

Eucalyptus Energy Farm: feasibility study and demonstration. Phase 1: site and species selection

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

Mariani, E.O.; Wood, W.A.; Kouchoukos, P.C.

1978-06-01

The results of investigations to determine the feasibility for establishing ''Eucalyptus Energy Farms'' as a potential source of biomass derived energy are presented. Included in this report are: the results of an extensive literature search and numerous field interviews (both domestically and internationally) to identify those Eucalyptus species most suitable for use within the United States; a description of the site selection criteria, site selection process, and identification of potential sites for use in testing the Eucalyptus Energy Farm concept; a description of the Eucalyptus species selection criteria, species selection process, and an identification of the specific species recommended formore » testing at specific sites; preliminary engineering designs for each of the proposed plantation sites; and environmental impact considerations related to Eucalyptus growing. It is concluded that although the Eucalyptus are extremely temperature sensitive and the geographic areas which appear suitable for their planting (within the United States) are principally confined to western and central California and the warmest regions of the southeastern United States, each of the areas contain large amounts of marginal land which could be converted into Eucalyptus based biomass plantations. Suitable sites, which are representative of the larger marginal land areas, are immediately available for use in establishing Eucalyptus screening test sites. Furthermore, there are not significant environmental conditions which would preclude the establishment of these initial test sites. It is therefore recommended that efforts be initiated to obtain selected provenances of Eucalyptus seeds (of the designated species) for further field testing and data collection within the United States, and that actual site selection be initiated.« less

Environmental assessment of mercury pollution in urban tailings from gold mining.

PubMed

Leiva, Manuel A G; Morales, Sandra

2013-04-01

It is well-known that small-scale artisanal mining is a source of mercury emissions into the environment, mainly from the use of rudimentary technologies that use mercury amalgamation in the extraction process. Mines near Andacollo, which is located in the Coquimbo region of Chile, use primitive methods to mine gold and copper. In this study, we determined the mercury content of gold mining wastes from Andacollo. At each site, we randomly sampled the soil at the surface and at a depth of 2 m following the ISO 10381 guidelines. Mercury analysis was performed with a direct mercury analyzer. At least one site was contaminated at a mercury concentration of 13.6±1.4 mg kg(-1), which was above the international recommendations that were set by the Canadian Council of Ministers of the Environment's soil quality guidelines (CA-SQG) and the Dutch guidelines (NL-RIVM). At least four of the fourteen sites in this study were within the control and tolerance levels of these recommendations. Better characterization of these sites is required to establish whether they represent a risk to the local community. Based on the US-EPA recommendations, which have a higher tolerance limit, none of the fourteen sites should pose a risk to humans. Copyright © 2013 Elsevier Inc. All rights reserved.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

PubMed Central

Dakkuri, Adnan; Abrons, Jeanine P.; Williams, Dennis; Ombengi, David N.; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O’Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

2016-01-01

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education. PMID:27170809

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

PubMed

Alsharif, Naser Z; Dakkuri, Adnan; Abrons, Jeanine P; Williams, Dennis; Ombengi, David N; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O'Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

2016-04-25

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

Hot Spots on the Web for Teacher Librarians: A Selection of Recommended Web Sites for TLs To Visit.

ERIC Educational Resources Information Center

1996

Six papers review and recommend sites on the Web as resources for teacher librarians include: "Just Do It: A Guide to Getting Out There and Doing It Yourself" (Catherine Ryan); "A Selection of Recommended Web Sites for TLs To Visit" (Karen Bonanno); "A Selection of Recommended Web Sites for TLs To Visit" (Sandra…

Recommended care adherence: improved by patient reminder letters but with potential attenuation by the healthcare process complexity.

PubMed

Zhang, Zhou; Fish, Jason

2012-01-01

American adults receive the recommended care just over half of the time for all recommended services. Many patient reminder strategies have attempted to increase the adherence rates for preventative and chronic disease management. However, there is a lack of data available in relation to adherence rates for symptom-specific recommended services and a lack of data identifying any contributions from the organisational structures to these adherence rates. To identify the efficacy and differences in patient reminder letter strategies on various categories of recommended services, as well as to analyse the relationship between a novel quantification of a healthcare system's process complexity with adherence rates. Retrospective cohort study analysing pilot data collected from an urban, academic healthcare provider utilising patient reminder letters. Adults attending one academic medical centre's outpatient practice from 2008 to 2009. Two reminder letters sent chronologically if the recommended care was not completed in the appropriate time frame. Adherence rates of each recommended service at baseline, after first and second reminder letters, and non-adherence rates despite the reminder letter intervention. Process flow complexity was calculated as a composite score combining elements of fastest time to complete routine order, number of different steps in routine order, number of departments involved, and number of sites patients visit. Patient adherence rates increased for all the recommended services after the first reminder letter. Preventative and Chronic Disease Management recommendations demonstrated additional moderate increases after the second reminder letter. Referrals and Radiologogy and Diagnostic Testing (acute, symptom specific) and Labs (acute and nonacute) demonstrated additional minimal adherence rate increases after the second reminder letter. Comparison of the process flow complexity demonstrated an inverse relationship between process complexity and adherence rates, particularly for non-acute orders. One reminder letter seemed to be sufficient for most recommended care. The complexity of the healthcare process may be an important predictive factor for patient adherence.

Evaluating existing access opportunities for disabled persons at remote shoreline recreation sites

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

Bley, M.R.; Kearns, M.T.

1995-12-31

Draft guidelines for providing outdoor recreation access opportunities for disabled persons have been recommended by the Recreation Access Advisory Committee and in the Universal Access to Outdoor Recreation: A Design Guide. The Federal Energy Regulatory Commission requires applicants for new hydropower licenses to consider access opportunities for disabled persons at existing hydropower projects. A process for evaluating existing access opportunities for disabled persons at remote shoreline recreation sites at hydropower projects is described. The process includes five steps: (1) preparing a preliminary map of existing recreation sites; (2) data collection in the field; (3) evaluating compliance of existing facilities; (4)more » feasibility of enhancing existing facilities; and (5) designing enhancements. The process will be refined when final standards and processes are approved by the appropriate agencies and organizations.« less

Multicenter Study on Incubation Conditions for Environmental Monitoring and Aseptic Process Simulation.

PubMed

Guinet, Roland; Berthoumieu, Nicole; Dutot, Philippe; Triquet, Julien; Ratajczak, Medhi; Thibaudon, Michel; Bechaud, Philippe; Arliaud, Christophe; Miclet, Edith; Giordano, Florine; Larcon, Marjorie; Arthaud, Catherine

Environmental monitoring and aseptic process simulations represent an integral part of the microbiological quality control system of sterile pharmaceutical products manufacturing operations. However, guidance documents and manufacturers practices differ regarding recommendations for incubation time and incubation temperature, and, consequently, the environmental monitoring and aseptic process simulation incubation strategy should be supported by validation data. To avoid any bias coming from in vitro studies or from single-site manufacturing in situ studies, we performed a collaborative study at four manufacturing sites with four samples at each location. The environmental monitoring study was performed with tryptic soy agar settle plates and contact plates, and the aseptic process simulation study was performed with tryptic soy broth and thioglycolate broth. The highest recovery rate was obtained with settle plates (97.7%) followed by contact plates (65.4%) and was less than 20% for liquid media (tryptic soy broth 19% and thioglycolate broth 17%). Gram-positive cocci and non-spore-forming Gram-positive rods were largely predominant with more than 95% of growth and recovered best at 32.5 °C. The highest recovery of molds was obtained at 22.5 °C alone or as the first incubation temperature. Strict anaerobes were not recovered. At the end of the five days of incubation no significant statistical difference was obtained between the four conditions. Based on these data a single incubation temperature at 32.5 °C could be recommended for these four manufacturing sites for both environmental monitoring and aseptic process simulation, and a second plate could be used, periodically incubated at 22.5 °C. Similar studies should be considered for all manufacturing facilities in order to determine the optimal incubation temperature regime for both viable environmental monitoring and aseptic process simulation. Microbiological environmental monitoring and aseptic process simulation confirm that pharmaceutical cleanrooms are in an appropriate hygienic condition for manufacturing of sterile drug products. Guidance documents from different health authorities or expert groups differ regarding recommendation of the applied incubation time and incubation temperature, leading to variable manufacturers practices. Some recent publications have demonstrated that laboratory studies are not relevant to determine the best incubation regime and that in situ manufacturing site studies should be used. To solve any possible bias coming from laboratory studies or single-site in situ studies, we conducted a multicenter study at four manufacturing sites with a significant amount of real environmental monitoring samples collected directly from the environment in pharmaceutical production during manufacturing operations with four solid and liquid nutrient media. These samples were then incubated under four different conditions suggested in the guidance documents. We believe that the results of our multicenter study confirming recent other single-site in situ studies could be the basis of the strategy to determine the best incubation regime for both viable environmental monitoring and aseptic process simulation in any manufacturing facility. © PDA, Inc. 2017.

Initial outcomes from federally mandated accreditation site surveys of advanced diagnostic imaging facilities performed by the ACR.

PubMed

Harvey, H Benjamin; Chow, David; Boston, Marion; Zhao, Jing; Lucey, Leonard; Monticciolo, Debra L

2014-07-01

The aim of this study was to evaluate the findings of the first year of validation site surveys performed by the ACR pursuant to new federal accreditation requirements for nonhospital advanced diagnostic imaging (ADI) facilities. In the first year of validation site surveys (November 2012 to November 2013), the ACR surveyed 943 ADI facilities across 21 states. Data were extracted from these site survey reports and analyzed on the basis of the survey outcomes and the frequency and type of deficiencies and recommendations. Follow-up data were obtained from the ACR for facilities deemed noncompliant on the site survey to determine if these facilities adequately took the corrective actions necessary to maintain accreditation. Of the 943 ADI facilities surveyed, 45% (n = 421) were deemed compliant with the ACR accreditation standards, and 55% (n = 522) had one or more deficiencies. Failure to produce the required personnel documentation and absence of mandatory written policies were the two most common causes of deficiencies. Facilities accredited in more modalities tended to fare better in the site surveys, with the number of accredited modalities at a facility negatively associated with the likelihood of a deficiency (P = .007). Of the facilities with deficiencies, 73% (n = 382) took the necessary corrective actions to maintain accreditation, 27% (n = 140) were in the process of taking corrective actions, and no facility has lost accreditation because of an inability to adequately address the deficiencies. Nonbinding recommendations were made to 37% (n = 346) of facilities, and facilities with deficiencies were statistically more likely to receive recommendations (P < .001). Initial site surveys of ADI facilities demonstrated a high proportion of deficient facilities, but no facility has lost accreditation because of an inability to correct these deficiencies. Knowledge of the most common sources of deficiencies and recommendations can assist ACR-accredited ADI facilities in better preparing for validation site surveys, reducing the likelihood of facility noncompliance. Copyright © 2014. Published by Elsevier Inc.

A peer review process as part of the implementation of clinical pathways in radiation oncology: Does it improve compliance?

PubMed

Gebhardt, Brian J; Heron, Dwight E; Beriwal, Sushil

Clinical pathways are patient management plans that standardize evidence-based practices to ensure high-quality and cost-effective medical care. Implementation of a pathway is a collaborative process in our network, requiring the active involvement of physicians. This approach promotes acceptance of pathway recommendations, although a peer review process is necessary to ensure compliance and to capture and approve off-pathway selections. We investigated the peer review process and factors associated with time to completion of peer review. Our cancer center implemented radiation oncology pathways for every disease site throughout a large, integrated network. Recommendations are written based upon national guidelines, published literature, and institutional experience with evidence evaluated hierarchically in order of efficacy, toxicity, and then cost. Physicians enter decisions into an online, menu-driven decision support tool that integrates with medical records. Data were collected from the support tool and included the rate of on- and off-pathway selections, peer review decisions performed by disease site directors, and time to complete peer review. A total of 6965 treatment decisions were entered in 2015, and 605 (8.7%) were made off-pathway and were subject to peer review. The median time to peer review decision was 2 days (interquartile range, 0.2-6.8). Factors associated with time to peer review decision >48 hours on univariate analysis include disease site (P < .0001) with a trend toward significance (P = .066) for radiation therapy modality. There was no difference between recurrent and non-recurrent disease (P = .267). Multivariable analysis revealed disease site was associated with time to peer review (P < .001), with lymphoma and skin/sarcoma most strongly influencing decision time >48 hours. Clinical pathways are an integral tool for standardizing evidence-based care throughout our large, integrated network, with 91.3% of all treatment decisions being made as per pathway. The peer review process was feasible, with <1% selections ultimately rejected, suggesting that awareness of peer review of treatment decisions encourages compliance with clinical pathway recommendations. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Wind Powering America State Outreach. Final Technical Report: Washington State

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

Stearns, Tim

2013-09-30

The Washington Department of Commerce, via a U.S. Department of Energy grant, supported research into siting and permitting processes for wind projects by Skagit County, Washington. The goal was to help a local government understand key issues, consider how other areas have addressed wind siting, and establish a basis for enacting permitting and zoning ordinances that provided a more predictable permitting path and process for landowners, citizens, government and developers of small and community wind projects. The County?s contractor developed a report that looked at various approaches to wind siting, interviewed stakeholders, and examined technology options. The contractor outlined keymore » issues and recommended the adoption of a siting process. The Skagit County Commission considered the report and directed the Skagit County Planning & Development Services Department to add development of wind guidelines to its work plan for potential changes to development codes.« less

Liquid rocket booster integration study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is the executive summary of the five volume series.

Liquid rocket booster integration study. Volume 5, part 1: Appendices

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is the appendices of the five volume series.

Liquid Rocket Booster Integration Study. Volume 2: Study synopsis

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is the study summary of the five volume series.

Streamlined Approach for Environmental Restoration (SAFER) Plan for Corrective Action Unit 117: Area 26 Pluto Disassembly Facility, Nevada Test Site, Nevada With Errata Sheets, Revision 0

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

Pat Matthews

This Streamlined Approach for Environmental Restoration (SAFER) Plan addresses the actions needed to achieve closure for Corrective Action Unit (CAU) 117, Pluto Disassembly Facility, identified in the Federal Facility Agreement and Consent Order. Corrective Action Unit 117 consists of one Corrective Action Site (CAS), CAS 26-41-01, located in Area 26 of the Nevada Test Site. This plan provides the methodology for field activities needed to gather the necessary information for closing CAS 26-41-01. There is sufficient information and process knowledge from historical documentation and investigations of similar sites regarding the expected nature and extent of potential contaminants to recommend closuremore » of CAU 117 using the SAFER process. Additional information will be obtained by conducting a field investigation before finalizing the appropriate corrective action for this CAS. The results of the field investigation will support a defensible recommendation that no further corrective action is necessary following SAFER activities. This will be presented in a Closure Report that will be prepared and submitted to the Nevada Division of Environmental Protection (NDEP) for review and approval. The site will be investigated to meet the data quality objectives (DQOs) developed on June 27, 2007, by representatives of NDEP; U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office; Stoller-Navarro Joint Venture; and National Security Technologies, LLC. The DQO process was used to identify and define the type, amount, and quality of data needed to determine and implement appropriate corrective actions for CAS 26-41-01 in CAU 117.« less

Governance for clinical decision support: case studies and recommended practices from leading institutions

PubMed Central

Sittig, Dean F; Ash, Joan S; Bates, David W; Feblowitz, Joshua; Fraser, Greg; Maviglia, Saverio M; McMullen, Carmit; Nichol, W Paul; Pang, Justine E; Starmer, Jack; Middleton, Blackford

2011-01-01

Objective Clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety; however, effective implementation of CDS requires effective clinical and technical governance structures. The authors sought to determine the range and variety of these governance structures and identify a set of recommended practices through observational study. Design Three site visits were conducted at institutions across the USA to learn about CDS capabilities and processes from clinical, technical, and organizational perspectives. Based on the results of these visits, written questionnaires were sent to the three institutions visited and two additional sites. Together, these five organizations encompass a variety of academic and community hospitals as well as small and large ambulatory practices. These organizations use both commercially available and internally developed clinical information systems. Measurements Characteristics of clinical information systems and CDS systems used at each site as well as governance structures and content management approaches were identified through extensive field interviews and follow-up surveys. Results Six recommended practices were identified in the area of governance, and four were identified in the area of content management. Key similarities and differences between the organizations studied were also highlighted. Conclusion Each of the five sites studied contributed to the recommended practices presented in this paper for CDS governance. Since these strategies appear to be useful at a diverse range of institutions, they should be considered by any future implementers of decision support. PMID:21252052

Region-to-area screening methodology for the Crystalline Repository Project

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

None

1985-04-01

The purpose of this document is to describe the Crystalline Repository Project's (CRP) process for region-to-area screening of exposed and near-surface crystalline rock bodies in the three regions of the conterminous United States where crystalline rock is being evaluated as a potential host for the second nuclear waste repository (i.e., in the North Central, Northeastern, and Southeastern Regions). This document indicates how the US Department of Energy's (DOE) General Guidelines for the Recommendation of Sites for Nuclear Waste Repositories (10 CFR 960) were used to select and apply factors and variables for the region-to-area screening, explains how these factors andmore » variable are to be applied in the region-to-area screening, and indicates how this methodology relates to the decision process leading to the selection of candidate areas. A brief general discussion of the screening process from the national survey through area screening and site recommendation is presented. This discussion sets the scene for detailed discussions which follow concerning the region-to-area screening process, the guidance provided by the DOE Siting Guidelines for establishing disqualifying factors and variables for screening, and application of the disqualifying factors and variables in the screening process. This document is complementary to the regional geologic and environmental characterization reports to be issued in the summer of 1985 as final documents. These reports will contain the geologic and environmental data base that will be used in conjunction with the methodology to conduct region-to-area screening.« less

Guidance: Strategies to Achieve Timely Settlement and Implementation of RD/RA at Superfund Sites

EPA Pesticide Factsheets

Memorandum recommends strategies to encourage PRPs to enter into a settlement using the model RD/RA Consent Decree; discusses the current model UAO; and suggests practical alternatives to expedite Superfund settlements and the cleanup process.

Developing Representative Michigan Truck Configurations for Bridge Load Rating

DOT National Transportation Integrated Search

2018-02-28

The objective of this study is to recommend a rating process representative of Michigan load effects for legal and extended permit vehicles. For this study, high fidelity WIM data from 20 Michigan sites were analyzed. Using vehicle weight and configu...

Development of traffic data input resources for the mechanistic empirical pavement design process.

DOT National Transportation Integrated Search

2011-12-12

The Mechanistic-Empirical Pavement Design Guide (MEPDG) for New and Rehabilitated Pavement Structures uses : nationally based data traffic inputs and recommends that state DOTs develop their own site-specific and regional : values. To support the MEP...

10 CFR 960.3-2-3 - Recommendation of sites for characterization.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Recommendation of sites for characterization. 960.3-2-3 Section 960.3-2-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-3 Recommendation of sites...

10 CFR 960.3-2-3 - Recommendation of sites for characterization.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Recommendation of sites for characterization. 960.3-2-3 Section 960.3-2-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-3 Recommendation of sites...

10 CFR 960.3-2-3 - Recommendation of sites for characterization.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Recommendation of sites for characterization. 960.3-2-3 Section 960.3-2-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-3 Recommendation of sites...

10 CFR 960.3-1-4-3 - Site recommendation for characterization.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Site recommendation for characterization. 960.3-1-4-3 Section 960.3-1-4-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-4-3 Site recommendation...

10 CFR 960.3-1-4-3 - Site recommendation for characterization.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Site recommendation for characterization. 960.3-1-4-3 Section 960.3-1-4-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-4-3 Site recommendation...

10 CFR 960.3-1-4-3 - Site recommendation for characterization.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Site recommendation for characterization. 960.3-1-4-3 Section 960.3-1-4-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-4-3 Site recommendation...

10 CFR 960.3-1-4-3 - Site recommendation for characterization.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Site recommendation for characterization. 960.3-1-4-3 Section 960.3-1-4-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-4-3 Site recommendation...

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

Haney, Thomas Jay

This report documents the Data Quality Objectives (DQOs) developed for the Idaho National Laboratory (INL) Site ambient air surveillance program. The development of the DQOs was based on the seven-step process recommended “for systematic planning to generate performance and acceptance criteria for collecting environmental data” (EPA 2006). The process helped to determine the type, quantity, and quality of data needed to meet current regulatory requirements and to follow U.S. Department of Energy guidance for environmental surveillance air monitoring design. It also considered the current air monitoring program that has existed at INL Site since the 1950s. The development of themore » DQOs involved the application of the atmospheric dispersion model CALPUFF to identify likely contamination dispersion patterns at and around the INL Site using site-specific meteorological data. Model simulations were used to quantitatively assess the probable frequency of detection of airborne radionuclides released by INL Site facilities using existing and proposed air monitors.« less

Liquid rocket booster integration study. Volume 3: Study products. Part 2: Sections 8-19

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is part two of the study products section of the five volume series.

Liquid rocket booster integration study. Volume 3, part 1: Study products

NASA Technical Reports Server (NTRS)

1988-01-01

The impacts of introducing liquid rocket booster engines (LRB) into the Space Transportation System (STS)/Kennedy Space Center (KSC) launch environment are identified and evaluated. Proposed ground systems configurations are presented along with a launch site requirements summary. Prelaunch processing scenarios are described and the required facility modifications and new facility requirements are analyzed. Flight vehicle design recommendations to enhance launch processing are discussed. Processing approaches to integrate LRB with existing STS launch operations are evaluated. The key features and significance of launch site transition to a new STS configuration in parallel with ongoing launch activities are enumerated. This volume is part one of the study products section of the five volume series.

Opportunities for Launch Site Integrated System Health Engineering and Management

NASA Technical Reports Server (NTRS)

Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.

2005-01-01

The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

Demystifying the Occupational Safety and Health Administration inspection process.

PubMed

Price, Lowell L; Goodman, Terri

2006-04-01

Being prepared for an Occupational Safety and Health Administration (OSHA) inspection can save a facility money, as well as potentially protect employees from serious illness or injury. This article explains the OSHA inspection process, types of violations that may be cited and the appeals process for employers and employees. Actual citations given in four recent OSHA health care facility inspections are discussed and general recommendations to prepare for an OSHA site visit are given.

The Microcomputer in the Administrative Office.

ERIC Educational Resources Information Center

Huntington, Fred

1983-01-01

Discusses microcomputer uses for administrative computing in education at site level and central office and recommends that administrators start with a word processing program for time management, an electronic spreadsheet for financial accounting, a database management system for inventories, and self-written programs to alleviate paper…

Implications of NGA for NEHRP site coefficients

USGS Publications Warehouse

Borcherdt, Roger D.

2012-01-01

Three proposals are provided to update tables 11.4-1 and 11.4-2 of Minimum Design Loads for Buildings and Other Structures (7-10), by the American Society of Civil Engineers (2010) (ASCE/SEI 7-10), with site coefficients implied directly by NGA (Next Generation Attenuation) ground motion prediction equations (GMPEs). Proposals include a recommendation to use straight-line interpolation to infer site coefficients at intermediate values of ̅vs (average shear velocity). Site coefficients are recommended to ensure consistency with ASCE/SEI 7-10 MCER (Maximum Considered Earthquake) seismic-design maps and simplified site-specific design spectra procedures requiring site classes with associated tabulated site coefficients and a reference site class with unity site coefficients. Recommended site coefficients are confirmed by independent observations of average site amplification coefficients inferred with respect to an average ground condition consistent with that used for the MCER maps. The NGA coefficients recommended for consideration are implied directly by the NGA GMPEs and do not require introduction of additional models.

Adherence to recommended electronic health record safety practices across eight health care organizations.

PubMed

Sittig, Dean F; Salimi, Mandana; Aiyagari, Ranjit; Banas, Colin; Clay, Brian; Gibson, Kathryn A; Goel, Ashutosh; Hines, Robert; Longhurst, Christopher A; Mishra, Vimal; Sirajuddin, Anwar M; Satterly, Tyler; Singh, Hardeep

2018-04-26

The Safety Assurance Factors for EHR Resilience (SAFER) guides were released in 2014 to help health systems conduct proactive risk assessment of electronic health record (EHR)- safety related policies, processes, procedures, and configurations. The extent to which SAFER recommendations are followed is unknown. We conducted risk assessments of 8 organizations of varying size, complexity, EHR, and EHR adoption maturity. Each organization self-assessed adherence to all 140 unique SAFER recommendations contained within 9 guides (range 10-29 recommendations per guide). In each guide, recommendations were organized into 3 broad domains: "safe health IT" (total 45 recommendations); "using health IT safely" (total 80 recommendations); and "monitoring health IT" (total 15 recommendations). The 8 sites fully implemented 25 of 140 (18%) SAFER recommendations. Mean number of "fully implemented" recommendations per guide ranged from 94% (System Interfaces-18 recommendations) to 63% (Clinical Communication-12 recommendations). Adherence was higher for "safe health IT" domain (82.1%) vs "using health IT safely" (72.5%) and "monitoring health IT" (67.3%). Despite availability of recommendations on how to improve use of EHRs, most recommendations were not fully implemented. New national policy initiatives are needed to stimulate implementation of these best practices.

A User-centered Model for Web Site Design

PubMed Central

Kinzie, Mable B.; Cohn, Wendy F.; Julian, Marti F.; Knaus, William A.

2002-01-01

As the Internet continues to grow as a delivery medium for health information, the design of effective Web sites becomes increasingly important. In this paper, the authors provide an overview of one effective model for Web site design, a user-centered process that includes techniques for needs assessment, goal/task analysis, user interface design, and rapid prototyping. They detail how this approach was employed to design a family health history Web site, Health Heritage . This Web site helps patients record and maintain their family health histories in a secure, confidential manner. It also supports primary care physicians through analysis of health histories, identification of potential risks, and provision of health care recommendations. Visual examples of the design process are provided to show how the use of this model resulted in an easy-to-use Web site that is likely to meet user needs. The model is effective across diverse content arenas and is appropriate for applications in varied media. PMID:12087113

Progress in centralised ethics review processes: Implications for multi-site health evaluations.

PubMed

Prosser, Brenton; Davey, Rachel; Gibson, Diane

2015-04-01

Increasingly, public sector programmes respond to complex social problems that intersect specific fields and individual disciplines. Such responses result in multi-site initiatives that can span nations, jurisdictions, sectors and organisations. The rigorous evaluation of public sector programmes is now a baseline expectation. For evaluations of large and complex multi-site programme initiatives, the processes of ethics review can present a significant challenge. However in recent years, there have been new developments in centralised ethics review processes in many nations. This paper provides the case study of an evaluation of a national, inter-jurisdictional, cross-sector, aged care health initiative and its encounters with Australian centralised ethics review processes. Specifically, the paper considers progress against the key themes of a previous five-year, five nation study (Fitzgerald and Phillips, 2006), which found that centralised ethics review processes would save time, money and effort, as well as contribute to more equitable workloads for researchers and evaluators. The paper concludes with insights for those charged with refining centralised ethics review processes, as well as recommendations for future evaluators of complex multi-site programme initiatives. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of Vitrification Processing Step for Rocky Flats Incinerator Ash

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

Wigent, W.L.; Luey, J.K.; Scheele, R.D.

In 1997, Pacific Northwest National Laboratory (PNNL) staff developed a processing option for incinerator ash at the Rocky Flats Environmental Technology Sites (RFETS). This work was performed with support from Los Alamos National Laboratory (LANL) and Safe Sites of Colorado (SSOC). A description of the remediation needs for the RFETS incinerator ash is provided in a report summarizing the recommended processing option for treatment of the ash (Lucy et al. 1998). The recommended process flowsheet involves a calcination pretreatment step to remove carbonaceous material followed by a vitrification processing step for a mixture of glass tit and calcined incinerator ash.more » Using the calcination pretreatment step to remove carbonaceous material reduced process upsets for the vitrification step, allowed for increased waste loading in the final product, and improved the quality of the final product. Figure 1.1 illustrates the flow sheet for the recommended processing option for treatment of RFETS incinerator ash. In 1998, work at PNNL further developed the recommended flow sheet through a series of studies to better define the vitrification operating parameters and to address secondary processing issues (such as characterizing the offgas species from the calcination process). Because a prototypical rotary calciner was not available for use, studies to evaluate the offgas from the calcination process were performed using a benchtop rotary calciner and laboratory-scale equipment (Lucy et al. 1998). This report focuses on the vitrification process step after ash has been calcined. Testing with full-scale containers was performed using ash surrogates and a muffle furnace similar to that planned for use at RFETS. Small-scale testing was performed using plutonium-bearing incinerator ash to verify performance of the waste form. Ash was not obtained from RFETS because of transportation requirements to calcine the incinerator ash prior to shipment of the material. Because part of PNNL's work was to characterize the ash prior to calcination and to investigate the effect of calcination on product quality, representative material was obtained from LANL. Ash obtained from LANL was selected based on its similarity to that currently stored at RFETS. The plutonium-bearing ashes obtained from LANL are likely from a RFETS incinerator, but the exact origin was not identified.« less

Study of Mechanization in DOD Libraries and Information Centers.

ERIC Educational Resources Information Center

Booz, Allen Applied Research, Inc., Bethesda, MD.

This report summarizes the on-site study of mechanization in DoD libraries and information centers. Included are presentations and evaluations on thesaurus building, file structure, input processing, serial control, selective dissemination of information, circulation control, equipments being used, recommendations on information retrieval systems,…

Ferrocyanide Safety Program. Quarterly report for the period ending March 31, 1994

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

Meacham, J.E.; Cash, R.J.; Dukelow, G.T.

1994-04-01

Various high-level radioactive waste from defense operations has accumulated at the Hanford Site in underground storage tanks since the mid-1940s. During the 1950s, additional tank storage space was required to support the defense mission. To obtain this additional storage volume within a short time period, and to minimize the need for constructing additional storage tanks, Hanford Site scientists developed a process to scavenge {sup 137}Cs from tank waste liquids. In implementing this process, approximately 140 metric tons of ferrocyanide were added to waste that was later routed to some Hanford Site single-shell tanks. The reactive nature of ferrocyanide in themore » presence of an oxidizer has been known for decades, but the conditions under which the compound can undergo endothermic and exothermic reactions have not been thoroughly studied. Because the scavenging process precipitated ferrocyanide from solutions containing nitrate and nitrite, an intimate mixture of ferrocyanides and nitrates and/or nitrites is likely to exist in some regions of the ferrocyanide tanks. This quarterly report provides a status of the activities underway at the Hanford Site on the Ferrocyanide Safety Issue, as requested by the Defense Nuclear Facilities Safety Board (DNFSB) in their Recommendation 90-7. A revised Ferrocyanide Safety Program Plan addressing the total Ferrocyanide Safety Program, including the six parts of DNFSB Recommendation 90-7, was recently prepared and released in March 1994. Activities in the revised program plan are underway or have been completed, and the status of each is described in Section 4.0 of this report.« less

75 FR 9638 - Surface Transportation Project Delivery Pilot Program; Caltrans Audit Report

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-03

... practice on a case- by-case basis. The FHWA recommends that Caltrans develop a departmentwide, holistic corrective action management approach and system that will develop and implement an internal process review... the Pilot Program. During the on-site audit, Caltrans staff and management continued to express...

NSAC Recommends a Relativistic Heavy-Ion Collider.

ERIC Educational Resources Information Center

Physics Today, 1984

1984-01-01

Describes the plan submitted by the Nuclear Science Advisory Committee to the Department of Energy and National Science Foundation urging construction of an ultrarelativistic heavy-ion collider designed to accelerate nucleon beams of ions as heavy as uranium. Discusses the process of selecting the type of facility as well as siting. (JM)

Brownfields Green Avenue Sites: Technical Memorandum - Conceptual Design for Sustainable Redevelopment

EPA Pesticide Factsheets

This technical memorandum briefly describes the site and proposed conceptual site plan, indicates conceptual design considerations, specifies recommended green and sustainable features, and offers other recommendations

10 CFR 960.3-2-3 - Recommendation of sites for characterization.

Code of Federal Regulations, 2010 CFR

2010-01-01

... POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-2-3 Recommendation of sites... characterization for the selection of the first repository, the Secretary shall recommend in writing to the..., and, after the first repository, consideration of regionality in §§ 960.3-1-1, 960.3-1-2, and 960.3-1...

Oncology drug health technology assessment recommendations: Canadian versus UK experiences

PubMed Central

Chabot, Isabelle; Rocchi, Angela

2014-01-01

Background Canada has two health technology assessment (HTA) agencies responsible for oncology drug funding recommendations: the Institut National d’Excellence en Santé et Services Sociaux (INESSS) for the province of Québec and the pan-Canadian Oncology Drug Review for the rest of Canada. The objective of the research was to review and compare the recommendations of these two agencies alongside an international comparator – the National Institute for Health and Care Excellence (NICE) in the United Kingdom – with respect to their recommendations records and the influence of clinical and cost-effectiveness evidence on the recommendations. Methods Recommendations were identified from the three agencies from January 1, 2002 to June 1, 2013. Recommendations were limited to five cancer sites (lung, breast, colon, kidney, blood) and to metastatic/advanced settings. Descriptive analyses examined the frequency of positive recommendations and factors related to a positive recommendation. For each recommendation, only publicly available information posted on the agency website was used to abstract data. Results There was a wide variation in the rate of positive recommendations, ranging from 48% for NICE to 95% for Canada’s national process (among the 74% of its recommendations that were publicly posted). Interagency agreement was low, with full agreement for only six of the 14 drugs commonly reviewed by all three agencies. Evidence of a survival gain was not necessary for a positive recommendation; progression-free survival was acceptable. Different approaches were taken when addressing unacceptable cost-effectiveness. NICE was most likely to yield a negative recommendation on these grounds, whereas Canada’s national process was most likely to yield a positive recommendation with a required pricing arrangement. Conclusion In this analysis, the primary reason for the observed divergence between agency recommendations appeared to be the availability of mechanisms in each jurisdiction to address cost-effectiveness subsequent to the HTA assessment process. Furthermore, caution is needed when interpreting cross-agency comparisons between HTA agencies, as recommendations may not correspond directly to subsequent funding decisions and actual patient access. This may be a concern, given the high international profile of assessments conducted by the reviewed HTA agencies. PMID:25075196

Developing Health Promotion Interventions on Social Networking Sites: Recommendations from The FaceSpace Project

PubMed Central

Pedrana, Alisa E; Stoove, Mark A; Chang, Shanton; Howard, Steve; Asselin, Jason; Ilic, Olivia; Batrouney, Colin; Hellard, Margaret E

2012-01-01

Online social networking sites offer a novel setting for the delivery of health promotion interventions due to their potential to reach a large population and the possibility for two-way engagement. However, few have attempted to host interventions on these sites, or to use the range of interactive functions available to enhance the delivery of health-related messages. This paper presents lessons learnt from “The FaceSpace Project”, a sexual health promotion intervention using social networking sites targeting two key at-risk groups. Based on our experience, we make recommendations for developing and implementing health promotion interventions on these sites. Elements crucial for developing interventions include establishing a multidisciplinary team, allowing adequate time for obtaining approvals, securing sufficient resources for building and maintaining an online presence, and developing an integrated process and impact evaluation framework. With two-way interaction an important and novel feature of health promotion interventions in this medium, we also present strategies trialled to generate interest and engagement in our intervention. Social networking sites are now an established part of the online environment; our experience in developing and implementing a health promotion intervention using this medium are of direct relevance and utility for all health organizations creating a presence in this new environment. PMID:22374589

Application of threshold concepts to ecological management problems: occupancy of Golden Eagles in Denali National Park, Alaska: Chapter 5

USGS Publications Warehouse

Eaton, Mitchell J.; Martin, Julien; Nichols, James D.; McIntyre, Carol; McCluskie, Maggie C.; Schmutz, Joel A.; Lubow, Bruce L.; Runge, Michael C.; Edited by Guntenspergen, Glenn R.

2014-01-01

In this chapter, we demonstrate the application of the various classes of thresholds, detailed in earlier chapters and elsewhere, via an actual but simplified natural resource management case study. We intend our example to provide the reader with the ability to recognize and apply the theoretical concepts of utility, ecological and decision thresholds to management problems through a formalized decision-analytic process. Our case study concerns the management of human recreational activities in Alaska’s Denali National Park, USA, and the possible impacts of such activities on nesting Golden Eagles, Aquila chrysaetos. Managers desire to allow visitors the greatest amount of access to park lands, provided that eagle nesting-site occupancy is maintained at a level determined to be acceptable by the managers themselves. As these two management objectives are potentially at odds, we treat minimum desired occupancy level as a utility threshold which, then, serves to guide the selection of annual management alternatives in the decision process. As human disturbance is not the only factor influencing eagle occupancy, we model nesting-site dynamics as a function of both disturbance and prey availability. We incorporate uncertainty in these dynamics by considering several hypotheses, including a hypothesis that site occupancy is affected only at a threshold level of prey abundance (i.e., an ecological threshold effect). By considering competing management objectives and accounting for two forms of thresholds in the decision process, we are able to determine the optimal number of annual nesting-site restrictions that will produce the greatest long-term benefits for both eagles and humans. Setting a utility threshold of 75 occupied sites, out of a total of 90 potential nesting sites, the optimization specified a decision threshold at approximately 80 occupied sites. At the point that current occupancy falls below 80 sites, the recommended decision is to begin restricting access to humans; above this level, it is recommended that all eagle territories be opened to human recreation. We evaluated the sensitivity of the decision threshold to uncertainty in system dynamics and to management objectives (i.e., to the utility threshold).

75 FR 984 - Draft Recommended Interim Preliminary Remediation Goals for Dioxin in Soil at CERCLA and RCRA Sites

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-07

... Recommended Interim Preliminary Remediation Goals for Dioxin in Soil at CERCLA and RCRA Sites AGENCY... Recommended Interim Preliminary Remediation Goals for Dioxin in Soil at Comprehensive Environmental Response... interim PRGs for dioxin in soil. These draft recommended interim PRGs were calculated using existing, peer...

Effects of diagnosis on treatment recommendations in chronic insomnia--a report from the APA/NIMH DSM-IV field trial.

PubMed

Buysse, D J; Reynolds, C F; Kupfer, D J; Thorpy, M J; Bixler, E; Kales, A; Manfredi, R; Vgontzas, A; Stepanski, E; Roth, T; Hauri, P; Stapf, D

1997-07-01

The objective of this study was to determine whether sleep specialists and nonspecialists recommend different treatments for different insomnia diagnoses according to two different diagnostic classifications. Two hundred sixteen patients with chronic insomnia at five sites were each interviewed by two clinicians: one sleep specialist and one nonsleep specialist. All interviewers indicated diagnoses using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV); sleep specialists also indicated diagnoses according to the International Classification for Sleep Disorders (ICSD). Interviewers then indicated how strongly they would recommend each item in a standard list of treatment and diagnostic interventions for each patient. We examined differences in treatment recommendations among the six most common DSM-IV diagnoses assigned by sleep specialists at different sites (n = 192), among the six most common ICSD diagnoses assigned by sleep specialists at different sites (n = 153), and among the six most common DSM-IV diagnoses assigned by nonspecialists at different sites (n = 186). In each analysis, specific treatment and polysomnography recommendations differed significantly for different diagnoses, using either DSM-IV or ICSD criteria. Conversely, different diagnoses were associated with different rank orderings of specific treatment and diagnostic recommendations. Sleep specialist and nonspecialist interviewers each distinguished treatment recommendations among different diagnoses, but in general, nonspecialists more strongly recommended medications and relaxation treatments. Significant site-related differences in treatment recommendations also emerged. Differences in treatment recommendations support the distinction between different DSM-IV and ICSD diagnoses, although they do not provide formal validation. Site-related differences suggest a lack of consensus in how these disorders are conceptualized and treated.

Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children.

PubMed

Finney Rutten, Lila J; St Sauver, Jennifer L; Beebe, Timothy J; Wilson, Patrick M; Jacobson, Debra J; Fan, Chun; Breitkopf, Carmen Radecki; Vadaparampil, Susan T; MacLaughlin, Kathy L; Jacobson, Robert M

2017-10-27

We tested the hypotheses that consistency and strength of clinician recommendation of the human papillomavirus (HPV) vaccination would be associated with vaccine delivery rates. From October 2015 through January 2016, we conducted a survey of primary care clinicians (n=227) in Southeastern Minnesota to evaluate clinician behaviors regarding HPV vaccination. The survey response rate was 41.0% (51 clinical sites). We used the Rochester Epidemiology Project, a clinical data linkage infrastructure, to ascertain clinical site-level HPV vaccination rates. We examined associations of clinician self-reports of both the consistency and strength of their recommendations for HPV vaccination for patients aged 11-12years (n=14,406) with site-level vaccination rates. The majority of clinicians reported consistently (always or usually) recommending the HPV vaccine to females (79.0%) and to males (62.2%); 71.9% of clinicians reported strongly recommending the vaccine to females while 58.6% reported strongly recommending to males. Consistency and strength of recommending the HPV vaccine was significantly higher among those practicing in pediatrics and board certified in pediatrics compared to family medicine. Higher rates of initiation (1 dose) [Incidence Rate Ratio (IRR)=1.05; 95% CI (1.01-1.09)] and completion (3 doses) [IRR=1.08; 95% CI (1.02-1.13)] were observed among clinical sites where, on average, clinicians more frequently reported always or usually recommending the vaccine for females compared to sites where, on average, clinicians reported recommending the vaccine less frequently. Similarly, higher rates of initiation [IRR=1.03; 95% CI (1.00-1.06)] and completion [IRR=1.04; CI (1.00, 1.08)] were observed among sites where clinicians reported strongly recommending the vaccine to females more frequently compared to sites where, on average, clinicians reported strongly recommending the HPV vaccine less frequently; similar associations were observed for male initiation [IRR=1.05; CI (1.02,1.08)] and completion [IRR=1.05; 95% CI (1.01, 1.09)]. Consistency and strength of HPV vaccination recommendation was associated with higher vaccination rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Brownfields Recommendations for Sustainable Site Design — Green Landscape Plan

EPA Pesticide Factsheets

The assessment of conditions contained in this report focuses on site-specific environmental and soil conditions that might affect recommendations related to sustainable landscaping and site design, stormwater management, and stormwater reuse.

Experiences with Information Technology Planning in State Government: A Multiple-Site Based Assessment.

ERIC Educational Resources Information Center

Byrd, Terry Anthony; And Others

1992-01-01

Discusses planning for information technology (IT) in state government and reports on the IT planning experiences of eight state agencies in Florida. Florida's Information Resource Commission is described, the information resources management (IRM) planning process is explained, and recommendations for IRM for other states are given. (20…

77 FR 64493 - National Advisory Committee on Institutional Quality and Integrity (NACIQI)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... process for institutions of higher education under Title IV, of the HEA, together with recommendations for... available via the Federal Digital System at: www.gpo.gov/fdsys . At this site you can view this document, as... the article search feature at: www.federalregister.gov . Specifically, through the advanced search...

Steering operational synergies in terrestrial observation networks: opportunity for advancing Earth system dynamics modelling

NASA Astrophysics Data System (ADS)

Baatz, Roland; Sullivan, Pamela L.; Li, Li; Weintraub, Samantha R.; Loescher, Henry W.; Mirtl, Michael; Groffman, Peter M.; Wall, Diana H.; Young, Michael; White, Tim; Wen, Hang; Zacharias, Steffen; Kühn, Ingolf; Tang, Jianwu; Gaillardet, Jérôme; Braud, Isabelle; Flores, Alejandro N.; Kumar, Praveen; Lin, Henry; Ghezzehei, Teamrat; Jones, Julia; Gholz, Henry L.; Vereecken, Harry; Van Looy, Kris

2018-05-01

Advancing our understanding of Earth system dynamics (ESD) depends on the development of models and other analytical tools that apply physical, biological, and chemical data. This ambition to increase understanding and develop models of ESD based on site observations was the stimulus for creating the networks of Long-Term Ecological Research (LTER), Critical Zone Observatories (CZOs), and others. We organized a survey, the results of which identified pressing gaps in data availability from these networks, in particular for the future development and evaluation of models that represent ESD processes, and provide insights for improvement in both data collection and model integration. From this survey overview of data applications in the context of LTER and CZO research, we identified three challenges: (1) widen application of terrestrial observation network data in Earth system modelling, (2) develop integrated Earth system models that incorporate process representation and data of multiple disciplines, and (3) identify complementarity in measured variables and spatial extent, and promoting synergies in the existing observational networks. These challenges lead to perspectives and recommendations for an improved dialogue between the observation networks and the ESD modelling community, including co-location of sites in the existing networks and further formalizing these recommendations among these communities. Developing these synergies will enable cross-site and cross-network comparison and synthesis studies, which will help produce insights around organizing principles, classifications, and general rules of coupling processes with environmental conditions.

Clinical Decision Support for a Multicenter Trial of Pediatric Head Trauma

PubMed Central

Swietlik, Marguerite; Deakyne, Sara; Hoffman, Jeffrey M.; Grundmeier, Robert W.; Paterno, Marilyn D.; Rocha, Beatriz H.; Schaeffer, Molly H; Pabbathi, Deepika; Alessandrini, Evaline; Ballard, Dustin; Goldberg, Howard S.; Kuppermann, Nathan; Dayan, Peter S.

2016-01-01

Summary Introduction For children who present to emergency departments (EDs) due to blunt head trauma, ED clinicians must decide who requires computed tomography (CT) scanning to evaluate for traumatic brain injury (TBI). The Pediatric Emergency Care Applied Research Network (PECARN) derived and validated two age-based prediction rules to identify children at very low risk of clinically-important traumatic brain injuries (ciTBIs) who do not typically require CT scans. In this case report, we describe the strategy used to implement the PECARN TBI prediction rules via electronic health record (EHR) clinical decision support (CDS) as the intervention in a multicenter clinical trial. Methods Thirteen EDs participated in this trial. The 10 sites receiving the CDS intervention used the Epic® EHR. All sites implementing EHR-based CDS built the rules by using the vendor’s CDS engine. Based on a sociotechnical analysis, we designed the CDS so that recommendations could be displayed immediately after any provider entered prediction rule data. One central site developed and tested the intervention package to be exported to other sites. The intervention package included a clinical trial alert, an electronic data collection form, the CDS rules and the format for recommendations. Results The original PECARN head trauma prediction rules were derived from physician documentation while this pragmatic trial led each site to customize their workflows and allow multiple different providers to complete the head trauma assessments. These differences in workflows led to varying completion rates across sites as well as differences in the types of providers completing the electronic data form. Site variation in internal change management processes made it challenging to maintain the same rigor across all sites. This led to downstream effects when data reports were developed. Conclusions The process of a centralized build and export of a CDS system in one commercial EHR system successfully supported a multicenter clinical trial. PMID:27437059

Continuing oversight through site monitoring: experiences of an institutional ethics committee in an Indian tertiary-care hospital.

PubMed

Shetty, Yashashri C; Marathe, Padmaja; Kamat, Sandhya; Thatte, Urmila

2012-01-01

WHO-TDR and the Indian Council of Medical Research recommend site visits by institutional ethics committees (IECs) for continued oversight, to ensure the ethical conduct of research. Our IEC conducted seven site visits in 2008-2009 using a standardised format to monitor adherence to protocol and the informed consent process. The study identified issues related to informed consent (6/7), deviation from protocol (5/7), reporting of study progress to the IEC (3/7), recruiting additional participants without IEC approval (2/7), reporting of serious adverse events (1/7), investigator's lack of awareness of protocol and the informed consent document (2/7) and other findings. Investigators were informed about the findings and were asked to submit an explanation. The IEC issued warnings about not repeating such lapses in the future (5/7), restricted enrollment of new participants (2/7), recommended continued good clinical practice training to the study team (4/7), advised the recruitment of additional study coordinators (2/7), and requested the submission of adverse event reports (2/7) or sponsors' audit reports (2/7). Our study showed that the ethical conduct of studies can be ensured by conducting routine site monitoring.

The DELPHI expert process of the German umbrella project AUGE as basis for recommendations to CO2 storage in Germany

NASA Astrophysics Data System (ADS)

Pilz, Peter; Schoebel, Birgit; Liebscher, Axel

2016-04-01

Within the GEOTECHNOLOGIEN funding scheme for geological CO2 storage by the Federal Ministry of Education and Research (BMBF) in Germany 33 projects (135 subprojects) have been funded with a total budget of 58 Mio € (excluding industry funds) from 2005 to 2014. In 2012, the German parliament passed the transposition of the EU CCS Directive 2009/31/EG into the national "Carbon Dioxide Storage Law" (KSpG). Annex 1 of the KSpG provides a description of criteria for the characterization and assessment of a potential CO2 storage site. Annex 2 describes the expected monitoring system of a CO2 storage site. The criteria given in the appendices are of general nature, which reflects (1) that the CO2 storage technology is still being developed and (2) that site specific aspects needs to be considered. In 2012 an umbrella project called AUGE has been launched in order to compile and summarize the results of the GEOTECHNOLOGIEN projects to underpin the two Annexes scientifically. By integration of the individual project results AUGE aims at derive recommendations for the review and implementation of the KSpG. The recommendations shall be drafted based on a common ground of science, public authorities and industry. Therefore, the AUGE project includes a Delphi expert process as an essential part. It is realized in cooperation with the company COMPARE Consulting, Göppingen. The implementation of the Delphi-Process is organized in three steps: • After the technical preparation of a standardized questionnaire (2014/2015) it was sent to 129 experts from science, industry and public authorities in Germany. After a few weeks of consideration time, 40 persons (30 %) had decided to participate actively in this inquiry. • Following the results of the first interrogation campaign, the second survey campaign started at the end of 2015. The same list of questions was used, complemented with the results of the first inquiry campaign. The intention is reduce the variance of the answers. 20 persons opted for replying in this second inquiry. The analysis of the step two results is in progress currently. • In the third step, it is planned to have 15 - 25 experts from all participating interest groups discussing the especially controversial questions in a workshop. The aim is to find a common sense for the recommendations. This third step of the Delphi-process is scheduled in the first quarter of 2016. The first step spanned the pool for recommendations, but the variety was too high for achieving a common sense. The variety could be significantly reduced in the second step. Possibly a final workshop is not necessary to achieve a sustainable common sense.

78 FR 68832 - National Advisory Committee on Institutional Quality and Integrity (NACIQI)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... process for institutions of higher education under Title IV, of the HEA, together with recommendations for... System at: www.gpo.gov/fdsys . At this site you can view this document, as well as all other documents of... documents of the Department published in the Federal Register by using the article search feature at: www...

Compliance of clinical microbiology laboratories in the United States with current recommendations for processing respiratory tract specimens from patients with cystic fibrosis.

PubMed

Zhou, Juyan; Garber, Elizabeth; Desai, Manisha; Saiman, Lisa

2006-04-01

Respiratory tract specimens from patients with cystic fibrosis (CF) require unique processing by clinical microbiology laboratories to ensure detection of all potential pathogens. The present study sought to determine the compliance of microbiology laboratories in the United States with recently published recommendations for CF respiratory specimens. Microbiology laboratory protocols from 150 of 190 (79%) CF care sites were reviewed. Most described the use of selective media for Burkholderia cepacia complex (99%), Staphylococcus aureus (82%), and Haemophilus influenzae (89%) and identified the species of all gram-negative bacilli (87%). Only 52% delineated the use of agar diffusion assays for susceptibility testing of Pseudomonas aeruginosa. Standardizing laboratory practices will improve treatment, infection control, and our understanding of the changing epidemiology of CF microbiology.

Selecting a Laboratory Information Management System for Biorepositories in Low- and Middle-Income Countries: The H3Africa Experience and Lessons Learned

PubMed Central

Musinguzi, Henry; Lwanga, Newton; Kezimbira, Dafala; Kigozi, Edgar; Katabazi, Fred Ashaba; Wayengera, Misaki; Joloba, Moses Lutaakome; Abayomi, Emmanuel Akin; Swanepoel, Carmen; Croxton, Talishiea; Ozumba, Petronilla; Thankgod, Anazodo; van Zyl, Lizelle; Mayne, Elizabeth Sarah; Kader, Mukthar; Swartz, Garth

2017-01-01

Biorepositories in Africa need significant infrastructural support to meet International Society for Biological and Environmental Repositories (ISBER) Best Practices to support population-based genomics research. ISBER recommends a biorepository information management system which can manage workflows from biospecimen receipt to distribution. The H3Africa Initiative set out to develop regional African biorepositories where Uganda, Nigeria, and South Africa were successfully awarded grants to develop the state-of-the-art biorepositories. The biorepositories carried out an elaborate process to evaluate and choose a laboratory information management system (LIMS) with the aim of integrating the three geographically distinct sites. In this article, we review the processes, African experience, lessons learned, and make recommendations for choosing a biorepository LIMS in the African context.

Recommended data sets, corn segments and spring wheat segments, for use in program development

NASA Technical Reports Server (NTRS)

Austin, W. W. (Principal Investigator)

1981-01-01

The sets of Large Area Crop Inventory Experiment sites, crop year 1978, which are recommended for use in the development and evaluation of classification techniques based on LANDSAT spectral data are presented. For each site, the following exists: (1) accuracy assessment digitized ground truth; (2) a minimum of 5 percent of the scene ground truth identified as corn or spring wheat; and (3) at least four acquisitions of acceptable data quality during the growing season of the crop of interest. The recommended data sets consist of 41 corn/soybean sites and 17 spring wheat sites.

10 CFR 960.3-1-3 - Regionality.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REPOSITORY Implementation Guidelines § 960.3-1-3 Regionality. In making site recommendations for repository development after the site for the first repository has been recommended, the Secretary shall give due... repositories. Such consideration shall take into account the proximity of sites to locations at which waste is...

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

PubMed

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

2017-05-01

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

Effects of dairy intake on weight maintenance

PubMed Central

Zemel, Michael B; Donnelly, Joseph E; Smith, Bryan K; Sullivan, Debra K; Richards, Joanna; Morgan-Hanusa, Danielle; Mayo, Matthew S; Sun, Xiaocun; Cook-Wiens, Galen; Bailey, Bruce W; Van Walleghen, Emily L; Washburn, Richard A

2008-01-01

Background To compare the effects of low versus recommended levels of dairy intake on weight maintenance and body composition subsequent to weight loss. Design and Methods Two site (University of Kansas-KU; University of Tennessee-UT), 9 month, randomized trial. Weight loss was baseline to 3 months, weight maintenance was 4 to 9 months. Participants were maintained randomly assigned to low dairy (< 1 dairy serving/d) or recommended dairy (> 3 servings/d) diets for the maintenance phase. Three hundred thirty eight men and women, age: 40.3 ± 7.0 years and BMI: 34.5 ± 3.1, were randomized; Change in weight and body composition (total fat, trunk fat) from 4 to 9 months were the primary outcomes. Blood chemistry, blood pressure, resting metabolism, and respiratory quotient were secondary outcomes. Energy intake, calcium intake, dairy intake, and physical activity were measured as process evaluation. Results During weight maintenance, there were no overall significant differences for weight or body composition between the low and recommended dairy groups. A significant site interaction occurred with the low dairy group at KU maintaining weight and body composition and the low dairy group at UT increasing weight and body fat. The recommended dairy group exhibited reductions in plasma 1,25-(OH)2-D while no change was observed in the low dairy group. No other differences were found for blood chemistry, blood pressure or physical activity between low and recommended dairy groups. The recommended dairy group showed significantly greater energy intake and lower respiratory quotient compared to the low dairy group. Conclusion Weight maintenance was similar for low and recommended dairy groups. The recommended dairy group exhibited evidence of greater fat oxidation and was able to consume greater energy without greater weight gain compared to the low dairy group. Recommended levels of dairy products may be used during weight maintenance without contributing to weight gain compared to diets low in dairy products. Trial Registration ClinicalTrials.gov NCT00686426 PMID:18950508

Patient engagement with surgical site infection prevention: an expert panel perspective.

PubMed

Tartari, E; Weterings, V; Gastmeier, P; Rodríguez Baño, J; Widmer, A; Kluytmans, J; Voss, A

2017-01-01

Despite remarkable developments in the use of surgical techniques, ergonomic advancements in the operating room, and implementation of bundles, surgical site infections (SSIs) remain a substantial burden, associated with increased morbidity, mortality and healthcare costs. National and international recommendations to prevent SSIs have been published, including recent guidelines by the World Health Organization, but implementation into clinical practice remains an unresolved issue. SSI improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved. The current SSI prevention strategies have focused mainly on the role of healthcare workers (HCWs) and procedure related risk factors. The importance and influence of patient participation is becoming an increasingly important concept and advocated as a means to improve patient safety. Novel interventions supporting an active participative role within SSI prevention programs have not been assessed. Empowering patients with information they require to engage in the process of SSI prevention could play a major role for the implementation of recommendations. Based on available scientific evidence, a panel of experts evaluated options for patient involvement in order to provide pragmatic recommendations for pre-, intra- and postoperative activities for the prevention of SSIs. Recommendations were based on existing guidelines and expert opinion. As a result, 9 recommendations for the surgical patient are presented here, including a practice brief in the form of a patient information leaflet. HCWs can use this information to educate patients and allow patient engagement.

Update on conjunctival pathology

PubMed Central

Mudhar, Hardeep Singh

2017-01-01

Conjunctival biopsies constitute a fairly large number of cases in a typical busy ophthalmic pathology practice. They range from a single biopsy through multiple mapping biopsies to assess the extent of a particular pathological process. Like most anatomical sites, the conjunctiva is subject to a very wide range of pathological processes. This article will cover key, commonly encountered nonneoplastic and neoplastic entities. Where relevant, sections will include recommendations on how best to submit specimens to the ophthalmic pathology laboratory and the relevance of up-to-date molecular techniques. PMID:28905821

Rangeland health attributes and indicators for qualitative assessment

USGS Publications Warehouse

Pyke, David A.; Herrick, J.E.; Pellant, Mike

2002-01-01

Panels of experts from the Society for Range Management and the National Research Council proposed that status of rangeland ecosystems could be ascertained by evaluating an ecological site's potential to conserve soil resources and by a series of indicators for ecosystem processes and site stability. Using these recommendations as a starting point, we developed a rapid, qualitative method for assessing a moment-in-time status of rangelands. Evaluators rate 17 indicators to assess 3 ecosystem attributes (soil and site stability, hydrologic function, and biotic integrity) for a given location. Indicators include rills, water flow patterns, pedestals and terracettes, bare ground, gullies, wind scour and depositional areas, litter movement, soil resistance to erosion, soil surface loss or degradation, plant composition relative to infiltration, soil compaction, plant functional/structural groups, plant mortality, litter amount, annual production, invasive plants, and reproductive capability. In this paper, we detail the development and evolution of the technique and introduce a modified ecological reference worksheet that documents the expected presence and amount of each indicator on the ecological site. In addition, we review the intended applications for this technique and clarify the differences between assessment and monitoring that lead us to recommend this technique be used for moment-in-time assessments and not be used for temporal monitoring of rangeland status. Lastly, we propose a mechanism for adapting and modifying this technique to reflect improvements in understanding of ecosystem processes. We support the need for quantitative measures for monitoring rangeland health and propose some measures that we believe may address some of the 17 indicators.

Characterization of Terrain in the Mars Surveyor 2001 Landing Site Latitude and Elevation Region Using Mapping Phase Mars Global Surveyor MOC Images

NASA Technical Reports Server (NTRS)

Malin, M. C.; Edgett, K. S.; Parker, T. J.

1999-01-01

One of the original objectives of the Mars Orbiter Camera (MOC), as proposed in 1985, was to acquire observations to be used in assessing future spacecraft landing sites. Images obtained by the Mars Global Surveyor MOC since March 1999 provide the highest resolution views (1.5-4.5 m/pixel) of the planet ever seen. We have been examining these new data to develop a general view of what Mars is like at meter-scale within the latitudes and elevations that are accessible to the Mars Surveyor 2001 lander. Our goal is to provide guidance to the 2001 landing site selection process, rather than to use MOC images to recommend a specific landing site.

United States Air Force 611th Air Support Group/Civil Engineering Squadron Elmendorf AFB, Alaska. Decision document for no further response action planned: Bullen Point Radar Installation, Alaska. Final report

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

Karmi, S.

1996-05-24

This Decision Document discusses the selection of no further action as the recommended action for two sites located at the Bullen Point radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the five sites located at the Bullen Point installation (U.S. Air Force 1996a,b). Based on the findings of these activities, two sites are recommended for no further action. Sites at the Bullen Point radar installation recommended for no further action are: Old Landfill/Dump Site East (LF06) and Drum Storage Area (SS10).

A descriptive evaluation of CDC's LEAN Works! Leading employees to activity and nutrition--a Web-based employer tool for workplace obesity management.

PubMed

Roemer, Enid C; Liss-Levinson, Rivka C; Samoly, Daniel K; Guy, Gery P; Tabrizi, Maryam J; Beckowski, Meghan S; Pei, Xiaofei; Goetzel, Ron Z

2013-01-01

The study aim was to determine the utility of and satisfaction with a Centers for Disease Control and Prevention (CDC) Web-based employer tool, CDC's LEAN Works!, which provides evidence-based recommendations and promising practices for obesity prevention and control at worksites. This study examined employers' natural usage (i.e., without any study parameters on how, when, or how much to use the Web site and its resources) and impressions of the Web site. Employers of varying sizes, industry types, and levels of maturity in offering obesity management programs and from both private and public sectors were recruited to participate in the study. A convenience sample of 29 employers enrolled to participate. Participants were followed over a 12-month period. First impressions, bimonthly use of the Web site, and final assessments were collected using self-report surveys and individual interviews. Descriptive analyses were conducted. Almost all (96%) of participants reported a positive experience with the Web site, noting it provided a wealth of information. Most reported they planned to continue to use the Web site to develop (77%), implement (92%), and evaluate (85%) their obesity management programs. Aspects of the Web site that employers found valuable included a step-by-step implementation process, templates and toolkits, specific recommendations, and promising practices. CDC's LEAN Works! is a useful resource for employers wishing to develop and implement evidence-based workplace obesity prevention programs.

Indoor Air Contamination from Hazardous Waste Sites: Improving the Evidence Base for Decision-Making.

PubMed

Johnston, Jill; MacDonald Gibson, Jacqueline

2015-11-27

At hazardous waste sites, volatile chemicals can migrate through groundwater and soil into buildings, a process known as vapor intrusion. Due to increasing recognition of vapor intrusion as a potential indoor air pollution source, in 2015 the U.S. Environmental Protection Agency (EPA) released a new vapor intrusion guidance document. The guidance specifies two conditions for demonstrating that remediation is needed: (1) proof of a vapor intrusion pathway; and (2) evidence that human health risks exceed established thresholds (for example, one excess cancer among 10,000 exposed people). However, the guidance lacks details on methods for demonstrating these conditions. We review current evidence suggesting that monitoring and modeling approaches commonly employed at vapor intrusion sites do not adequately characterize long-term exposure and in many cases may underestimate risks. On the basis of this evidence, we recommend specific approaches to monitoring and modeling to account for these uncertainties. We propose a value of information approach to integrate the lines of evidence at a site and determine if more information is needed before deciding whether the two conditions specified in the vapor intrusion guidance are satisfied. To facilitate data collection and decision-making, we recommend a multi-directional community engagement strategy and consideration of environment justice concerns.

Indoor Air Contamination from Hazardous Waste Sites: Improving the Evidence Base for Decision-Making

PubMed Central

Johnston, Jill; MacDonald Gibson, Jacqueline

2015-01-01

At hazardous waste sites, volatile chemicals can migrate through groundwater and soil into buildings, a process known as vapor intrusion. Due to increasing recognition of vapor intrusion as a potential indoor air pollution source, in 2015 the U.S. Environmental Protection Agency (EPA) released a new vapor intrusion guidance document. The guidance specifies two conditions for demonstrating that remediation is needed: (1) proof of a vapor intrusion pathway; and (2) evidence that human health risks exceed established thresholds (for example, one excess cancer among 10,000 exposed people). However, the guidance lacks details on methods for demonstrating these conditions. We review current evidence suggesting that monitoring and modeling approaches commonly employed at vapor intrusion sites do not adequately characterize long-term exposure and in many cases may underestimate risks. On the basis of this evidence, we recommend specific approaches to monitoring and modeling to account for these uncertainties. We propose a value of information approach to integrate the lines of evidence at a site and determine if more information is needed before deciding whether the two conditions specified in the vapor intrusion guidance are satisfied. To facilitate data collection and decision-making, we recommend a multi-directional community engagement strategy and consideration of environment justice concerns. PMID:26633433

Nuclear education and training: marriages that work

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

Hanson, H.D.

1985-11-01

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

WE-G-BRA-04: Common Errors and Deficiencies in Radiation Oncology Practice

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

Kry, S; Dromgoole, L; Alvarez, P

Purpose: Dosimetric errors in radiotherapy dose delivery lead to suboptimal treatments and outcomes. This work reviews the frequency and severity of dosimetric and programmatic errors identified by on-site audits performed by the IROC Houston QA center. Methods: IROC Houston on-site audits evaluate absolute beam calibration, relative dosimetry data compared to the treatment planning system data, and processes such as machine QA. Audits conducted from 2000-present were abstracted for recommendations, including type of recommendation and magnitude of error when applicable. Dosimetric recommendations corresponded to absolute dose errors >3% and relative dosimetry errors >2%. On-site audits of 1020 accelerators at 409 institutionsmore » were reviewed. Results: A total of 1280 recommendations were made (average 3.1/institution). The most common recommendation was for inadequate QA procedures per TG-40 and/or TG-142 (82% of institutions) with the most commonly noted deficiency being x-ray and electron off-axis constancy versus gantry angle. Dosimetrically, the most common errors in relative dosimetry were in small-field output factors (59% of institutions), wedge factors (33% of institutions), off-axis factors (21% of institutions), and photon PDD (18% of institutions). Errors in calibration were also problematic: 20% of institutions had an error in electron beam calibration, 8% had an error in photon beam calibration, and 7% had an error in brachytherapy source calibration. Almost all types of data reviewed included errors up to 7% although 20 institutions had errors in excess of 10%, and 5 had errors in excess of 20%. The frequency of electron calibration errors decreased significantly with time, but all other errors show non-significant changes. Conclusion: There are many common and often serious errors made during the establishment and maintenance of a radiotherapy program that can be identified through independent peer review. Physicists should be cautious, particularly in areas highlighted herein that show a tendency for errors.« less

Hanford Site Beryllium Program: Past, Present, and Future - 12428

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

Fisher, Mark; Garcia, Pete; Goeckner, Julie

2012-07-01

The U.S. Department of Energy (DOE) has a long history of beryllium use because of the element's broad application to many nuclear operations and processes. At the Hanford Site beryllium alloy was used to fabricate parts for reactors, including fuel rods for the N-Reactor during plutonium production. Because of continued confirmed cases of chronic beryllium disease (CBD), and data suggesting CBD occurs at exposures to low-level concentrations, the DOE decided to issue a rule to further protect federal and contractor workers from hazards associated with exposure to beryllium. When the beryllium rule was issued in 1999, each of the Hanfordmore » Site contractors developed a Chronic Beryllium Disease Prevention Program (CBDPP) and initial site wide beryllium inventories. A new site-wide CBDPP, applicable to all Hanford contractors, was issued in May, 2009. In the spring of 2010 the DOE Headquarters Office of Health, Safety, and Security (HSS) conducted an independent inspection to evaluate the status of implementation of the Hanford Site Chronic Beryllium Disease Prevention Program (CBDPP). The report identified four Findings and 12 cross-cutting Opportunities for Improvement (OFIs). A corrective action plan (CAP) was developed to address the Findings and crosscutting OFIs. The DOE directed affected site contractors to identify dedicated resources to participate in development of the CAP, along with involving stakeholders. The CAP included general and contractor-specific recommendations. Following initiation of actions to implement the approved CAP, it became apparent that additional definition of product deliverables was necessary to assure that expectations were adequately addressed and CAP actions could be closed. Consequently, a supplement to the original CAP was prepared and transmitted to DOE-HQ for approval. Development of the supplemental CAP was an eight month effort. From the onset a core group of CAP development members were identified to develop a mechanism for assuring that consensus was achieved on products developed as part of the CAP and the closure process. The original CAP was developed based on a large number of actions developed from the HSS report. This was essentially a 'bottoms up' approach. The revised CAP development team concluded that a more holistic, process-based approach was appropriate to assure that the resulting deliverable resulted in a best-in-class product. Consequently, issues and recommendations contained in the HSS report were grouped into 11 program areas, specific product deliverables were identified within each of the program areas, and a work breakdown structure (WBS) was logically applied to number the groupings. While the revised approach to product development utilizes a more holistic, 'top down' approach, the intent was still to incorporate specific recommendations and address specific issues contained in the HSS report. Through implementation of this new approach, a collaborative team has been established that works together using a consensus process for ensuring product completion. Benefits of the new approach include building a level of trust amongst all parties, quality of the products have improved, and acceptance by all parties of what action will truly meet the intent of the deficiency and make the beryllium program stronger. Open dialogue occurs amongst the core Be CAP team members, Hanford contractors, and DOE. It has been a learning process and will continue to be one, but everyone shares the common goal of reducing worker exposure to beryllium. (authors)« less

Site Classification using Multichannel Channel Analysis of Surface Wave (MASW) method on Soft and Hard Ground

NASA Astrophysics Data System (ADS)

Ashraf, M. A. M.; Kumar, N. S.; Yusoh, R.; Hazreek, Z. A. M.; Aziman, M.

2018-04-01

Site classification utilizing average shear wave velocity (Vs(30) up to 30 meters depth is a typical parameter. Numerous geophysical methods have been proposed for estimation of shear wave velocity by utilizing assortment of testing configuration, processing method, and inversion algorithm. Multichannel Analysis of Surface Wave (MASW) method is been rehearsed by numerous specialist and professional to geotechnical engineering for local site characterization and classification. This study aims to determine the site classification on soft and hard ground using MASW method. The subsurface classification was made utilizing National Earthquake Hazards Reduction Program (NERHP) and international Building Code (IBC) classification. Two sites are chosen to acquire the shear wave velocity which is in the state of Pulau Pinang for soft soil and Perlis for hard rock. Results recommend that MASW technique can be utilized to spatially calculate the distribution of shear wave velocity (Vs(30)) in soil and rock to characterize areas.

ISRU: An Overview of NASA'S Current Development Activities and Long-Term Goals

NASA Technical Reports Server (NTRS)

Sanders, Gerald B.; Nicholson, Leonard S. (Technical Monitor)

2000-01-01

The concept of "living off the land" by utilizing the indigenous resources of the Moon, Mars, or other potential sites of robotic and human exploration has been termed In-Situ Resource Utilization (ISRU). It is fundamental to any program of extended human presence and operation on other extraterrestrial bodies that we learn how to utilize the indigenous resources. The chief benefits of ISRU are that it can reduce the mass, cost, and risk of robotic and human exploration while providing capabilities that enable the commercial development of space. In January 1997, the American Institute of Aeronautics and Astronautics (AIAA) Space Processing Technical Committee released a position paper entitled, "Need for A NASA Indigenous Space Resource Utilization (ISRU) Program". Besides outlining some of the potential advantages of incorporating ISRU into Lunar and Mars human mission plans and providing an overview of technologies and processes of interest, the position paper concluded with a list of seven recommendations to NASA. This paper will examine the seven recommendations proposed and provide an overview of NASA's current ISRU development activities and possible long term goals with respect to these recommendations.

CARETS: A prototype regional environmental information system. Volume 12: User evaluation of experimental land use maps and related products from the central Atlantic test site

NASA Technical Reports Server (NTRS)

Alexander, R. H. (Principal Investigator); Mcginty, H. K., III

1975-01-01

The author has identified the following significant results. Recommendations resulting from the CARETS evaluation reflect the need to establish a flexible and reliable system for providing more detailed raw and processed land resource information as well as the need to improve the methods of making information available to users.

Site Selection for the Disposal of LLW in Taiwan

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

Chuang, W.S.; Chi, L.M.; Tien, N.C.

2006-07-01

This paper presents the implementation status of the low-level radioactive waste (LLW) disposal program in Taiwan, including the disposal facility regulations, status of waste management, final disposal program, licensing procedures, waste acceptance criteria, site selection criteria and processes and preliminary disposal concepts. The first phase of site selection for low-level radioactive waste final disposal in Taiwan was implemented between 1992 and 2002. The site selection process adopted a Geographic Information System (GIS), Hierarchical Analysis System, Expert Evaluation System, and site reconnaissance. An incentive program for voluntary sites was also initiated. After a series of evaluations and discussion of 30 potentialmore » candidate sites, including 8 recommended sites, 5 qualified voluntary townships, and several remote uninhabited small islets, Hsiao-chiou islet was selected as the first priority candidate site in February 1998. The geological investigation work in Hsiao-chiou was conducted from March 1999 through October 2000. An Environmental Impact Statement Report (EIS) and the Investment Feasibility Study Report (IFS) were submitted to the Environmental Protection Agency (EPA) in November 2000 and to the Ministry of Economic Affairs (MOEA) in June 2001, respectively. Unfortunately, the site investigation was discontinued in 2002 due to political and public acceptance consideration. After years of planning, the second phase of the site selection process was launched in August 2004 and will be conducted through 2008. It is planned that a repository will be constructed in early 2009 and start to operate in 2014. The site selection process for the second phase is based on the earlier work and four potential candidate sites were selected for evaluation until 2005. A near surface disposal concept is proposed for a site located in the Taiwan strait, and cavern disposal concepts are proposed for three other sites located on the main island. This paper presents the implementation status of the LLW disposal program in Taiwan, including the disposal facility regulations, status of waste management, final disposal program, licensing procedures, waste acceptance criteria, site selection criteria and processes, and preliminary disposal concepts 'NIMBY' (Not in my backyard) is a critical problem for implementation of the final disposal project. Resistance from local communities has been continuously received during site characterization. To overcome this, an incentive program to encourage community acceptance has been approved by the Government. Programs for community promotion are being proposed and negotiations are also underway. (authors)« less

Recommended Determination of Region IV Concerning the Yazoo Backwater Area Pumps Project

EPA Pesticide Factsheets

This document explains the basis for EPA Region IV’s recommendation to prohibit the specification of certain waters of the United States as a discharge site for dredge site for dredged or fill material.

Brownfields Waterfront Sustainability Pilot, Allentown PA: Technical Memorandum on Conceptual Design Using Low Impact Development

EPA Pesticide Factsheets

This technical memorandum briefly describes the site and the master plan, indicates design constraints considered, specifies recommended LID stormwater techniques and features for sustainable redevelopment of the site, and offers other recommendations.

Risk assessment guidance for Superfund: Volume 1 -- Human health evaluation manual. Supplement to Part A: Community involvement in Superfund risk assessments

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

NONE

1999-03-01

The purpose of the guidance document is to provide the site team--risk assessor, remedial project manager (RPM), and community involvement coordinator--with information to improve community involvement in the Superfund risk assessment process. Specifically, the document: provides suggestions for how Superfund staff and community members can work together during the early stages of Superfund cleanup; identifies where, within the framework of the human health risk assessment methodology, community input can augment and improve EPA`s estimates of exposure and risk; recommends questions the site team should ask the community; and illustrates why community involvement is valuable during the human health assessment atmore » Superfund sites.« less

Design of Ontology-Based Sharing Mechanism for Web Services Recommendation Learning Environment

NASA Astrophysics Data System (ADS)

Chen, Hong-Ren

The number of digital learning websites is growing as a result of advances in computer technology and new techniques in web page creation. These sites contain a wide variety of information but may be a source of confusion to learners who fail to find the information they are seeking. This has led to the concept of recommendation services to help learners acquire information and learning resources that suit their requirements. Learning content like this cannot be reused by other digital learning websites. A successful recommendation service that satisfies a certain learner must cooperate with many other digital learning objects so that it can achieve the required relevance. The study proposes using the theory of knowledge construction in ontology to make the sharing and reuse of digital learning resources possible. The learning recommendation system is accompanied by the recommendation of appropriate teaching materials to help learners enhance their learning abilities. A variety of diverse learning components scattered across the Internet can be organized through an ontological process so that learners can use information by storing, sharing, and reusing it.

The Hunters Point cogeneration project: Environmental justice in power plant siting

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

Kosloff, L.H.; Varanini, E.E. III

1997-12-31

The recent Hunters Point, San Francisco power plant siting process in California represents the first time that environmental justice has arisen as a major power plant siting issue. Intervenors argued that the siting process was racially and economically biased and were supported by leading environmental justice activists at the Golden Gate Law School`s Environmental Justice Clinic, a leading thinker in this field. The applicant argued that environmental justice charges cannot realistically be made against a modern natural-gas energy facility with state-of-the-art environmental controls. The applicant also argued that environmental justice concerns were fully addressed through the extensive environmental and socioeconomicmore » review carried out by California Energy Commission staff. After extensive testimony and cross-examination, the Commission agreed with the applicant. This case has important lessons for companies that could be charged with environmental justice violations and environmental justice activists who must decide where to most effectively target their efforts. This paper reviews the proceeding and its lessons and makes recommendations regarding future applicability of environmental justice issues to the power generation sector. The authors represented the applicant in the facility siting proceeding.« less

Evaluation of process excellence tools in improving donor flow management in a tertiary care hospital in South India

PubMed Central

Venugopal, Divya; Rafi, Aboobacker Mohamed; Innah, Susheela Jacob; Puthayath, Bibin T.

2017-01-01

BACKGROUND: Process Excellence is a value based approach and focuses on standardizing work processes by eliminating the non-value added processes, identify process improving methodologies and maximize capacity and expertise of the staff. AIM AND OBJECTIVES: To Evaluate the utility of Process Excellence Tools in improving Donor Flow Management in a Tertiary care Hospital by studying the current state of donor movement within the blood bank and providing recommendations for eliminating the wait times and to improve the process and workflow. MATERIALS AND METHODS: The work was done in two phases; The First Phase comprised of on-site observations with the help of an expert trained in Process Excellence Methodology who observed and documented various aspects of donor flow, donor turn around time, total staff details and operator process flow. The Second Phase comprised of constitution of a Team to analyse the data collected. The analyzed data along with the recommendations were presented before an expert hospital committee and the management. RESULTS: Our analysis put forward our strengths and identified potential problems. Donor wait time was reduced by 50% after lean due to better donor management with reorganization of the infrastructure of the donor area. Receptionist tracking showed that 62% of the total time the staff wastes in walking and 22% in other non-value added activities. Defining Duties for each staff reduced the time spent by them in non-value added activities. Implementation of the token system, generation of unique identification code for donors and bar code labeling of the tubes and bags are among the other recommendations. CONCLUSION: Process Excellence is not a programme; it's a culture that transforms an organization and improves its Quality and Efficiency through new attitudes, elimination of wastes and reduction in costs. PMID:28970681

Evaluation of process excellence tools in improving donor flow management in a tertiary care hospital in South India.

PubMed

Venugopal, Divya; Rafi, Aboobacker Mohamed; Innah, Susheela Jacob; Puthayath, Bibin T

2017-01-01

Process Excellence is a value based approach and focuses on standardizing work processes by eliminating the non-value added processes, identify process improving methodologies and maximize capacity and expertise of the staff. To Evaluate the utility of Process Excellence Tools in improving Donor Flow Management in a Tertiary care Hospital by studying the current state of donor movement within the blood bank and providing recommendations for eliminating the wait times and to improve the process and workflow. The work was done in two phases; The First Phase comprised of on-site observations with the help of an expert trained in Process Excellence Methodology who observed and documented various aspects of donor flow, donor turn around time, total staff details and operator process flow. The Second Phase comprised of constitution of a Team to analyse the data collected. The analyzed data along with the recommendations were presented before an expert hospital committee and the management. Our analysis put forward our strengths and identified potential problems. Donor wait time was reduced by 50% after lean due to better donor management with reorganization of the infrastructure of the donor area. Receptionist tracking showed that 62% of the total time the staff wastes in walking and 22% in other non-value added activities. Defining Duties for each staff reduced the time spent by them in non-value added activities. Implementation of the token system, generation of unique identification code for donors and bar code labeling of the tubes and bags are among the other recommendations. Process Excellence is not a programme; it's a culture that transforms an organization and improves its Quality and Efficiency through new attitudes, elimination of wastes and reduction in costs.

A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success.

PubMed

Wright, Adam; Ash, Joan S; Erickson, Jessica L; Wasserman, Joe; Bunce, Arwen; Stanescu, Ana; St Hilaire, Daniel; Panzenhagen, Morgan; Gebhardt, Eric; McMullen, Carmit; Middleton, Blackford; Sittig, Dean F

2014-01-01

To describe the activities performed by people involved in clinical decision support (CDS) at leading sites. We conducted ethnographic observations at seven diverse sites with a history of excellence in CDS using the Rapid Assessment Process and analyzed the data using a series of card sorts, informed by Linstone's Multiple Perspectives Model. We identified 18 activities and grouped them into four areas. Area 1: Fostering relationships across the organization, with activities (a) training and support, (b) visibility/presence on the floor, (c) liaising between people, (d) administration and leadership, (e) project management, (f) cheerleading/buy-in/sponsorship, (g) preparing for CDS implementation. Area 2: Assembling the system with activities (a) providing technical support, (b) CDS content development, (c) purchasing products from vendors (d) knowledge management, (e) system integration. Area 3: Using CDS to achieve the organization's goals with activities (a) reporting, (b) requirements-gathering/specifications, (c) monitoring CDS, (d) linking CDS to goals, (e) managing data. Area 4: Participation in external policy and standards activities (this area consists of only a single activity). We also identified a set of recommendations associated with these 18 activities. All 18 activities we identified were performed at all sites, although the way they were organized into roles differed substantially. We consider these activities critical to the success of a CDS program. A series of activities are performed by sites strong in CDS, and sites adopting CDS should ensure they incorporate these activities into their efforts.

[Validation of plasma creatinine measurement on UniCel DxC 600 according to LAB GTA 04 recommendation].

PubMed

Chianea, Denis; Renard, Christophe; Garcia, Carine; Mbongo, Elvire; Monpeurt, Corine; Vest, Philippe

2010-01-01

The accreditation process, according to NF EN ISO 15189, implies a prior evaluation of the new reagent on-site for the implementation of each new assay technique. Thus, our new standardized method for determination of creatinine (non compensated method) in plasma or serum on UniCel DxC 600 (Beckman Coulter) has been tested according to LAB GTA 04 protocol. The reagent meets the quality criteria recommended by Valtec protocol, except fidelity with the low concentration standard (50 micromol/L). Besides there is no problem of results transferability with the two other techniques used in the laboratory (Jaffe compensated and enzymatic methods performed on Cobas Integra 800).

ECHO-AGE: an innovative model of geriatric care for long-term care residents with dementia and behavioral issues.

PubMed

Catic, Angela G; Mattison, Melissa L P; Bakaev, Innokentiy; Morgan, Marisa; Monti, Sara M; Lipsitz, Lewis

2014-12-01

To design, implement, and assess the pilot phase of an innovative, remote case-based video-consultation program called ECHO-AGE that links experts in the management of behavior disorders in patients with dementia to nursing home care providers. Pilot study involving surveying of participating long-term care sites regarding utility of recommendations and resident outcomes. Eleven long-term care sites in Massachusetts and Maine. An interprofessional specialty team at a tertiary care center and staff from 11 long-term care sites. Long-term care sites presented challenging cases regarding residents with dementia and/or delirium related behavioral issues to specialists via video-conferencing. Baseline resident characteristics and follow-up data regarding compliance with ECHO-AGE recommendations, resident improvement, hospitalization, and mortality were collected from the long-term care sites. Forty-seven residents, with a mean age of 82 years, were presented during the ECHO-AGE pilot period. Eighty-three percent of residents had a history of dementia and 44% were taking antipsychotic medications. The most common reasons for presentation were agitation, intrusiveness, and paranoia. Behavioral plans were recommended in 72.3% of patients. Suggestions for medication adjustments were also frequent. ECHO-AGE recommendations were completely or partially followed in 88.6% of residents. When recommendations were followed, sites were much more likely to report clinical improvement (74% vs 20%, P < .03). Hospitalization was also less common among residents for whom recommendations were followed. The results suggest that a case-based video-consultation program can be successful in improving the care of elders with dementia and/or delirium related behavioral issues by linking specialists with long-term care providers. Published by Elsevier Inc.

Fiscal Year 2009 Revegetation Assessment

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

Michael Lewis

2009-10-01

This report summarizes the Fiscal Year 2009 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Recommendation(s) for each site.

Fiscal Year 2010 Revegetation Assessment

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

Jenifer Nordstrom; Mike Lewis

2010-11-01

This report summarizes the Fiscal Year 2010 Revegetation Assessment by Battelle Energy Alliance, LLC. This assessment was conducted to supplement documentation related to the Storm Water Pollution Prevention Plan for Construction Activities and to ensure that disturbed vegetation and soil at various locations are being restored. This report provides the following information for each site being monitored by the Idaho National Laboratory Environmental Support and Services: • Summary of each site • Assessment of vegetation status and site stabilization at each location • Recommendation(s) for each site.

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

Not Available

The site observational work plan (SOWP) for the Riverton, Wyoming, Uranium Mill Tailings Remedial Action (UMTRA) Project Site is the first document for the UMTRA Ground Water Project to address site-specific activities to meet compliance with the U.S. Environmental Protection Agency (EPA) proposed ground water standards (52 FR 36000 (1987)). In support of the activities the regulatory framework and drivers are presented along with a discussion of the relationship of this SOWP to other UMTRA Ground Water Project programmatic documents. A combination of the two compliance strategies that will be recommended for this site are no remediation with the applicationmore » of alternate concentration levels (ACL) and natural flushing in conjunction with institutional controls. ACLs are to be applied to constituents that occur at concentrations above background levels but which are essential nutrients and occur within nutritional ranges and/or have very low toxicity and high dietary intake rates compared to the levels detected in the ground water. The essential premise of natural flushing is that ground water movement and natural attenuation processes will reduce the detected contamination to background levels within 1 00 years. These two recommended compliance strategies were evaluated by applying Riverton site-specific data to the compliance framework developed in the UMTRA Ground Water programmatic environmental impact statement. There are three aquifers beneath the site: a surficial unconfined aquifer, a middle semiconfined aquifer, and a deeper confined aquifer. The milling-related contamination at the site has affected both the surficial and semiconfined aquifers, although the leaky shale aquifers separating these units limits the downward migration of contamination into the semiconfined aquifer. A shale aquitard separates the semiconfined aquifer from the underlying confined aquifer which has not been contaminated by milling-related constituents.« less

Study on Personalized Recommendation Model of Internet Advertisement

NASA Astrophysics Data System (ADS)

Zhou, Ning; Chen, Yongyue; Zhang, Huiping

With the rapid development of E-Commerce, the audiences put forward higher requirements on personalized Internet advertisement than before. The main function of Personalized Advertising System is to provide the most suitable advertisements for anonymous users on Web sites. The paper offers a personalized Internet advertisement recommendation model. By mining the audiences' historical and current behavior, and the advertisers' and publisher's web site content, etc, the system can recommend appropriate advertisements to corresponding audiences.

Marketing E-Commerce by Social media using Product Recommendations and user Embedding

NASA Astrophysics Data System (ADS)

Ramalingam, V. V.; Pandian, A.; Masilamani, Kirthiga

2018-04-01

MarketingE-CommercebySodal media is the best way to improve marketing and business widely.The major issues faced with E-commerce and Social media interfacing is cold- start cross-site problem. The cold-start problem occurs at a situation when user is not having the history of purchase records.For the user who does not have a history of purchase records, we have introduced a method of finding the users’ interested product without knowing any of the demographic information of the user. The product is recommended on basesof visits i.e., the item which is most likely to be visited by the users occur in the hit list. This product is rated at the top position for the users to purchase. The e-commerce with social media sites uses the strategy of user embedding and product recommendations. The product recommendations are achieved by incorporating LatentDirichlet Allocation(LDA), Re Ranking and Collaborative Filtering algorithms. The proposed framework can enhance the recommendation system by embedding products and users. This shows the potential of solving cold-start cross-site problem across the e-commerce and social media sites and enhances the marketing strategy.

Data requirements for valuing externalities: The role of existing permitting processes

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

Lee, A.D.; Baechler, M.C.; Callaway, J.M.

1990-08-01

While the assessment of externalities, or residual impacts, will place new demands on regulators, utilities, and developers, existing processes already require certain data and information that may fulfill some of the data needs for externality valuation. This paper examines existing siting, permitting, and other processes and highlights similarities and differences between their data requirements and the data required to value environmental externalities. It specifically considers existing requirements for siting new electricity resources in Oregon and compares them with the information and data needed to value externalities for such resources. This paper also presents several observations about how states can takemore » advantage of data acquired through processes already in place as they move into an era when externalities are considered in utility decision-making. It presents other observations on the similarities and differences between the data requirements under existing processes and those for valuing externalities. This paper also briefly discusses the special case of cumulative impacts. And it presents recommendations on what steps to take in future efforts to value externalities. 35 refs., 2 tabs.« less

K-Basins Sludge Treatment and Packaging at the Hanford Site - 13585

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

Fogwell, Thomas W.; Honeyman, James O.; Stegen, Gary

Highly radioactive sludge resulting from the storage of degraded spent nuclear fuel has been consolidated in Engineered Containers (ECs) in the 105-K West Storage Basin located on the Hanford site near the Columbia River in Washington State. CH2M Hill Plateau Remediation Company (CHPRC) is proceeding with a project to retrieve the sludge, place it in Sludge Transport and Storage Containers (STSCs) and store those filled containers within the T Plant Canyon facility on the Hanford Site Central Plateau (Phase 1). Retrieval and transfer of the sludge material will enable removal of the 105-K West Basin and allow remediation of themore » subsurface contamination plumes under the basin. The U.S. Department of Energy (DOE) plans to treat and dispose of this K Basins sludge (Phase 2) as Remote Handled Transuranic Waste (RH TRU) at the Waste Isolation Pilot Plant (WIPP) located in New Mexico. The K Basin sludge currently contains uranium metal which reacts with water present in the stored slurry, generating hydrogen and other byproducts. The established transportation and disposal requirements require the transformation of the K Basins sludge to a chemically stable, liquid-free, packaged waste form. The Treatment and Packaging Project includes removal of the containerised sludge from T Plant, the treatment of the sludge as required, and packaging of all the sludge into a form that is certifiable for transportation to and disposal at WIPP. Completion of this scope will require construction and operation of a Sludge Treatment and Packaging Facility (STPF), which could be either a completely new facility or a modification of an existing Hanford Site facility. A Technology Evaluation and Alternatives Analysis (TEAA) for the STP Phase 2 was completed in 2011. A Request for Technology Information (RFI) had been issued in October 2009 to solicit candidate technologies for use in Phase 2. The RFI also included a preliminary definition of Phase 2 functions and requirements. Potentially applicable technologies were identified through a commercial procurement process, technical workshops, and review of the numerous previous sludge treatment technology studies. The identified technology approaches were screened using the criteria established in the Decision Plan, and focused bench top feasibility testing was conducted. Engineering evaluations of the costs, schedules, and technical maturity were developed and evaluated. Recommendations were developed based on technical evaluations. The criteria used in the evaluation process were as follows: (1) Safety, (2) Regulatory/stakeholder acceptance, (3) Technical maturity, (4) Operability and maintainability, (5) Life cycle cost and schedule, (6) Potential for beneficial integration with ongoing STP-Phase 1 activities, and (7) Integration with Site-wide RH-TRU processing/packaging, planning, schedule, and approach. The TEAA recommended Warm Water Oxidation (WWO) as the baseline treatment technology and two risk reduction enhancement options for further consideration during development of the process - size reduction and chemical oxidation (Fenton's reagent). The enhancement options would potentially allow a useful reduction in the total operating time required to process the K Basins sludge. The U.S. Department of Energy's Richland Field Office (DOE-RL) has approved this recommended technical approach. The baseline process can be broken down into the following main process steps: (1) STSC transfer from T Plant to the Sludge Treatment and Packaging Facility (STPF). (2) Retrieval of sludge from the STSCs and transfer to the Receipt and Reaction Tank (RRT). (3) Preparation for immobilization by oxidation using heated water (i.e., WWO) for those batches that require it and concentration by evaporating water at about atmospheric pressure in the RRT. (4) Immobilization by using additives to eliminate free liquids and packaging of the treated sludge into drums. (5) Inspection and handling of the filled drums prior to transfer to a separate storage and shipping facility. (6) Handling of vapor, condensate, and other waste streams generated by the process. Each of these steps is discussed in the paper, together with the current state of progress in developing the technology and requirements for continued development. A schematic of the recommended baseline WWO treatment process is given below. (authors)« less

Nursing considerations to complement the Surviving Sepsis Campaign guidelines.

PubMed

Aitken, Leanne M; Williams, Ged; Harvey, Maurene; Blot, Stijn; Kleinpell, Ruth; Labeau, Sonia; Marshall, Andrea; Ray-Barruel, Gillian; Moloney-Harmon, Patricia A; Robson, Wayne; Johnson, Alexander P; Lan, Pang Nguk; Ahrens, Tom

2011-07-01

To provide a series of recommendations based on the best available evidence to guide clinicians providing nursing care to patients with severe sepsis. Modified Delphi method involving international experts and key individuals in subgroup work and electronic-based discussion among the entire group to achieve consensus. We used the Surviving Sepsis Campaign guidelines as a framework to inform the structure and content of these guidelines. We used the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system to rate the quality of evidence from high (A) to very low (D) and to determine the strength of recommendations, with grade 1 indicating clear benefit in the septic population and grade 2 indicating less confidence in the benefits in the septic population. In areas without complete agreement between all authors, a process of electronic discussion of all evidence was undertaken until consensus was reached. This process was conducted independently of any funding. Sixty-three recommendations relating to the nursing care of severe sepsis patients are made. Prevention recommendations relate to education, accountability, surveillance of nosocomial infections, hand hygiene, and prevention of respiratory, central line-related, surgical site, and urinary tract infections, whereas infection management recommendations related to both control of the infection source and transmission-based precautions. Recommendations related to initial resuscitation include improved recognition of the deteriorating patient, diagnosis of severe sepsis, seeking further assistance, and initiating early resuscitation measures. Important elements of hemodynamic support relate to improving both tissue oxygenation and macrocirculation. Recommendations related to supportive nursing care incorporate aspects of nutrition, mouth and eye care, and pressure ulcer prevention and management. Pediatric recommendations relate to the use of antibiotics, steroids, vasopressors and inotropes, fluid resuscitation, sedation and analgesia, and the role of therapeutic end points. Consensus was reached regarding many aspects of nursing care of the severe sepsis patient. Despite this, there is an urgent need for further evidence to better inform this area of critical care.

Overview of technology modeling in the Remedial Action Assessment System (RAAS)

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

Johnson, C.D.; Bagaasen, L.M.; Chan, T.C.

1994-08-01

There are numerous hazardous waste sites under the jurisdiction of the US Department of Energy (DOE). To assist the cleanup of these sites in a more consistent, timely, and cost-effective manner, the Remedial Action Assessment System (RAAS) is being developed by the Pacific Northwest Laboratory (PNL). RAAS is a software tool designed to automate the initial technology selection within the remedial investigation/feasibility study (RI/FS) process. The software does several things for the user: (1) provides information about available remedial technologies, (2) sorts possible technologies to recommend a list of technologies applicable to a given site, (3) points out technical issuesmore » that may prevent the implementation of a technology, and (4) provides an estimate of the effectiveness of a given technology at a particular site. Information from RAAS can be used to compare remediation options and guide selection of technologies for further study.« less

Ancillary Care in South African HIV Vaccine Trials: Addressing Needs, Drafting Protocols, and Engaging Community

PubMed Central

Slack, Catherine M.

2014-01-01

There has been debate about sponsor-investigator ethical responsibilities to address participants’ medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for “moral negotiation” recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns. PMID:24572086

Ancillary care in South African HIV vaccine trials: addressing needs, drafting protocols, and engaging community.

PubMed

Slack, Catherine M

2014-02-01

There has been debate about sponsor-investigator ethical responsibilities to address participants' medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for "moral negotiation" recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns.

Improving the Climate for Female Scientists at the National Center for Atmospheric Research

NASA Astrophysics Data System (ADS)

Killeen, T. L.

2003-12-01

In the summer of 2000, at the invitation of the former Director of the National Center for Atmospheric Research (NCAR), a committee of senior female scientists affiliated with the American Physical Society's Committee on the Status of Women in Physics visited NCAR and NCAR's parent organization, the University Corporation for Atmospheric Research (UCAR). The purpose of the site visit was to develop recommendations designed to improve the climate for women scientists at NCAR. This site visit and the subsequent written report and response from NCAR/UCAR management were instrumental in the establishment of a series of new programs and recruitment/mentoring activities that have had a significant impact at NCAR. The APS Committee's report included recommendations in the areas of: staff recruitment and demographic balance; communication and consistent implementation of policies; mentoring and career development programs; and "family friendliness". The constructive and helpful report of the visiting APS committee was openly shared with staff and led to a series of discussions, debates, actions, and programs at NCAR that continue to this day. This poster will describe the APS Committee's recommendations, the institutional process that occurred in response to this study, and the resulting actions and their impact at the national center. Specific progress since the site visit has included a doubling of the percentage participation by females in the ladder (tenure-equivalent) scientist track at NCAR to a level that now significantly exceeds the national average for tenured or tenure-track female faculty at Ph.D.-granting institutions in the geosciences.

Optimization of site layout for change of plant operation

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

Reuwer, S.M.; Kasperski, E.; Joseph, T.D.

1995-12-31

Several of the Florida Power & Light operating fossil power plants have undergone significant site layout changes as well as changes in plant operation. The FPL Fort Lauderdale Plant was repowered in 1992 which consisted of using four (4) Westinghouse 501F Combustion Turbines rated at 158 Mw each, to repower two (2) existing steam turbines rates at 143 Mw each. In 1991, a physical security fence separation occurred between Turkey Point Plants`s fossil fueled Units 1&2, and its nuclear fueled Units 3&4. As a result of this separation, certain facilities common to both the nuclear side and fossil side ofmore » the plant required relocating. Also, the Sanford and Manatee Plants were evaluated for the use of a new fuel as an alternative source. Manatee Plant is currently in the licensing process for modifications to burn a new fuel, requiring expansion of backened clean-up equipment, with additional staff to operate this equipment. In order to address these plant changes, site development studies were prepared for each plant to determine the suitability of the existing ancillary facilities to support the operational changes, and to make recommendations for facility improvement if found inadequate. A standardized process was developed for all of the site studies. This proved to be a comprehensive process and approach, that gave FPL a successful result that all the various stake holders bought into. This process was objectively based, focused, and got us to where we need to be as quickly as possible. As a result, this paper details the outline and various methods developed to prepare a study following this process, that will ultimately provide the optimum site development plan for the changing plant operations.« less

Addendum to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 454: Historical Undrground Storage Tank Release Sites, Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the April 1998, Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 454: Historical Underground Storage Tank Release Sites as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modificationmore » document, this addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 12-25-09, Spill 960722-02 (from UST 12-B-3). This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Addendum to the Closure Report for Corrective Action Unit 356: Mud Pits and Disposal Sites Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the November 2002, Closure Report for Corrective Action Unit 356: Mud Pits and Disposal Sites as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of: •more » This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 03-04-01, Area 3 Change House Septic System • CAS 03-09-04, Mud Pit These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Addendum to the Closure Report for Corrective Action Unit 398: Area 25 Spill Sites, Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the April 2003, Closure Report for Corrective Action Unit 398: Area 25 Spill Sites as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of: • Thismore » cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 25-25-17, Subsurface Hydraulic Oil Spill. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Addendum to the Closure Report for Corrective Action Unit 322: Areas 1 & 3 Release Sites and Injection Wells Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the June 2006, Closure Report for Corrective Action Unit 322: Areas 1 & 3 Release Sites and Injection Wells as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, thismore » addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 01-25-01, AST Release • CAS 03-25-03, Mud Plant AST Diesel Release These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Comprehensive profiling of retroviral integration sites using target enrichment methods from historical koala samples without an assembled reference genome

PubMed Central

Alquezar-Planas, David E.; Ishida, Yasuko; Courtiol, Alexandre; Timms, Peter; Johnson, Rebecca N.; Lenz, Dorina; Helgen, Kristofer M.; Roca, Alfred L.; Hartman, Stefanie

2016-01-01

Background. Retroviral integration into the host germline results in permanent viral colonization of vertebrate genomes. The koala retrovirus (KoRV) is currently invading the germline of the koala (Phascolarctos cinereus) and provides a unique opportunity for studying retroviral endogenization. Previous analysis of KoRV integration patterns in modern koalas demonstrate that they share integration sites primarily if they are related, indicating that the process is currently driven by vertical transmission rather than infection. However, due to methodological challenges, KoRV integrations have not been comprehensively characterized. Results. To overcome these challenges, we applied and compared three target enrichment techniques coupled with next generation sequencing (NGS) and a newly customized sequence-clustering based computational pipeline to determine the integration sites for 10 museum Queensland and New South Wales (NSW) koala samples collected between the 1870s and late 1980s. A secondary aim of this study sought to identify common integration sites across modern and historical specimens by comparing our dataset to previously published studies. Several million sequences were processed, and the KoRV integration sites in each koala were characterized. Conclusions. Although the three enrichment methods each exhibited bias in integration site retrieval, a combination of two methods, Primer Extension Capture and hybridization capture is recommended for future studies on historical samples. Moreover, identification of integration sites shows that the proportion of integration sites shared between any two koalas is quite small. PMID:27069793

IMPLICATIONS OF GLOBAL CLIMATE CHANGE FOR NATURAL RESOURCE DAMAGE ASSESSMENT, RESTORATION, AND REHABILITATION

PubMed Central

Rohr, Jason R; Johnson, Philip; Hickey, Christopher W; Helm, Roger C; Fritz, Alyce; Brasfield, Sandra

2013-01-01

Various international and national regulations hold polluters liable for the cleanup of released hazardous substances and the restoration/rehabilitation of natural resources to preincident baseline conditions, a process often referred to as natural resource damage assessment and restoration (NRDAR). Here, we, the authors, describe how global climate change (GCC) will challenge each of the steps of NRDAR processes and offer eight recommendations to improve these processes in light of GCC. First, we call for a better understanding of the net effects of GCC and contaminants on natural resources. Second, we urge facilities and environmental managers to plan for GCC-related factors that are expected to increase the probability of contaminant releases. Third, we suggest re-evaluating definitions of baseline and reference conditions given that GCC will alter both their trajectories and variability. Fourth, we encourage long-term monitoring to improve the quantification of baseline conditions that will change as climate changes. This will enhance the accuracy of injury assessments, the effectiveness of restoration, and the detection of early warning signs that ecosystems are approaching tipping points. Fifth, in response to or anticipation of GCC, restoration projects may need to be conducted in areas distant from the site of injury or focused on functionally equivalent natural resources; thus, community involvement in NRDAR processes will be increasingly important. Sixth, we promote using NRDAR restoration projects as opportunities to mitigate GCC-related impacts. Seventh, we recommend adaptive management approaches to NRDAR processes and communication of successes and failures widely. Finally, we recommend focusing on managing the stressors that might be exacerbated by GCC, such as pollution and habitat loss, because there is a long history of successfully mitigating these stressors, which can be more easily managed on local scales than climate change. We believe that adoption of these recommendations will lead to a more efficacious NRDAR process, despite the challenges posed by climate change. Environ. Toxicol. Chem. 2013;32:93–101. © 2012 SETAC PMID:23097077

Implications of global climate change for natural resource damage assessment, restoration, and rehabilitation.

PubMed

Rohr, Jason R; Johnson, Philip; Hickey, Christopher W; Helm, Roger C; Fritz, Alyce; Brasfield, Sandra

2013-01-01

Various international and national regulations hold polluters liable for the cleanup of released hazardous substances and the restoration/rehabilitation of natural resources to preincident baseline conditions, a process often referred to as natural resource damage assessment and restoration (NRDAR). Here, we, the authors, describe how global climate change (GCC) will challenge each of the steps of NRDAR processes and offer eight recommendations to improve these processes in light of GCC. First, we call for a better understanding of the net effects of GCC and contaminants on natural resources. Second, we urge facilities and environmental managers to plan for GCC-related factors that are expected to increase the probability of contaminant releases. Third, we suggest re-evaluating definitions of baseline and reference conditions given that GCC will alter both their trajectories and variability. Fourth, we encourage long-term monitoring to improve the quantification of baseline conditions that will change as climate changes. This will enhance the accuracy of injury assessments, the effectiveness of restoration, and the detection of early warning signs that ecosystems are approaching tipping points. Fifth, in response to or anticipation of GCC, restoration projects may need to be conducted in areas distant from the site of injury or focused on functionally equivalent natural resources; thus, community involvement in NRDAR processes will be increasingly important. Sixth, we promote using NRDAR restoration projects as opportunities to mitigate GCC-related impacts. Seventh, we recommend adaptive management approaches to NRDAR processes and communication of successes and failures widely. Finally, we recommend focusing on managing the stressors that might be exacerbated by GCC, such as pollution and habitat loss, because there is a long history of successfully mitigating these stressors, which can be more easily managed on local scales than climate change. We believe that adoption of these recommendations will lead to a more efficacious NRDAR process, despite the challenges posed by climate change. Copyright © 2012 SETAC.

Defense Healthcare Information Assurance Program

DTIC Science & Technology

1999-11-01

56k Modem • Cisco 1OS 12.0 operation at the MTFs, the Team • Cisco 3640 Router Configuration Fileo 24- 56k Modems recommended the Cisco 3600 series...temporarily substituted by the vendor pending availability of ordered components (e.g., the modem circuit board for the router). " Each site created a...control for software / hardware modifications and upgrades? 3.5 Is there a process for introducing new equipment (such as hosts, printers, or modems

Recommendations for Benchmarking Web Site Usage among Academic Libraries.

ERIC Educational Resources Information Center

Hightower, Christy; Sih, Julie; Tilghman, Adam

1998-01-01

To help library directors and Web developers create a benchmarking program to compare statistics of academic Web sites, the authors analyzed the Web server log files of 14 university science and engineering libraries. Recommends a centralized voluntary reporting structure coordinated by the Association of Research Libraries (ARL) and a method for…

Teaching about Bullying and Cyberbullying with the Internet

ERIC Educational Resources Information Center

Risinger, C. Frederick

2011-01-01

Bullying and cyber bullying are important issues in schools, not only in the United States but in many other nations. In this article, the author recommends sites that he thinks would be helpful for teachers and schools combating bullying and cyber bullying. These recommended sites provide teacher lesson plans and other resources dealing with…

A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success

PubMed Central

Wright, Adam; Ash, Joan S; Erickson, Jessica L; Wasserman, Joe; Bunce, Arwen; Stanescu, Ana; St Hilaire, Daniel; Panzenhagen, Morgan; Gebhardt, Eric; McMullen, Carmit; Middleton, Blackford; Sittig, Dean F

2014-01-01

Objective To describe the activities performed by people involved in clinical decision support (CDS) at leading sites. Materials and methods We conducted ethnographic observations at seven diverse sites with a history of excellence in CDS using the Rapid Assessment Process and analyzed the data using a series of card sorts, informed by Linstone's Multiple Perspectives Model. Results We identified 18 activities and grouped them into four areas. Area 1: Fostering relationships across the organization, with activities (a) training and support, (b) visibility/presence on the floor, (c) liaising between people, (d) administration and leadership, (e) project management, (f) cheerleading/buy-in/sponsorship, (g) preparing for CDS implementation. Area 2: Assembling the system with activities (a) providing technical support, (b) CDS content development, (c) purchasing products from vendors (d) knowledge management, (e) system integration. Area 3: Using CDS to achieve the organization's goals with activities (a) reporting, (b) requirements-gathering/specifications, (c) monitoring CDS, (d) linking CDS to goals, (e) managing data. Area 4: Participation in external policy and standards activities (this area consists of only a single activity). We also identified a set of recommendations associated with these 18 activities. Discussion All 18 activities we identified were performed at all sites, although the way they were organized into roles differed substantially. We consider these activities critical to the success of a CDS program. Conclusions A series of activities are performed by sites strong in CDS, and sites adopting CDS should ensure they incorporate these activities into their efforts. PMID:23999670

Installation restoration program. Site investigation report. Volume 1: Section 1 through 6. 155th Air Refueling Group, Nebraska Air National Guard, Lincoln, Nebraska. Revision 04. Final report

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

NONE

1995-04-01

Site Investigation Report, Volume 1: Sections 1 through 6, Appendix A. A Site Investigation was performed at the 155th Air Refueling Group at Lincoln, NE to evaluate six areas of suspected contamination identified during a Preliminary Assessment. The sites that this investigation were conducted at are: Site 1- Fuel Farm, POL Storage Area, Site 2 - West End of Old Oak Creek, Site 3 Former Tank Cleaning/Hazardous Waste Storage Area, Site 4 - Access Road, Dust Control Area, , Site 5 - Army National Guard Oil Storage Area, and Site 6 - Hydraulic Pressure Check Unit Storage Area. The reportmore » recommended no further action for Sites 3 through 6 due to low levels or no contamination being found. The report recommended that the portion of Site 2 that is located downstream of Site 1 should be included in Site 1.« less

Uncovering the essential links in online commercial networks

NASA Astrophysics Data System (ADS)

Zeng, Wei; Fang, Meiling; Shao, Junming; Shang, Mingsheng

2016-09-01

Recommender systems are designed to effectively support individuals' decision-making process on various web sites. It can be naturally represented by a user-object bipartite network, where a link indicates that a user has collected an object. Recently, research on the information backbone has attracted researchers' interests, which is a sub-network with fewer nodes and links but carrying most of the relevant information. With the backbone, a system can generate satisfactory recommenda- tions while saving much computing resource. In this paper, we propose an enhanced topology-aware method to extract the information backbone in the bipartite network mainly based on the information of neighboring users and objects. Our backbone extraction method enables the recommender systems achieve more than 90% of the accuracy of the top-L recommendation, however, consuming only 20% links. The experimental results show that our method outperforms the alternative backbone extraction methods. Moreover, the structure of the information backbone is studied in detail. Finally, we highlight that the information backbone is one of the most important properties of the bipartite network, with which one can significantly improve the efficiency of the recommender system.

Improving Clinical Workflow in Ambulatory Care: Implemented Recommendations in an Innovation Prototype for the Veteran’s Health Administration

PubMed Central

Patterson, Emily S.; Lowry, Svetlana Z.; Ramaiah, Mala; Gibbons, Michael C.; Brick, David; Calco, Robert; Matton, Greg; Miller, Anne; Makar, Ellen; Ferrer, Jorge A.

2015-01-01

Introduction: Human factors workflow analyses in healthcare settings prior to technology implemented are recommended to improve workflow in ambulatory care settings. In this paper we describe how insights from a workflow analysis conducted by NIST were implemented in a software prototype developed for a Veteran’s Health Administration (VHA) VAi2 innovation project and associated lessons learned. Methods: We organize the original recommendations and associated stages and steps visualized in process maps from NIST and the VA’s lessons learned from implementing the recommendations in the VAi2 prototype according to four stages: 1) before the patient visit, 2) during the visit, 3) discharge, and 4) visit documentation. NIST recommendations to improve workflow in ambulatory care (outpatient) settings and process map representations were based on reflective statements collected during one-hour discussions with three physicians. The development of the VAi2 prototype was conducted initially independently from the NIST recommendations, but at a midpoint in the process development, all of the implementation elements were compared with the NIST recommendations and lessons learned were documented. Findings: Story-based displays and templates with default preliminary order sets were used to support scheduling, time-critical notifications, drafting medication orders, and supporting a diagnosis-based workflow. These templates enabled customization to the level of diagnostic uncertainty. Functionality was designed to support cooperative work across interdisciplinary team members, including shared documentation sessions with tracking of text modifications, medication lists, and patient education features. Displays were customized to the role and included access for consultants and site-defined educator teams. Discussion: Workflow, usability, and patient safety can be enhanced through clinician-centered design of electronic health records. The lessons learned from implementing NIST recommendations to improve workflow in ambulatory care using an EHR provide a first step in moving from a billing-centered perspective on how to maintain accurate, comprehensive, and up-to-date information about a group of patients to a clinician-centered perspective. These recommendations point the way towards a “patient visit management system,” which incorporates broader notions of supporting workload management, supporting flexible flow of patients and tasks, enabling accountable distributed work across members of the clinical team, and supporting dynamic tracking of steps in tasks that have longer time distributions. PMID:26290887

A decision support tool for landfill methane generation and gas collection.

PubMed

Emkes, Harriet; Coulon, Frédéric; Wagland, Stuart

2015-09-01

This study presents a decision support tool (DST) to enhance methane generation at individual landfill sites. To date there is no such tool available to provide landfill decision makers with clear and simplified information to evaluate biochemical processes within a landfill site, to assess performance of gas production and to identify potential remedies to any issues. The current lack in understanding stems from the complexity of the landfill waste degradation process. Two scoring sets for landfill gas production performance are calculated with the tool: (1) methane output score which measures the deviation of the actual methane output rate at each site which the prediction generated by the first order decay model LandGEM; and (2) landfill gas indicators' score, which measures the deviation of the landfill gas indicators from their ideal ranges for optimal methane generation conditions. Landfill gas indicators include moisture content, temperature, alkalinity, pH, BOD, COD, BOD/COD ratio, ammonia, chloride, iron and zinc. A total landfill gas indicator score is provided using multi-criteria analysis to calculate the sum of weighted scores for each indicator. The weights for each indicator are calculated using an analytical hierarchical process. The tool is tested against five real scenarios for landfill sites in UK with a range of good, average and poor landfill methane generation over a one year period (2012). An interpretation of the results is given for each scenario and recommendations are highlighted for methane output rate enhancement. Results demonstrate how the tool can help landfill managers and operators to enhance their understanding of methane generation at a site-specific level, track landfill methane generation over time, compare and rank sites, and identify problems areas within a landfill site. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of breastfeeding Web sites for patient education.

PubMed

Dornan, Barbara A; Oermann, Marilyn H

2006-01-01

To evaluate the quality of Web sites on breastfeeding for patient education. Descriptive study of 30 Web sites on breastfeeding for patient education, evaluated based on the Health Information Technology Institute (HITI) criteria, readability, and eight content criteria from the American Academy of Pediatrics (AAP) policy statement on breastfeeding. The mean Flesch-Kincaid Grade Level for readability of the 30 sites was 9.2. Seven of the sites included all eight of the content criteria from the AAP, and three sites did not include any of the information recommended by the AAP content criteria. Nurses should be able to recommend best patient education materials for their patients. The five best Web sites for breastfeeding education are identified for patient teaching, and the HITI criteria are explained for nurses to learn how to evaluate Web sites for themselves and their patients.

Evaluation of the antipsychotic medication review process at four long-term facilities in Alberta.

PubMed

Birney, Arden; Charland, Paola; Cole, Mollie; Aslam Arain, Mubashir

2016-01-01

The goal of this evaluation was to understand how four long-term care (LTC) facilities in Alberta have implemented medication reviews for the Appropriate Use of Antipsychotics (AUA) initiative. We aimed to determine how interprofessional (IP) collaboration was incorporated in the antipsychotic medication reviews and how the reviews had been sustained. Four LTC facilities in Alberta participated in this evaluation. We conducted semistructured interviews with 18 facility staff and observed one antipsychotic medication review at each facility. We analyzed data according to the following key components that we identified as relevant to the antipsychotic medication reviews: the structure of the reviews, IP interactions between the staff members, and strategies for sustaining the reviews. The duration of antipsychotic medication reviews ranged from 1 to 1.5 hours. The number of professions in attendance ranged from 3 to 9; a pharmacist led the review at two sites, while a registered nurse led the review at one site and a nurse practitioner at the remaining site. The number of residents discussed during the review ranged from 6 to 20. The process at some facilities was highly IP, demonstrating each of the six IP competencies. Other facilities conducted the review in a less IP manner due to challenges of physician involvement and staff workload, particularly of health care aides. Facilities that had an nurse practitioner on site were more efficient with the process of implementing recommendations resulting from the medication reviews. The LTC facilities were successful in implementing the medication review process and the process seemed to be sustainable. A few challenges were observed in the implementation process at two facilities. IP practice moved forward the goals of the AUA initiative to reduce the inappropriate use of antipsychotics.

Investigation of seismicity and related effects at NASA Ames-Dryden Flight Research Facility, Computer Center, Edwards, California

NASA Technical Reports Server (NTRS)

Cousineau, R. D.; Crook, R., Jr.; Leeds, D. J.

1985-01-01

This report discusses a geological and seismological investigation of the NASA Ames-Dryden Flight Research Facility site at Edwards, California. Results are presented as seismic design criteria, with design values of the pertinent ground motion parameters, probability of recurrence, and recommended analogous time-history accelerograms with their corresponding spectra. The recommendations apply specifically to the Dryden site and should not be extrapolated to other sites with varying foundation and geologic conditions or different seismic environments.

Planning and conducting a multi-institutional project on fatigue.

PubMed

Nail, L M; Barsevick, A M; Meek, P M; Beck, S L; Jones, L S; Walker, B L; Whitmer, K R; Schwartz, A L; Stephen, S; King, M E

1998-09-01

To describe the process used in proposal development and study implementation for a complex multisite project on cancer treatment-related fatigue (CRF), identify strategies used to manage the project, and provide recommendations for teams planning multisite research. Information derived from project team meeting records, correspondence, proposals, and personal recollection. The project was built on preexisting relationships among the three site investigators who then built a team including faculty, research coordinators, staff nurses, and students. Study sites had a range of organizational models, and the proposal was designed to capitalize on the organizational and resource strengths of each setting. Three team members drawn from outside oncology nursing provided expertise in measurement and experience with fatigue in other populations. Planning meetings were critical to the success of the project. Conference calls, fax technology, and electronic mail were used for communication. Flexibility was important in managing crises and shifting responsibility for specific components of the work. The team documented and evaluated the process used for multisite research, completed a major instrumentation study, and developed a cognitive-behavioral intervention for CRF. Accomplishments during the one-year planning grant exceeded initial expectations. The process of conducting multisite research is complex, especially when the starting point is a planning grant with specific research protocols to be developed and implemented over one year. Explicit planning for decision-making processes to be used throughout the project, acknowledging the differences among the study settings and planning the protocols to capitalize upon those differences, and recruiting a strong research team that included a member with planning grant and team-building expertise were essential elements for success. Specific recommendations for others planning multisite research are related to team-building, team membership, communication, behavioral norms, role flexibility, resources, feedback, problem management, and shared recognition.

Applicability of NASQAN data for ecosystem assessments on the Missouri River

USGS Publications Warehouse

Blevins, Dale W.; Fairchild, James

2001-01-01

The effectiveness of ecological restoration efforts on large developed rivers is often unknown because comprehensive ecological monitoring programs are often absent. Although Eulerian water-quality monitoring programs, such as the National Stream Quality Accounting Network (NASQAN) program, are more common, they are usually not designed for ecological assessment. Therefore, this paper addresses the value of NASQAN for ecological assessments on the Missouri River and identifies potential program additions and modifications to assess certain ecological changes in physical habitat, biological structure and function, and ecotoxicity. Five additional sites: The analysis of chlorophyll, mercury, ATP, potential endocrine disruptors, total trace elements, and selected total hydrophobic organics; and the hourly measurement of dissolved oxygen, turbidity, and temperature are recommended. Hourly measurements would require an entirely new operational aspect to NASQAN. However, the presence of data loggers and satellite transmitters in the gauging stations at all NASQAN sites substantially improves the feasibility of continuous water-quality monitoring. The use of semipermeable membrane devices (SPMDs) to monitor dissolved bioaccumulating organics and trace elements, identification and enumeration of zooplankton, and characterization of the bioavailability of organic matter are also recommended. The effect of biological processes on the conservative assumptions that are used in flux and source determinations of NASQAN constituents are also evaluated. Organic carbon, organic nitrogen, dissolved phosphate, and dissolved inorganic nitrogen are the NASQAN constituents most vulnerable to biological processes and thus violation of conservative assumptions.

Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites.

PubMed

Bjegovich-Weidman, Marija; Kahabka, Jill; Bock, Amy; Frick, Jacob; Kowalski, Helga; Mirro, Joseph

2012-03-01

Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would result in significant cost savings, currently being quantified as a result of consolidation and improved efficiency. A reinvestment of these cost savings would be required to address facility expansion and program enhancement to maximize patient-centered expert care consistently across all of our remaining sites of service.

Lessons Learned for Collaborative Clinical Content Development

PubMed Central

Collins, S.A.; Bavuso, K.; Zuccotti, G.; Rocha, R.A.

2013-01-01

Background Site-specific content configuration of vendor-based Electronic Health Records (EHRs) is a vital step in the development of standardized and interoperable content that can be used for clinical decision-support, reporting, care coordination, and information exchange. The multi-site, multi-stakeholder Acute Care Documentation (ACD) project at Partners Healthcare Systems (PHS) aimed to develop highly structured clinical content with adequate breadth and depth to meet the needs of all types of acute care clinicians at two academic medical centers. The Knowledge Management (KM) team at PHS led the informatics and knowledge management effort for the project. Objectives We aimed to evaluate the role, governance, and project management processes and resources for the KM team’s effort as part of the standardized clinical content creation. Methods We employed the Center for Disease Control’s six step Program Evaluation Framework to guide our evaluation steps. We administered a forty-four question, open-ended, semi-structured voluntary survey to gather focused, credible evidence from members of the KM team. Qualitative open-coding was performed to identify themes for lessons learned and concluding recommendations. Results Six surveys were completed. Qualitative data analysis informed five lessons learned and thirty specific recommendations associated with the lessons learned. The five lessons learned are: 1) Assess and meet knowledge needs and set expectations at the start of the project; 2) Define an accountable decision-making process; 3) Increase team meeting moderation skills; 4) Ensure adequate resources and competency training with online asynchronous collaboration tools; 5) Develop focused, goal-oriented teams and supportive, consultative service based teams. Conclusions Knowledge management requirements for the development of standardized clinical content within a vendor-based EHR among multi-stakeholder teams and sites include: 1) assessing and meeting informatics knowledge needs, 2) setting expectations and standardizing the process for decision-making, and 3) ensuring the availability of adequate resources and competency training. PMID:23874366

Basic Information About the School Siting Guidelines

EPA Pesticide Factsheets

EPA's voluntary school siting guidelines provide recommendations for local school districts and community members on how to evaluate environmental factors to make the best possible school siting decisions.

10 CFR 960.3-1-4 - Evidence for siting decisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-4 Evidence for siting decisions. The siting... recommendation of a candidate site for the development of a repository. Each of these decisions will be supported...

Recommending Peers for Learning: Matching on Dissimilarity in Interpretations to Provoke Breakdown

ERIC Educational Resources Information Center

Rajagopal, Kamakshi; van Bruggen, Jan M.; Sloep, Peter B.

2017-01-01

People recommenders are a widespread feature of social networking sites and educational social learning platforms alike. However, when these systems are used to extend learners' Personal Learning Networks, they often fall short of providing recommendations of learning value to their users. This paper proposes a design of a people recommender based…

The impact of deposition site on vaccination efficiency of a live bacterial poultry vaccine.

PubMed

Evans, J D; Leigh, S A; Purswell, J L; Collier, S D; Kim, E J; Boykin, D L; Branton, S L

2015-08-01

Vaccines are utilized within the poultry industry to minimize disease-associated losses and spray vaccination is a commonly utilized means for the mass application of poultry vaccines. During this process, vaccine-laden particles are deposited upon target areas (e.g., eyes, nares, and oral cavity) resulting in the direct internalization of the vaccine. However, particles are also deposited on nontarget areas such as the exterior of the subject and its surrounding environment. To better determine the fate of particles deposited upon nontarget areas and the impact of deposition site on the efficiency of vaccine application, a live bacterial poultry vaccine (AviPro(®) MG F) was applied via spray using a spray cabinet with a slotted partition allowing for head-only, body-only, and whole-bird spray application. At 11 wk age, Hy-Line(®) W-36 pullets (n = 280) were allocated equally among 7 treatments including: nonvaccinated controls, pullets spray-vaccinated at the manufacturer's recommended dose (1X) in a site-specific manner (head-only, body-only, and whole-bird), pullets spray-vaccinated at 5X the recommended level (body-only), pullets vaccinated by manual eye-drop application (1X), and pullets eye-drop vaccinated at a level approximating that achieved during the spray vaccination process (1/700X). At 6 to 7 wk postvaccination, vaccination efficiency was assessed via serological-based assays [serum plate agglutination (SPA) and ELISA] and the detection of vaccine-derived in vivo populations. Results indicate an additive contribution of the vaccine deposited on the body to the overall vaccination efficiency of this live bacterial live poultry vaccine. © 2015 Poultry Science Association Inc.

Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service.

PubMed

Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A

2016-12-01

A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P < 0.001). The improved NRS form is now incorporated into standard nursing practice and NRS is embedded in the organisation's 'Point of Care Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.

Finding the Public Voice: A Few Observations After Experience on the SRS Citizens Advisory Board - 12226

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

Bridges, Donald

2012-07-01

This Paper reflects my views on some of the difficulties and successes in seeking and reflecting the opinions and input of the typical citizen relative to the Savannah River Site (SRS) cleanup programs. These views are based on four years of membership on the SRS Citizens Advisory Board (CAB). The Savannah River Site Citizens Advisory Board was established by Department of Energy- Environmental Management in 1994 with the goal of improving cleanup decisions by reflecting priorities and concerns of stakeholders and generally improving communication with the public, particularly in the areas most impacted by site operations. The SRS CAB hasmore » been a successful venture and has had a notable record of accomplishments with approximately 285 recommendations over its 17-year history. Many of these recommendations have been very specific and have impacted Site priorities on many issues of concern to the public. However, attaining this success and truly reflecting the views of the typical citizen is a difficult proposition. This concept begs such questions as: where do you get the input? how do you get these views? and how do you know when you've gotten it right? As a Board we have had to deal with groups who seem to have a bias either in favor of or strongly opposed to certain cleanup actions or other groups who have a total focus on a single topic such as jobs. It is our role to ensure that a balanced approach is adopted which reflects the sentiments of the general public. After some four years experience on the Board I have formulated a few ideas that should make the Board one that more completely reflects public sentiments and makes useful thoughtful input. Therefore, this paper looks at the manner and difficulty of seeking input and generally communicating with the public while offering some views on how to improve the process. The Citizens Advisory Board was envisioned as a body of private citizens who looked at cleanup activities of the Site and reflected the public view and input as the Site carried out the EM mission. In my view this body has carried out that mandate. Over its 17-year history the CAB has been diligent in its duties and enthusiastic in its involvement. The CAB has been energetic, active, and innovative in their work. The SRS CAB has developed a number of innovative and effective measures to serve the public good by improving the internal procedures to make the Board more informed and the external processes to make the public more involved. This paper described some of the more useful measures, which have assisted in that pursuit. This work has resulted in numerous recommendations that have led to many improvements in Site cleanup. By any measure this body of work by the CAB is a noteworthy success. (authors)« less

Measure Guideline: Optimizing the Configuration of Flexible Duct Junction Boxes

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

Beach, R.; Burdick, A.

2014-03-01

This measure guideline offers additional recommendations to heating, ventilation, and air conditioning (HVAC) system designers for optimizing flexible duct, constant-volume HVAC systems using junction boxes within Air Conditioning Contractors of America (ACCA) Manual D guidance. IBACOS used computational fluid dynamics software to explore and develop guidance to better control the airflow effects of factors that may impact pressure losses within junction boxes among various design configurations. These recommendations can help to ensure that a system aligns more closely with the design and the occupants' comfort expectations. Specifically, the recommendations described herein show how to configure a rectangular box with fourmore » outlets, a triangular box with three outlets, metal wyes with two outlets, and multiple configurations for more than four outlets. Designers of HVAC systems, contractors who are fabricating junction boxes on site, and anyone using the ACCA Manual D process for sizing duct runs will find this measure guideline invaluable for more accurately minimizing pressure losses when using junction boxes with flexible ducts.« less

A multistage controlled intervention to increase stair climbing at work: effectiveness and process evaluation.

PubMed

Bellicha, Alice; Kieusseian, Aurélie; Fontvieille, Anne-Marie; Tataranni, Antonio; Copin, Nane; Charreire, Hélène; Oppert, Jean-Michel

2016-04-11

Stair climbing helps to accumulate short bouts of physical activity throughout the day as a strategy for attaining recommended physical activity levels. There exists a need for effective long-term stair-climbing interventions that can be transferred to various worksite settings. The aims of this study were: 1) to evaluate short- and long-term effectiveness of a worksite stair-climbing intervention using an objective measurement of stair climbing and a controlled design; and 2) to perform a process evaluation of the intervention. We performed a controlled before-and-after study. The study was conducted in two corporate buildings of the same company located in Paris (France), between September, 2013 and September, 2014. The status of either "intervention site" or "control site" was assigned by the investigators. Participants were on-site employees (intervention site: n = 783; control site: n = 545 at baseline). Two one-month intervention phases using signs (intervention phase 1) and enhancement of stairwell aesthetics (intervention phase 2) were performed. The main outcome was the change in stair climbing, measured with automatic counters and expressed in absolute counts/day/100 employees and percent change compared to baseline. Qualitative outcomes were used to describe the intervention process. Stair climbing significantly increased at the intervention site (+18.7%) but decreased at the control site (-13.3%) during the second intervention phase (difference between sites: +4.6 counts/day/100 employees, p < 0.001). After the intervention and over the long term, stair climbing returned to baseline levels at the intervention site, but a significant difference between sites was found (intervention site vs. control site: +2.9 counts/day/100 employees, p < 0.05). Some important facets of the intervention were implemented as intended but other aspects had to be adapted. The main difficulty reported by the company's staff members lay in matching the internal communications rules with critical intervention criteria. The program was maintained at the setting level after the end of the study. This study shows a successful stair-climbing intervention at the worksite. The main barriers to adoption and implementation were related to location and visibility of posters. Process evaluation was useful in identifying these barriers throughout the study, and in finding appropriate solutions.

Addendum to the Closure Report for Corrective Action Unit 335: Area 6 Injection Well and Drain Pit Nevada Test Site, Nevada, Revison 0

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

Lynn Kidman

This document constitutes an addendum to the June 2003, Closure Report for Corrective Action Unit 335: Area 6 Injection Well and Drain Pit as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consistsmore » of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 06-20-02, 20-inch Cased Hole • CAS 06-23-03, Drain Pit These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Addendum to the Corrective Action Decision Document/Closure Report for Corrective Action Unit 321: Area 22 Weather Station Fuel Storage Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the August 2001, Corrective Action Decision Document / Closure Report for Corrective Action Unit 321: Area 22 Weather Station Fuel Storage as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modificationmore » document, this addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 22-99-05, Fuel Storage Area. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Addendum to the Closure Report for Corrective Action Unit 214: Bunkers and Storage Areas Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the September 2006, Closure Report for Corrective Action Unit 214: Bunkers and Storage Areas as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of: • Thismore » cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 25-23-01, Contaminated Materials • CAS 25-23-19, Radioactive Material Storage These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Addendum to the Closure Report for Corrective Action Unit 342: Area 23 Mercury Fire Training Pit Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the April 2000, Closure Report for Corrective Action Unit 342: Area 23 Mercury Fire Training Pit as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of:more » • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 23-56-01, Former Mercury Fire Training Pit. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Associations between meeting combinations of 24-h movement guidelines and health-related quality of life in children from 12 countries.

PubMed

Sampasa-Kanyinga, H; Standage, M; Tremblay, M S; Katzmarzyk, P T; Hu, G; Kuriyan, R; Maher, C; Maia, J; Olds, T; Sarmiento, O L; Tudor-Locke, C; Chaput, J-P

2017-12-01

To examine whether meeting vs not meeting movement/non-movement guidelines (moderate-to-vigorous physical activity [MVPA], screen time, sleep duration), and combinations of these recommendations, are associated with health-related quality of life (HRQoL) in children from 12 countries in five major geographic regions of the world and explore whether the associations vary by study site. Observational, multinational cross-sectional study. This study included 6106 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. Participants completed the KIDSCREEN-10 to provide a global measure of their HRQoL. Sleep duration and MVPA were assessed using 24-h accelerometry. Screen time was assessed through self-report. Meeting the recommendations was defined as ≥60 min/day for MVPA, ≤2 h/day for screen time, and between 9 and 11 h/night for sleep duration. Age, sex, highest parental education, unhealthy diet pattern score, and body mass index z-score were included as covariates in statistical models. In the full sample, children meeting the screen time recommendation, the screen time + sleep recommendation, and all three recommendations had significantly better HRQoL than children not meeting any of these guidelines. Differences in HRQoL scores between sites were also found within combinations of movement/non-movement behaviors. For example, while children in Australia, Canada, and USA self-reported better HRQoL when meeting all three recommendations, children in Kenya and Portugal reported significantly lower HRQoL when meeting all three recommendations (relative to not meeting any). Self-reported HRQoL is generally higher when children meet established movement/non-movement recommendations. However, differences between study sites also suggest that interventions aimed at improving lifestyle behaviors and HRQoL should be locally and culturally adapted. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

75 FR 65310 - Environmental Management Site-Specific Advisory Board, Nevada

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Nevada AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Nevada Test Site. The Federal Advisory... Board is to make recommendations to DOE-EM and site management in the areas of environmental restoration...

Movement and fate of atrazine and bromide in central Kansas croplands

USGS Publications Warehouse

Sophocleous, M.; Townsend, M.A.; Whittemore, Donald O.

1990-01-01

Two flooding experiments were conducted at two sites with different soils to study the transport and fate of the commonly used herbicide atrazine and inorganic chemicals in the Great Bend Prairie croplands of south-central Kansas. The instantaneous profile method supplemented by the use of an organic (atrazine) and an inorganic (bromide) tracer chemical was used to characterize in situ the hydraulic and chemical properties of the appropriately instrumented field sites. Atrazine readily degraded to hydroxyatrazine and biodegradation by-products and was not detected deeper in the soil profile and underlying shallow aquifer. The classical processes of chemical movement based on porous media-equilibrium-diffuse flow did not fit the data well at either site. Incompletely mixed, slug flow appeared to predominate at one of the sites and preferential flow at the other. The slug movement caused 'piston-type' displacement of more saline solutions in the soil profile to the shallow water table. Recommendations for conducting related field studies based on our sampling experience are given. ?? 1990.

Report on Lessons Learned from the NP 2010 Early Site Permit Program FINAL REPORT

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

None, None

2008-03-26

This report provides a summary of lessons learned from the demonstration of the licensing process for three Early Site Permit (ESP) applications supported as part of the Department of Energy’s (DOE) Nuclear Power 2010 (NP 2010) program. The ESP process was established by the Nuclear Regulatory Commission (NRC) to enable completion of the site evaluation component of nuclear power plant licensing under 10 CFR Part 52 before a utility makes a decision to build a plant. Early Site Permits are valid for 10 to 20 years and can be renewed for an additional 10 to 20 years. NRC review ofmore » an ESP application addresses site safety issues, environmental protection issues, and plans for coping with emergencies. Successful completion of the ESP process will establish that a site is suitable for possible future construction and operation of a nuclear power plant. Most importantly, an ESP resolves significant site-related safety and environmental issues early in the decision process and helps achieve acceptance by the public. DOE competitively selected Dominion Nuclear Energy North Anna, LLC (Dominion); System Energy Resources, Inc. (an Entergy subsidiary); and Exelon Generation Company, LLC (Exelon) in 2002 to demonstrate the ESP process and provided cost-shared support through the NP 2010 program. Dominion pursued an ESP for the North Anna site in Virginia; System Energy Resources, Inc. pursued an ESP for the Grand Gulf site in Mississippi; and Exelon pursued an ESP for the Clinton site in Illinois. After successfully demonstrating the process, the NRC issued an ESP for Clinton on March 17, 2007; Grand Gulf on April 5, 2007; and North Anna on November 27, 2007. As with all successful projects, there are lessons to be learned from the NP 2010 early site permitting demonstration that can help improve future implementation guidance documents and regulatory review standards. In general, these lessons pertain to the effectiveness of the regulatory process, experience related to guidance for developing and reviewing ESP applications, issues involving ESP plant parameters, and suggestions for future ESP applicants. The development, submittal, and issuance of these first ESPs under DOE’s NP 2010 program started the momentum to exercise NRC’s new 10 CFR Part 52 licensing process. Several key questions that define critical issues regarding the effectiveness of regulations pertaining to ESPs have been identified and summarized in this report. However, the final resolution of whether the ESP component of the Part 52 process significantly contributes to the predictability in nuclear power plant licensing requires more experience and time, such as the completion of the ongoing combined Construction and Operating License (COL) process for the North Anna and Grand Gulf sites. The three ESP project participants prepared and submitted to DOE lessons learned reports from their experience in developing, submitting, and receiving an ESP. This document summarizes these reports, which are appended hereto. The Nuclear Energy Institute (http://www.nei.org/) and NRC (http://www.nrc.gov/) have also prepared reports regarding their perspectives on lessons learned during the ESP process. Their documents can be accessed on their respective web sites. Following is a summary of the lessons learned from the NP 2010 ESP projects. Effectiveness of the ESP Process: In general, the ESP process is expected (subject to demonstration of the ESP finality provisions in the North Anna and Grand Gulf ESPs) to provide high value for applicants as a site banking and risk mitigation strategy. However, several aspects of the initial process, such as NRC hearings and determining an acceptable approach to the NRC’s Emergency Planning requirements, proved challenging for the applicants. Project Execution: Initial regulatory and industry guidance for planning and executing an ESP application program proved to be insufficient to address NRC’s document review expectations. However, continuous communication between NRC and the applicants helped establish an acceptable framework for the applications and resulted in the successful issuance of three ESPs. Still, formal guidance from both NRC and industry is needed for issues involving merchant plants; data collection issues; and interactions between NRC, the public, and the applicants. Specific Plant Parameter Issues: The use of the Plant Parameter Envelope (PPE) approach, when the applicant has not yet chosen a reactor technology, proved to be a major source of confusion between applicants and NRC. This issue had also been a topic of discussion during the NRC ESP hearings. Based upon North Anna and Grand Gulf COLA experiences, the need should be evaluated for future NRC guidance pertaining to the PPE approach to clarify these issues. In addition, NRC, applicants, and industry spent considerable time and resources deciding how to employ new seismic analysis approaches. Future guidance in this area would also be very useful. Best Project Practices: A variety of good practices were identified, such as using specific project tracking and milestone items, handling very large documents electronically, employing a formal and rigorous document review process, and sharing large files across organizational sites. This report also includes a set of general recommendations to assist future ESP applicants. Several recommendations highlight the need for NRC and industry to continue to work together to improve the ESP process.« less

Addendum to the Closure Report for Corrective Action Unit 394: Areas 12, 18, and 29 Spill/Release Sites Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the September 2003, Closure Report for Corrective Action Unit 394: Areas 12, 18, and 29 Spill/Release Sites as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consistsmore » of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 12-25-04, UST 12-16-2 Waste Oil Release • CAS 18-25-01, Oil Spills • CAS 18-25-02, Oil Spills • CAS 18-25-03, Oil Spill • CAS 29-44-01, Fuel Spill These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Candidate Low-Temperature Glass Waste Forms for Technetium-99 Recovered from Hanford Effluent Management Facility Evaporator Concentrate

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

Ding, Mei; Tang, Ming; Rim, Jung Ho

Alternative treatment and disposition options may exist for technetium-99 (99Tc) in secondary liquid waste from the Hanford Direct-Feed Low-Activity Waste (DFLAW) process. One approach includes development of an alternate glass waste form that is suitable for on-site disposition of technetium, including salts and other species recovered by ion exchange or precipitation from the EMF evaporator concentrate. By recovering the Tc content from the stream, and not recycling the treated concentrate, the DFLAW process can potentially be operated in a more efficient manner that lowers the cost to the Department of Energy. This report provides a survey of candidate glass formulationsmore » and glass-making processes that can potentially incorporate technetium at temperatures <700 °C to avoid volatilization. Three candidate technetium feed streams are considered: (1) dilute sodium pertechnetate loaded on a non-elutable ion exchange resin; (2) dilute sodium-bearing aqueous eluent from ion exchange recovery of pertechnetate, or (3) technetium(IV) oxide precipitate containing Sn and Cr solids in an aqueous slurry. From the technical literature, promising candidate glasses are identified based on their processing temperatures and chemical durability data. The suitability and technical risk of three low-temperature glass processing routes (vitrification, encapsulation by sintering into a glass composite material, and sol-gel chemical condensation) for the three waste streams was assessed, based on available low-temperature glass data. For a subset of candidate glasses, their long-term thermodynamic behavior with exposure to water and oxygen was modeled using Geochemist’s Workbench, with and without addition of reducing stannous ion. For further evaluation and development, encapsulation of precipitated TcO2/Sn/Cr in a glass composite material based on lead-free sealing glasses is recommended as a high priority. Vitrification of pertechnetate in aqueous anion exchange eluent solution using a high lead content borate glass, or other low melting glass is also recommended for further evaluation and development. Additional laboratory studies of phase behavior and chemical durability of low-temperature glasses is also recommended to provide risk mitigation if one of the primary development paths proves infeasible. This report is a deliverable for the task “Candidate Low-T Glass Waste Forms for EMF Bottoms On-Site Disposition Alternative Option.”« less

US Department of Energy response to standards for remedial actions at inactive uranium processing sites: Proposed rule

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

Not Available

1988-01-29

The Title I groundwater standards for inactive uranium mill tailings sites, which were promulgated on January 5, 1983, by the US Environmental Protection Agency (EPA) for the Uranium Mill Tailings Remedial Action (UMTRA) Project, were remanded to the EPA on September 3, 1985, by the US Tenth Circuit Court of Appeals. The Court instructed the EPA to compile general groundwater standards for all Title I sites. On September 24, 1987, the EPA published proposed standards (52FR36000-36008) in response to the remand. This report includes an evaluation of the potential effects of the proposed EPA groundwater standards on the UMTRA Project,more » as well as a discussion of the DOE's position on the proposed standards. The report also contains and appendix which provides supporting information and cost analyses. In order to assess the impacts of the proposed EPA standards, this report summarizes the proposed EPA standards in Section 2.0. The next three sections assess the impacts of the three parts of the EPA standards: Subpart A considers disposal sites; Subpart B is concerned with restoration at processing sites; and Subpart C addresses supplemental standards. Section 6.0 integrates previous sections into a recommendations section. Section 7.0 contains the DOE response to questions posed by the EPA in the preamble to the proposed standards. 6 refs., 5 figs., 3 tabs.« less

Basic hydrogeologic and remote sensing data for selection of sanitary landfill sites

NASA Technical Reports Server (NTRS)

Brooks, H. K.; Ruth, B. E.; Degner, J. D.

1977-01-01

Solid waste disposal were studied in Volusia County to protect the water supply in the area. Highlands in this County are of limited areal extent and, most significantly, the sand hills and ridges are in areas where recharge of the Floridan aquifer occurs. This study proves that well drained soils meeting the current State requirements are of limited areal extent. These areas should not be utilized as sanitary landfill sites! Rather, it is recommended that the Tomoka Farm Road site into the adjacent wetlands be extended. The County site on Rima Ridge recommended by Greenleaf-Telesca as the primary waste burial site in the County should be re-evaluated because of potential danger to the Daytona Beach water supply.

Revisions to US EPA Superfund Risk and Dose Assessment Models and Guidance - 13403

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

Walker, Stuart A.

2013-07-01

The U.S. Environmental Protection Agency (EPA) Superfund program's six Preliminary Remediation Goal (PRG) and Dose Compliance Concentration (DCC) internet based calculators for risk and dose assessment at Superfund sites are being revised to reflect better science, revisions to existing exposure scenarios and new scenarios, and changes to match up more closely with the EPA chemical regional screening level calculator. A revised version of the 1999 guidance document that provides an overview for the Superfund risk assessment process at radioactively contaminated sites, 'Radiation Risk Assessment At CERCLA Sites: Q and A', is being completed that will reflect Superfund recommended guidance andmore » other technical documents issued over the past 13 years. EPA is also issuing a series of fact sheets in the document 'Superfund Radiation Risk Assessment: A Community Tool-kit'. This presentation would go over those changes that are expected to be finished by this spring. (authors)« less

Final environmental impact statement. Waste Isolation Pilot Plant

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

Not Available

1980-10-01

This volume contains the appendices for the Final Environmental Impact Statement for the Waste Isolation Pilot Plant (WIPP). Alternative geologic environs are considered. Salt, crystalline rock, argillaceous rock, and tuff are discussed. Studies on alternate geologic regions for the siting of WIPP are reviewed. President Carter's message to Congress on the management of radioactive wastes and the findings and recommendations of the interagency review group on nuclear waste management are included. Selection criteria for the WIPP site including geologic, hydrologic, tectonic, physicochemical compatability, and socio-economic factors are presented. A description of the waste types and the waste processing procedures aremore » given. Methods used to calculate radiation doses from radionuclide releases during operation are presented. A complete description of the Los Medanos site, including archaeological and historic aspects is included. Environmental monitoring programs and long-term safety analysis program are described. (DMC)« less

Closure Report for Corrective Action Unit 118: Area 27 Super Kukla Facility, Nevada Test Site, Nevada with ROTC 1, Revision 0

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

Mark Burmeister

2007-09-01

This CR provides documentation and justification for the closure of CAU 118 without further corrective action. This justification is based on process knowledge and the results of the investigative and closure activities conducted in accordance with the CAU 118 SAFER Plan: Streamlined Approach for Environmental Restoration (SAFER) Plan for CAU 118: Area 27 Super Kukla Facility, Nevada Test Site, Nevada (NNSA/NSO, 2006). The SAFER Plan provides information relating to site history as well as the scope and planning of the investigation. This CR also provides the analytical and radiological survey data to confirm that the remediation goals were met asmore » specified in the CAU 118 SAFER Plan (NNSA/NSO, 2006). The Nevada Division of Environmental Protection (NDEP) approved the CAU 118 SAFER Plan (Murphy, 2006), which recommends closure in place with use restrictions (URs).« less

United States Air Force 611th Air Support Group/Civil Engineering Squadron, Elmendorf AFB, Alaska. Decision document for no further response action planned Oliktok Point Radar Installation, Alaska. Final report

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

Karmi, S.

1996-06-03

This Decision Document discusses the selection of no further action as the recommended action for four sites located at the Oliktok Point radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the eight sites located at the Oliktok Point installation (U.S. Air Force 1996a,b). Based on the findings of these activities, four sites are recommended for no further action.

Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology.

PubMed

Hastey, Christine J; Boyd, Halsey; Schuetz, Audrey N; Anderson, Karen; Citron, Diane M; Dzink-Fox, Jody; Hackel, Meredith; Hecht, David W; Jacobus, Nilda V; Jenkins, Stephen G; Karlsson, Maria; Knapp, Cynthia C; Koeth, Laura M; Wexler, Hannah; Roe-Carpenter, Darcie E

2016-12-01

Antimicrobial susceptibility testing of anaerobic isolates was conducted at four independent sites from 2010 to 2012 and compared to results from three sites during the period of 2007-2009. This data comparison shows significant changes in antimicrobial resistance in some anaerobic groups. Therefore, we continue to recommend institutions regularly perform susceptibility testing when anaerobes are cultured from pertinent sites. Annual generation of an institutional-specific antibiogram is recommended for tracking of resistance trends over time. Copyright © 2016 Elsevier Ltd. All rights reserved.

Node-based measures of connectivity in genetic networks.

PubMed

Koen, Erin L; Bowman, Jeff; Wilson, Paul J

2016-01-01

At-site environmental conditions can have strong influences on genetic connectivity, and in particular on the immigration and settlement phases of dispersal. However, at-site processes are rarely explored in landscape genetic analyses. Networks can facilitate the study of at-site processes, where network nodes are used to model site-level effects. We used simulated genetic networks to compare and contrast the performance of 7 node-based (as opposed to edge-based) genetic connectivity metrics. We simulated increasing node connectivity by varying migration in two ways: we increased the number of migrants moving between a focal node and a set number of recipient nodes, and we increased the number of recipient nodes receiving a set number of migrants. We found that two metrics in particular, the average edge weight and the average inverse edge weight, varied linearly with simulated connectivity. Conversely, node degree was not a good measure of connectivity. We demonstrated the use of average inverse edge weight to describe the influence of at-site habitat characteristics on genetic connectivity of 653 American martens (Martes americana) in Ontario, Canada. We found that highly connected nodes had high habitat quality for marten (deep snow and high proportions of coniferous and mature forest) and were farther from the range edge. We recommend the use of node-based genetic connectivity metrics, in particular, average edge weight or average inverse edge weight, to model the influences of at-site habitat conditions on the immigration and settlement phases of dispersal. © 2015 John Wiley & Sons Ltd.

Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

PubMed Central

2012-01-01

Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors. PMID:22333210

Implementation of Recommendations from the One System Comparative Evaluation of the Hanford Tank Farms and Waste Treatment Plant Safety Bases

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

Garrett, Richard L.; Niemi, Belinda J.; Paik, Ingle K.

2013-11-07

A Comparative Evaluation was conducted for One System Integrated Project Team to compare the safety bases for the Hanford Waste Treatment and Immobilization Plant Project (WTP) and Tank Operations Contract (TOC) (i.e., Tank Farms) by an Expert Review Team. The evaluation had an overarching purpose to facilitate effective integration between WTP and TOC safety bases. It was to provide One System management with an objective evaluation of identified differences in safety basis process requirements, guidance, direction, procedures, and products (including safety controls, key safety basis inputs and assumptions, and consequence calculation methodologies) between WTP and TOC. The evaluation identified 25more » recommendations (Opportunities for Integration). The resolution of these recommendations resulted in 16 implementation plans. The completion of these implementation plans will help ensure consistent safety bases for WTP and TOC along with consistent safety basis processes. procedures, and analyses. and should increase the likelihood of a successful startup of the WTP. This early integration will result in long-term cost savings and significant operational improvements. In addition, the implementation plans lead to the development of eight new safety analysis methodologies that can be used at other U.S. Department of Energy (US DOE) complex sites where URS Corporation is involved.« less

Creating the first MedlinePlus "Go Local" service: lessons and recommendations from the evaluation of NC Health Info.

PubMed

Silbajoris, Christie; McDuffee, Diana; Olney, Cynthia

2007-01-01

NC Health Info is an online collection of North Carolina based health services Web sites that seamlessly links local health resources to topical health information on MedlinePlus, the National Library of Medicine's consumer health information Web site. NC Health Info was the first project to connect local resources with MedlinePlus in the "Go Local" initiative. As such, NC Health Info serves as a model for other states to follow in connecting their own local information with Medline- Plus. This paper describes the processes used and lessons learned during a year-long evaluation of NC Health Info. Evaluation results may be of interest and applicable to any existing or planned "Go Local" project.

Orbital transfer vehicle launch operations study. Volume 2: Detailed summary

NASA Technical Reports Server (NTRS)

1986-01-01

A series of Operational Design Drivers were identified. Several of these could have significant impact(s) on program costs. These recommendations, for example, include such items as: complete factory assembly and checkout prior to shipment to the ground launch site to make significant reductions in time required at the launch site as well as overall manpower required to do this work; minimize use of nonstandard equipment when orbiter provided equipment is available; and require commonality (or interchangeability) of subsystem equipment elements that are common to the space station, Orbit Maneuvering Vehicles, and/or Orbit Transfer Vehicles. Several additional items were identified that will require a significant amount of management attention (and direction) to resolve. Key elements of the space based processing plans are discussed.

Initial basalt target site selection evaluation for the Mars penetrator drop test

NASA Technical Reports Server (NTRS)

Bunch, T. E.; Quaide, W. L.; Polkowski, G.

1976-01-01

Potential basalt target sites for an air drop penetrator test were described and the criteria involved in site selection were discussed. A summary of the background field geology and recommendations for optimum sites are also presented.

Testing the ecological site group concept

USDA-ARS?s Scientific Manuscript database

The 2016 “Ecological Sites for Landscape Management” special issue of Rangelands recommended an update to our thinking of Ecological Sites, suggesting that in our desire to make Ecological Sites more quantitative, we abandoned consideration of Ecological Sites’ spatial context. In response, Ecologic...

Use of Social Networking Sites and Adherence to Physical Activity and Screen Time Recommendations in Adolescents.

PubMed

Sampasa-Kanyinga, Hugues; Chaput, Jean-Philippe

2016-05-01

Adolescents are recommended to achieve ≥ 60 min/day of moderate-to-vigorous physical activity (PA) and ≤2 h/day of screen time (ST). This study examined the relationships between the use of social networking sites (SNSs) and adherence to PA and ST recommendations in a large sample of Canadian adolescents. This cross-sectional school-based survey included a representative sample of 9388 students in grades 7 to 12 across Ontario, Canada. After adjustment for several confounding variables, results showed that male adolescents who use SNSs for fewer hours (≤ 1 h/day) had greater odds of adherence to PA and to both PA and ST recommendations concurrently, while those who use it for more hours (≥ 3 h/day) had lower odds of adherence to the ST recommendation. Female adolescents who use SNSs for more hours had lower odds of adherence to the ST recommendation (use of SNSs ≥ 2 h/day) and to both PA and ST recommendations concurrently (use of SNSs ≥ 5 h/day). Heavy use of SNSs has a negative influence on the adherence to the ST recommendation in both males and females; however, infrequent use of SNSs was related to the adherence to the PA recommendation and concurrent adherence to both recommendations in males only.

10 CFR 960.3-1-1 - Diversity of geohydrologic settings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-1 Diversity of geohydrologic... development of repositories may be located. To the extent practicable, sites recommended as candidate sites...

Examining the front lines of local environmental public health practice: a Maryland case study.

PubMed

Resnick, Beth; Zablotsky, Joanna; Nachman, Keeve; Burke, Thomas

2008-01-01

Local environmental public health (EPH) is the foundation of a nation's environmental protection infrastructure. With increasing pressure to demonstrate the ability of EPH activities to effectively protect health, the Johns Hopkins Center for Excellence in EPH Practice, as part of the Centers for Disease Control and Prevention's (CDC's) EPH capacity-building effort, developed the Profile of Maryland Environmental Public Health Practice. This profile offers an examination of front-line local EPH strengths, needs, challenges, and provides recommendations to strengthen the EPH infrastructure. A multistep process was conducted, including site visits to all of Maryland's 24 local EPH agencies and a questionnaire addressing administrative structure, communication, funding, workforce, crisis management, technology, and legal authority, completed by local EPH directors. The Maryland Profile revealed a dedicated and responsive workforce limited by a neglected, fragmented, and underfunded EPH infrastructure. Recommendations regarding leadership, workforce, training, technology, communication, and legal authority are offered. This research has implications for the national EPH infrastructure. Recommendations offered are consistent with the CDC's findings in A National Strategy to Revitalize Environmental Public Health Services. These findings and recommendations offer opportunities to facilitate the advancement of an EPH system to better protect the nation's health.

WOCN Society Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy-An Executive Summary.

PubMed

This article provides an executive summary of the recommendations from the Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy, published by the Wound, Ostomy and Continence Nurses Society (WOCN Society). It presents an overview of the process used to update and develop the guideline and lists specific recommendations from the guideline. We provide recommendations that include the following topics: stoma construction, preoperative education, stoma site marking, selection of an ostomy pouching system, postoperative education, postoperative management issues, follow-up care after discharge from the acute care setting, health-related quality of life, and stomal and peristomal complications. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patient outcomes. The full text of the published guideline, which includes available evidence supporting the recommendations and a complete reference list, is available in print and as a mobile application from the WOCN Society's online bookstore (http://www.wocn.org). Refer to Supplemental Digital Content 1 (available at: http://links.lww.com/JWOCN/A40) associated with this article for a complete reference list for the guideline.

Solar energy in California industry - Applications, characteristics and potential

NASA Technical Reports Server (NTRS)

Barbieri, R. H.; Pivirotto, D. S.

1978-01-01

Results of a survey to determine the potential applicability of solar thermal energy to industrial processes in California are presented. It is found that if the heat for all industrial processes at temperatures below 212 F were supplied by solar energy, total state energy consumption could be reduced by 100 trillion Btus (2%), while the use of solar energy in processes between 212 and 350 F could displace 500 trillion Btus. The issues and problems with which solar energy must contend are illustrated by a description of fluid milk processing operations. Solar energy application is found to be technically feasible for processes with thermal energy requirements below 212 F, with design, and degree of technical, economic and management feasibility being site specific. It is recommended that the state provide support for federal and industrial research, development and demonstration programs in order to stimulate acceptance of solar process heat application by industry.

77 FR 59598 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-28

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

75 FR 9404 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

75 FR 61711 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

75 FR 56526 - Environmental Management Site-Specific Advisory Board, Portsmouth

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Portsmouth AGENCY... Initiative Workshop of the Environmental Management Site-Specific Advisory Board (EM SSAB), Portsmouth. The... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

75 FR 66074 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

75 FR 54600 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

76 FR 5147 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

75 FR 24686 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management and...

From Observation to Information: Data-Driven Understanding of on Farm Yield Variation

PubMed Central

Jiménez, Daniel; Dorado, Hugo; Cock, James; Prager, Steven D.; Delerce, Sylvain; Grillon, Alexandre; Andrade Bejarano, Mercedes; Benavides, Hector; Jarvis, Andy

2016-01-01

Agriculture research uses “recommendation domains” to develop and transfer crop management practices adapted to specific contexts. The scale of recommendation domains is large when compared to individual production sites and often encompasses less environmental variation than farmers manage. Farmers constantly observe crop response to management practices at a field scale. These observations are of little use for other farms if the site and the weather are not described. The value of information obtained from farmers’ experiences and controlled experiments is enhanced when the circumstances under which it was generated are characterized within the conceptual framework of a recommendation domain, this latter defined by Non-Controllable Factors (NCFs). Controllable Factors (CFs) refer to those which farmers manage. Using a combination of expert guidance and a multi-stage analytic process, we evaluated the interplay of CFs and NCFs on plantain productivity in farmers’ fields. Data were obtained from multiple sources, including farmers. Experts identified candidate variables likely to influence yields. The influence of the candidate variables on yields was tested through conditional forests analysis. Factor analysis then clustered harvests produced under similar NCFs, into Homologous Events (HEs). The relationship between NCFs, CFs and productivity in intercropped plantain were analyzed with mixed models. Inclusion of HEs increased the explanatory power of models. Low median yields in monocropping coupled with the occasional high yields within most HEs indicated that most of these farmers were not using practices that exploited the yield potential of those HEs. Varieties grown by farmers were associated with particular HEs. This indicates that farmers do adapt their management to the particular conditions of their HEs. Our observations confirm that the definition of HEs as recommendation domains at a small-scale is valid, and that the effectiveness of distinct management practices for specific micro-recommendation domains can be identified with the methodologies developed. PMID:26930552

Assessing and Managing Multiple Risks in a Changing World ...

EPA Pesticide Factsheets

Roskilde University hosted a November 2015 workshop on “Environmental Risk – Assessing and Managing Multiple Risks in a Changing World”. Thirty attendees from 9 countries developed consensus recommendations regarding: implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process involving both universal and site-, region-, or problem-specific protection goals; addressing societal issues; risk management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. We encourage both cross- and inter-disciplinary approaches to address 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and non-chemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk assessment process; 4) fully integrate risk assessors and communities of interest into the risk management process; 5) consider socio-economics and increase transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference con

The EM SSAB Annual Work Plan Process: Focusing Board Efforts and Resources - 13667

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

Young, Ralph

One of the most daunting tasks for any new member of a local board of the Environmental Management Site Specific Advisory Board (EM SSAB) is to try to understand the scope of the clean-up activities going on at the site. In most cases, there are at least two or three major cleanup activities in progress as well as monitoring of past projects. When planning for future projects is added to the mix, the list of projects can be long. With the clean-up activities involving all major environmental media - air, water, soils, and groundwater, new EM SSAB members can findmore » themselves totally overwhelmed and ineffective. Helping new members get over this initial hurdle is a major objective of EM and all local boards of the EM SSAB. Even as members start to understand the size and scope of the projects at a site, they can still be frustrated at the length of time it takes to see results and get projects completed. Many project and clean-up timelines for most of the sites go beyond 10 years, so it's not unusual for an EM SSAB member to see the completion of only 1 or 2 projects over the course of their 6-year term on the board. This paper explores the annual work planning process of the EM SSAB local boards, one tool that can be used to educate EM SSAB members into seeing the broader picture for the site. EM SSAB local work plans divide the site into projects focused on a specific environmental issue or media such as groundwater and/or waste disposal options. Projects are further broken down into smaller segments by highlighting major milestones. Using these metrics, local boards of the EM SSAB can start to quantify the effectiveness of the project in achieving the ultimate goal of site clean-up. These metrics can also trigger board advice and recommendations for EM. At the beginning of each fiscal year, the EM SSAB work plan provides a road map with quantifiable checkpoints for activities throughout the year. When the work plans are integrated with site-specific, enforceable regulatory milestones, they can provide a comprehensive work plan for not only the board, but also regulators, site contractors, and DOE. Because the work plans are reviewed and approved by DOE, they carry some weight in holding local boards of the EM SSAB accountable. This structure provides the basis for local boards to achieve their primary function, to provide DOE with information, advice, and recommendations concerning issues affecting the EM program at the site. (authors)« less

Breckinridge Project, initial effort. Report VII, Volume III. Cultural resource assessment socioeconomic background data

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

Macfarlane, Heather; Janzen, Donald E.

1980-11-26

This report has been prepared in conjunction with an environmental baseline study for a commercial coal conversion facility being conducted by Ashland Synthetic Fuels, Inc. (ASFI) and Airco Energy Company (AECO). This report represents a cultural resource assessment for the proposed plant site and two potential solid waste disposal areas. This assessment presents data collected by Dames and Moore during a recent archaeological reconnaissance of the unsurveyed southeastern portion of the proposed plant site and two potential solid waste disposal areas. Also, results of two previous surveys on the northern and southwestern portion of the plant site for American Smeltingmore » and Refining Company (ASARCO) and Kentucky Utilities are included. The Dames and Moore survey of the southeastern portion of the plant site identified one archaeological site, three standing structures and one historic cemetery. In addition 47 archaeological sites and six standing structures are known from two previous surveys of the remainder of the plant site (Cowan 1975 and Turnbow et al 1980). Eleven of the previously recorded archaeological sites were recommended for further assessment to evaluate their potential for inclusion within the Holt Bottoms Archaeological District currently listed on the National Register of Historic Places. None of the archaeological sites or standing structures located within the plant site during the Dames and Moore survey were recommended for further assessment. A total of eight archaeological sites were located during the Dames and Moore survey of the two potential solid waste disposal areas. Of this total only two sites were recommended for further assessment. Also, one previously unknown historic cemetry was located in the southernmost potential waste disposal area.« less

Consolidated Storage Facilities: Camel's Nose or Shared Burden? - 13112

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

Williams, James M.

2013-07-01

The Blue Ribbon Commission (BRC) made a strong argument why the reformulated nuclear waste program should make prompt efforts to develop one or more consolidated storage facilities (CSFs), and recommended the amendment of NWPA Section 145(b) 2 (linking 'monitored retrievable storage' to repository development) as an essential means to that end. However, other than recommending that the siting of CSFs should be 'consent-based' and that spent nuclear fuel (SNF) at stranded sites should be first-in-line for removal, the Commission made few recommendations regarding how CSF development should proceed. Working with three other key Senators, Jeff Bingaman attempted in the 112.more » Congress to craft legislation (S. 3469) to put the BRC recommendations into legislative language. The key reason why the Nuclear Waste Administration Act of 2012 did not proceed was the inability of the four senators to agree on whether and how to amend NWPA Section 145(b). A brief review of efforts to site consolidated storage since the Nuclear Waste Policy Amendments Act of 1987 suggests a strong and consistent motivation to shift the burden to someone (anyone) else. This paper argues that modification of NWPA Section 145(b) should be accompanied by guidelines for regional development and operation of CSFs. After review of the BRC recommendations regarding CSFs, and the 'camel's nose' prospects if implementation is not accompanied by further guidelines, the paper outlines a proposal for implementation of CSFs on a regional basis, including priorities for removal from reactor sites and subsequently from CSFs to repositories. Rather than allowing repository siting to be prejudiced by the location of a single remote CSF, the regional approach limits transport for off-site acceptance and storage, increases the efficiency of removal operations, provides a useful basis for compensation to states and communities that accept CSFs, and gives states with shared circumstances a shared stake in storage and disposal in an integrated national program. (authors)« less

Brazilian Consensus Recommendation on the Use of Polymethylmethacrylate Filler in Facial and Corporal Aesthetics.

PubMed

Blanco Souza, Túlio Armanini; Colomé, Letícia Marques; Bender, Eduardo André; Lemperle, Gottfriede

2018-06-05

Considering that aesthetic benefits can be obtained with the use of permanent filling materials, this work focuses on the development of a consensus regarding the facial and corporal use of polymethylmethacrylate (PMMA) filler in Brazil. A questionnaire regarding PMMA treatment, which included items on the main indication, application site, volume of product applied, criteria for selection of the material, complications, contraindications, and individual professional experience, was distributed to the Expert Group members. In addition, the responses were summarized, constituting the starting point for the debate regarding the use of PMMA-based fillers on The First Brazilian PMMA Symposium to create a guideline to be followed in PMMA facial and corporal treatments. This survey involved 87,371 cases. PMMA treatment is recommended for restorative and aesthetic purposes in facial and corporal cases, particularly for facial balance. PMMA 30% filler is recommended in specific facial sites (nose, mentum, mandible angle, zygomatic arc, and malar). PMMA filler is contraindicated in other sites (lips) regardless of concentration. With regard to facial treatment, the juxtaperiostal is the application plane most recommended. For PMMA corporal application, intramuscular is the application plane most indicated, while intradermal and justadermal planes are contraindicated. The submuscular plane application is relative to PMMA filler concentration. The experts also inquired regarding the amount of PMMA recommended in each corporal site (50 mL in the calf, 100-150 mL in the gluteal region). These recommendations provide a guideline for physicians, supporting them to perform safe and efficacious treatment with PMMA fillers. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Designing HIV Testing Algorithms Based on 2015 WHO Guidelines Using Data from Six Sites in Sub-Saharan Africa

PubMed Central

Kosack, Cara S.; Shanks, Leslie; Beelaert, Greet; Benson, Tumwesigye; Savane, Aboubacar; Ng'ang'a, Anne; Bita, André; Zahinda, Jean-Paul B. N.; Fransen, Katrien

2017-01-01

ABSTRACT Our objective was to evaluate the performance of HIV testing algorithms based on WHO recommendations, using data from specimens collected at six HIV testing and counseling sites in sub-Saharan Africa (Conakry, Guinea; Kitgum and Arua, Uganda; Homa Bay, Kenya; Douala, Cameroon; Baraka, Democratic Republic of Congo). A total of 2,780 samples, including 1,306 HIV-positive samples, were included in the analysis. HIV testing algorithms were designed using Determine as a first test. Second and third rapid diagnostic tests (RDTs) were selected based on site-specific performance, adhering where possible to the WHO-recommended minimum requirements of ≥99% sensitivity and specificity. The threshold for specificity was reduced to 98% or 96% if necessary. We also simulated algorithms consisting of one RDT followed by a simple confirmatory assay. The positive predictive values (PPV) of the simulated algorithms ranged from 75.8% to 100% using strategies recommended for high-prevalence settings, 98.7% to 100% using strategies recommended for low-prevalence settings, and 98.1% to 100% using a rapid test followed by a simple confirmatory assay. Although we were able to design algorithms that met the recommended PPV of ≥99% in five of six sites using the applicable high-prevalence strategy, options were often very limited due to suboptimal performance of individual RDTs and to shared falsely reactive results. These results underscore the impact of the sequence of HIV tests and of shared false-reactivity data on algorithm performance. Where it is not possible to identify tests that meet WHO-recommended specifications, the low-prevalence strategy may be more suitable. PMID:28747371

40 CFR 246.200-6 - Recommended procedures: Storage.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommended procedures: Storage. 246....200-6 Recommended procedures: Storage. Among the alternatives for paper storage are on-site bailing, the use of stationary compactors, or storage in corrugated boxes or normal waste containers. Stored...

40 CFR 246.200-6 - Recommended procedures: Storage.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommended procedures: Storage. 246....200-6 Recommended procedures: Storage. Among the alternatives for paper storage are on-site bailing, the use of stationary compactors, or storage in corrugated boxes or normal waste containers. Stored...

40 CFR 246.200-6 - Recommended procedures: Storage.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Storage. 246....200-6 Recommended procedures: Storage. Among the alternatives for paper storage are on-site bailing, the use of stationary compactors, or storage in corrugated boxes or normal waste containers. Stored...

40 CFR 246.200-6 - Recommended procedures: Storage.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Storage. 246....200-6 Recommended procedures: Storage. Among the alternatives for paper storage are on-site bailing, the use of stationary compactors, or storage in corrugated boxes or normal waste containers. Stored...

40 CFR 246.200-6 - Recommended procedures: Storage.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Storage. 246....200-6 Recommended procedures: Storage. Among the alternatives for paper storage are on-site bailing, the use of stationary compactors, or storage in corrugated boxes or normal waste containers. Stored...

Installation restoration program. Site investigation report. Revision 4. Volume 2: Appendix B through Appendix E. 155th Air Refueling Group, Nebraska Air National Guard, Lincoln Municipal Airport, Lincoln, Nebraska. Final report

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

NONE

1995-04-01

This is Site investigation Report, Volume 2 Appendix B through E. A Site Investigation was performed at the 155th Air Refueling Group at Lincoln, NE to evaluate six areas of suspected contamination identified during a Preliminary Assessment. The sites that this investigation were conducted at are: Site 1 - Fuel Farm, POL Storage Area Site 2 - West End of Old Oak Creek, Site 3 - Former Tank Cleaning/Hazardous Waste Storage Area, Site 4 - Access Road, Dust Control Area, Site 5 - Army National Guard Oil Storage Area, and Site 6 - Hydraulic Pressure Check Unit Storage Area. Themore » report recommended no further action for Sites 3 through 6 due to low levels or no contamination being found. The report recommended that the portion of Site 2 that is located downstream of Site 1 should be included in Site 1. Appendix 2 consist of the following appendix: Well Data and Geologic Boring Logs (Appendix B), Survey Data (Appendix C), Quality Control (Appendix D), and Analytical Results (Appendix E).« less

[Useful web sites for information about the recommendations of good practices in laboratory medicine].

PubMed

Szymanowicz, A; Watine, J

2010-12-01

In this paper are presented some useful web sites to find updated reference tables concerning the recommendations of professional practices in laboratory medicine. The knowledge of these reference tables can allow the biologist to develop its role of advice to the clinicians. It can also help him to assure a relevant interpretation of the laboratory results and to value the interest for the patient.

Development of a Recommender System based on Personal History

NASA Astrophysics Data System (ADS)

Tanaka, Katsuaki; Hori, Koichi; Yamamoto, Masato

The flood of information on the Internet makes a person who surf it without some strong intention strayed into it. One of the ways to control the balance between a person and the flood is a recommender system by computer, and many web sites use it. These systems work on a web site for the same kind of items. However the field of personal activity is not limited to handle the same kind of thing and a web site, but also offline area in the real world. To handle personal offline activities, LifeLog is proposed as method to record it, but the main purpose of LifeLog is recording a personal history. How to use a history has still been studied stage. The authors have developed a recommender system that captures personal context from history of personal online and offline activities, treats information on web sites as a large set of context, and finds out and extends overlap of them, then recommends information located there. The aim of the system is that a person can enjoy waves of information again. The system worked as a part of My-life Assist Service. It was a service for mobile phones provided by NTT DoCoMo, Inc. as a field experiment from Dec. 2007 to Feb. 2008.

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

Strickland, Christopher E.; Johnson, Christian D.; Lee, Brady D.

Iodine-129 (129I) generated at the U.S. Department of Energy (DOE) Hanford Site during plutonium production was released to the subsurface, resulting in several large, though dilute, plumes in the groundwater, including the plume in the 200-UP-1 operable unit (OU). Because 129I is an uncommon contaminant, relevant remediation experience and scientific literature are limited, though work is under way to better understand the fate and transport of 129I in the environment and the effectiveness of potential remediation technologies. The recent UP-1 Evaluation Plan for Iodine and report on the Conceptual Model of Iodine Behavior in the Subsurface at the Hanford Sitemore » provide information on the history of contamination in the 200-UP-1 OU, relevant controlling processes (biological and geochemical), risk, the conceptual site model, and potential remedial options, which provided a foundation for this study. In this study, available information was compiled and used to categorize potential remediation technologies, culminating in a recommendation of promising technologies for further evaluation. Approaches to improve the technical information about promising technologies are also recommended in this study so that a subsequent evaluation of potential remediation alternatives can assess these technologies.« less

77 FR 4027 - Environmental Management Site-Specific Advisory Board, Nevada

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Nevada AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Nevada. The Federal Advisory Committee Act (Pub... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management, and...

76 FR 80354 - Environmental Management Site-Specific Advisory Board, Nevada

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Nevada AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Nevada. The Federal Advisory Committee Act (Pub... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management, and...

75 FR 82004 - Environmental Management Site-Specific Advisory Board, Nevada

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Nevada AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Nevada. The Federal Advisory Committee Act (Pub... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management, and...

78 FR 20311 - Environmental Management Site-Specific Advisory Board Chairs

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board Chairs AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB) Chairs. The Federal Advisory Committee Act (Pub... Board is to make recommendations to DOE-EM and site management in the areas of environmental restoration...

77 FR 12044 - Environmental Management Site-Specific Advisory Board, Nevada

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Environmental Management Site-Specific Advisory Board (EM SSAB), Nevada. The Federal Advisory Committee Act (Pub... Board is to make recommendations to DOE-EM and site management in the areas of environmental restoration... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Nevada AGENCY...

76 FR 39080 - Environmental Management Site-Specific Advisory Board, Idaho National Laboratory

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Idaho National... meeting of the Environmental Management Site-Specific Advisory Board (EM SSAB), Idaho National Laboratory... recommendations to DOE-EM and site management in the areas of environmental restoration, waste management, and...

Addendum to the Closure Report for Corrective Action Unit 427: Area 3 Septic Waste Systems 2, 6, Tonopah Test Range, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the April 1999, Closure Report for Corrective Action Unit 427: Area 3 Septic Waste Systems 2, 6, Tonopah Test Range, Nevada as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modificationmore » document, this addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 03-05-002-SW02, Septic Waste System • CAS 03-05-002-SW06, Septic Waste System These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Addendum to the Closure Report for Corrective Action Unit 423: Area 3 Building 03-60 Underground Discharge Point, Tonopah Test Range, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the July 1999, Closure Report for Corrective Action Unit 423: Area 3 Building 0360 Underground Discharge Point, Tonopah Test Range, Nevada as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modificationmore » document, this addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 03-02-002-0308, Underground Discharge Point. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Public-health assessment for Algoma Municipal Landfill, Algoma, Kewaunee County, Wisconsin, Region 5. CERCLIS No. WID980610380. Final report

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

Not Available

1992-07-22

The Algoma Landfill Superfund Site is a former municipal landfill which accepted hazardous industrial waste from several area companies. The contaminant of concern is benzene in on-site groundwater. Samples taken from off-site private water supplies in the vicinity of the landfill did not indicate the presence of contaminants. On-site soil and sediment samples revealed low levels of inorganic chemicals. Although soil samples were not analyzed for asbestos it remains a contaminant of concern since asbestos-containing debris was reportedly buried as the site. The Algoma Landfill Superfund Site is a indeterminate public health hazard. There is insufficient data to evaluate workermore » exposure to airborne asbestos in the past when Kalo dust was deposited at the site. The public health assessment recommends that access to the site be restricted to prevent trespassing and disturbance of the soil. Additional groundwater monitoring and characterization is recommended as well as sampling of surface soil for asbestos contamination.« less

Early Evaluation of the VIIRS Calibration, Cloud Mask and Surface Reflectance Earth Data Records

NASA Technical Reports Server (NTRS)

Vermote, Eric; Justice, Chris; Csiszar, Ivan

2014-01-01

Surface reflectance is one of the key products fromVIIRS and as withMODIS, is used in developing several higherorder land products. The VIIRS Surface Reflectance (SR) Intermediate Product (IP) is based on the heritageMODIS Collection 5 product (Vermote, El Saleous, & Justice, 2002). The quality and character of surface reflectance depend on the accuracy of the VIIRS Cloud Mask (VCM), the aerosol algorithms and the adequate calibration of the sensor. The focus of this paper is the early evaluation of the VIIRS SR product in the context of the maturity of the operational processing system, the Interface Data Processing System (IDPS). After a brief introduction, the paper presents the calibration performance and the role of the surface reflectance in calibration monitoring. The analysis of the performance of the cloud mask with a focus on vegetation monitoring (no snow conditions) shows typical problems over bright surfaces and high elevation sites. Also discussed is the performance of the aerosol input used in the atmospheric correction and in particular the artifacts generated by the use of the Navy Aerosol Analysis and Prediction System. Early quantitative results of the performance of the SR product over the AERONET sites showthatwith the fewadjustments recommended, the accuracy iswithin the threshold specifications. The analysis of the adequacy of the SR product (Land PEATE adjusted version) in applications of societal benefits is then presented. We conclude with a set of recommendations to ensure consistency and continuity of the JPSS mission with the MODIS Land Climate Data Record.

The JINR Tier1 Site Simulation for Research and Development Purposes

NASA Astrophysics Data System (ADS)

Korenkov, V.; Nechaevskiy, A.; Ososkov, G.; Pryahina, D.; Trofimov, V.; Uzhinskiy, A.; Voytishin, N.

2016-02-01

Distributed complex computing systems for data storage and processing are in common use in the majority of modern scientific centers. The design of such systems is usually based on recommendations obtained via a preliminary simulated model used and executed only once. However big experiments last for years and decades, and the development of their computing system is going on, not only quantitatively but also qualitatively. Even with the substantial efforts invested in the design phase to understand the systems configuration, it would be hard enough to develop a system without additional research of its future evolution. The developers and operators face the problem of the system behaviour predicting after the planned modifications. A system for grid and cloud services simulation is developed at LIT (JINR, Dubna). This simulation system is focused on improving the effciency of the grid/cloud structures development by using the work quality indicators of some real system. The development of such kind of software is very important for making a new grid/cloud infrastructure for such big scientific experiments like the JINR Tier1 site for WLCG. The simulation of some processes of the Tier1 site is considered as an example of our application approach.

United States Air Force 611th Air Support Group/Civil Engineering Squadron Elmendorf AFB, Alaska. Decision document for no further response action planned: Barter Island Radar Installation, Alaska. Final report, December 1995-May 1996

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

Karmi, S.; Madden, J.; Borsetti, R.

1996-05-03

This Decision Document discusses the selection of no further action as the recommended action for nine sites located at the Barter Island radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the 14 sites located at the Barter Island installation (U.S. Air Force 1996a,b). Based on the findings of these activities, nine sites are recommended for no further action.

Utility of the advanced chronic kidney disease patient management tools: case studies.

PubMed

Patwardhan, Meenal B; Matchar, David B; Samsa, Gregory P; Haley, William E

2008-01-01

Appropriate management of advanced chronic kidney disease (CKD) delays or limits its progression. The Advanced CKD Patient Management Toolkit was developed using a process-improvement technique to assist patient management and address CKD-specific management issues. We pilot tested the toolkit in 2 community nephrology practices, assessed the utility of individual tools, and evaluated the impact on conformance to an advanced CKD guideline through patient chart abstraction. Tool use was distinct in the 2 sites and depended on the site champion's involvement, the extent of process reconfiguration demanded by a tool, and its perceived value. Baseline conformance varied across guideline recommendations (averaged 54%). Posttrial conformance increased in all clinical areas (averaged 59%). Valuable features of the toolkit in real-world settings were its ability to: facilitate tool selection, direct implementation efforts in response to a baseline performance audit, and allow selection of tool versions and customizing them. Our results suggest that systematically created, multifaceted, and customizable tools can promote guideline conformance.

Introducing practice-based learning and improvement ACGME core competencies into a family medicine residency curriculum.

PubMed

Coleman, Mary Thoesen; Nasraty, Soraya; Ostapchuk, Michael; Wheeler, Stephen; Looney, Stephen; Rhodes, Sandra

2003-05-01

The Accreditation Council for Graduate Medical Education (ACGME) recommends integrating improvement activities into residency training. A curricular change was designed at the Department of Family and Community Medicine, University of Louisville, to address selected ACGME competencies by incorporating practice-based improvement activities into the routine clinical work of family medicine residents. Teams of residents, faculty, and office staff completed clinical improvement projects at three ambulatory care training sites. Residents were given academic credit for participation in team meetings. After 6 months, residents presented results to faculty, medical students, other residents, and staff from all three training sites. Residents, staff, and faculty were recognized for their participation. Resident teams demonstrated ACGME competencies in practice-based improvement: Chart audits indicated improvement in clinical projects; quality improvement tools demonstrated analysis of root causes and understanding of the process; plan-do-study-act cycle worksheets demonstrated the change process. Improvement activities that affect patient care and demonstrate selected ACGME competencies can be successfully incorporated into the daily work of family medicine residents.

Implementing AORN recommended practices for sterilization.

PubMed

Graybill-D'Ercole, Patricia

2013-05-01

Any hospital or facility in which surgery and other invasive procedures are performed should have accommodations for cleaning, decontaminating, disinfecting, and sterilizing instruments, equipment, and other essential supplies that are used for patient procedures. Sterilization is essential to reducing or preventing the risk of surgical site infections. This is a collaborative process and should include all health care providers who handle these instruments, including perioperative nurses. The revised AORN "Recommended practices for sterilization," which became effective June 15, 2012, includes updates on sterilizing single-use items, inspecting critical items before sterilization, using low-temperature hydrogen peroxide vapor sterilization methods, and immediate use steam sterilization. This RP document is the first AORN document to be evidence rated and accepted for inclusion in the Agency for Healthcare Research and Quality National Guideline Clearinghouse. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Report of the Peer Review Panel on the early site suitability evaluation of the Potential Repository Site at Yucca Mountain, Nevada; Yucca Mountain Site Characterization Project

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

NONE

1992-01-01

The US Department of Energy (DOE) Yucca mountain Site Characterization Project Office (YMPO) assigned Science Applications International Corporation (SAIC), the Technical and Management Support Services (T&MSS) contractor to the YmPo, the task of conducting an Early Site Suitability Evaluation (ESSE) of the Yucca mountain site as a potential site for a high-level radioactive waste repository. First, the assignment called for the development of a method to evaluate a single site against the DOE General Guidelines for Recommendation of Sites for Nuclear Waste Repositories, 10 CFR Part 960. Then, using this method, an evaluation team, the ESSE Core Team, of seniormore » YMP scientists, engineers, and technical experts, evaluated new information obtained about the site since publication of the final Environmental Assessment (DOE, 1986) to determine if new suitability/unsuitability findings could be recommended. Finally, the Core Team identified further information and analyses needed to make final determinations for each of the guidelines. As part of the task, an independent peer review of the ESSE report has been conducted. Expertise was solicited that covered the entire spectrum of siting guidelines in 10 CFR Part 960 in order to provide a complete, in-depth critical review of the data evaluated and cited in the ESSE report, the methods used to evaluate the data, and the conclusions and recommendations offered by the report. Fourteen nationally recognized technical experts (Table 2) served on the Peer Review Panel. The comments from the Panel and the responses prepared by the ESSE Core Team, documented on formal Comment Response Forms, constitute the body of this document.« less

76 FR 21878 - Environmental Management Site-Specific Advisory Board, Portsmouth

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Portsmouth AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Portsmouth. The Federal Advisory Committee Act... Board: The purpose of the Board is to make recommendations to DOE-EM and site management in the areas of...

75 FR 65615 - Environmental Management Site-Specific Advisory Board, Portsmouth

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Portsmouth AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Portsmouth. The Federal Advisory Committee Act... the Board: The purpose of the Board is to make recommendations to DOE-EM and site management in the...

75 FR 82003 - Environmental Management Site-Specific Advisory Board, Portsmouth

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Portsmouth AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Portsmouth. The Federal Advisory Committee Act... the Board: The purpose of the Board is to make recommendations to DOE-EM and site management in the...

77 FR 75626 - Environmental Management Site-Specific Advisory Board, Portsmouth

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-21

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Portsmouth AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Portsmouth. The Federal Advisory Committee Act...: Purpose of the Board: The purpose of the Board is to make recommendations to DOE-EM and site management in...

77 FR 37390 - Environmental Management Site-Specific Advisory Board, Portsmouth

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-21

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Portsmouth AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Portsmouth. The Federal Advisory Committee Act... Board: The purpose of the Board is to make recommendations to DOE-EM and site management in the areas of...

77 FR 2283 - Environmental Management Site-Specific Advisory Board, Portsmouth

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Portsmouth AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Portsmouth. The Federal Advisory Committee Act... Board: The purpose of the Board is to make recommendations to DOE-EM and site management in the areas of...

Final Report: Technical Assistance for the Kearsarge Metallurgical Corporation Superfund Site, Conway, New Hampshire, EPA Region 1

EPA Pesticide Factsheets

This report reviews and provides recommendations for a long-term groundwater monitoring network for the Kearsarge Metallurgical Corporation Superfund site (KMC site). The KMC site is a former foundry and metal fabrication facility in Conway, New Hampshire.

Addendum to the Closure Report for Corrective Action Unit 326: Areas 6 and 27 Release Sites, Nevada Test Site, Nevada, Revision 1

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

Grant Evenson

This document constitutes an addendum to the Closure Report for Corrective Action Unit 326: Areas 6 and 27 Release Sites, Nevada Test Site, Nevada (Revision 1), December 2002 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • Themore » cover, title, and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 06-25-01, CP-1 Heating Oil Release. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Phytoremediation and bioremediation of polychlorinated biphenyls (PCBs): state of knowledge and research perspectives.

PubMed

Passatore, Laura; Rossetti, Simona; Juwarkar, Asha A; Massacci, Angelo

2014-08-15

This review summarizes the bioremediation and phytoremediation technologies proposed so far to detoxify PCB-contaminated sites. A critical analysis about the potential and limits of the PCB pollution treatment strategies by means of plants, fungi and bacteria are elucidated, including the new insights emerged from recent studies on the rhizosphere potential and on the implementation of simultaneous aerobic and anaerobic biodegradation processes. The review describes the biodegradation and phytoremediation processes and elaborates on the environmental variables affecting contaminant degradation rates, summarizing the amendments recommended to enhance PCB degradation. Additionally, issues connected with PCB toxicology, actual field remediation strategies and economical evaluation are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

Assessing the quality of infertility resources on the World Wide Web: tools to guide clients through the maze of fact and fiction.

PubMed

Okamura, Kyoko; Bernstein, Judith; Fidler, Anne T

2002-01-01

The Internet has become a major source of health information for women, but information placed on the World Wide Web does not routinely undergo a peer review process before dissemination. In this study, we present an analysis of 197 infertility-related Web sites for quality and accountability, using JAMA's minimal core standards for responsible print. Only 2% of the web sites analyzed met all four recommended standards, and 50.8% failed to report any of the four. Commercial web sites were more likely to fail to meet minimum standards (71.2%) than those with educational (46.8%) or supportive (29.8%) elements. Web sites with educational and informational components were most common (70.6%), followed by commercial sites (52.8%) and sites that offered a forum for infertility support and activism (28.9%). Internet resources available to infertile patients are at best variable. The current state of infertility-related materials on the World Wide Web offers unprecedented opportunities to improve services to a growing number of e-health users. Because of variations in quality of site content, women's health clinicians must assume responsibility for a new role as information monitor. This study provides assessment tools clinicians can apply and share with clients.

Evaluation of site plan review procedures.

DOT National Transportation Integrated Search

1988-01-01

The site plan review procedures of the Virginia Department of Transportation (VDOT) were evaluated. The objectives of the evaluation were to recommend (1) a set of site plan review procedures including a checklist, (2) definitions of the roles and re...

Prophylactic antibiotics in dermatological surgery.

PubMed

Lee, Michael R; Paver, Robert

2016-05-01

This is a review of the common pathogens of surgical site infections, antibiotic coverage for particular anatomical sites, mechanisms by which surgical site infections occur and the latest data and recommendations for prophylactic antibiotics in the prevention of surgical site infections, infective endocarditis and haematogenous joint infections. Recent evidence-based guidelines on surgical prophylaxis is for restricted indications and a shorter duration of antibiotic prophylaxis in situations where no clinical benefit of prolonged therapy has been proven, in order to minimise the potential adverse ecological and clinical effects associated with antibiotic therapy. This review recommends the cautious use of prophylactic antibiotics in dermatological surgery to help prevent the growing problem of bacterial resistance as well as other morbidity and health-care costs. © 2015 The Australasian College of Dermatologists.

10 CFR 960.3-1 - Siting provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REPOSITORY Implementation Guidelines § 960.3-1 Siting provisions. The siting provisions establish the... repositories. As required by the Act, § 960.3-1-3 specifies consideration of a regional distribution of repositories after recommendation of a site for development of the first repository. Section 960.3-1-4...

The MedlinePlus public user interface: studies of design challenges and opportunities.

PubMed

Marill, Jennifer L; Miller, Naomi; Kitendaugh, Paula

2006-01-01

What are the challenges involved in designing, modifying, and improving a major health information portal that serves over sixty million page views a month? MedlinePlus, the National Library of Medicine's (NLM's) consumer health Website, is examined. Challenges are presented as six "studies," which describe selected design issues and how NLM staff resolved them. Improving MedlinePlus is an iterative process. Changes in the public user interface are ongoing, reflecting Web design trends, usability testing recommendations, user survey results, new technical requirements, and the need to grow the site in an orderly way. Testing and analysis should accompany Website design modifications. New technologies may enhance a site but also introduce problems. Further modifications to MedlinePlus will be informed by the experiences described here.

Possible Impacts of Nanoparticles on Children of Thai Construction Industry

NASA Astrophysics Data System (ADS)

Musikaphan, W.; Kitisriworaphan, T.

A possible impact of nanoparticles on human health becomes a concerned issue especially among children who probably lack of self protection. For Thai construction workers, their pre-school children are more likely to expose such the fine particles due to they have to spend their lives in construction site. This study points out the health problems related to nanoparticles exposition among pre-school children of Thai construction workers. The finding indicated that children who reside and play in construction site are more likely to expose to chemical particles and left behind toxic materials during pre and post construction process than others. Thus, urgent policy is strongly recommended for this vulnerable group since all children are very important as the main source of the national productivity in the future, especially in the aging society.

American Academy of Sleep Medicine (AASM) Position Paper for the Use of Telemedicine for the Diagnosis and Treatment of Sleep Disorders

PubMed Central

Singh, Jaspal; Badr, M. Safwan; Diebert, Wendy; Epstein, Lawrence; Hwang, Dennis; Karres, Valerie; Khosla, Seema; Mims, K. Nicole; Shamim-Uzzaman, Afifa; Kirsch, Douglas; Heald, Jonathan L.; McCann, Kathleen

2015-01-01

The American Academy of Sleep Medicine's (AASM) Taskforce on Sleep Telemedicine supports telemedicine as a means of advancing patient health by improving access to the expertise of Board-Certified Sleep Medicine Specialists. However, such access improvement needs to be anchored in attention to quality and value in diagnosing and treating sleep disorders. Telemedicine is also useful to promote professionalism through patient care coordination and communication between other specialties and sleep medicine. Many of the principles and key concepts adopted here are based on U.S. industry standards, with special consideration given to the body of work by the American Telemedicine Association (http://www.americantelemed.org/), and abide by standards endorsed by the American Medical Association (http://www.ama-assn.org/). Practitioners who wish to integrate sleep telemedicine into their practice should have a clear understanding of the salient issues, key terminology, and the following recommendations from the AASM. The Taskforce recommends the following: Clinical care standards for telemedicine services should mirror those of live office visits, including all aspects of diagnosis and treatment decisions as would be reasonably expected in traditional office-based encounters.Clinical judgment should be exercised when determining the scope and extent of telemedicine applications in the diagnosis and treatment of specific patients and sleep disorders.Live Interactive Telemedicine for sleep disorders, if utilized in a manner consistent with the principles outlined in this document, should be recognized and reimbursed in a manner competitive or comparable with traditional in-person visits.Roles, expectations, and responsibilities of providers involved in the delivery of sleep telemedicine should be defined, including those at originating sites and distant sites.The practice of telemedicine should aim to promote a care model in which sleep specialists, patients, primary care providers, and other members of the healthcare team aim to improve the value of healthcare delivery in a coordinated fashion.Appropriate technical standards should be upheld throughout the telemedicine care delivery process, at both the originating and distant sites, and specifically meet the standards set forth by the Health Insurance Portability and Accountability Act (HIPAA).Methods that aim to improve the utility of telemedicine exist and should be explored, including the utilization of patient presenters, local resources and providers, adjunct testing, and add-on technologies.Quality Assurance processes should be in place for telemedicine care delivery models that aim to capture process measures, patient outcomes, and patient/provider experiences with the model(s) employed.Time for data management, quality processes, and other aspects of care delivery related to telemedicine encounters should be recognized in value-based care delivery models.The use of telemedicine services and its equipment should adhere to strict professional and ethical standards so as not to violate the intent of the telemedicine interaction while aiming to improve overall patient access, quality, and/or value of care.When billing for telemedicine services, it is recommended that patients, providers, and others rendering services understand payor reimbursements, and that there be financial transparency throughout the process.Telemedicine utilization for sleep medicine is likely to rapidly expand, as are broader telehealth applications in general; further research into the impact and outcomes of these are needed. This document serves as a resource by defining issues and terminology and explaining recommendations. However, it is not intended to supersede regulatory or credentialing recommendations and guidelines. It is intended to support and be consistent with professional and ethical standards of the profession. Citation: Singh J, Badr MS, Diebert W, Epstein L, Hwang D, Karres V, Khosla S, Mims KN, Shamim-Uzzaman A, Kirsch D, Heald JL, McCann K. American Academy of Sleep Medicine (AASM) position paper for the use of telemedicine for the diagnosis and treatment of sleep disorders. J Clin Sleep Med 2015;11(10):1187–1198. PMID:26414983

American Academy of Sleep Medicine (AASM) Position Paper for the Use of Telemedicine for the Diagnosis and Treatment of Sleep Disorders.

PubMed

Singh, Jaspal; Badr, M Safwan; Diebert, Wendy; Epstein, Lawrence; Hwang, Dennis; Karres, Valerie; Khosla, Seema; Mims, K Nicole; Shamim-Uzzaman, Affifa; Kirsch, Douglas; Heald, Jonathan L; McCann, Kathleen

2015-10-15

The American Academy of Sleep Medicine's (AASM) Taskforce on Sleep Telemedicine supports telemedicine as a means of advancing patient health by improving access to the expertise of Board-Certified Sleep Medicine Specialists. However, such access improvement needs to be anchored in attention to quality and value in diagnosing and treating sleep disorders. Telemedicine is also useful to promote professionalism through patient care coordination and communication between other specialties and sleep medicine. Many of the principles and key concepts adopted here are based on U.S. industry standards, with special consideration given to the body of work by the American Telemedicine Association (http://www.americantelemed.org/), and abide by standards endorsed by the American Medical Association (http://www.ama-assn.org/). Practitioners who wish to integrate sleep telemedicine into their practice should have a clear understanding of the salient issues, key terminology, and the following recommendations from the AASM. The Taskforce recommends the following: • Clinical care standards for telemedicine services should mirror those of live office visits, including all aspects of diagnosis and treatment decisions as would be reasonably expected in traditional office-based encounters. • Clinical judgment should be exercised when determining the scope and extent of telemedicine applications in the diagnosis and treatment of specific patients and sleep disorders. • Live Interactive Telemedicine for sleep disorders, if utilized in a manner consistent with the principles outlined in this document, should be recognized and reimbursed in a manner competitive or comparable with traditional in-person visits. • Roles, expectations, and responsibilities of providers involved in the delivery of sleep telemedicine should be defined, including those at originating sites and distant sites. • The practice of telemedicine should aim to promote a care model in which sleep specialists, patients, primary care providers, and other members of the healthcare team aim to improve the value of healthcare delivery in a coordinated fashion. • Appropriate technical standards should be upheld throughout the telemedicine care delivery process, at both the originating and distant sites, and specifically meet the standards set forth by the Health Insurance Portability and Accountability Act (HIPAA). • Methods that aim to improve the utility of telemedicine exist and should be explored, including the utilization of patient presenters, local resources and providers, adjunct testing, and add-on technologies. • Quality Assurance processes should be in place for telemedicine care delivery models that aim to capture process measures, patient outcomes, and patient/provider experiences with the model(s) employed. • Time for data management, quality processes, and other aspects of care delivery related to telemedicine encounters should be recognized in value-based care delivery models. • The use of telemedicine services and its equipment should adhere to strict professional and ethical standards so as not to violate the intent of the telemedicine interaction while aiming to improve overall patient access, quality, and/or value of care. • When billing for telemedicine services, it is recommended that patients, providers, and others rendering services understand payor reimbursements, and that there be financial transparency throughout the process. • Telemedicine utilization for sleep medicine is likely to rapidly expand, as are broader telehealth applications in general; further research into the impact and outcomes of these are needed. This document serves as a resource by defining issues and terminology and explaining recommendations. However, it is not intended to supersede regulatory or credentialing recommendations and guidelines. It is intended to support and be consistent with professional and ethical standards of the profession. © 2015 American Academy of Sleep Medicine.

The impact of fear appeals on processing and acceptance of action recommendations.

PubMed

de Hoog, Natascha; Stroebe, Wolfgang; de Wit, John B F

2005-01-01

A stage model of processing of fear-arousing communications was tested in an experiment that examined the impact of vulnerability to a severe health risk, the quality of the arguments supporting a protective action recommendation, and the source to which the recommendation was attributed, on processing and acceptance of the recommendation. Argument quality influenced attitudes toward the recommendation (but not intention to act), and this effect was mediated by negative thoughts about the recommendation. Vulnerability influenced intention to act (but not attitudes), and this effect was mediated by perceived threat and positive thoughts about the recommendation. The pattern of findings suggests that although vulnerability to a severe health risk induces biased processing of the recommendation, biased processing is restricted to intentions and does not compromise the evaluation of the recommendation. The theoretical and practical implications of these findings are discussed.

Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008.

PubMed

Wright, Tina I; Baddour, Larry M; Berbari, Elie F; Roenigk, Randall K; Phillips, P Kim; Jacobs, M Amanda; Otley, Clark C

2008-09-01

Antibiotic prophylaxis is an important component of dermatologic surgery, and recommendations in this area should reflect the updated 2007 guidelines of the American Heart Association, the American Dental Association with the American Academy of Orthopaedic Surgeons guidelines, and recent prospective studies on surgical site infection. To provide an update on the indications for antibiotic prophylaxis in dermatologic surgery for the prevention of infective endocarditis, hematogenous total joint infection, and surgical site infection. A literature review was performed, expert consensus was obtained, and updated recommendations were created, consistent with the most current authoritative guidelines from the American Heart Association and the American Dental Association with the American Academy of Orthopaedic Surgeons. For patients with high-risk cardiac conditions, and a defined group of patients with prosthetic joints at high risk for hematogenous total joint infection, prophylactic antibiotics are recommended when the surgical site is infected or when the procedure involves breach of the oral mucosa. For the prevention of surgical site infections, antibiotics may be indicated for procedures on the lower extremities or groin, for wedge excisions of the lip and ear, skin flaps on the nose, skin grafts, and for patients with extensive inflammatory skin disease. These recommendations are not based on multiple, large-scale, prospective trials. There is a strong shift away from administration of prophylactic antibiotics in many dermatologic surgery settings, based on updated authoritative guidelines. These recommendations provide guidance to comply with the most current guidelines, modified to address dermatology-specific considerations. Managing physicians may utilize these guidelines while individualizing their approach based on all clinical considerations.

Recommendations for the return of research results to study participants and guardians: a report from the Children's Oncology Group.

PubMed

Fernandez, Conrad V; Ruccione, Kathleen; Wells, Robert J; Long, Jay B; Pelletier, Wendy; Hooke, Mary C; Pentz, Rebecca D; Noll, Robert B; Baker, Justin N; O'Leary, Maura; Reaman, Gregory; Adamson, Peter C; Joffe, Steven

2012-12-20

The Children's Oncology Group (COG) strongly supports the widely recognized principle that research participants should be offered a summary of study results. The mechanism by which to do so in a cooperative research group setting has not been previously described. On the basis of a review of the available empirical and theoretic literature and on iterative, multidisciplinary discussion, a COG Return of Results Task Force (RRTF) offered detailed recommendations for the return of results to research study participants. The RRTF established guidelines for the notification of research participants and/or their parents/guardians about the availability of research results, a mechanism for and timing of sharing results via registration on the COG public Web site, the scope of the research to be shared, the target audience, and a process for creating and vetting lay summaries of study results. The RRTF recognized the challenges in adequately conveying complex scientific results to audiences with varying levels of health literacy and recommended that particularly sensitive or complex results be returned using direct personal contact. The RRTF also recommended evaluation of the cost, effectiveness, and impact of sharing results. These recommendations provide a framework for the offering and returning of results to participants. They can be used by individual investigators, multi-investigator research collaboratives, and large cooperative groups.

Recommendations for the Return of Research Results to Study Participants and Guardians: A Report From the Children's Oncology Group

PubMed Central

Fernandez, Conrad V.; Ruccione, Kathleen; Wells, Robert J.; Long, Jay B.; Pelletier, Wendy; Hooke, Mary C.; Pentz, Rebecca D.; Noll, Robert B.; Baker, Justin N.; O'Leary, Maura; Reaman, Gregory; Adamson, Peter C.; Joffe, Steven

2012-01-01

Purpose The Children's Oncology Group (COG) strongly supports the widely recognized principle that research participants should be offered a summary of study results. The mechanism by which to do so in a cooperative research group setting has not been previously described. Methods On the basis of a review of the available empirical and theoretic literature and on iterative, multidisciplinary discussion, a COG Return of Results Task Force (RRTF) offered detailed recommendations for the return of results to research study participants. Results The RRTF established guidelines for the notification of research participants and/or their parents/guardians about the availability of research results, a mechanism for and timing of sharing results via registration on the COG public Web site, the scope of the research to be shared, the target audience, and a process for creating and vetting lay summaries of study results. The RRTF recognized the challenges in adequately conveying complex scientific results to audiences with varying levels of health literacy and recommended that particularly sensitive or complex results be returned using direct personal contact. The RRTF also recommended evaluation of the cost, effectiveness, and impact of sharing results. Conclusion These recommendations provide a framework for the offering and returning of results to participants. They can be used by individual investigators, multi-investigator research collaboratives, and large cooperative groups. PMID:23109703

First ARM Aerosol Chemical Speciation Monitor Users’ Meeting Report

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

Watson, Thomas; Aiken, Allison; Zhang, Qi

The first U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) user facility aerosol chemical speciation monitor (ACSM) users’ meeting was held on April 11-13, 2017, at Aerodyne Research, Inc. in Billerica, Massachusetts, to discuss the Southern Great Plains (SGP) atmospheric observatory ACSM data quality and establish best practices for data collection and processing. The participants examined six years of calibration and processed data. Specific issues raised by data users were addressed and case studies from two field experiments were examined. The most recent data from the ACSM installed in the newly commissioned SGP ARM Mobile Facility 7 (AMF7) weremore » also evaluated. The participants recommended that the SGP ACSM data be reprocessed using calibration values averaged over the history of SGP ACSM calibrations. They also recommended that the data quality be evaluated by comparing (1) observed versus predicted particulate ammonium (NH4+) mass loadings, and (2) ACSM mass loadings versus mass loadings calculated from particle size and light scattering data. The contents of the datastreams from the ACSM were defined based on ARM requirements and the necessary tasks to implement these recommendations were assigned to the mentor and the instrument manufacturer. Some of the recommendations were implemented for the SGP data and are presented in this report. Data from two ARM sites located in marine environments were also analyzed. These analyses as well as instrument intercomparisons have led to further questions about data treatment. These will be addresses in the second users’ meeting scheduled for the summer of 2018.« less

Indicator organisms in meat and poultry slaughter operations: their potential use in process control and the role of emerging technologies.

PubMed

Saini, Parmesh K; Marks, Harry M; Dreyfuss, Moshe S; Evans, Peter; Cook, L Victor; Dessai, Uday

2011-08-01

Measuring commonly occurring, nonpathogenic organisms on poultry products may be used for designing statistical process control systems that could result in reductions of pathogen levels. The extent of pathogen level reduction that could be obtained from actions resulting from monitoring these measurements over time depends upon the degree of understanding cause-effect relationships between processing variables, selected output variables, and pathogens. For such measurements to be effective for controlling or improving processing to some capability level within the statistical process control context, sufficiently frequent measurements would be needed to help identify processing deficiencies. Ultimately the correct balance of sampling and resources is determined by those characteristics of deficient processing that are important to identify. We recommend strategies that emphasize flexibility, depending upon sampling objectives. Coupling the measurement of levels of indicator organisms with practical emerging technologies and suitable on-site platforms that decrease the time between sample collections and interpreting results would enhance monitoring process control.

77 FR 43583 - DOE Response to Recommendation 2012-1 of the Defense Nuclear Facilities Safety Board, Savannah...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-25

... DEPARTMENT OF ENERGY DOE Response to Recommendation 2012-1 of the Defense Nuclear Facilities Safety Board, Savannah River Site Building 235-F Safety AGENCY: Department of Energy. ACTION: Notice. SUMMARY: On May 8, 2012, the Defense Nuclear Facilities Safety Board submitted Recommendation 2012-1...

Exploring Learner Attitudes toward Web-Based Recommendation Learning Service System for Interdisciplinary Applications

ERIC Educational Resources Information Center

Chen, Hong-Ren; Huang, Jhen-Gang

2012-01-01

The booming digital-content industry has resulted in an increasing number of e-learning Internet websites that provide online learning services. Recommendations for learning sites are used by diverse learners to identify the most appropriate learning resources. However, research into recommendations about learning has concentrated primarily on…

Addendum to the Closure Report for Corrective Action Unit 358: Areas 18, 19, 20 Cellars/Mud Pits Nevada Test Site, Nevada

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

Lynn Kidman

This document constitutes an addendum to the January 2004, Closure Report for Corrective Action Unit 358: Areas 18, 19, 20 Cellars/Mud Pits as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of:more » • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 20-23-02, Postshot Cellar • CAS 20-23-03, Cellar • CAS 20-23-04, Postshot Cellar • CAS 20-23-05, Postshot Cellar • CAS 20-23-06, Cellar • CAS 20-37-01, Cellar & Mud Pit • CAS 20-37-05, Cellar These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Select Results from the Energy Assessor Experiment in the 2012 Commercial Buildings Energy Consumption Survey

EIA Publications

2015-01-01

As part of an effort to make EIA’s energy consumption surveys as accurate and efficient as possible, EIA invited the National Research Council (NRC) to review the Commercial Buildings Energy Consumption Survey (CBECS) data-gathering process and make recommendations for improvements. The NRC suggested sending professional energy assessors to some sites and comparing the data obtained from the survey to the data collected by the assessors. Results from the energy assessment data collection have largely confirmed the quality of data gathered by CBECS interviewers.

Implementing guidelines: Proposed definitions of neuropsychology services in pediatric oncology.

PubMed

Baum, Katherine T; Powell, Stephanie K; Jacobson, Lisa A; Gragert, Marsha N; Janzen, Laura A; Paltin, Iris; Rey-Casserly, Celiane M; Wilkening, Greta N

2017-08-01

Several organizations have published guidelines for the neuropsychological care of survivors of childhood cancer. However, there is limited consensus in how these guidelines are applied. The model of neuropsychology service delivery is further complicated by the variable terminology used to describe recommended services. In an important first step to translate published guidelines into clinical practice, this paper proposes definitions for specific neuropsychological processes and services, with the goal of facilitating consistency across sites to foster future clinical program development and to clarify clinical practice guidelines. © 2017 Wiley Periodicals, Inc.

Third Generation (3G) Site Characterization: Cryogenic Core Collection and High Throughput Core Analysis - An Addendum to Basic Research Addressing Contaminants in Low Permeability Zones - A State of the Science Review

DTIC Science & Technology

2016-07-29

Research Addressing Contaminants in Low Permeability Zones - A State of the Science Review SERDP Project ER-1740 JULY 2016 Tom Sale Saeed...process, or service by trade name, trademark, manufacturer , or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or...managing releases of chlorinated solvents and other persistent contaminants in groundwater in unconsolidated sediments. N/A U U U UU 126 Dr. Tom Sale 970

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

Aurelio, Mario; Taguibao, Kristine Joy; Vargas, Edmundo

In the selection of sites for disposal facilities involving low- and intermediate-level radioactive waste (LILW), International Atomic Energy Agency (IAEA) recommendations require that 'the region in which the site is located shall be such that significant tectonic and surface processes are not expected to occur with an intensity that would compromise the required isolation capability of the repository'. Evaluating the appropriateness of a site therefore requires a deep understanding of the geological and tectonic setting of the area. The Philippines sits in a tectonically active region frequented by earthquakes and volcanic activity. Its highly variable morphology coupled with its locationmore » along the typhoon corridor in the west Pacific region subjects the country to surface processes often manifested in the form of landslides. The Philippine LILW near surface repository project site is located on the north eastern sector of the Island of Luzon in northern Philippines. This island is surrounded by active subduction trenches; to the east by the East Luzon Trough and to the west by the Manila Trench. The island is also traversed by several branches of the Philippine Fault System. The Philippine LILW repository project is located more than 100 km away from any of these major active fault systems. In the near field, the project site is located less than 10 km from a minor fault (Dummon River Fault) and more than 40 km away from a volcanic edifice (Mt. Caguas). This paper presents an analysis of the potential hazards that these active tectonic features may pose to the project site. The assessment of such geologic hazards is imperative in the characterization of the site and a crucial input in the design and safety assessment of the repository. (authors)« less

Webbing It.

ERIC Educational Resources Information Center

Brandsberg, Jennifer

1996-01-01

Provides a quick look at some World Wide Web sites that contain current election year information. Recommends Project Vote Smart, a site with links to online news organizations, the home pages of all presidential candidates, and other political sites. Briefly notes several interactive CD-ROM resources. (MJP)

Managing protected areas under climate change: challenges and priorities.

PubMed

Rannow, Sven; Macgregor, Nicholas A; Albrecht, Juliane; Crick, Humphrey Q P; Förster, Michael; Heiland, Stefan; Janauer, Georg; Morecroft, Mike D; Neubert, Marco; Sarbu, Anca; Sienkiewicz, Jadwiga

2014-10-01

The implementation of adaptation actions in local conservation management is a new and complex task with multiple facets, influenced by factors differing from site to site. A transdisciplinary perspective is therefore required to identify and implement effective solutions. To address this, the International Conference on Managing Protected Areas under Climate Change brought together international scientists, conservation managers, and decision-makers to discuss current experiences with local adaptation of conservation management. This paper summarizes the main issues for implementing adaptation that emerged from the conference. These include a series of conclusions and recommendations on monitoring, sensitivity assessment, current and future management practices, and legal and policy aspects. A range of spatial and temporal scales must be considered in the implementation of climate-adapted management. The adaptation process must be area-specific and consider the ecosystem and the social and economic conditions within and beyond protected area boundaries. However, a strategic overview is also needed: management at each site should be informed by conservation priorities and likely impacts of climate change at regional or even wider scales. Acting across these levels will be a long and continuous process, requiring coordination with actors outside the "traditional" conservation sector. To achieve this, a range of research, communication, and policy/legal actions is required. We identify a series of important actions that need to be taken at different scales to enable managers of protected sites to adapt successfully to a changing climate.

Effectiveness of amphibians as biodiversity surrogates in pond conservation.

PubMed

Ilg, Christiane; Oertli, Beat

2017-04-01

Amphibian decline has led to worldwide conservation efforts, including the identification and designation of sites for their protection. These sites could also play an important role in the conservation of other freshwater taxa. In 89 ponds in Switzerland, we assessed the effectiveness of amphibians as a surrogate for 4 taxonomic groups that occur in the same freshwater ecosystems as amphibians: dragonflies, aquatic beetles, aquatic gastropods, and aquatic plants. The ponds were all of high value for amphibian conservation. Cross-taxon correlations were tested for species richness and conservation value, and Mantel tests were used to investigate community congruence. Species richness, conservation value, and community composition of amphibians were weakly congruent with these measures for the other taxonomic groups. Paired comparisons for the 5 groups considered showed that for each metric, amphibians had the lowest degree of congruence. Our results imply that site designation for amphibian conservation will not necessarily provide protection for freshwater biodiversity as a whole. To provide adequate protection for freshwater species, we recommend other taxonomic groups be considered in addition to amphibians in the prioritization and site designation process. © 2016 Society for Conservation Biology.

The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia.

PubMed

Shiferaw, Fassil; Zolfo, Maria

2012-01-01

Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes. This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources. Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites. Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect 'one size fits all' technology and the use of combined interoperable applications, according to the local context, is highly recommended. Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts.

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

K.E. Rasmuson

The U.S. Department of Energy has implemented a program to reclaim lands disturbed by site characterization at Yucca Mountain. Long term goals of the program are to re-establish processes on disturbed sites that will lead to self-sustaining plant communities. The Biological Opinion for Yucca Mountain Site Characterization Studies required that the U.S. Department of Energy develop a Reclamation Standards and Monitoring Plan to evaluate the success of reclamation efforts. According to the Reclamation Standards and Monitoring Plan, reclaimed sites will be monitored periodically, remediated if necessary, and eventually compared to an appropriate reference area to determine whether reclamation goals havemore » been achieved and the site can be released from further monitoring. Plant cover, density, and species richness (success parameters) on reclaimed sites are compared to 60 percent of the values (success criteria) for the same parameters on the reference area. Small sites (less than 0.1 ha) are evaluated for release using qualitative methods while large sites (greater than 0.1 ha) are evaluated using quantitative methods. In the summer of 2000, 31 small sites reclaimed in 1993 and 1994 were evaluated for reclamation success and potential release from further monitoring. Plant density, cover, and species richness were estimated on the C-Well Pipeline, UE-25 Large Rocks test site, and 29 ground surface facility test pits. Evidence of erosion, reproduction and natural recruitment, exotic species abundance, and animal use (key attributes) also were recorded for each site and used in success evaluations. The C-Well Pipeline and ground surface facility test pits were located in a ''Larrea tridentata - Ephedra nevadensis'' vegetation association while the UE-25 Large Rocks test site was located in an area dominated by ''Coleogyne ramosissima and Ephedra nevadensis''. Reference areas in the same vegetation associations with similar slope and aspect were chosen for comparison to the reclaimed sites. Sixty percent of the reference area means for density, cover, and species richness were compared to the estimated means for the reclaimed sites. Plant density, cover, and species richness at the C-Well Pipeline and UE-25 Large Rocks test site were greater than the success criteria and all key attributes indicated the sites were in acceptable condition. Therefore, these two sites were recommended for release from further monitoring. Of the 29 ground surface facility test pits, 26 met the criterion for density, 21 for cover, and 23 for species richness. When key attributes and conditions of the plant community near each pit were taken into account, 27 of these pits were recommended for release. Success parameters and key attributes at ground surface facility test pits 19 and 20 were inadequate for site release. Transplants of native species were added to these two sites in 2001 to improve density, cover, and species richness.« less

Spruce No. 1 Surface Mine Recommended Determination

EPA Pesticide Factsheets

This document explains the basis for the EPA Region III recommendation to withdraw the specification of Pigeonroost Branch, Oldhouse Branch and their tributaries within Logan County, WV as a disposal site for dredged or fill material.

Social but safe? Quality and safety of diabetes-related online social networks.

PubMed

Weitzman, Elissa R; Cole, Emily; Kaci, Liljana; Mandl, Kenneth D

2011-05-01

To foster informed decision-making about health social networking (SN) by patients and clinicians, the authors evaluated the quality/safety of SN sites' policies and practices. Multisite structured observation of diabetes-focused SN sites. Measurements 28 indicators of quality and safety covering: (1) alignment of content with diabetes science and clinical practice recommendations; (2) safety practices for auditing content, supporting transparency and moderation; (3) accessibility of privacy policies and the communication and control of privacy risks; and (4) centralized sharing of member data and member control over sharing. Quality was variable across n=10 sites: 50% were aligned with diabetes science/clinical practice recommendations with gaps in medical disclaimer use (30% have) and specification of relevant glycosylated hemoglobin levels (0% have). Safety was mixed with gaps in external review approaches (20% used audits and association links) and internal review approaches (70% use moderation). Internal safety review offers limited protection: misinformation about a diabetes 'cure' was found on four moderated sites. Of nine sites with advertising, transparency was missing on five; ads for unfounded 'cures' were present on three. Technological safety was poor with almost no use of procedures for secure data storage and transmission; only three sites support member controls over personal information. Privacy policies' poor readability impedes risk communication. Only three sites (30%) demonstrated better practice. Limitations English-language diabetes sites only. The quality/safety of diabetes SN is variable. Observed better practice suggests improvement is feasible. Mechanisms for improvement are recommended that engage key stakeholders to balance autonomy, community ownership, conditions for innovation, and consumer protection.

Corrective Action Decision Document for Corrective Action Unit 568. Area 3 Plutonium Dispersion Sites, Nevada National Security Site, Nevada Revision 0

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

Matthews, Patrick

The purpose of this Corrective Action Decision Document is to identify and provide the rationale for the recommendation of corrective action alternatives (CAAs) for the 14 CASs within CAU 568. Corrective action investigation (CAI) activities were performed from April 2014 through May 2015, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 568: Area 3 Plutonium Dispersion Sites, Nevada National Security Site, Nevada; and in accordance with the Soils Activity Quality Assurance Plan, which establishes requirements, technical planning, and general quality practices. The purpose of the CAI was to fulfill data needs as defined during themore » DQO process. The CAU 568 dataset of investigation results was evaluated based on a data quality assessment. This assessment demonstrated that the dataset is complete and acceptable for use in fulfilling the DQO data needs. Based on the evaluation of analytical data from the CAI, review of future and current operations at the 14 CASs, and the detailed and comparative analysis of the potential CAAs, the following corrective actions are recommended for CAU 568: • No further action is the preferred corrective action for CASs 03-23-17, 03-23-22, 03-23-26. • Closure in place is the preferred corrective action for CAS 03-23-19; 03-45-01; the SE DCBs at CASs 03-23-20, 03-23-23, 03-23-31, 03-23-32, 03-23-33, and 03-23-34; and the Pascal-BHCA at CAS 03-23-31. • Clean closure is the preferred corrective action for CASs 03-08-04, 03-23-30, and 03-26-04; and the four well head covers at CASs 03-23-20, 03-23-23, 03-23-31, and 03-23-33.« less

Academic Library Web Sites: Current Practice and Future Directions

ERIC Educational Resources Information Center

Detlor, Brian; Lewis, Vivian

2006-01-01

To address competitive threats, academic libraries are encouraged to build robust Web sites personalized to learning and research tasks. Through an evaluation of Association of Research Libraries (ARL)-member Web sites, we suggest how library Web sites should evolve and reflect upon the impacts such recommendations may have on academic libraries…

Library Web Sites in Pakistan: An Analysis of Content

ERIC Educational Resources Information Center

Qutab, Saima; Mahmood, Khalid

2009-01-01

Purpose: The purpose of this paper is to investigate library web sites in Pakistan, to analyse their content and navigational strengths and weaknesses and to give recommendations for developing better web sites and quality assessment studies. Design/methodology/approach: Survey of web sites of 52 academic, special, public and national libraries in…

Site survey for optimum location of Optical Communication Experimental Facility

NASA Technical Reports Server (NTRS)

1968-01-01

Site survey was made to determine the optimum location for an Optical Communication Experimental Facility /OCEF/ and to recommend several sites, graded according to preference. A site was desired which could perform two-way laser communication with a spacecraft and laser tracking with a minimum of interruption by weather effects.

Analysis of pathology department Web sites and practical recommendations.

PubMed

Nero, Christopher; Dighe, Anand S

2008-09-01

There are numerous customers for pathology departmental Web sites, including pathology department staff, clinical staff, residency applicants, job seekers, and other individuals outside the department seeking department information. Despite the increasing importance of departmental Web sites as a means of distributing information, no analysis has been done to date of the content and usage of pathology department Web sites. In this study, we analyzed pathology department Web sites to examine the elements present on each site and to evaluate the use of search technology on these sites. Further, we examined the usage patterns of our own departmental Internet and internet Web sites to better understand the users of pathology Web sites. We reviewed selected departmental pathology Web sites and analyzed their content and functionality. Our institution's departmental pathology Web sites were modified to enable detailed information to be stored regarding users and usage patterns, and that information was analyzed. We demonstrate considerable heterogeneity in departmental Web sites with many sites lacking basic content and search features. In addition, we demonstrate that increasing the traffic of a department's informational Web sites may result in reduced phone inquiries to the laboratory. We propose recommendations for pathology department Web sites to maximize promotion of a department's mission. A departmental pathology Web site is an essential communication tool for all pathology departments, and attention to the users and content of the site can have operational impact.

Remediation System Evaluation, Vineland Chemical Company Superfund Site, Vineland, New Jersey

EPA Pesticide Factsheets

The Vineland Chemical Company Superfund Site was selected by EPA OSRTI based on recommendations from the EPA Remedial Project Manager for the site and from the U.S. Army Corps of Engineers (USACE) Philadelphia District that provides oversight of remedial..

Recommendation Systems for Geoscience Data Portals Built by Analyzing Usage Patterns

NASA Astrophysics Data System (ADS)

Crosby, C.; Nandigam, V.; Baru, C.

2009-04-01

Since its launch five years ago, the National Science Foundation-funded GEON Project (www.geongrid.org) has been providing access to a variety of geoscience data sets such as geologic maps and other geographic information system (GIS)-oriented data, paleontologic databases, gravity and magnetics data and LiDAR topography via its online portal interface. In addition to data, the GEON Portal also provides web-based tools and other resources that enable users to process and interact with data. Examples of these tools include functions to dynamically map and integrate GIS data, compute synthetic seismograms, and to produce custom digital elevation models (DEMs) with user defined parameters such as resolution. The GEON portal built on the Gridsphere-portal framework allows us to capture user interaction with the system. In addition to the site access statistics captured by tools like Google Analystics which capture hits per unit time, search key words, operating systems, browsers, and referring sites, we also record additional statistics such as which data sets are being downloaded and in what formats, processing parameters, and navigation pathways through the portal. With over four years of data now available from the GEON Portal, this record of usage is a rich resource for exploring how earth scientists discover and utilize online data sets. Furthermore, we propose that this data could ultimately be harnessed to optimize the way users interact with the data portal, design intelligent processing and data management systems, and to make recommendations on algorithm settings and other available relevant data. The paradigm of integrating popular and commonly used patterns to make recommendations to a user is well established in the world of e-commerce where users receive suggestions on books, music and other products that they may find interesting based on their website browsing and purchasing history, as well as the patterns of fellow users who have made similar selections. However, this paradigm has not yet been explored for geoscience data portals. In this presentation we will present an initial analysis of user interaction and access statistics for the GEON OpenTopography LiDAR data distribution and processing system to illustrate what they reveal about user's spatial and temporal data access patterns, data processing parameter selections, and pathways through the data portal. We also demonstrate what these usage statistics can illustrate about aspects of the data sets that are of greatest interest. Finally, we explore how these usage statistics could be used to improve the user's experience in the data portal and to optimize how data access interfaces and tools are designed and implemented.

Quarterly report on Defense Nuclear Facilities Safety Board Recommendation 90-7 for the period ending December 31, 1992

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

Cash, R.J.; Dukelow, G.T.; Forbes, C.J.

1993-03-01

This is the seventh quarterly report on the progress of activities addressing safety issues associated with Hanford Site high-level radioactive waste tanks that contain ferrocyanide compounds. In the presence of oxidizing materials, such as nitrates or nitrites, ferrocyanide can be made to explode in the laboratory by heating it to high temperatures [above 285{degrees}C (545{degrees}F)]. In the mid 1950s approximately 140 metric tons of ferrocyanide were added to 24 underground high-level radioactive waste tanks. An implementation plan (Cash 1991) responding to the Defense Nuclear Facilities Safety Board Recommendation 90-7 (FR 1990) was issued in March 1991 describing the activities thatmore » were planned and underway to address each of the six parts of Recommendation 90-7. A revision to the original plan was transmitted to US Department of Energy by Westinghouse Hanford Company in December 1992. Milestones completed this quarter are described in this report. Contents of this report include: Introduction; Defense Nuclear Facilities Safety Board Implementation Plan Task Activities (Defense Nuclear Facilities Safety Board Recommendation for enhanced temperature measurement, Recommendation for continuous temperature monitoring, Recommendation for cover gas monitoring, Recommendation for ferrocyanide waste characterization, Recommendation for chemical reaction studies, and Recommendation for emergency response planning); Schedules; and References. All actions recommended by the Defense Nuclear Facilities Safety Board for emergency planning by Hanford Site emergency preparedness organizations have been completed.« less

Winds of War: Enhancing Civilian and Military Partnerships to Assure Readiness: White Paper.

PubMed

Schwab, C William

2015-08-01

This White Paper summarizes the state of readiness of combat surgeons and provides action recommendations that address the problems of how to train, sustain, and retain them for future armed conflicts. As the basis for the 2014 Scudder Oration, I explored how to secure an improved partnership between military and civilian surgery, which would optimize learning platforms and embed military trauma personnel at America's academic medical universities for trauma combat casualty care (TCCC). To craft and validate these recommendations, I conducted an integrative and iterative process of literature reviews, interviews of military and civilian leaders, and a survey of military-affiliated surgeons. The recommended action points advance the training of combat surgeons and their trauma teams by creating an expanded network of TCCC training sites and sourcing the cadre of combat-seasoned surgeons currently populating our civilian and military teaching hospitals and universities. The recommendation for the establishment of a TCCC readiness center or command within the Medical Health System of the Department of Defense includes a military and civilian advisory board, with the reformation of a think tank of content experts to address high-level solutions for military medicine, readiness, and TCCC. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Comparing the ISO-recommended and the cumulative data-reduction algorithms in S-on-1 laser damage test by a reverse approach method

NASA Astrophysics Data System (ADS)

Zorila, Alexandru; Stratan, Aurel; Nemes, George

2018-01-01

We compare the ISO-recommended (the standard) data-reduction algorithm used to determine the surface laser-induced damage threshold of optical materials by the S-on-1 test with two newly suggested algorithms, both named "cumulative" algorithms/methods, a regular one and a limit-case one, intended to perform in some respects better than the standard one. To avoid additional errors due to real experiments, a simulated test is performed, named the reverse approach. This approach simulates the real damage experiments, by generating artificial test-data of damaged and non-damaged sites, based on an assumed, known damage threshold fluence of the target and on a given probability distribution function to induce the damage. In this work, a database of 12 sets of test-data containing both damaged and non-damaged sites was generated by using four different reverse techniques and by assuming three specific damage probability distribution functions. The same value for the threshold fluence was assumed, and a Gaussian fluence distribution on each irradiated site was considered, as usual for the S-on-1 test. Each of the test-data was independently processed by the standard and by the two cumulative data-reduction algorithms, the resulting fitted probability distributions were compared with the initially assumed probability distribution functions, and the quantities used to compare these algorithms were determined. These quantities characterize the accuracy and the precision in determining the damage threshold and the goodness of fit of the damage probability curves. The results indicate that the accuracy in determining the absolute damage threshold is best for the ISO-recommended method, the precision is best for the limit-case of the cumulative method, and the goodness of fit estimator (adjusted R-squared) is almost the same for all three algorithms.

Chronic Diarrhea

MedlinePlus

... Water Fluoridation Leadership Policy & Recommendations Fast Facts Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ... this disease, consult a health care provider. Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ...

Body Hygiene

MedlinePlus

... Water Fluoridation Leadership Policy & Recommendations Fast Facts Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ... Protect Your Eyes CDC. Hygiene-related Diseases Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ...

Treating pain on skin graft donor sites: Review and clinical recommendations.

PubMed

Sinha, Sarthak; Schreiner, Amanda J; Biernaskie, Jeff; Nickerson, Duncan; Gabriel, Vincent A

2017-11-01

Split-thickness skin grafting is the most common reconstructive procedure in managing burn injuries. Harvesting split-thickness skin creates a new partial thickness wound referred to as the donor site. Pain at the donor site is reported to be one of the most distressing symptoms during the early postoperative period. Here, we (a) identify strategies for managing donor site pain, (b) assess the quality of individual studies, and (c) formulate evidence-based recommendations based on the amount and consistency of evidence. Our analysis revealed five distinct approaches to minimize donor site pain. These include: continuous subcutaneous local anesthetic infusion (three studies), subcutaneous anesthetic injection (five studies), topical agents (six studies), nonpharmacological interventions (three studies), and wound dressings (18 studies). Available randomized control trials typically evaluated pain on standardized scales (i.e. Visual Analog Scale, Numerical Rating Scale), and compared the experimental group with standard care. Recommended treatments include: (a) subcutaneous anesthetic injection of adrenaline-lidocaine; (b) ice application; (c) topical agents, such as lidocaine and bupivacaine; and (d) hydrocolloid- and polyurethane-based wound dressings accompanied with fibrin sealant. Methodologically sound randomized control trials examining the efficacy of modified tumescent solution, ropivacaine, plasma therapy, noncontact ultrasound, and morphine gels are lacking and should be a priority for future research.

Corrective Action Decision Document for Corrective Action Unit 204: Storage Bunkers, Nevada Test Site, Nevada: Revision 0, Including Errata Sheet

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

U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office

2004-04-01

This Corrective Action Decision Document identifies the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office's corrective action alternative recommendation for each of the corrective action sites (CASs) within Corrective Action Unit (CAU) 204: Storage Bunkers, Nevada Test Site (NTS), Nevada, under the Federal Facility Agreement and Consent Order. An evaluation of analytical data from the corrective action investigation, review of current and future operations at each CAS, and a detailed comparative analysis of potential corrective action alternatives were used to determine the appropriate corrective action for each CAS. There are six CASs in CAU 204, which aremore » all located between Areas 1, 2, 3, and 5 on the NTS. The No Further Action alternative was recommended for CASs 01-34-01, 02-34-01, 03-34-01, and 05-99-02; and a Closure in Place with Administrative Controls recommendation was the preferred corrective action for CASs 05-18-02 and 05-33-01. These alternatives were judged to meet all requirements for the technical components evaluated as well as applicable state and federal regulations for closure of the sites and will eliminate potential future exposure pathways to the contaminated media at CAU 204.« less

Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section.

PubMed

Segreti, John; Parvizi, Javad; Berbari, Elie; Ricks, Philip; Berríos-Torres, Sandra I

Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection. The updated guideline applies evidence-based methodology, presents recommendations for potential strategies to reduce the risk of SSI, and includes an arthroplasty-specific section. This article serves to introduce the guideline development process and to complement the Prosthetic Joint Arthroplasty section with background information on PJI-specific economic burden, epidemiology, pathogenesis and microbiology, and risk factor information.

Surgical infection in a videolaparoscopic cholecystectomy when using peracetic acid for the sterilization of instruments.

PubMed

de Melo, Edluza Maria Viana Bezerra; Leão, Cristiano de Souza; Andreto, Luciana Marques; de Mello, Maria Júlia Gonçalves

2013-01-01

To determine the frequency of surgical site infection in patients undergoing laparoscopic cholecystectomy with instruments sterilized by peracetic acid. We conducted a retrospective, cohort, descriptive, cross-sectional study. Peracetic acid has been used for sterilization following the protocol recommended by the manufacturer. We observed the criteria and indicators of process and structure for preventing surgical site infection pre and intraoperatively. For epidemiological surveillance, outpatient visits were scheduled for the 15th and between the 30th and 45th days after discharge. Among the 247 patients, there were two cases of surgical site infection (0.8%). One patient was readmitted to systemic antibiotic therapy and percutaneous puncture; in the other the infection was superficial and followed at the clinic. Ethical issues prevent the conduction of a prospective study because of peracetic acid have been banned for the sterilization of instruments that penetrate organs and cavities. Nevertheless, these results encourage prospective case-control studies comparing its use (historical control) with ethylene oxide sterilization.

Safety inspections in construction sites: A systems thinking perspective.

PubMed

Saurin, Tarcisio Abreu

2016-08-01

Although safety inspections carried out by government officers are important for the prevention of accidents, there is little in-depth knowledge on their outcomes and processes leading to these. This research deals with this gap by using systems thinking (ST) as a lens for obtaining insights into safety inspections in construction sites. Thirteen case studies of sites with prohibited works were carried out, discussing how four attributes of ST were used in the inspections. The studies were undertaken over 6 years, and sources of evidence involved participant observation, direct observations, analysis of documents and interviews. Two complementary ways for obtaining insights into inspections, based on ST, were identified: (i) the design of the study itself needs to be in line with ST; and (ii) data collection and analysis should focus on the agents involved in the inspections, the interactions between agents, the constraints and opportunities faced by agents, the outcomes of interactions, and the recommendations for influencing interactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Verbal and numerical consumer recommendations: switching between recommendation formats leads to preference inconsistencies.

PubMed

Maciejovsky, Boris; Budescu, David V

2013-06-01

Many Web sites provide consumers with product recommendations, which are typically presented by a sequence of verbal reviews and numerical ratings. In three experiments, we demonstrate that when participants switch between formats (e.g., from verbal to numerical), they are more prone to preference inconsistencies than when they aggregate the recommendations within the same format (e.g., verbal). When evaluating recommendations, participants rely primarily on central-location measures (e.g., mean) and less on other distribution characteristics (e.g., variance). We explain our findings within the theoretical framework of stimulus-response compatibility and we make practical recommendations for the design of recommendation systems and Web portals.

A planned care approach and patient registry to improve adherence to clinical guidelines for the diagnosis and management of attention-deficit/hyperactivity disorder.

PubMed

Geltman, Paul L; Fried, Lise E; Arsenault, Lisa N; Knowles, Alice M; Link, David A; Goldstein, Joel N; Perrin, James M; Hacker, Karen A

2015-01-01

Attention-deficit/hyperactivity disorder (ADHD) affects almost 2.4 million US children. Because American Academy of Pediatrics guidelines for ADHD recommend use of standardized diagnostic instruments, regular follow-up and the chronic care model, this pilot project sought to implement and assess an electronic registry of patients with ADHD combined with care coordination by a planned care team. This quality improvement project was structured with 2 intervention and 2 control clinics to facilitate evaluation of the use of a planned care system for management of ADHD. Care teams included a pediatrician, nurse, medical assistant, and care coordinator and tracked patients using an electronic registry with data drawn from the EMR. Clinical work flows were pilot tested to facilitate use of the Vanderbilt scales and their incorporation into the EMR at intervention sites. Outcome measures included 2 recommended clinical follow-ups based on HEDIS measures as well as use of the Vanderbilt rating scales. Initiation phase measure was for follow-up after initiating medication, while the continuation phase measure was for subsequent follow-up during the first year of treatment. Measures were monitored during the project year and then also in the ensuing period of spread of the intervention to other sites. Although the modified HEDIS initiation phase measure for patients newly on medication remained static at approximately 50% throughout the project period, the continuation phase measure showed improvement from 35% at baseline to 45% at the end of the project assessment year, a 29% increase. Follow-up for patients stable on medications also remained unchanged during the project period, but during subsequent spreading of the intervention to nonproject sites, follow-up of these patients improved to over 90%. In adjusted analyses, patients with ADHD at intervention sites were over 2 times more likely than patients at control sites to have had a Vanderbilt score documented in their records. The project achieved modest improvements in the diagnostic and treatment process for patients with ADHD. The use of a planned care system and electronic patient registry shows promise for improving the diagnosis and treatment process for patients with ADHD. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The use of a non-nuclear density gauge for monitoring the compaction process of asphalt pavement

NASA Astrophysics Data System (ADS)

Van den bergh, Wim; Vuye, Cedric; Kara, Patricia; Couscheir, Karolien; Blom, Johan; Van Bouwel, Philippe

2017-09-01

The mechanical performance of an asphalt pavement affects its durability - thus carbon footprint. Many parameters contribute to the success of a durable asphalt mix, e.g. material selection, an accurate mix and even the road design in which the asphalt mix quality is quantified. The quality of the asphalt mix, by its mechanical properties, is also related to the compaction degree. However, and specifically for high volume rates, the laying process at the construction site needs an effective method to monitor and adjust immediately the compaction quality before cooling and without damaging the layer, which is now absent. In this paper the use of a non-nuclear density gauge (PQI - Pavement Quality Indicator) is evaluated, based on a site at Brussels Airport. Considering the outcome of the present research, this PQI is advised as a unique tool for continuous density measurements and allow immediate adjustments during compaction, and decreases the number of core drilling for quality control, and as a posteriori asphalt pavement density test where cores are prohibited. The use of PQI could be recommended to be a part of the standard quality control process in the Flemish region.

Multivariate thermo-hygrometric characterisation of the archaeological site of Plaza de l'Almoina (Valencia, Spain) for preventive conservation.

PubMed

Fernández-Navajas, Angel; Merello, Paloma; Beltrán, Pedro; García-Diego, Fernando-Juan

2013-07-29

Preventive conservation requires monitoring and control of the parameters involved in the deterioration process, mainly temperature and relative humidity. It is important to characterise an archaeological site prior to carrying out comparative studies in the future for preventive conservation, either by regular studies to verify whether the conditions are constant, or occasional ones when the boundary conditions are altered. There are numerous covered archaeological sites, but few preventive conservation works that give special attention to the type of cover installed. In particular, there is no background of microclimatic studies in sites that are in the ground and, as in the Plaza de l'Almoina (Valencia, Spain), are buried and partially covered by a transparent roof. A large effect of the transparent cover was found by the sensors located below this area, with substantial increases in temperature and a decrease in the relative humidity during the day. Surrounding zones also have values above the recommended temperature values. On the other hand, the influence of a buried water drainage line near the site is notable, causing an increase in relative humidity levels in the surrounding areas. Multivariate statistical analyses enabled us to characterise the microclimate of the archaeological site, allowing future testing to determine whether the conservation conditions have been altered.

Multivariate Thermo-Hygrometric Characterisation of the Archaeological Site of Plaza de l’Almoina (Valencia, Spain) for Preventive Conservation

PubMed Central

Fernández-Navajas, Ángel; Merello, Paloma; Beltrán, Pedro; García-Diego, Fernando-Juan

2013-01-01

Preventive conservation requires monitoring and control of the parameters involved in the deterioration process, mainly temperature and relative humidity. It is important to characterise an archaeological site prior to carrying out comparative studies in the future for preventive conservation, either by regular studies to verify whether the conditions are constant, or occasional ones when the boundary conditions are altered. There are numerous covered archaeological sites, but few preventive conservation works that give special attention to the type of cover installed. In particular, there is no background of microclimatic studies in sites that are in the ground and, as in the Plaza de l’Almoina (Valencia, Spain), are buried and partially covered by a transparent roof. A large effect of the transparent cover was found by the sensors located below this area, with substantial increases in temperature and a decrease in the relative humidity during the day. Surrounding zones also have values above the recommended temperature values. On the other hand, the influence of a buried water drainage line near the site is notable, causing an increase in relative humidity levels in the surrounding areas. Multivariate statistical analyses enabled us to characterise the microclimate of the archaeological site, allowing future testing to determine whether the conservation conditions have been altered. PMID:23899937

Mathematical modeling of heavy metals contamination from MSW landfill site in Khon Kaen, Thailand.

PubMed

Tantemsapya, N; Naksakul, Y; Wirojanagud, W

2011-01-01

Kham Bon landfill site is one of many municipality waste disposal sites in Thailand which are in an unsanitary condition. The site has been receiving municipality wastes without separating hazardous waste since 1968. Heavy metals including, Pb, Cr and Cd are found in soil and groundwater around the site, posing a health risk to people living nearby. In this research, contamination transport modelling of Pb, Cr and Cd was simulated using MODFLOW for two periods, at the present (2010) and 20 years prediction (2030). Model results showed that heavy metals, especially Pb and Cr migrated toward the north-eastern and south-eastern direction. The 20 years prediction showed that, heavy metals tend to move from the top soil to the deeper aquifer. The migration would not exceed 500 m radius from the landfill centre in the next 20 years, which is considered to be a slow process. From the simulation model, it is recommended that a mitigation measure should be performed to reduce the risk from landfill contamination. Hazardous waste should be separated for proper management. Groundwater contamination in the aquifer should be closely monitored. Consumption of groundwater in a 500 m radius must be avoided. In addition, rehabilitation of the landfill site should be undertaken to prevent further mobilization of pollutants.

Assessment of mammographic film processor performance in a hospital and mobile screening unit.

PubMed

Murray, J G; Dowsett, D J; Laird, O; Ennis, J T

1992-12-01

In contrast to the majority of mammographic breast screening programmes, film processing at this centre occurs on site in both hospital and mobile trailer units. Initial (1989) quality control (QC) sensitometric tests revealed a large variation in film processor performance in the mobile unit. The clinical significance of these variations was assessed and acceptance limits for processor performance determined. Abnormal mammograms were used as reference material and copied using high definition 35 mm film over a range of exposure settings. The copies were than matched with QC film density variation from the mobile unit. All films were subsequently ranked for spatial and contrast resolution. Optimal values for processing time of 2 min (equivalent to film transit time 3 min and developer time 46 s) and temperature of 36 degrees C were obtained. The widespread anomaly of reporting film transit time as processing time is highlighted. Use of mammogram copies as a means of measuring the influence of film processor variation is advocated. Careful monitoring of the mobile unit film processor performance has produced stable quality comparable with the hospital based unit. The advantages of on site film processing are outlined. The addition of a sensitometric step wedge to all mammography film stock as a means of assessing image quality is recommended.

Report on 2005 Defense Base Closure and Realignment Implementation

DTIC Science & Technology

2007-04-01

Marcos 559 ARNG RC Seguin 560 ARNG RC Snyder 561 ARNG RC Taylor 562 ARNG RC Terrell 563 ARNG RC Texarkana 564 ARNG RC Tyler 565 Benavidez USARC, El...realignment actions: Sep 1 2011 563 ARNG RC Texarkana , TX Commission recommendation(s) affected by this installation: Number Title 44 Reserve Component...AL421382002700 State: Alabama Sites Sites RC Total 51 38 Phase Beg. End <=2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Preliminary site evaluation report on Potomac Electric Power Company's proposed station H. Final report

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

Not Available

1987-06-01

This report provides a preliminary environmental assessment of two 375-MW Coal Gasification-Combined Cycle (GCC) units which the Potomac Electric Power Company proposes to construct on their existing Dickerson Generating Station site in western Montgomery County, Maryland. A mass-burn municipal solid-waste incinerator is also proposed at the site by Montgomery County. Research on the GCC technology and data for the air, land, and water environs in and around the site indicates that the proposed GCC technology offers substantial engineering, environmental, and economic benefits. Overall environmental impacts should be less than those anticipated for a comparably sized pulverized-coal power plant. Projected air,more » land, and water impacts appear to be within any applicable regulatory standards or limitations. However, four areas of concern were identified which could be of significant consequence to the suitability of the site. Recommendations are provided for detailed site evaluations including monitoring recommendations to fill data or information gaps.« less

Internet Presentation of Departments of Pediatric Surgery in Germany and Their Compliance with Recommended Criteria for Promoting Services and Offering Professional Information for Patients.

PubMed

Farhat, Naim; Zoeller, Christoph; Petersen, Claus; Ure, Benno

2016-08-01

Introduction The presentation of health institutions in the internet is highly variable concerning marketing features and medical information. We aimed to investigate the structure and the kind of information provided on the Web sites of all departments of pediatric surgery in Germany. Furthermore, we aimed to identify the degree to which these Web sites comply with internet marketing recommendations for generating business. Method The Web sites of all pediatric surgery units referred to as departments on the official Web site of the German Society of Pediatric Surgery (GSPS) were assessed. The search engine Google was used by entering the terms "pediatric surgery" and the name of the city. Besides general data eight content characteristics focusing on ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, contact details, and medical information were evaluated according to published recommendations. Results A total of 85 departments of pediatric surgery were included. On Google search results 44 (52%) ranked number one and 34 (40%) of the department's homepages were accessible directly through the homepage link of the GSPS. A link to own digital and/or social media was offered on 11 (13%) homepages. Nine sites were multilingual. The most common navigation bar item was clinical services on 74 (87%) homepages. Overall, 76 (89%) departments presented their doctors and 17 (20%) presented other staff members with images of doctors on 53 (62%) and contact data access from the homepage on 68 (80%) Web sites. On 25 (29%) Web sites information on the medical conditions treated were presented, on 17 (20%) details of treating concepts, and on 4 (5%) numbers of patients with specific conditions treated in the own department per year. Conclusion We conclude that numerous of the investigated online presentations do not comply with recommended criteria for offering professional information for patients and for promoting services. Only less than one-third of the departments of pediatric surgery in Germany offer information about the medical conditions they treat. Features, which may influence the decision of patients and parents such as ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, and contact information were differently lacking on many Web sites. Georg Thieme Verlag KG Stuttgart · New York.

Addendum to the Closure Report for Corrective Action Unit 339: Area 12 Fleet Operations Steam Cleaning Discharge Area, Nevada Test Site, Revision 0

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

Grant Evenson

This document constitutes an addendum to the Closure Report for CAU 339: Area 12 Fleet Operations Steam Cleaning Discharge Area Nevada Test Site, December 1997 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • The cover, title, andmore » signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 12-19-01, A12 Fleet Ops Steam Cleaning Efflu. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Addendum 2 to the Closure Report for Corrective Action Unit 358: Areas 18, 19, 20 Cellars/Mud Pits, Nevada Test Site, Nevada, Revison 0

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

Grant Evenson

This document constitutes an addendum to the Closure Report for Corrective Action Unit 358: Areas 18, 19, 20 Cellars/Mud Pits, Nevada Test Site, Nevada, January 2004 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • The cover, title,more » and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 19-09-05, Mud Pit. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

CORRECTIVE ACTION DECISION DOCUMENT FOR CORRECTIVE ACTION UNIT 383: AREA 12 E-TUNNEL SITES, NEVADA TEST SITE, REV. NO. 0

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

Mark McLane

2005-03-01

This Corrective Action Decision Document (CADD) was prepared by the Defense Threat Reduction Agency (DTRA) and the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO). The recommendations and corrective actions described within this document apply to the future closure of Corrective Action Unit (CAU) 383, Area 12 E-Tunnel Sites, which is a joint DTRA and NNSA/NSO site. The CAU consists of three (3) Corrective Action Sites (CASs): CAS 12-06-06 (Muckpile); CAS 12-25-02 (Oil Spill); and CAS 12-28-02 (Radioactive Material). In addition to these CASs, E-Tunnel Ponds One, Two, and Three, and the Drainage Area above themore » ponds were included since closure of the Muckpile will impact these areas. This CADD is consistent with the requirements of the ''Federal Facility Agreement and Consent Order'' agreed to by the State of Nevada, the U.S. Department of Energy, and the U.S. Department of Defense. The DTRA point of contact is the Nevada Operations Office, Environmental Project Manager; currently Ms. Tiffany A. Lantow. The NNSA/NSO point of contact is the Environmental Restoration, Industrial Sites Project Manager; currently Ms. Janet Appenzeller-Wing. The purpose of this CADD is to identify and provide the rationale for the selection of a recommended corrective action alternative for CAU 383. This document presents the recommended corrective action for CAU 383 (E-Tunnel Sites); however, implementation may be affected by the corrective action (to be determined) for CAU 551 (Area 12 Muckpiles) due to the close proximity of B, C, D, and F-Tunnels. The scope of this CADD consists of the following tasks: (1) Develop corrective action objectives; (2) Identify corrective action alternative screening criteria; (3) Develop corrective action alternatives; (4) Perform detailed and comparative evaluations of the corrective action alternatives in relation to the corrective action objectives and screening criteria; and (5) Recommend and justify a preferred corrective action alternative for CAU 383.« less

The 21st Century Teachers' Guide to Recommended Internet Sites. Neal-Schuman NetGuide Series [with CD-ROM].

ERIC Educational Resources Information Center

DiGeorgio, Marvin; Lesage, Sylvia

This book is a practical Internet guide designed to help teachers and students at all levels and in all academic disciplines discover a selection of educational sites from around the world. More than 400 sites are described and organized by academic discipline, and these sites offer links to thousands of other educational sites on the Internet.…

Rehabilitation (exercise and strength training) and osteoarthritis: A critical narrative review.

PubMed

Nguyen, Christelle; Lefèvre-Colau, Marie-Martine; Poiraudeau, Serge; Rannou, François

2016-06-01

Rehabilitation is widely recommended in national and international guidelines for managing osteoarthritis (OA) in primary care settings. According to the 2014 OA Research Society International (OARSI) recommendations, rehabilitation is even considered the core treatment of OA and is recommended for all patients. Rehabilitation for OA widely includes land- and water-based exercise, strength training, weight management, self-management and education, biomechanical interventions, and physically active lifestyle. We performed a critical narrative review of the efficacy and safety of rehabilitation for managing OA and discuss evidence-based international recommendations. The process of article selection was unsystematic. Articles were selected based on authors' expertise, self-knowledge, and reflective practice. For the purpose of the review, we focused on land- and water-based exercise and strength training for knee, hip and hand OA. Other aspects of rehabilitation in OA are treated elsewhere in this special issue. Exercise therapy is widely recommended for managing knee, hip and hand OA. However, the level of evidence varies according to OA location. Overall, consistent evidence suggests that exercise therapy and specific strengthening exercise or strength training for the lower limb reduce pain and improve physical function in knee OA. Evidence for other OA sites are less consistent. Therefore, because of the lack of specific studies, recommendations for hip and hand OA are mainly derived from studies of knee OA. In addition, no recommendations have been established regarding the exercise regimen. The efficacy and safety of exercise therapy and strength training need to be further evaluated in randomized controlled trials of patients with hip and hand OA. The optimal delivery of exercise programs also has to be more clearly defined. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Health Implications of Increased Coal Use in the Western States

PubMed Central

Guidotti, Tee L.

1979-01-01

The National Energy Plan proposed by President Carter provides for the rapid development of coal resources in the United States, particularly in the West. The potential consequences for health of this development were considered by the Advisory Committee on Health and Environmental Effects of Increased Coal Utilization, reporting to the Department of Energy. Their report recommended rigid adherence to pertinent existing regulations, improved environmental monitoring, expanded research in selected relevant topics and development of procedures for selecting the sites of new coal-fired power plants. Although the report was a major exercise in technology assessment, it is fundamentally a cautious document that proposes no new solutions or approaches. A review of occupational and community health problems associated with coal mining and coal utilization suggests that lessons from past experiences, especially in Appalachia, cannot be applied to the West uncritically. The two regions are fundamentally different in scale, topography and social development. In the West, future problems related to coal are likely to derive from unknown risks associated with coal processing technologies, land reclamation and water quality at the sites of power generation, and extensive social and demographic changes at centers of industrial activity that may have secondary effects on health. Additional considerations should supplement the recommendations of the Advisory Committee report. PMID:483803

Developing a "toolkit" to measure implementation of concurrent palliative care in rural community cancer centers.

PubMed

Zubkoff, Lisa; Dionne-Odom, J Nicholas; Pisu, Maria; Babu, Dilip; Akyar, Imatullah; Smith, Tasha; Mancarella, Gisella A; Gansauer, Lucy; Sullivan, Margaret Murray; Swetz, Keith M; Azuero, Andres; Bakitas, Marie A

2018-02-01

Despite national guidelines recommending early concurrent palliative care for individuals newly diagnosed with metastatic cancer, few community cancer centers, especially those in underserved rural areas do so. We are implementing an early concurrent palliative care model, ENABLE (Educate, Nurture, Advise, Before Life Ends) in four, rural-serving community cancer centers. Our objective was to develop a "toolkit" to assist community cancer centers that wish to integrate early palliative care for patients with newly diagnosed advanced cancer and their family caregivers. Guided by the RE-AIM (Reach, Effectiveness-Adoption, Implementation, Maintenance) framework, we undertook an instrument-development process based on the literature, expert and site stakeholder review and feedback, and pilot testing during site visits. We developed four instruments to measure ENABLE implementation: (1) the ENABLE RE-AIM Self-Assessment Tool to assess reach, adoption, implementation, and maintenance; (2) the ENABLE General Organizational Index to assess institutional implementation; (3) an Implementation Costs Tool; and (4) an Oncology Clinicians' Perceptions of Early Concurrent Oncology Palliative Care survey. We developed four measures to determine early palliative care implementation. These measures have been pilot-tested, and will be integrated into a comprehensive "toolkit" to assist community cancer centers to measure implementation outcomes. We describe the lessons learned and recommend strategies for promoting long-term program sustainability.

Health implications of increased coal use in the Western States.

PubMed

Guidotti, T L

1979-07-01

The National Energy Plan proposed by President Carter provides for the rapid development of coal resources in the United States, particularly in the West. The potential consequences for health of this development were considered by the Advisory Committee on Health and Environmental Effects of Increased Coal Utilization, reporting to the Department of Energy. Their report recommended rigid adherence to pertinent existing regulations, improved environmental monitoring, expanded research in selected relevant topics and development of procedures for selecting the sites of new coal-fired power plants. Although the report was a major exercise in technology assessment, it is fundamentally a cautious document that proposes no new solutions or approaches. A review of occupational and community health problems associated with coal mining and coal utilization suggests that lessons from past experiences, especially in Appalachia, cannot be applied to the West uncritically. The two regions are fundamentally different in scale, topography and social development. In the West, future problems related to coal are likely to derive from unknown risks associated with coal processing technologies, land reclamation and water quality at the sites of power generation, and extensive social and demographic changes at centers of industrial activity that may have secondary effects on health. Additional considerations should supplement the recommendations of the Advisory Committee report.

Application of science-based restoration planning to a desert river system.

PubMed

Laub, Brian G; Jimenez, Justin; Budy, Phaedra

2015-06-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

Application of Science-Based Restoration Planning to a Desert River System

NASA Astrophysics Data System (ADS)

Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

2015-06-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

Application of science-based restoration planning to a desert river system

USGS Publications Warehouse

Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

2015-01-01

Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

Corrective Action Decision Document for Corrective Action Unit 340: Pesticide Release sites, Nevada Test Site, Nevada

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

DOE /NV

This Corrective Action Decision Document has been prepared for Corrective Action Unit 340, the NTS Pesticide Release Sites, in accordance with the Federal Facility Agreement and Consent Order of 1996 (FFACO, 1996). Corrective Action Unit 340 is located at the Nevada Test Site, Nevada, and is comprised of the following Corrective Action Sites: 23-21-01, Area 23 Quonset Hut 800 Pesticide Release Ditch; 23-18-03, Area 23 Skid Huts Pesticide Storage; and 15-18-02, Area 15 Quonset Hut 15-11 Pesticide Storage. The purpose of this Corrective Action Decision Document is to identify and provide a rationale for the selection of a recommended correctivemore » action alternative for each Corrective Action Site. The scope of this Corrective Action Decision Document consists of the following tasks: Develop corrective action objectives; Identify corrective action alternative screening criteria; Develop corrective action alternatives; Perform detailed and comparative evaluations of the corrective action alternatives in relation to the corrective action objectives and screening criteria; and Recommend and justify a preferred corrective action alternative for each Corrective Action Site.« less

Waste processing building with incineration technology

NASA Astrophysics Data System (ADS)

Wasilah, Wasilah; Zaldi Suradin, Muh.

2017-12-01

In Indonesia, waste problem is one of major problem of the society in the city as part of their life dynamics. Based on Regional Medium Term Development Plan of South Sulawesi Province in 2013-2018, total volume and waste production from Makassar City, Maros, Gowa, and Takalar Regency estimates the garbage dump level 9,076.949 m3/person/day. Additionally, aim of this design is to present a recommendation on waste processing facility design that would accommodate waste processing process activity by incineration technology and supported by supporting activity such as place of education and research on waste, and the administration activity on waste processing facility. Implementation of incineration technology would reduce waste volume up to 90% followed by relative negative impact possibility. The result planning is in form of landscape layout that inspired from the observation analysis of satellite image line pattern of planning site and then created as a building site pattern. Consideration of building orientation conducted by wind analysis process and sun path by auto desk project Vasari software. The footprint designed by separate circulation system between waste management facility interest and the social visiting activity in order to minimize the croos and thus bring convenient to the building user. Building mass designed by inseparable connection series system, from the main building that located in the Northward, then connected to a centre visitor area lengthways, and walked to the waste processing area into the residue area in the Southward area.

Caring letters for suicide prevention: implementation of a multi-site randomized clinical trial in the U.S. military and Veteran Affairs healthcare systems.

PubMed

Luxton, David D; Thomas, Elissa K; Chipps, Joan; Relova, Rona M; Brown, Daphne; McLay, Robert; Lee, Tina T; Nakama, Helenna; Smolenski, Derek J

2014-03-01

Caring letters is a suicide prevention intervention that entails the sending of brief messages that espouse caring concern to patients following discharge from treatment. First tested more than four decades ago, this intervention is one of the only interventions shown in a randomized controlled trial to reduce suicide mortality rates. Due to elevated suicide risk among patients following psychiatric hospitalization and the steady increase in suicide rates among the U.S. military personnel, it is imperative to test interventions that may help prevent suicide among high-risk military personnel and veterans. This paper describes the design, methods, study protocol, and regulatory implementation processes for a multi-site randomized controlled trial that aims to evaluate the effectiveness of a caring emails intervention for suicide prevention in the military and VA healthcare systems. The primary outcome is suicide mortality rates to be determined 24 months post-discharge from index hospital stay. Healthcare re-utilization rates will also be evaluated and comprehensive data will be collected regarding suicide risk factors. Recommendations for navigating the military and VA research regulatory processes and implementing a multi-site clinical trial at military and VA hospitals are discussed. Published by Elsevier Inc.

Assay optimisation and technology transfer for multi-site immuno-monitoring in vaccine trials

PubMed Central

Harris, Stephanie A.; Satti, Iman; Bryan, Donna; Walker, K. Barry; Dockrell, Hazel M.; McShane, Helen; Ho, Mei Mei

2017-01-01

Cellular immunological assays are important tools for the monitoring of responses to T-cell-inducing vaccine candidates. As these bioassays are often technically complex and require considerable experience, careful technology transfer between laboratories is critical if high quality, reproducible data that allows comparison between sites, is to be generated. The aim of this study, funded by the European Union Framework Program 7-funded TRANSVAC project, was to optimise Standard Operating Procedures and the technology transfer process to maximise the reproducibility of three bioassays for interferon-gamma responses: enzyme-linked immunosorbent assay (ELISA), ex-vivo enzyme-linked immunospot and intracellular cytokine staining. We found that the initial variability in results generated across three different laboratories reduced following a combination of Standard Operating Procedure harmonisation and the undertaking of side-by-side training sessions in which assay operators performed each assay in the presence of an assay ‘lead’ operator. Mean inter-site coefficients of variance reduced following this training session when compared with the pre-training values, most notably for the ELISA assay. There was a trend for increased inter-site variability at lower response magnitudes for the ELISA and intracellular cytokine staining assays. In conclusion, we recommend that on-site operator training is an essential component of the assay technology transfer process and combined with harmonised Standard Operating Procedures will improve the quality, reproducibility and comparability of data produced across different laboratories. These data may be helpful in ongoing discussions of the potential risk/benefit of centralised immunological assay strategies for large clinical trials versus decentralised units. PMID:29020010

Hygiene-Related Diseases: Athlete's Foot (Tinea Pedis)

MedlinePlus

... Water Fluoridation Leadership Policy & Recommendations Fast Facts Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ... pedis. Dermatol Clin. 2003;21:431-62. Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ...

Integration of site-specific health information: Agency for Toxic Substances and Disease Registry health assessments

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

Lesperance, A.M.; Siegel, M.R.

The Agency for Toxic Substances and Disease Registry is required to conduct a health assessment of any site that is listed on or proposed for the US Environmental Protection Agency's National Priorities List. Sixteen US Department of Energy (DOE) sites currently fall into this category. Health assessments contain a qualitative description of impacts to public health and the environment from hazardous waste sites, as well as recommendations for actions to mitigate or eliminate risk. Because these recommendations may have major impacts on compliance activities at DOE facilities, the health assessments are an important source of information for the monitoring activitiesmore » of DOE's Office of Environmental Compliance (OEC). This report provides an overview of the activities involved in preparing the health assessment, its role in environmental management, and its key elements.« less

Improvement of Physical Therapist Assessment of Risk of Falls in the Hospital and Discharge Handover Through an Intervention to Modify Clinical Behavior.

PubMed

Thomas, Susie; Mackintosh, Shylie

2016-06-01

Discharge from the hospital is a high risk transition period for older adults at risk of falls. Guidelines relevant to physical therapists for managing this risk are well documented, but commonly not implemented. This project implemented an intervention to improve physical therapists' adherence to key guideline recommendations for managing risk of falls on discharge from one hospital. A pretest-posttest study design was undertaken and was underpinned by the Theoretical Domains Framework (TDF) to aid in the design of interventions to increase physical therapists' adherence to guideline recommendations and to identify barriers to these interventions. A multifaceted intervention was implemented, including the establishment of a governance committee, education sessions, development of a "pathway" to guide practice, modification of an existing standardized assessment proforma, development of standardized processes and indicators for handover, increasing availability of educational handouts, audit and feedback processes, and allocation of dedicated staffing to oversee falls prevention within the physical therapy department. There were significant improvements in physical therapist behavior leading to key guideline recommendations being met, including: the proportion of patients who were identified to be at risk of falls (6.3% preintervention versus 94.8% postintervention) prior to discharge, an increase in documentation of clinical handover at discharge (68.6% preintervention versus 90.9% postintervention), and improvement in the quality of this documented clinical handover (34.9% of case notes met 5 criteria preintervention versus 92.9% postintervention). The approach was resource intensive and consequently may be difficult to replicate at other sites. A multifaceted intervention underpinned by the TDF, designed to modify physical therapists' behavior to improve adherence to guideline recommendations for managing risk of falls on discharge from one hospital, was successful. © 2016 American Physical Therapy Association.

Children's Media Culture in the New Millennium: Mapping the Digital Landscape.

ERIC Educational Resources Information Center

Montgomery, Kathryn C.

2000-01-01

Describes technological, demographic, and market forces shaping the new digital media culture and the various Web sites being created for children and teens, explaining how heavily-promoted commercial sites overshadow educational sites. Discusses efforts to create safe Internet zones for children. Recommends actions to promote development of a…

Longleaf pine site zones

Treesearch

Phillip J. Craul; John S. Kush; William D. Boyer

2005-01-01

The authors delineate six major climatic areas of the longleaf pine (Pinus palustris Mill.) region. They subdivide these areas into 21 site zones, each of which is deemed homogenous with respect to climate, physiography, and soils. The site zones are mapped and their climate, physiography, and soils described. The authors recommend that plantings of...

Central site monitoring: results from a test of accuracy in identifying trials and sites failing Food and Drug Administration inspection.

PubMed

Lindblad, Anne S; Manukyan, Zorayr; Purohit-Sheth, Tejashri; Gensler, Gary; Okwesili, Paul; Meeker-O'Connell, Ann; Ball, Leslie; Marler, John R

2014-04-01

Site monitoring and source document verification account for 15%-30% of clinical trial costs. An alternative is to streamline site monitoring to focus on correcting trial-specific risks identified by central data monitoring. This risk-based approach could preserve or even improve the quality of clinical trial data and human subject protection compared to site monitoring focused primarily on source document verification. To determine whether a central review by statisticians using data submitted to the Food and Drug Administration (FDA) by clinical trial sponsors can identify problem sites and trials that failed FDA site inspections. An independent Analysis Center (AC) analyzed data from four anonymous new drug applications (NDAs) where FDA had performed site inspections overseen by FDA's Office of Scientific Investigations (OSI). FDA team members in the OSI chose the four NDAs from among all NDAs with data in Study Data Tabulation Model (SDTM) format. Two of the NDAs had data that OSI had deemed unreliable in support of the application after FDA site inspections identified serious data integrity problems. The other two NDAs had clinical data that OSI deemed reliable after site inspections. At the outset, the AC knew only that the experimental design specified two NDAs with significant problems. FDA gave the AC no information about which NDAs had problems, how many sites were inspected, or how many were found to have problems until after the AC analysis was complete. The AC evaluated randomization balance, enrollment patterns, study visit scheduling, variability of reported data, and last digit reference. The AC classified sites as 'High Concern', 'Moderate Concern', 'Mild Concern', or 'No Concern'. The AC correctly identified the two NDAs with data deemed unreliable by OSI. In addition, central data analysis correctly identified 5 of 6 (83%) sites for which FDA recommended rejection of data and 13 of 15 sites (87%) for which any regulatory deviations were identified during inspection. Of the six sites for which OSI reviewed inspections and found no deviations, the central process flagged four at the lowest level of concern, one at a moderate level, and one was not flagged. Central data monitoring during the conduct of a trial while data checking was in progress was not evaluated. Systematic central monitoring of clinical trial data can identify problems at the same trials and sites identified during FDA site inspections. Central data monitoring in conjunction with an overall monitoring process that adapts to identify risks as a trial progresses has the potential to reduce the frequency of site visits while increasing data integrity and decreasing trial costs compared to processes that are dependent primarily on source documentation.

Advantages and scientific basis of breastfeeding

USDA-ARS?s Scientific Manuscript database

The evidence behind current recommendations for breastfeeding is presented as a series of powerpoint slides with detailed references. Web sites and resources for infant feeding recommendations from the American Academy of Pediatrics and other health care provider professional groups are detailed. Ev...

Remediation management of complex sites using an adaptive site management approach.

PubMed

Price, John; Spreng, Carl; Hawley, Elisabeth L; Deeb, Rula

2017-12-15

Complex sites require a disproportionate amount of resources for environmental remediation and long timeframes to achieve remediation objectives, due to their complex geologic conditions, hydrogeologic conditions, geochemical conditions, contaminant-related conditions, large scale of contamination, and/or non-technical challenges. A recent team of state and federal environmental regulators, federal agency representatives, industry experts, community stakeholders, and academia worked together as an Interstate Technology & Regulatory Council (ITRC) team to compile resources and create new guidance on the remediation management of complex sites. This article summarizes the ITRC team's recommended process for addressing complex sites through an adaptive site management approach. The team provided guidance for site managers and other stakeholders to evaluate site complexities and determine site remediation potential, i.e., whether an adaptive site management approach is warranted. Adaptive site management was described as a comprehensive, flexible approach to iteratively evaluate and adjust the remedial strategy in response to remedy performance. Key aspects of adaptive site management were described, including tools for revising and updating the conceptual site model (CSM), the importance of setting interim objectives to define short-term milestones on the journey to achieving site objectives, establishing a performance model and metrics to evaluate progress towards meeting interim objectives, and comparing actual with predicted progress during scheduled periodic evaluations, and establishing decision criteria for when and how to adapt/modify/revise the remedial strategy in response to remedy performance. Key findings will be published in an ITRC Technical and Regulatory guidance document in 2017 and free training webinars will be conducted. More information is available at www.itrc-web.org. Copyright © 2017 Elsevier Ltd. All rights reserved.

Addendum to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 452: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, Revision 0

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

Grant Evenson

This document constitutes an addendum to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 452: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, April 1998 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additionalmore » information • The cover, title, and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the URs for CASs: • 25-25-09, Spill H940825C (from UST 25-3101-1) • 25-25-14, Spill H940314E (from UST 25-3102-3) • 25-25-15, Spill H941020E (from UST 25-3152-1) These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Addendum 2 to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 454: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, Revision 0

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

Grant Evenson

This document constitutes an addendum to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 454: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, April 1998 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additionalmore » information • The cover, title, and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the URs for CASs: • 12-25-08, Spill H950524F (from UST 12-B-1) • 12-25-10, Spill H950919A (from UST 12-COMM-1) These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Comparison of long-term SLR and GNSS solutions from selected stations in the frame of GGOS realization

NASA Astrophysics Data System (ADS)

Szafranek, K.; Schillak, S.; Araszkiewicz, A.; Figurski, M.; Lehmann, M.; Lejba, P.

2012-04-01

Up-to-date investigations concerning space geodesy are mostly aimed at data of various techniques joint processing. The poster presents solutions (North, East, Up components) of selected stations (McDonald, Yarragadee, Greenbelt, Monument Peak, Zimmerwald, Borowiec, Mt.Stromlo-Orroral, Potsdam, Graz, Herstmonceux and Wettzell), which adopted Satellite Laser Ranging (SLR) and Global Navigation Satellite System (GNSS) techniques and which were gathering the data in the same time (from 1994 to 2010). Processing of both types of data was made according to Global Geodetic Observing System (GGOS) recommendations, the same models and parameters from IERS Conventions 2010 were used in both processing strategies (if it was possible). The main goal was to obtain coordinates and their changes in time (velocities) basing on both techniques and to compare the results. The station coordinates were determined for the common reference epoch of both techniques - for first day of each month. Monthly orbital arcs for laser observations were created basing on solutions from several SLR sites (observations to LAGEOS-1 and LAGEOS-2 satellites) with the best solutions quality and the highest amount of observations. For GNSS coordinates determination about 130 sites belonging to International GNSS Service (IGS) were selected: 30 with local ties to SLR sites and others basing on their geolocalization (length of the baselines) and solutions time series analysis. Mainly, core IGS stations were used. Solutions of both techniques were analyzed in order to verify agreement of both techniques and for independent control of local ties.

NGST Science Instruments and Process

NASA Technical Reports Server (NTRS)

Mather, John

1999-01-01

Possible NGST (Next Generation Space Telescope) instruments have been studied by NASA, ESA (European Space Agency), and CSA (Canadian Space Agency) teams, and their reports were presented at this meeting and published on the NGST web sites. The instrument capabilities will be evaluated by the Ad Hoc Science Working Group and the technical readiness will be reviewed by a technical panel. Recommendations will be made to the NASA Project Scientist, who will present a report for public comment. NASA. ESA, and the CSA will then allocate instrument, responsibilities in early 2000. NASA will choose its scientific investigations with instruments in 2002.

Needle Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations

DTIC Science & Technology

2012-07-06

SUBJECT: Needle Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations 2012-05 2 demonstrating the...Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations 2012-05 3 needle may be too short to reliably reach the...at the AAL as the preferred site for needle decompression of a presumed tension pneumothorax . Further, studies evaluating chest wall thickness are

77 FR 4799 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

...] Recommendation 12-02: Pro Nuclear Future Use for Paducah Gaseous Diffusion Plant Site Public Comments Adjourn... clean-up science and technology activities). Comments outside of the scope may be submitted via written...

The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia

PubMed Central

Shiferaw, Fassil; Zolfo, Maria

2012-01-01

Background Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes. Objective This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources. Design Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites. Results Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect ‘one size fits all’ technology and the use of combined interoperable applications, according to the local context, is highly recommended. Conclusions Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts. PMID:22479235

Corrective Action Decision Document for Corrective Action Unit 204: Storage Bunkers, Nevada Test Site, Nevada, Rev. No. 0

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

Robert Boehlecke

2004-04-01

The six bunkers included in CAU 204 were primarily used to monitor atmospheric testing or store munitions. The ''Corrective Action Investigation Plan (CAIP) for Corrective Action Unit 204: Storage Bunkers, Nevada Test Site, Nevada'' (NNSA/NV, 2002a) provides information relating to the history, planning, and scope of the investigation; therefore, it will not be repeated in this CADD. This CADD identifies potential corrective action alternatives and provides a rationale for the selection of a recommended corrective action alternative for each CAS within CAU 204. The evaluation of corrective action alternatives is based on process knowledge and the results of investigative activitiesmore » conducted in accordance with the CAIP (NNSA/NV, 2002a) that was approved prior to the start of the Corrective Action Investigation (CAI). Record of Technical Change (ROTC) No. 1 to the CAIP (approval pending) documents changes to the preliminary action levels (PALs) agreed to by the Nevada Division of Environmental Protection (NDEP) and DOE, National Nuclear Security Administration Nevada Site Office (NNSA/NSO). This ROTC specifically discusses the radiological PALs and their application to the findings of the CAU 204 corrective action investigation. The scope of this CADD consists of the following: (1) Develop corrective action objectives; (2) Identify corrective action alternative screening criteria; (3) Develop corrective action alternatives; (4) Perform detailed and comparative evaluations of corrective action alternatives in relation to corrective action objectives and screening criteria; and (5) Recommend and justify a preferred corrective action alternative for each CAS within CAU 204.« less

Cultural adaptation process for international dissemination of the strengthening families program.

PubMed

Kumpfer, Karol L; Pinyuchon, Methinin; Teixeira de Melo, Ana; Whiteside, Henry O

2008-06-01

The Strengthening Families Program (SFP) is an evidence-based family skills training intervention developed and found efficacious for substance abuse prevention by U.S researchers in the 1980s. In the 1990s, a cultural adaptation process was developed to transport SFP for effectiveness trials with diverse populations (African, Hispanic, Asian, Pacific Islander, and Native American). Since 2003, SFP has been culturally adapted for use in 17 countries. This article reviews the SFP theory and research and a recommended cultural adaptation process. Challenges in international dissemination of evidence-based programs (EBPs) are discussed based on the results of U.N. and U.S. governmental initiatives to transport EBP family interventions to developing countries. The technology transfer and quality assurance system are described, including the language translation and cultural adaptation process for materials development, staff training, and on-site and online Web-based supervision and technical assistance and evaluation services to assure quality implementation and process evaluation feedback for improvements.

Content validation using an expert panel: assessment process for assistive technology adopted by farmers with disabilities.

PubMed

Mathew, S N; Field, W E; French, B F

2011-07-01

This article reports the use of an expert panel to perform content validation of an experimental assessment process for the safety of assistive technology (AT) adopted by farmers with disabilities. The validation process was conducted by a panel of six experts experienced in the subject matter, i.e., design, use, and assessment of AT for farmers with disabilities. The exercise included an evaluation session and two focus group sessions. The evaluation session consisted of using the assessment process under consideration by the panel to evaluate a set of nine ATs fabricated by a farmer on his farm site. The expert panel also participated in the focus group sessions conducted immediately before and after the evaluation session. The resulting data were analyzed using discursive analysis, and the results were incorporated into the final assessment process. The method and the results are presented with recommendations for the use of expert panels in research projects and validation of assessment tools.

ASDE-2 Reliability Improvement Study : Volume I. Operational Data and Modification Recommendations.

DOT National Transportation Integrated Search

1974-11-01

Eight airport sites and the FAA Oklahoma Depot were visited and surveys conducted to obtain reliability, maintainability and performance data on the ASDE-2 Radar System. The data was analyzed and recommendations for modification to the equipment made...

ASDE-2 Reliability Improvement Study : Volume II. Modulator, Receiver and Indicator Interface Recommendations

DOT National Transportation Integrated Search

1974-11-01

Eight airport sites and the FAA Oklahoma Depot were visited and surveys conducted to obtain reliability, maintainability and performance data on the ASDE-2 Radar System. The data was analyzed and recommendations for modification to the equipment made...

Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

PubMed

Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

2011-11-01

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.

The 50 Constellation Priority Sites

NASA Technical Reports Server (NTRS)

Noble, S.; Joosten, K.; Eppler, D.; Gruener, J.; Mendell, W.; French, R.; Plescia, J.; Spudis, P.; Wargo, M.; Robinson, M.;

Spatio-Temporal Process Variability in Watershed Scale Wetland Restoration Planning

NASA Astrophysics Data System (ADS)

Evenson, G. R.

2012-12-01

Watershed scale restoration decision making processes are increasingly informed by quantitative methodologies providing site-specific restoration recommendations - sometimes referred to as "systematic planning." The more advanced of these methodologies are characterized by a coupling of search algorithms and ecological models to discover restoration plans that optimize environmental outcomes. Yet while these methods have exhibited clear utility as decision support toolsets, they may be critiqued for flawed evaluations of spatio-temporally variable processes fundamental to watershed scale restoration. Hydrologic and non-hydrologic mediated process connectivity along with post-restoration habitat dynamics, for example, are commonly ignored yet known to appreciably affect restoration outcomes. This talk will present a methodology to evaluate such spatio-temporally complex processes in the production of watershed scale wetland restoration plans. Using the Tuscarawas Watershed in Eastern Ohio as a case study, a genetic algorithm will be coupled with the Soil and Water Assessment Tool (SWAT) to reveal optimal wetland restoration plans as measured by their capacity to maximize nutrient reductions. Then, a so-called "graphical" representation of the optimization problem will be implemented in-parallel to promote hydrologic and non-hydrologic mediated connectivity amongst existing wetlands and sites selected for restoration. Further, various search algorithm mechanisms will be discussed as a means of accounting for temporal complexities such as post-restoration habitat dynamics. Finally, generalized patterns of restoration plan optimality will be discussed as an alternative and possibly superior decision support toolset given the complexity and stochastic nature of spatio-temporal process variability.

What do you mean you can't sterilize it? The reusable medical device matrix.

PubMed

Stephens, Anne; Assang, AnnMarie

2010-12-01

Health Canada recommends that hospitals should have procedures in place to ensure Reusable Medical Devices (RMD) are cleaned, disinfected and sterilized according to the manufacturer's instructions. For the purpose of this paper, reusable medical devices will be referred to as RMDs and include all instrumentation and devices that the Central Processing Department (CPD) resterilizes for use in the hospital. Patient safety in surgery begins in CPD. Manufacturer recommendations for the decontamination and sterilization of surgical instrumentation are of utmost importance to Operating Room (OR) and CPD staff. With recommendations that are unclear, nonspecific or unattainable there was a need to define what it means institutionally to meet standards and provide safe patient care while continuing to support the advancement of surgical technology. The purpose of this paper is to describe the challenges faced by one multisite organization (The University Health Network) in managing the sterilization of surgical instrumentation. The development of The Guidance Matrix by the network's inter-professional Reusable Medical Device (RMD) Committee, will be discussed along with information about the elements of this tool and an illustration of how it is used. The key benefits of The Guidance Matrix, including how its use has facilitated transparent decision-making, communication and collaboration regarding sterilization issues across the sites, will be described. Sterilization processes in Central Processing Departments (CPD) include chemical indicators, dated load indicators, and tamperproof locks and filters. The lack of an indicator of sterilization can be a frustrating experience for an OR Nurse. But do we really understand the critical importance of all these indicators? The foundation of sterilizing reusable medical devices (RMDs) begins with proper processes, standards and subsequent scientific validation from the vendors. According to AORN, patient safety is vital and it begins with proper cleaning and processing of the surgical instruments. Surgical site infections can increase the length of stay and the cost of the patients' hospitalization, as well as increased risk, morbidity and even mortality. 1 Today's patients are far more informed than they were in the past. They can gather information from the internet as well as from television, radio, and print media. This knowledge empowers the patient to expect that their healthcare providers are practicing due diligence. It is the ethical duty and responsibility of nurses to provide safe, competent care while protecting the rights of the patient and being accountable to the professional governing bodies. In other words, we are advocates for both our patients and the healthcare system.2 Using both new and innovative instruments in the OR was, in the past, as simple as a surgeon requesting an instrument, the perioperative nurse ordering the instrument and CPD processing it for use in the OR. That is no longer the case. With a wide range of more complex instrumentation and an increasing focus on sterilization strategies, healthcare facilities have had to adopt a more rigorous approach. There are many challenges in the world of sterile processing. A common one, faced on a regular basis, is the provision of vague, inaccurate reprocessing recommendations from the medical device manufacturer. Canadian centres are not able to meet European standards for reprocessing. European cycles, often referred to as "Fractionated Steam Cycles", are different than the pre-vacuum steam cycles run in Canada.

Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline.

PubMed

Polkowski, M; Larghi, A; Weynand, B; Boustière, C; Giovannini, M; Pujol, B; Dumonceau, J-M

2012-02-01

This article is the second of a two-part publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided Trucut biopsy. The first part (the Clinical Guideline) focused on the results obtained with EUS-guided sampling, and the role of this technique in patient management, and made recommendations on circumstances that warrant its use. The current Technical Guideline discusses issues related to learning, techniques, and complications of EUS-guided sampling, and to processing of specimens. Technical issues related to maximizing the diagnostic yield (e.g., rapid on-site cytopathological evaluation, needle diameter, microcore isolation for histopathological examination, and adequate number of needle passes) are discussed and recommendations are made for various settings, including solid and cystic pancreatic lesions, submucosal tumors, and lymph nodes. The target readership for the Clinical Guideline mostly includes gastroenterologists, oncologists, internists, and surgeons while the Technical Guideline should be most useful to endoscopists who perform EUS-guided sampling. A two-page executive summary of evidence statements and recommendations is provided. © Georg Thieme Verlag KG Stuttgart · New York.

Chapter 8. Medical procedures. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Zimmerman, Janice L; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on ensuring that adequate resources are available and appropriate protocols are developed to safely perform procedures in patients with and without influenza illness. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including performing medical procedures. Key recommendations include: (1) specify high-risk procedures (aerosol generating-procedures); (2) determine if certain procedures will not be performed during a pandemic; (3) develop protocols for safe performance of high-risk procedures that include appropriateness, qualifications of personnel, site, personal protection equipment, safe technique and equipment needs; (4) ensure adequate training of personnel in high-risk procedures; (5) procedures should be performed at the bedside whenever possible; (6) ensure safe respiratory therapy practices to avoid aerosols; (7) provide safe respiratory equipment; and (8) determine criteria for cancelling and/or altering elective procedures. Judicious planning and adoption of protocols for safe performance of medical procedures are necessary to optimize outcomes during a pandemic.

A Group-Decision Approach for Evaluating Educational Web Sites

ERIC Educational Resources Information Center

Hwang, Gwo-Jen; Huanga, Tony C. K.; Tseng, Judy C. R.

2004-01-01

With the advent of network technologies, many educational web sites have been developed to assist students in the learning of subjects on computer networks. However, without proper aid, students may have difficulty in selecting appropriate web sites, that are of benefit to them; hence, studying, evaluating and recommending educational web sites…

Effects of chemical site preparation on herbaceous vegetation prior to hardwood plantation establishment

Treesearch

Andrew B. Self; Andrew W. Ezell; Andrew J. Londo; John D. Hodges; Derek K. Alkire

2012-01-01

Chemical site preparation is sometimes prescribed when attempting hardwood afforestation in the South. However, adequate research has not been conducted regarding the efficacy of various herbicide treatments often recommended. For practical purposes, the question of whether chemical site preparation provides residual control of herbaceous vegetation in retired...

Improving integration and coordination of funding, technical assistance, and reporting/data collection: recommendations from CDC and USAPI stakeholders.

PubMed

Ka'opua, Lana Sue I; White, Susan F; Rochester, Phyllis F; Holden, Debra J

2010-09-01

Current US Federal funding mechanisms may foster program silos that disable sharing of resources and information across programs within a larger system of public health services. Such silos present challenges to USAPI communities where human resources, health infrastructure, and health financing are limited. Integrative and coordinated approaches have been recommended. The CDC Pacific Islands Integration and Coordination project was initiated by the Division of Cancer Prevention and Control (DCPC). Its project aim was to identify ways for the CDC to collaborate with the USAPI in improving CDC activities and processes related to chronic disease. This article focuses on recommendations for improving coordination and integration in three core areas of health services programming: funding, program reporting/data collection and analysis, and technical assistance. Preliminary information on challenges and issues relevant to the core areas was gathered through site visits, focus groups, key informant interviews, and other sources. This information was used by stakeholder groups from the CDC and the USAPI to develop recommendations in the core programming areas. Recommendations generated at the CDC and USAPI stakeholder meetings were prepared into a single set of recommendations and stakeholders reviewed the document for accuracy prior to its dissemination to CDC's National Center for Chronic Disease Prevention and Health Promotion programs management and staff. Key recommendations, include: (1) consideration of resource s and other challenges unique to the USAPI when reviewing funding applications, (2) consideration of ways to increase flexibility in USAPI use of program funds, (3) dedicate funding and human resources for technical assistance, (4) provide opportunities for capacity-building across programs and jurisdictions, (5) consider ways to more directly link program reporting with technical assistance. This project provided a unique opportunity for CDC and USAPI stakeholders to share diverse perspectives on challenges to public health programs in the USAPI. Despite diverse experiences, the final set of recommendations reflected a high level of concordance between USAPI and CDC stakeholders on ways to improve coordination and integration of CDC processes and activities in the three core areas. Recommendations have informed some actions already initiated by the DCPC, including the dedication of funds for leadership institutes aimed at enhancing USAPI capacity for sustainable, integrated regional and jurisdictional cancer control infrastructure. Such efforts are an important beginning, but more remains to be done. Indicated is the need for continuous dialogue and collaboration. While this project focused on the USAPI, our results may be relevant to those interested in inter-organizational collaborations, medically underserved areas, public health services programs, and community-based participatory approaches.

Detection of selected periodontal bacteria in preschool children affected by early childhood caries.

PubMed

Pantuckova, Pavla; Bartosova, Michaela; Broukal, Zdenek; Kukletova, Martina; Holla, Lydie Izakovicova

2016-11-01

The aim of this study was to compare the detection frequency of periodontal bacteria in dental plaque in children with early childhood caries (ECC) with and without gingival inflammation. A convenience sample of 25 preschool children (mean age 3.61 years, SD 1.42) was recruited. Dental plaque was taken from periodontal areas with and without visible signs of inflammation and processed using the StomaGene® (Protean s.r.o. Czech Republic) and ParoCheck® 20 (Greiner Bio-one GmbH, Germany) detection kits. The two sample t tests between percents for differences between inflammatory and healthy sites and kappa statistics for the agreement of both systems were used. At the inflammatory sites, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were significantly more frequently detected by StomaGene® while Fusobacterium nucleatum, A. actinomycetemcomitans, Tanarella forsythia and Prevotella intermedia were significantly more frequently identified by ParoCheck® test. The agreement between the two detection systems was substantial for A. actinomycetemcomitans and F. nucleatum in the samples collected from inflamed sites and only for F. nucleatum from clinically healthy sites. Therefore, we recommend that the same system should be used when the same patient is examined repeatedly.

Mood as a resource in dealing with health recommendations: how mood affects information processing and acceptance of quit-smoking messages.

PubMed

Das, Enny; Vonkeman, Charlotte; Hartmann, Tilo

2012-01-01

An experimental study tested the effects of positive and negative mood on the processing and acceptance of health recommendations about smoking in an online experiment. It was hypothesised that positive mood would provide smokers with the resources to systematically process self-relevant health recommendations. One hundred and twenty-seven participants (smokers and non-smokers) read a message in which a quit smoking programme was recommended. Participants were randomly assigned to one of four conditions: positive versus negative mood, and strong versus weak arguments for the recommended action. Systematic message processing was inferred when participants were able to distinguish between high- and low-quality arguments, and by congruence between attitudes and behavioural intentions. Persuasion was measured by participant's attitudes towards smoking and the recommended action, and by their intentions to follow the action recommendation. As predicted, smokers systematically processed the health message only under positive mood conditions; non-smokers systematically processed the health message only under negative mood conditions. Moreover, smokers' attitudes towards the health message predicted intentions to quit smoking only under positive mood conditions. Findings suggest that positive mood may decrease defensive processing of self-relevant health information.

Estimation of empirical site amplification factors in Taiwan

NASA Astrophysics Data System (ADS)

Chung, Chi-Hsuan; Wen, Kuo-Liang; Kuo, Chun-Hsiang

2017-04-01

Lots of infrastructures are under construction in metropolises in Taiwan in recent years and thus leads to increasement of population density and urbanization in those area. Taiwan island is located in plate boundaries in which the high seismicity is caused by active tectonic plates. The Chi-Chi earthquake (Mw 7.6) in 1999 caused a fatality of more than 2000, and the Meinong earthquake (Mw 6.5) in 2016 caused a fatality of 117 in Tainan city as well as damages on hundreds of buildings. The cases imply seismic vulnerability of urban area. During the improvements for seismic hazard analysis and seismic design, consideration of seismic site amplifications in different site conditions is one of important issues. This study used selected and processed strong motion records observed by the TSMIP network. The site conditions considered as Vs30 used in this study were investigated at most stations (Kuo et al. 2012; Kuo et al. 2016). Since strong motion records and site conditions are both available, we are able to use the data to analyze site amplifications of seismic waves at different periods. The result may be a reference for future modification of seismic design codes to decrease potential seismic hazards and losses. We adopted the strong motion and site database of the SSHAC (Senior Seismic Hazard Analysis Committee) Level 3 project in Taiwan. The selected significant crustal and subduction events of magnitude larger than six for analysis. The amplification factors of PGA, PGV, PGD, and spectra acceleration at 0.3, 1.0, and 3.0 seconds were evaluated using the processed strong motions. According to the recommendation of SSHAC Level 3 project, the site condition of Vs30 = 760 m/s is considered as the reference rock site in this study. The stations with Vs30 between 600 m/s and 900 m/s and used as the reference rock sites in reality. For each event, we find a reference rock site and other site within a certain distance (region dependent) to calculate site amplifications of ground motions. Relationships of site amplification factors and Vs30 are therefore derived for strong motions by regression analysis. Soil nonlinearity (decrease of amplifications) has to be considered at soft soil sites during a strong shaking. We also discuss amplification factors in terms of different intensities if data is available.

Analysis of ILRS Site Ties

NASA Astrophysics Data System (ADS)

Husson, V. S.; Long, J. L.; Pearlman, M.

2001-12-01

By the end of 2000, 94% of ILRS stations had completed station and site information forms (i.e. site logs). These forms contain six types of information. These six categories include site identifiers, contact information, approximate coordinates, system configuration history, system ranging capabilities, and local survey ties. The ILRS Central Bureau, in conjunction with the ILRS Networks and Engineering Working Group, has developed procedures to quality control site log contents. Part of this verification entails data integrity checks of local site ties and is the primary focus of this paper. Local survey ties are critical to the combination of space geodetic network coordinate solutions (i.e. GPS, SLR, VLBI, DORIS) of the International Terrestrial Reference Frame (ITRF). Approximately 90% of active SLR sites are collocated with at least one other space geodetic technique. The process used to verify these SLR ties, at collocated sites, is identical to the approach used in ITRF2000. Local vectors (X, Y, Z) from each ILRS site log are differenced from its corresponding ITRF2000 position vectors (i.e. no transformations). These X, Y, and Z deltas are converted into North, East, and Up. Any deltas, in any component, larger than 5 millimeter is flagged for investigation. In the absence of ITRF2000 SLR positions, CSR positions were used. To further enhance this comparison and to fill gaps in information, local ties contained in site logs from the other space geodetic services (i.e. IGS, IVS, IDS) were used in addition to ITRF2000 ties. Case studies of two collocated sites (McDonald/Ft. Davis and Hartebeeshtoek) will be explored in-depth. Recommendations on how local site surveys should be conducted and how this information should be managed will also be presented.

Surgical swab counting: a qualitative analysis from the perspective of the scrub nurse.

PubMed

D'Lima, D; Sacks, M; Blackman, W; Benn, J

2014-05-01

The aim of the study was to conduct a qualitative exploration of the sociotechnical processes underlying retained surgical swabs, and to explore the fundamental reasons why the swab count procedure and related protocols fail in practice. Data was collected through a set of 27 semistructured qualitative interviews with scrub nurses from a large, multi-site teaching hospital. Interview transcripts were analysed using established constant comparative methods, moving between inductive and deductive reasoning. Key findings were associated with interprofessional perspectives, team processes and climate and responsibility for the swab count. The analysis of risk factors revealed that perceived social and interprofessional issues played a significant role in the reliability of measures to prevent retained swabs. This work highlights the human, psychological and organisational factors that impact upon the reliability of the process and gives rise to recommendations to address contextual factors and improve perioperative practice and training.

Recommendations for portable supplemental meteorological instrumentation for incident response

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

Brown, R.M.; Tichler, J.L.

The Nuclear Regulatory Commission (NRC) staff requested technical assistance in recommending portable supplementary meteorological instrumentation which can be deployed to nuclear power plant sites in response to incidents. A supplementary meteorological system (SMS), whose primary function is to collect, analyze and disseminate supplemental meteorological information, is recommended. Instrument specifications are discussed along with maintenance and staffing requirements. A cost evaluation of the components is made. 5 refs., 1 fig.

Corrective Action Investigation Plan for Corrective Action Unit 374: Area 20 Schooner Unit Crater Nevada Test Site, Nevada, Revision 0

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

Patrick Matthews

Corrective Action Unit 374 is located in Areas 18 and 20 of the Nevada Test Site, which is approximately 65 miles northwest of Las Vegas, Nevada. Corrective Action Unit 374 comprises the five corrective action sites (CASs) listed below: • 18-22-05, Drum • 18-22-06, Drums (20) • 18-22-08, Drum • 18-23-01, Danny Boy Contamination Area • 20-45-03, U-20u Crater (Schooner) These sites are being investigated because existing information on the nature and extent of potential contamination is insufficient to evaluate and recommend corrective action alternatives (CAAs). Additional information will be obtained by conducting a corrective action investigation before evaluating CAAsmore » and selecting the appropriate corrective action for each CAS. The results of the field investigation will support a defensible evaluation of viable CAAs that will be presented in the Corrective Action Decision Document. The sites will be investigated based on the data quality objectives (DQOs) developed on October 20, 2009, by representatives of the Nevada Division of Environmental Protection and the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office. The DQO process was used to identify and define the type, amount, and quality of data needed to develop and evaluate appropriate corrective actions for CAU 374.« less

Sexual assault reporting procedures at Ohio colleges.

PubMed

Krivoshey, Mira S; Adkins, Rachel; Hayes, Rebecca; Nemeth, Julianna M; Klein, Elizabeth G

2013-01-01

To assess how Ohio colleges conform to recommendations that address barriers to reporting sexual assault. A study sample of Ohio 4-year colleges (N = 105). College Web sites were examined between March and November 2011 for their availability of sexual assault policies using 8 measures. Of the colleges in the sample, 66% had an online sexual assault policy. Less than 1% of colleges included definitions for applicable sexual offenses in the Ohio Revised Code. All colleges with a policy included on-campus personnel to whom a victim could report. Approximately 25% and 31% of colleges included confidential or 24/7 reporting options, respectively. Many colleges are failing to offer basic reporting options to victims of sexual assault. Having a clearly labeled sexual assault policy on a campus Web site that includes 24/7 reporting options and defines acts of sexual assault can aid victims in the reporting process.

A design thinking approach to evaluating interprofessional education.

PubMed

Cahn, Peter S; Bzowyckyj, Andrew; Collins, Lauren; Dow, Alan; Goodell, Kristen; Johnson, Alex F; Klocko, David; Knab, Mary; Parker, Kathryn; Reeves, Scott; Zierler, Brenda K

2016-05-01

The complex challenge of evaluating the impact of interprofessional education (IPE) on patient and community health outcomes is well documented. Recently, at the Radcliffe Institute for Advanced Study in the United States, leaders in health professions education met to help generate a direction for future IPE evaluation research. Participants followed the stages of design thinking, a process for human-centred problem solving, to reach consensus on recommendations. The group concluded that future studies should focus on measuring an intermediate step between learning activities and patient outcomes. Specifically, knowing how IPE-prepared students and preceptors influence the organisational culture of a clinical site as well as how the culture of clinical sites influences learners' attitudes about collaborative practice will demonstrate the value of educational interventions. With a mixed methods approach and an appreciation for context, researchers will be able to identify the factors that foster effective collaborative practice and, by extension, promote patient-centred care.

Best strategies to implement clinical pathways in an emergency department setting: study protocol for a cluster randomized controlled trial.

PubMed

Jabbour, Mona; Curran, Janet; Scott, Shannon D; Guttman, Astrid; Rotter, Thomas; Ducharme, Francine M; Lougheed, M Diane; McNaughton-Filion, M Louise; Newton, Amanda; Shafir, Mark; Paprica, Alison; Klassen, Terry; Taljaard, Monica; Grimshaw, Jeremy; Johnson, David W

2013-05-22

The clinical pathway is a tool that operationalizes best evidence recommendations and clinical practice guidelines in an accessible format for 'point of care' management by multidisciplinary health teams in hospital settings. While high-quality, expert-developed clinical pathways have many potential benefits, their impact has been limited by variable implementation strategies and suboptimal research designs. Best strategies for implementing pathways into hospital settings remain unknown. This study will seek to develop and comprehensively evaluate best strategies for effective local implementation of externally developed expert clinical pathways. We will develop a theory-based and knowledge user-informed intervention strategy to implement two pediatric clinical pathways: asthma and gastroenteritis. Using a balanced incomplete block design, we will randomize 16 community emergency departments to receive the intervention for one clinical pathway and serve as control for the alternate clinical pathway, thus conducting two cluster randomized controlled trials to evaluate this implementation intervention. A minimization procedure will be used to randomize sites. Intervention sites will receive a tailored strategy to support full clinical pathway implementation. We will evaluate implementation strategy effectiveness through measurement of relevant process and clinical outcomes. The primary process outcome will be the presence of an appropriately completed clinical pathway on the chart for relevant patients. Primary clinical outcomes for each clinical pathway include the following: Asthma--the proportion of asthmatic patients treated appropriately with corticosteroids in the emergency department and at discharge; and Gastroenteritis--the proportion of relevant patients appropriately treated with oral rehydration therapy. Data sources include chart audits, administrative databases, environmental scans, and qualitative interviews. We will also conduct an overall process evaluation to assess the implementation strategy and an economic analysis to evaluate implementation costs and benefits. This study will contribute to the body of evidence supporting effective strategies for clinical pathway implementation, and ultimately reducing the research to practice gaps by operationalizing best evidence care recommendations through effective use of clinical pathways. ClinicalTrials.gov: NCT01815710.

Deriving site-specific soil clean-up values for metals and metalloids: Rationale for including protection of soil microbial processes

PubMed Central

Kuperman, Roman G; Siciliano, Steven D; Römbke, Jörg; Oorts, Koen

2014-01-01

Although it is widely recognized that microorganisms are essential for sustaining soil fertility, structure, nutrient cycling, groundwater purification, and other soil functions, soil microbial toxicity data were excluded from the derivation of Ecological Soil Screening Levels (Eco-SSL) in the United States. Among the reasons for such exclusion were claims that microbial toxicity tests were too difficult to interpret because of the high variability of microbial responses, uncertainty regarding the relevance of the various endpoints, and functional redundancy. Since the release of the first draft of the Eco-SSL Guidance document by the US Environmental Protection Agency in 2003, soil microbial toxicity testing and its use in ecological risk assessments have substantially improved. A wide range of standardized and nonstandardized methods became available for testing chemical toxicity to microbial functions in soil. Regulatory frameworks in the European Union and Australia have successfully incorporated microbial toxicity data into the derivation of soil threshold concentrations for ecological risk assessments. This article provides the 3-part rationale for including soil microbial processes in the development of soil clean-up values (SCVs): 1) presenting a brief overview of relevant test methods for assessing microbial functions in soil, 2) examining data sets for Cu, Ni, Zn, and Mo that incorporated soil microbial toxicity data into regulatory frameworks, and 3) offering recommendations on how to integrate the best available science into the method development for deriving site-specific SCVs that account for bioavailability of metals and metalloids in soil. Although the primary focus of this article is on the development of the approach for deriving SCVs for metals and metalloids in the United States, the recommendations provided in this article may also be applicable in other jurisdictions that aim at developing ecological soil threshold values for protection of microbial processes in contaminated soils. PMID:24376192

Integrating unmanned aerial systems and LSPIV for rapid, cost-effective stream gauging

NASA Astrophysics Data System (ADS)

Lewis, Quinn W.; Lindroth, Evan M.; Rhoads, Bruce L.

2018-05-01

Quantifying flow in rivers is fundamental to assessments of water supply, water quality, ecological conditions, hydrological responses to storm events, and geomorphological processes. Image-based surface velocity measurements have shown promise in extending the range of discharge conditions that can be measured in the field. The use of Unmanned Aerial Systems (UAS) in image-based measurements of surface velocities has the potential to expand applications of this method. Thus far, few investigations have assessed this potential by evaluating the accuracy and repeatability of discharge measurements using surface velocities obtained from UAS. This study uses large-scale particle image velocimetry (LSPIV) derived from videos captured by cameras on a UAS and a fixed tripod to obtain discharge measurements at ten different stream locations in Illinois, USA. Discharge values are compared to reference values measured by an acoustic Doppler current profiler, a propeller meter, and established stream gauges. The results demonstrate the effects of UAS flight height, camera steadiness and leveling accuracy, video sampling frequency, and LSPIV interrogation area size on surface velocities, and show that the mean difference between fixed and UAS cameras is less than 10%. Differences between LSPIV-derived and reference discharge values are generally less than 20%, not systematically low or high, and not related to site parameters like channel width or depth, indicating that results are relatively insensitive to camera setup and image processing parameters typically required of LSPIV. The results also show that standard velocity indices (between 0.85 and 0.9) recommended for converting surface velocities to depth-averaged velocities yield reasonable discharge estimates, but are best calibrated at specific sites. The study recommends a basic methodology for LSPIV discharge measurements using UAS that is rapid, cost-efficient, and does not require major preparatory work at a measurement location, pre- and post-processing of imagery, or extensive background in image analysis and PIV.

Quality and readability of online patient information regarding sclerotherapy for venous malformations.

PubMed

Pass, Jonathan H; Patel, Amani H; Stuart, Sam; Barnacle, Alex M; Patel, Premal A

2018-05-01

Patients often use the internet as a source of information about their condition and treatments. However, this information is unregulated and varies in quality. To evaluate the readability and quality of online information for pediatric and adult patients and caregivers regarding sclerotherapy for venous malformations. "Venous malformation sclerotherapy" was entered into Google, and results were reviewed until 20 sites that satisfied predefined inclusion criteria were identified. Scientific and non-patient-focused web pages were excluded. Readability was assessed using the Flesch Reading Ease Score and American Medical Association reading difficulty recommendations and quality was assessed using Journal of the American Medical Association standards and assessing if the site displayed HONcode (Health on the Net Code) certification. Assessment of the breadth of relevant information was made using a predefined checklist. Forty-nine search engine results were reviewed before 20 sites were identified for analysis. Average Flesch Reading Ease Score was 44 (range: 24.2-70.1), representing a "fairly difficult" reading level. None of the sites had a Flesch Reading Ease Score meeting the American Medical Association recommendation of 80-90. Only one site met all four Journal of the American Medical Association quality criteria (average: 2.1). None of the sites displayed a HONcode seal. The information most frequently found was: sclerotherapy is performed by radiologists, multiple treatments may be needed and surgery is an alternative treatment. Online information regarding sclerotherapy for venous malformations is heterogeneous in quality and breadth of information, and does not meet readability recommendations for patient information. Radiologists should be aware of and account for this when meeting patients.

EVALUATION OF VADOSE ZONE TREATMENT TECHNOLOGIES TO IMMOBILIZE TECHNETIUM-99

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

PETERSEN, S.W.

2006-03-15

The Hanford Site End State Vision document (DOE/RL-2003-59) states: ''There should be an aggressive plan to develop technology for remediation of the contamination that could get to the groundwater (particularly the technetium [{sup 99}Tc])''. In addition, there is strong support from the public and regulatory agencies for the above statement, with emphasis on investigation of treatment alternatives. In July 2004, PNNL completed a preliminary evaluation of remediation technologies with respect to their effectiveness and implementability for immobilization of {sup 99}Tc beneath the BC Cribs in the 200 West Area (Truex, 2004). As a result of this evaluation, PNNL recommended treatabilitymore » testing of in situ soil desiccation, because it has the least uncertainty of those technologies evaluated in July 2004 (Treatability Test Outline, September 30, 2004). In 2005, DOE-RL and Fluor Hanford convened an independent technical panel to review alternative remediation technologies, including desiccation, at a three-day workshop in Richland, Washington. The panel was composed of experts in vadose-zone transport, infiltration control, hydrology, geochemistry, environmental engineering, and geology. Their backgrounds include employment in academia, government laboratories, industry, and consulting. Their review, presented in this document, is based upon written reports from Hanford, oral presentations from Hanford staff, and each panel members' years of experience in their particular field of expertise. The purpose of this report is to document the panel's evaluation of various treatment alternatives with potential for minimizing contaminant migration in the deep vadose zone at the Department of Energy Hanford Site. The panel was tasked with assessing the most viable and practical approach and making recommendations for testing. The evaluation of vadose-zone treatment alternatives was conducted to be broadly applicable at a variety of locations at Hanford. However, because of limitations of time, the panel was asked to focus on one example, {sup 99}Tc contamination below the BC Cribs and Trenches. It is well recognized that conditions at BC Cribs and Trenches are not the same as those at other Hanford locations, but it was selected so that the panel could develop an understanding of site conditions at one location. The recommendations in this report are not intended to address the regulatory decision process for this site.« less

Use of wetlands for water quality improvement under the USEPA Region V Clean Lakes Program

NASA Astrophysics Data System (ADS)

Landers, Judith C.; Knuth, Barbara A.

1991-03-01

The United States Environmental Protection Agency (USEPA) Region V Clean Lakes Program employs artificial and modified natural wetlands in an effort to improve the water quality of selected lakes. We examined use of wetlands at seven lake sites and evaluated the physical and institutional means by which wetland projects are implemented and managed, relative to USEPA program goals and expert recommendations on the use of wetlands for water quality improvement. Management practices recommended by wetlands experts addressed water level and retention, sheet flow, nutrient removal, chemical treatment, ecological and effectiveness monitoring, and resource enhancement. Institutional characteristics recommended included local monitoring, regulation, and enforcement and shared responsibilities among jurisdictions. Institutional and ecological objectives of the National Clean Lakes Program were met to some degree at every site. Social objectives were achieved to a lesser extent. Wetland protection mechanisms and appropriate institutional decentralization were present at all sites. Optimal management techniques were employed to varying degrees at each site, but most projects lack adequate monitoring to determine adverse ecological impacts and effectiveness of pollutant removal and do not extensively address needs for recreation and wildlife habitat. There is evidence that the wetland projects are contributing to improved lake water quality; however, more emphasis needs to be placed on wetland protection and long-term project evaluation.

Automated detection using natural language processing of radiologists recommendations for additional imaging of incidental findings.

PubMed

Dutta, Sayon; Long, William J; Brown, David F M; Reisner, Andrew T

2013-08-01

As use of radiology studies increases, there is a concurrent increase in incidental findings (eg, lung nodules) for which the radiologist issues recommendations for additional imaging for follow-up. Busy emergency physicians may be challenged to carefully communicate recommendations for additional imaging not relevant to the patient's primary evaluation. The emergence of electronic health records and natural language processing algorithms may help address this quality gap. We seek to describe recommendations for additional imaging from our institution and develop and validate an automated natural language processing algorithm to reliably identify recommendations for additional imaging. We developed a natural language processing algorithm to detect recommendations for additional imaging, using 3 iterative cycles of training and validation. The third cycle used 3,235 radiology reports (1,600 for algorithm training and 1,635 for validation) of discharged emergency department (ED) patients from which we determined the incidence of discharge-relevant recommendations for additional imaging and the frequency of appropriate discharge documentation. The test characteristics of the 3 natural language processing algorithm iterations were compared, using blinded chart review as the criterion standard. Discharge-relevant recommendations for additional imaging were found in 4.5% (95% confidence interval [CI] 3.5% to 5.5%) of ED radiology reports, but 51% (95% CI 43% to 59%) of discharge instructions failed to note those findings. The final natural language processing algorithm had 89% (95% CI 82% to 94%) sensitivity and 98% (95% CI 97% to 98%) specificity for detecting recommendations for additional imaging. For discharge-relevant recommendations for additional imaging, sensitivity improved to 97% (95% CI 89% to 100%). Recommendations for additional imaging are common, and failure to document relevant recommendations for additional imaging in ED discharge instructions occurs frequently. The natural language processing algorithm's performance improved with each iteration and offers a promising error-prevention tool. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Management of Disused Radioactive Sealed Sources in the Slovak Republic - 12100

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

Salzer, Peter

2012-07-01

After splitting-up the Czechoslovak Federation in 1993, the system of management of institutional radioactive waste, where disused sources represent its significant part, had had to build from beginning, since all corresponding activities had remained in the Czech part of the Federation. The paper presents the development of legislative and institutional framework of the disused radioactive sealed source management, development of the national inventory and development of management practices. According the Governmental decision (1994), the management of disused sealed sources and institutional radioactive waste at whole was based on maximal utilization of facilities inside nuclear facilities, particularly in the NPP A1more » (shut down in the past, currently under decommissioning). This approach has been recently changing by Governmental decision (2009) to construct 'non-nuclear facility' - central storage for remained disused sealed sources collected from the places of use, where they were stored in some cases for tens of years. The approaches to siting and construction of this storage facility will be presented, as well as the current approaches to solution of the disused radioactive sources final disposal. Environmental impact assessment process in regard to the given facility/activity is slowly drawing to a close. The final statement of the Ministry of Environment can be expected in January or February 2012, probably recommending option 1 as preferred [6]. According to the Slovak legislation, the final statement has a status of recommendation for ongoing processes leading to the siting license. Very recently, in December 2012, Government of the Slovak republic decided to postpone putting the facility into operation by the end of June, 2014. (author)« less

A qualitative study of the coverage of influenza vaccination on Dutch news sites and social media websites.

PubMed

Lehmann, Birthe A; Ruiter, Robert A C; Kok, Gerjo

2013-06-05

Information about influenza and the effectiveness of vaccination against influenza is largely available on the Internet, and may influence individual decision making about participation in future influenza vaccination rounds. E-health information has often been found to be inaccurate, or even to contradict Health Authority recommendations, especially when it concerns controversial topics. By means of an online media monitoring programme, Dutch news sites and social media websites were scanned for the Dutch counterparts of the terms influenza, vaccination, vaccine and epidemic during February, March and April 2012. Data were processed with QSR NVivo 8.0 and analysed using a general inductive approach. Three overarching themes were found in both media sources: (1) the (upcoming) influenza epidemic, (2) general information regarding the virus, its prevention and treatment, and (3) uncertainty and mistrust regarding influenza vaccination. Social media tended to report earlier on developments such as the occurrence of an influenza epidemic. The greatest difference was that in social media, influenza was not considered to be a serious disease, and more opposition to the flu shot was expressed in social media, as compared to news media. News media and social media discussed the same topics regarding influenza, but differed in message tone. Whereas news media reports tended to be more objective and non-judgmental, social media more critically evaluated the harmfulness of influenza and the necessity of the flu shot. Media may influence decision making and behaviours of Internet users and may thereby influence the success of vaccination campaigns and recommendations made by health authorities. Social media may be more of a problem in this sense, since it is neither controlled nor censored. Future research should investigate the actual impact of Internet media on the influenza decision making process of its users.

Framework for Investigating Asbestos-Contaminated Superfund Sites

EPA Science Inventory

The document presents a recommended framework for investigating and characterizing the potential for human exposure and risk from asbestos contamination in outdoor soil and indoor dust at Superfund removal and remedial sites. The framework presents specific strategies and method...

Remedial Action Assessment System: A computer-based methodology for conducting feasibility studies

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

White, M.K.; Buelt, J.L.; Stottlemyre, J.A.

1991-02-01

Because of the complexity and number of potential waste sites facing the US Department of Energy (DOE) for potential cleanup, DOE is supporting the development of a computer-based methodology to streamline the remedial investigation/feasibility study process. The Remedial Action Assessment System (RAAS), can be used for screening, linking, and evaluating established technology processes in support of conducting feasibility studies. It is also intended to do the same in support of corrective measures studies. The user interface employs menus, windows, help features, and graphical information while RAAS is in operation. Object-oriented programming is used to link unit processes into sets ofmore » compatible processes that form appropriate remedial alternatives. Once the remedial alternatives are formed, the RAAS methodology can evaluate them in terms of effectiveness, implementability, and cost. RAAS will access a user-selected risk assessment code to determine the reduction of risk after remedial action by each recommended alternative. The methodology will also help determine the implementability of the remedial alternatives at a site and access cost estimating tools to provide estimates of capital, operating, and maintenance costs. This paper presents the characteristics of two RAAS prototypes currently being developed. These include the RAAS Technology Information System, which accesses graphical, tabular and textual information about technologies, and the main RAAS methodology, which screens, links, and evaluates remedial technologies. 4 refs., 3 figs., 1 tab.« less

Congress Examines Nuclear Waste Disposal Recommendations

NASA Astrophysics Data System (ADS)

Showstack, Randy

2012-02-01

During an 8 February U.S. congressional hearing to examine how to move forward on dealing with spent nuclear fuel and to review other recommendations of the recently released final report of the White House-appointed Blue Ribbon Commission on America's Nuclear Future (BRC), Yucca Mountain was the 65,000-ton gorilla in the room. BRC's charge was to conduct a comprehensive review of policies to manage the back end of the nuclear fuel cycle and recommend a new strategy for dealing with the 65,000 tons of spent nuclear fuel currently stored at 75 sites around the country and the 2000 tons of new spent fuel being produced each year. However, BRC specifically did not evaluate Yucca Mountain. A 26 January letter from BRC to U.S. secretary of energy Steven Chu states, "You directed that the Commission was not to serve as a siting body. Accordingly, we have not evaluated Yucca Mountain or any other location as a potential site for the storage of spent nuclear fuel or disposal of high-level waste nor have we taken a position on the administration's request to withdraw the Yucca Mountain license application."

EPA Recommends Modifications to Part of Industri-plex Superfund Cleanup in Woburn, Mass.

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) proposes recommended modifications to part of the cleanup of the Industri-plex Superfund Site in Woburn, Mass. Beginning today (May 3, 2018), there will be a 14-day public comment period on EPA’s proposal.

Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide ...

EPA Pesticide Factsheets

On September 22, 2006, the draft Evaluation of the Carinogenicity of Ethylene Oxide (EPA/635/R-06/003) and the draft charge to external peer reviewers were released for external peer review and public comment. This draft was reviewed by EPA’s Science Advisory Board (SAB) and the expert panel’s final report was made available December 21, 2007. Since that time the Agency implemented the May 2009 IRIS assessment development process in which other federal agencies and the Executive Offices of the President are provided two opportunities to comment on IRIS human health assessments; Interagency Science Consultation (Step 3) prior to public comment/peer review and Interagency Science Discussion (Step 6b) following peer review. In July, 2011, the draft assessment incorporating the SAB recommendations (December 2007) was sent to other federal agencies and Executive Offices of the President as part of Step 6 of the IRIS process. Following the May 2009 process, all written comments submitted by other agencies will be made publicly available. Accordingly, the interagency comments for ethylene oxide and the interagency science discussion materials provided to the other agencies are posted on this site. Note: After further consideration EPA has decided to undertake an additional peer review of the revised draft assessment on how the Agency responded to the SAB panel recommendations (December 2007), the exposure-response modeling of epidemiologic data, including n

Where does the carbon go? A model–data intercomparison of vegetation carbon allocation and turnover processes at two temperate forest free-air CO2 enrichment sites

PubMed Central

De Kauwe, Martin G; Medlyn, Belinda E; Zaehle, Sönke; Walker, Anthony P; Dietze, Michael C; Wang, Ying-Ping; Luo, Yiqi; Jain, Atul K; El-Masri, Bassil; Hickler, Thomas; Wårlind, David; Weng, Ensheng; Parton, William J; Thornton, Peter E; Wang, Shusen; Prentice, I Colin; Asao, Shinichi; Smith, Benjamin; McCarthy, Heather R; Iversen, Colleen M; Hanson, Paul J; Warren, Jeffrey M; Oren, Ram; Norby, Richard J

2014-01-01

Elevated atmospheric CO2 concentration (eCO2) has the potential to increase vegetation carbon storage if increased net primary production causes increased long-lived biomass. Model predictions of eCO2 effects on vegetation carbon storage depend on how allocation and turnover processes are represented. We used data from two temperate forest free-air CO2 enrichment (FACE) experiments to evaluate representations of allocation and turnover in 11 ecosystem models. Observed eCO2 effects on allocation were dynamic. Allocation schemes based on functional relationships among biomass fractions that vary with resource availability were best able to capture the general features of the observations. Allocation schemes based on constant fractions or resource limitations performed less well, with some models having unintended outcomes. Few models represent turnover processes mechanistically and there was wide variation in predictions of tissue lifespan. Consequently, models did not perform well at predicting eCO2 effects on vegetation carbon storage. Our recommendations to reduce uncertainty include: use of allocation schemes constrained by biomass fractions; careful testing of allocation schemes; and synthesis of allocation and turnover data in terms of model parameters. Data from intensively studied ecosystem manipulation experiments are invaluable for constraining models and we recommend that such experiments should attempt to fully quantify carbon, water and nutrient budgets. PMID:24844873

Is Yucca Mountain a long-term solution for disposing of US spent nuclear fuel and high-level radioactive waste?

PubMed

Thorne, M C

2012-06-01

On 26 January 2012, the Blue Ribbon Commission on America's Nuclear Future released a report addressing, amongst other matters, options for the managing and disposal of high-level waste and spent fuel. The Blue Ribbon Commission was not chartered as a siting commission. Accordingly, it did not evaluate Yucca Mountain or any other location as a potential site for the storage or disposal of spent nuclear fuel and high-level waste. Nevertheless, if the Commission's recommendations are followed, it is clear that any future proposals to develop a repository at Yucca Mountain would require an extended period of consultation with local communities, tribes and the State of Nevada. Furthermore, there would be a need to develop generally applicable regulations for disposal of spent fuel and high-level radioactive waste, so that the Yucca Mountain site could be properly compared with alternative sites that would be expected to be identified in the initial phase of the site-selection process. Based on what is now known of the conditions existing at Yucca Mountain and the large number of safety, environmental and legal issues that have been raised in relation to the DOE Licence Application, it is suggested that it would be imprudent to include Yucca Mountain in a list of candidate sites for future evaluation in a consent-based process for site selection. Even if there were a desire at the local, tribal and state levels to act as hosts for such a repository, there would be enormous difficulties in attempting to develop an adequate post-closure safety case for such a facility, and in showing why this unsaturated environment should be preferred over other geological contexts that exist in the USA and that are more akin to those being studied and developed in other countries.

Corrective Action Decision Document/Corrective Action Plan for Corrective Action Unit 547: Miscellaneous Contaminated Waste Sites, Nevada National Security Site, Nevada, Revision 0

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

Mark Krauss

2011-09-01

The purpose of this CADD/CAP is to present the corrective action alternatives (CAAs) evaluated for CAU 547, provide justification for selection of the recommended alternative, and describe the plan for implementing the selected alternative. Corrective Action Unit 547 consists of the following three corrective action sites (CASs): (1) CAS 02-37-02, Gas Sampling Assembly; (2) CAS 03-99-19, Gas Sampling Assembly; and(3) CAS 09-99-06, Gas Sampling Assembly. The gas sampling assemblies consist of inactive process piping, equipment, and instrumentation that were left in place after completion of underground safety experiments. The purpose of these safety experiments was to confirm that a nuclearmore » explosion would not occur in the case of an accidental detonation of the high-explosive component of the device. The gas sampling assemblies allowed for the direct sampling of the gases and particulates produced by the safety experiments. Corrective Action Site 02-37-02 is located in Area 2 of the Nevada National Security Site (NNSS) and is associated with the Mullet safety experiment conducted in emplacement borehole U2ag on October 17, 1963. Corrective Action Site 03-99-19 is located in Area 3 of the NNSS and is associated with the Tejon safety experiment conducted in emplacement borehole U3cg on May 17, 1963. Corrective Action Site 09-99-06 is located in Area 9 of the NNSS and is associated with the Player safety experiment conducted in emplacement borehole U9cc on August 27, 1964. The CAU 547 CASs were investigated in accordance with the data quality objectives (DQOs) developed by representatives of the Nevada Division of Environmental Protection (NDEP) and the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office. The DQO process was used to identify and define the type, amount, and quality of data needed to determine and implement appropriate corrective actions for CAU 547. Existing radiological survey data and historical knowledge of the CASs were sufficient to meet the DQOs and evaluate CAAs without additional investigation. As a result, further investigation of the CAU 547 CASs was not required. The following CAAs were identified for the gas sampling assemblies: (1) clean closure, (2) closure in place, (3) modified closure in place, (4) no further action (with administrative controls), and (5) no further action. Based on the CAAs evaluation, the recommended corrective action for the three CASs in CAU 547 is closure in place. This corrective action will involve construction of a soil cover on top of the gas sampling assembly components and establishment of use restrictions at each site. The closure in place alternative was selected as the best and most appropriate corrective action for the CASs at CAU 547 based on the following factors: (1) Provides long-term protection of human health and the environment; (2) Minimizes short-term risk to site workers in implementing corrective action; (3) Is easily implemented using existing technology; (4) Complies with regulatory requirements; (5) Fulfills FFACO requirements for site closure; (6) Does not generate transuranic waste requiring offsite disposal; (7) Is consistent with anticipated future land use of the areas (i.e., testing and support activities); and (8) Is consistent with other NNSS site closures where contamination was left in place.« less

Site Guidelines for a "Making Middle Grades Work" Technical Review Visit

ERIC Educational Resources Information Center

Southern Regional Education Board, 2004

2004-01-01

The purpose of the Technical Review Visit (TRV) is to follow up on the actions taken to implement the recommendations indicated for each challenge in the most recent Technical Assistance Visit (TAV) report. This document provides the following: (1) Site Guidelines for the Making Middle Grades Work (MMGW) Technical Review Visit; (2) Site Checklist;…

Repetitive Reaction and Restitution (R3) induction of drought hardiness in conifer container seedlings

Treesearch

Jol Hodgson

2011-01-01

Planting failures are often attributed to unexpectedly harsh conditions after planting. Characterization of soil water at the planting site, along with associated influences of site preparation and soil texture, is recommended. Additionally, tree planting technique and seedling biology should be targeted to site conditions. A nursery regime for induction of drought...

Teaching World History and Global Issues with the Internet

ERIC Educational Resources Information Center

Risinger, C. Frederick

2011-01-01

In this article, the author recommends websites that include both traditional world history content and sites that focus on contemporary world issues and problems. The first two sites provide an intellectual stage for both world history and global studies. While they don't have lesson plans or links to other sites, they provide an understanding of…

A Comparative Study of the Application of Fluorescence Excitation-Emission Matrices Combined with Parallel Factor Analysis and Nonnegative Matrix Factorization in the Analysis of Zn Complexation by Humic Acids

PubMed Central

Boguta, Patrycja; Pieczywek, Piotr M.; Sokołowska, Zofia

2016-01-01

The main aim of this study was the application of excitation-emission fluorescence matrices (EEMs) combined with two decomposition methods: parallel factor analysis (PARAFAC) and nonnegative matrix factorization (NMF) to study the interaction mechanisms between humic acids (HAs) and Zn(II) over a wide concentration range (0–50 mg·dm−3). The influence of HA properties on Zn(II) complexation was also investigated. Stability constants, quenching degree and complexation capacity were estimated for binding sites found in raw EEM, EEM-PARAFAC and EEM-NMF data using mathematical models. A combination of EEM fluorescence analysis with one of the proposed decomposition methods enabled separation of overlapping binding sites and yielded more accurate calculations of the binding parameters. PARAFAC and NMF processing allowed finding binding sites invisible in a few raw EEM datasets as well as finding totally new maxima attributed to structures of the lowest humification. Decomposed data showed an increase in Zn complexation with an increase in humification, aromaticity and molecular weight of HAs. EEM-PARAFAC analysis also revealed that the most stable compounds were formed by structures containing the highest amounts of nitrogen. The content of oxygen-functional groups did not influence the binding parameters, mainly due to fact of higher competition of metal cation with protons. EEM spectra coupled with NMF and especially PARAFAC processing gave more adequate assessments of interactions as compared to raw EEM data and should be especially recommended for modeling of complexation processes where the fluorescence intensities (FI) changes are weak or where the processes are interfered with by the presence of other fluorophores. PMID:27782078

Installation Restoration Program. Phase II. Confirmation/Quantification Stage I.

DTIC Science & Technology

1986-02-24

Drilling and sampling three...borings at Site 8; o Drilling and sampling three borings at Site 11; and o Drilling and sampling three borings at Site 12. The ground water samples...8217-"~~~~~~.."." . " -’ - . .. . ;’ "..-. ’,"",,.- - -".-" - ’ -- -... ... ~ -. . ... ... " " 1 *. Sites Recommended Action Rationale U 8 Drill and sample one background To estimate

Strategy for selecting Mars Pathfinder landing sites

NASA Technical Reports Server (NTRS)

Greeley, Ronald; Kuzmin, Ruslin O.

1994-01-01

A strategy for Pathfinder site selection must be developed that is fundamentally different from most previous considerations. At least two approaches can be identified. In one approach, the objective is to select a site representing a key geologic unit on Mars, i.e., a unit that is widespread, easily recognized, and used frequently as a datum in various investigations. The second approach is to select a site that potentially affords access to a wide variety of rock types. Because rover range is limited, rocks from a variety of sources must be assembled in a small area for sampling. Regardless of the approach taken in site selection, the Pathfinder site should include eolian deposits and provisions should be made to obtain measurements on soils. A recommended approach for selecting the Mars Pathfinder landing site is to identify a deltaic deposit, composed of sediments derived from sources of various ages and geologic units that shows evidence of eolian activity. The site should be located as close as possible to the part of the outwash where rapid deposition occurred because the likelihood of 'sorting' by size and composition increases with distance, decreasing the probability of heterogeneity. In addition, it is recommended that field operation tests be conducted to gain experience and insight into conducting science with Pathfinder.

Relationship between peripheral insertion site and catheter-related phlebitis in adult hospitalized patients: a systematic review.

PubMed

Comparcini, Dania; Simonetti, Valentina; Blot, Stijn; Tomietto, Marco; Cicolini, Giancarlo

2017-01-01

To explore the relationship between the anatomical site of peripheral venous catheterization and risk of catheter-related phlebitis. Peripheral venous catheterization is frequently associated with phlebitis. Recent guidelines, recommend the use of an upper-extremity site for catheter insertion but no univocal consensus exists on the anatomical site with lower risk of phlebitis. Systematic review. We searched Medline (PubMed) and CINAHL (EBSCOhost) databases until the end of January 2017. We also reviewed the reference lists of retrieved articles and gray literature was excluded. Searches were limited to articles published in English with no restriction imposed to date of publication. The primary outcome was the incidence of phlebitis associated with anatomical site of peripheral catheterization. We included randomized controlled trials and observational studies on adult patients who required a peripheral catheter for the administration of medi- cation, intermittent or continuous fluid infusion. Antecubital fossa veins are associated with lower phlebitis rates, while hands veins are the most risky sites to develop phlebitis. There is no consensus regarding vein in forearm. Choosing the right anatomical site to insert a peripheral venous catheter is important to decrease phlebitis rate. Further studies should compare indwelling time in different anatomical sites with phlebitis rate. A more standardized approach in defining and assessing phlebitis among studies is recommended.

Optimizing Visits to the Site of Death for Bereaved Families After Disasters and Terrorist Events.

PubMed

Kristensen, Pål; Dyregrov, Atle; Weisæth, Lars; Straume, Marianne; Dyregrov, Kari; Heir, Trond; Bugge, Renate Grønvold

2017-09-13

In recent years it has been common after disasters and terrorist events to offer bereaved families the opportunity to visit the place where their loved ones died. Many report that such visits are beneficial in processing their loss. Various factors, both cognitive (eg, counteracting disbelief) and existential or emotional (eg, achieving a sense of closeness to the deceased), are associated with the experienced benefit. Nonetheless, exacerbations of trauma and grief reactions (eg, re-enactment fantasies) are common, with some of the bereaved also reporting adverse reactions after the visit. Subsequently, proper preparations are a prerequisite before such visits take place. This article describes how to optimize collective visits to the site of death after disasters or terrorist events for bereaved families. Important questions-for example, concerning those who should be responsible for organizing a visit and those who should be invited, the timing of the visit, what can be done at the site, the need for support personnel, and other practical issues-are discussed and general guidelines are recommended. (Disaster Med Public Health Preparedness. 2017;page 1 of 5).

Towards AN Inventory for Archaeological Heritage Management in Israel

NASA Astrophysics Data System (ADS)

Alef, Y.

2017-08-01

The vast amount of archaeological data and information that is systematically accumulated in the Israel Antiquities Authority database, has not yet been transformed into a tool for heritage management, i.e. accessible knowledge of the sites' cultural significance and risk assessment that is needed to support wise decision making regarding its future. As a response, a pilot project for developing an inventory for the archaeological heritage management was launched. A basic ESRI ArcGIS Online system was developed as a prototype, following the categories recommended in international standards for documentation. Five field surveys implementing the GIS system were conducted to examine different aspects and workflows: ancient synagogues in the Galilee, sites at risk, mosaics in Tel Shiqmona, the ancient settlement of Huqoq and sites included in The National Master Plan for Forests and Afforestation. The pilot project revealed the main gaps in knowledge and the critical faults in the working procedures. In spite of the systems' technological limitations, the results were convincing enough to promote a multidisciplinary discussion about the need for integration of significance and risk assessment in the working processes of the organization.

Information Security Controls against Cross-Site Request Forgery Attacks on Software Applications of Automated Systems

NASA Astrophysics Data System (ADS)

Barabanov, A. V.; Markov, A. S.; Tsirlov, V. L.

2018-05-01

This paper presents statistical results and their consolidation, which were received in the study into security of various web-application against cross-site request forgery attacks. Some of the results were received in the study carried out within the framework of certification for compliance with information security requirements. The paper provides the results of consolidating information about the attack and protection measures, which are currently used by the developers of web-applications. It specifies results of the study, which demonstrate various distribution types: distribution of identified vulnerabilities as per the developer type (Russian and foreign), distribution of the security measures used in web-applications, distribution of the identified vulnerabilities as per the programming languages, data on the number of security measures that are used in the studied web-applications. The results of the study show that in most cases the developers of web-applications do not pay due attention to protection against cross-site request forgery attacks. The authors give recommendations to the developers that are planning to undergo a certification process for their software applications.

Corrective Action Decision Document/Corrective Action Plan for Corrective Action Unit 104: Area 7 Yucca Flat Atmospheric Test Sites Nevada National Security Site, Nevada, Revision 0

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

Patrick Matthews

2012-10-01

CAU 104 comprises the following corrective action sites (CASs): • 07-23-03, Atmospheric Test Site T-7C • 07-23-04, Atmospheric Test Site T7-1 • 07-23-05, Atmospheric Test Site • 07-23-06, Atmospheric Test Site T7-5a • 07-23-07, Atmospheric Test Site - Dog (T-S) • 07-23-08, Atmospheric Test Site - Baker (T-S) • 07-23-09, Atmospheric Test Site - Charlie (T-S) • 07-23-10, Atmospheric Test Site - Dixie • 07-23-11, Atmospheric Test Site - Dixie • 07-23-12, Atmospheric Test Site - Charlie (Bus) • 07-23-13, Atmospheric Test Site - Baker (Buster) • 07-23-14, Atmospheric Test Site - Ruth • 07-23-15, Atmospheric Test Site T7-4 •more » 07-23-16, Atmospheric Test Site B7-b • 07-23-17, Atmospheric Test Site - Climax These 15 CASs include releases from 30 atmospheric tests conducted in the approximately 1 square mile of CAU 104. Because releases associated with the CASs included in this CAU overlap and are not separate and distinguishable, these CASs are addressed jointly at the CAU level. The purpose of this CADD/CAP is to evaluate potential corrective action alternatives (CAAs), provide the rationale for the selection of recommended CAAs, and provide the plan for implementation of the recommended CAA for CAU 104. Corrective action investigation (CAI) activities were performed from October 4, 2011, through May 3, 2012, as set forth in the CAU 104 Corrective Action Investigation Plan.« less

An Analysis of Major Recommendations of NAC's On-Site Review Teams.

ERIC Educational Resources Information Center

Nelipovich, Michael

1982-01-01

An analysis of major recommendations of the National Accreditation Council for Agencies Serving the Blind and Visually Handicapped received by 50 state and not-for-profit agencies raised questions about emphasis on administrative standards and low concern about physical facilities. Suggestions, including elimination of duplications, are made. (CL)

Manual of Regulations and Recommendations for School Building Planning and Construction.

ERIC Educational Resources Information Center

Engelking, D. F.

Recommendations and suggestions, as well as statutory provisions and state board regulations, are presented regarding school building construction in Idaho. The material is organized into the following sections--(1) school building planning, (2) the school site, (3) construction planning and requirements, (4) secondary school planning, (5)…

Procyon LLC: From Music Recommendations to Preference Mapping

ERIC Educational Resources Information Center

Chinn, Susan J.

2011-01-01

Procyon LLC had re-launched and renamed their music discovery site, Electra, to Capella, in 2008. Its core strength had originated from Electra's proprietary technology, which used music libraries from real people, its members, to generating "automated word-of-mouth" recommendations, targeted advertising and editorial content. With the re-launch,…

Optimization Review Report: Saunders Supply Company Superfund Site Suffolk County, Virginia, EPA Region 3

EPA Pesticide Factsheets

This site is a 7-1/3 acre former wood treating plant. The source areas included wastewater ponds, treatment areas, and burn pits. This report summarizes the findings and recommendations of the optimization review team.

Addendum to the Closure Report for Corrective Action Unit 403: Second Gas Station, Tonopah Test Range, Nevada, Revision 0

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

Grant Evenson

This document constitutes an addendum to the Closure Report for Corrective Action Unit 403: Second Gas Station, Tonopah Test Range, Nevada, September 1998 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • The cover, title, and signature pagesmore » of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 03-02-004-0360, Underground Storage Tanks. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Thermal hydraulic feasibility assessment of the hot conditioning system and process

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

Heard, F.J.

1996-10-10

The Spent Nuclear Fuel Project was established to develop engineered solutions for the expedited removal, stabilization, and storage of spent nuclear fuel from the K Basins at the U.S. Department of Energy`s Hanford Site in Richland, Washington. A series of analyses have been completed investigating the thermal-hydraulic performance and feasibility of the proposed Hot Conditioning System and process for the Spent Nuclear Fuel Project. The analyses were performed using a series of thermal-hydraulic models that could respond to all process and safety-related issues that may arise pertaining to the Hot Conditioning System. The subject efforts focus on independently investigating, quantifying,more » and establishing the governing heat production and removal mechanisms, flow distributions within the multi-canister overpack, and performing process simulations for various purge gases under consideration for the Hot Conditioning System, as well as obtaining preliminary results for comparison with and verification of other analyses, and providing technology- based recommendations for consideration and incorporation into the Hot Conditioning System design bases.« less

Malaria Diagnostics in Clinical Trials

PubMed Central

Murphy, Sean C.; Shott, Joseph P.; Parikh, Sunil; Etter, Paige; Prescott, William R.; Stewart, V. Ann

2013-01-01

Malaria diagnostics are widely used in epidemiologic studies to investigate natural history of disease and in drug and vaccine clinical trials to exclude participants or evaluate efficacy. The Malaria Laboratory Network (MLN), managed by the Office of HIV/AIDS Network Coordination, is an international working group with mutual interests in malaria disease and diagnosis and in human immunodeficiency virus/acquired immunodeficiency syndrome clinical trials. The MLN considered and studied the wide array of available malaria diagnostic tests for their suitability for screening trial participants and/or obtaining study endpoints for malaria clinical trials, including studies of HIV/malaria co-infection and other malaria natural history studies. The MLN provides recommendations on microscopy, rapid diagnostic tests, serologic tests, and molecular assays to guide selection of the most appropriate test(s) for specific research objectives. In addition, this report provides recommendations regarding quality management to ensure reproducibility across sites in clinical trials. Performance evaluation, quality control, and external quality assessment are critical processes that must be implemented in all clinical trials using malaria tests. PMID:24062484

Addendum to the Corrective Action Decision Document/Closure Report for Corrective Action Unit 406: Area 3 Building 03-74 & Building 03-58 Underground Discharge Points and Corrective Action Unit 429: Area 3 Building 03-55 & Area 9 Building 09-52 Underground Discharge Points, Tonopah Test Range, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the March 2000, Corrective Action Decision Document / Closure Report for Corrective Action Unit 406: Area 3 Building 03-74 & 03-58 Underground Discharge Points and Corrective Action Unit 429: Area 3 Building 03-55 & Area 9 Building 09-52 Underground Discharge Points (TTR) as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. Themore » approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 03-51-001-0355 – Photo Shop UDP, Drains in CAU 429. It should be noted that there are no changes to CAU 406. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

A Recommendation System to Facilitate Business Process Modeling.

PubMed

Deng, Shuiguang; Wang, Dongjing; Li, Ying; Cao, Bin; Yin, Jianwei; Wu, Zhaohui; Zhou, Mengchu

2017-06-01

This paper presents a system that utilizes process recommendation technology to help design new business processes from scratch in an efficient and accurate way. The proposed system consists of two phases: 1) offline mining and 2) online recommendation. At the first phase, it mines relations among activity nodes from existing processes in repository, and then stores the extracted relations as patterns in a database. At the second phase, it compares the new process under construction with the premined patterns, and recommends proper activity nodes of the most matching patterns to help build a new process. Specifically, there are three different online recommendation strategies in this system. Experiments on both real and synthetic datasets are conducted to compare the proposed approaches with the other state-of-the-art ones, and the results show that the proposed approaches outperform them in terms of accuracy and efficiency.

Social network supported process recommender system.

PubMed

Ye, Yanming; Yin, Jianwei; Xu, Yueshen

2014-01-01

Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced.

Decision Document for the Storm Water Outfalls/Industrial Wastewater Treatment Plant, Pesticide Rinse Area, Old Fire Fighting Training Pit, Illicit PCB Dump Site, and the Battery Acid Pit Fort Lewis, Washington

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

Cantrell, Kirk J; Liikala, Terry L; Strenge, Dennis L

PNNL conducted independent site evaluations for four sites at Fort Lewis, Washington, to determine their suitability for closure on behalf of the installation. These sites were recommended for ''No Further Action'' by previous investigators and included the Storm Water Outfalls/Industrial Waste Water Treatment Plant (IWTP), the Pesticide Rinse Area, the Old Fire Fighting Training Pit, and the Illicit PCB Dump Site.

Decision Document for the Storm Water Outfalls/Industrial Wastewater Treatment Plant, Pesticide Rinse Area, Old Fire Fighting Training Pit, Illicit PCB Dump Site, and the Battery Acid Pit Fort Lewis, Washington

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

Cantrell, Kirk J.; Liikala, Terry L.; Strenge, Dennis L.

PNNL conducted independent site evaluations for four sites at Fort Lewis, Washington, to determine their suitability for closure on behalf of the installation. These sites were recommended for "No Further Action" by previous invesitgators and included the Storm Water Outfalls/Industrial Waste Water Treatment Plant (IWTP), the Pesticide Rinse Area, the Old Fire Fighting Training Pit, and the Illicit PCB Dump Site.

Implementing AORN recommended practices for prevention of transmissible infections.

PubMed

Patrick, Marcia R; Hicks, Rodney W

2013-12-01

Preventing infection in the perioperative setting is a critical element of patient and health care worker safety. This article reviews the recommendations in the AORN "Recommended practices for prevention of transmissible infections in the perioperative practice setting." The recommended practices are intended to help perioperative nurses implement standard and transmission-based precautions (ie, contact, droplet, airborne), including use of personal protective equipment as well as interventions to prevent surgical site infections and exposure to bloodborne pathogens. Additional recommendations cover vaccination programs and how to manage personnel who require work restrictions. Hospital and ambulatory patient scenarios are included to help perioperative nurses apply the recommendations in daily practice. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Grazed Riparian Management and Stream Channel Response in Southeastern Minnesota (USA) Streams

NASA Astrophysics Data System (ADS)

Magner, Joseph A.; Vondracek, Bruce; Brooks, Kenneth N.

2008-09-01

The U.S. Department of Agriculture-Natural Resources Conservation Service has recommended domestic cattle grazing exclusion from riparian corridors for decades. This recommendation was based on a belief that domestic cattle grazing would typically destroy stream bank vegetation and in-channel habitat. Continuous grazing (CG) has caused adverse environmental damage, but along cohesive-sediment stream banks of disturbed catchments in southeastern Minnesota, short-duration grazing (SDG), a rotational grazing system, may offer a better riparian management practice than CG. Over 30 physical and biological metrics were gathered at 26 sites to evaluate differences between SDG, CG, and nongrazed sites (NG). Ordinations produced with nonmetric multidimensional scaling (NMS) indicated a gradient with a benthic macroinvertebrate index of biotic integrity (IBI) and riparian site management; low IBI scores associated with CG sites and higher IBI scores associated with NG sites. Nongrazed sites were associated with reduced soil compaction and higher bank stability, as measured by the Pfankuch stability index; whereas CG sites were associated with increased soil compaction and lower bank stability, SDG sites were intermediate. Bedrock geology influenced NMS results: sites with carbonate derived cobble were associated with more stable channels and higher IBI scores. Though current riparian grazing practices in southeastern Minnesota present pollution problems, short duration grazing could reduce sediment pollution if managed in an environmentally sustainable fashion that considers stream channel response.

Grazed riparian management and stream channel response in southeastern Minnesota (USA) streams

USGS Publications Warehouse

Magner, J.A.; Vondracek, B.; Brooks, K.N.

2008-01-01

The U.S. Department of Agriculture-Natural Resources Conservation Service has recommended domestic cattle grazing exclusion from riparian corridors for decades. This recommendation was based on a belief that domestic cattle grazing would typically destroy stream bank vegetation and in-channel habitat. Continuous grazing (CG) has caused adverse environmental damage, but along cohesive-sediment stream banks of disturbed catchments in southeastern Minnesota, short-duration grazing (SDG), a rotational grazing system, may offer a better riparian management practice than CG. Over 30 physical and biological metrics were gathered at 26 sites to evaluate differences between SDG, CG, and nongrazed sites (NG). Ordinations produced with nonmetric multidimensional scaling (NMS) indicated a gradient with a benthic macroinvertebrate index of biotic integrity (IBI) and riparian site management; low IBI scores associated with CG sites and higher IBI scores associated with NG sites. Nongrazed sites were associated with reduced soil compaction and higher bank stability, as measured by the Pfankuch stability index; whereas CG sites were associated with increased soil compaction and lower bank stability, SDG sites were intermediate. Bedrock geology influenced NMS results: sites with carbonate derived cobble were associated with more stable channels and higher IBI scores. Though current riparian grazing practices in southeastern Minnesota present pollution problems, short duration grazing could reduce sediment pollution if managed in an environmentally sustainable fashion that considers stream channel response. ?? 2008 Springer Science+Business Media, LLC.

41 CFR 101-6.2109 - How does the Administrator receive and respond to comments?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 6... transmits a State process recommendation for a program selected under § 101-6.2106. (b)(1) The single point... and entities where there is no State process recommendation. (2) If a State process recommendation is...

76 FR 59449 - Advisory Committee on Reactor Safeguards; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-26

... Recommendations on the Near-Term Task Force Report Regarding the Events at the Fukushima Dai-ichi Site in Japan... the Fukushima Dai-ichi site in Japan. 10:15 a.m.-11:45 a.m.: Development of Draft Fire Human...

Hacking Facebook Privacy and Security

DTIC Science & Technology

2012-08-28

that their information is somehow protected. However, practically this is not always the case and privacy on social networking sites has received...fraudsters target Facebook and other social networking sites to harvest information about you. Here’s how we recommend you set your Facebook privacy

Technical Support Document: Development of the Advanced Energy Design Guide for K-12 Schools--30% Energy Savings

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

Pless, S.; Torcellini, P.; Long, N.

2007-09-01

This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for K-12 School Buildings (K-12 AEDG), a design guidance document intended to provide recommendations for achieving 30% energy savings in K-12 Schools over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The 30% energy savings target is the first step toward achieving net-zero energy schools; schools that, on an annual basis, draw from outside sources less or equal energy than they generate on site from renewable energy sources.

Geologic Measurements using Rover Images: Lessons from Pathfinder with Application to Mars 2001

NASA Technical Reports Server (NTRS)

Bridges, N. T.; Haldemann, A. F. C.; Herkenhoff, K. E.

1999-01-01

The Pathfinder Sojourner rover successfully acquired images that provided important and exciting information on the geology of Mars. This included the documentation of rock textures, barchan dunes, soil crusts, wind tails, and ventifacts. It is expected that the Marie Curie rover cameras will also successfully return important information on landing site geology. Critical to a proper analysis of these images will be a rigorous determination of rover location and orientation. Here, the methods that were used to compute rover position for Sojourner image analysis are reviewed. Based on this experience, specific recommendations are made that should improve this process on the '01 mission.

An Online Course for Instruction in the Reponsible Conduct of Research

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

Michael Kalichman

2004-10-12

Responsible Conduct of Research (RCR) is the process by which regulations, guidelines, standards and ethics are reconciled to promote integrity in research. The development of this online resource, with contributions from the Department of Health and Human Services (DHHS), will allow the DOE system to offer state-of-the-art education in RCR to its sites. The intent of the project is to establish basic RCR content websites, publicize for public use and review, revise as recommended or as ethics change, and to continue supplementing with new material. The resulting resources will be posted on the Web (http://rcrec.org/r)

Proposed satellite laser ranging and very long baseline interferometry sites for crustal dynamics investigations

NASA Technical Reports Server (NTRS)

Lowman, P. D.; Allenby, R. J.; Frey, H. V.

1979-01-01

Recommendations are presented for a global network of 125 sites for geodetic measurements by satellite laser ranging and very long baseline interferometry. The sites were proposed on the basis of existing facilities and scientific value for investigation of crustal dynamics as related to earthquake hazards. Tectonic problems are discussed for North America peripheral regions and for the world. The sites are presented in tables and maps, with bibliographic references.

Implementation Report for Great II Study, Upper Mississippi River (Guttenberg, Iowa to Saverton, Missouri).

DTIC Science & Technology

1981-06-01

Districts completed Environmental Impact Statements (EIS) in accordance with the National Enviromental Policy Act of 1969. The EIS described the...the GREAT site as the primary site, but will evaluate alternative sites to determine if the GREAT site is justified, recognizing environmental, social ...the recommendation was to ease the conflicts between commercial navigation and recreational boaters. In essence, the program suggested by RID is the no

Mercury poisoning dentistry: high-level indoor air mercury contamination at selected dental sites.

PubMed

Khwaja, Mahmood A; Abbasi, Maryam Shabbir

2014-01-01

Mercury (Hg), also known as quick silver, is an essential constituent of dental amalgam. It is a toxic substance of global concern. Children are more at risk from mercury poisoning which affects their neurological development and brain. In the past, a number of studies at dental sites in many countries have been carried out and reported. The present report briefly describes and discusses our recent investigations carried out at 34 dental sites (teaching institutions, hospitals and private clinics) in Pakistan. It is evident from the data that at many sites the indoor mercury vapor levels exceed far above the permissible limit recommended for safe physical and mental health. At these sites, public in general and the medical, paramedical staff and vulnerable population in particular, are at most serious risk to health resulting from exposure to toxic and hazardous mercury. To minimize such risk, some of the recommendations are, best in-house environmental practices for occupational health and safety, mercury contaminated waste reduction at source, mercury specific legislation and ratification of Minamata convention on mercury by Pakistan and other world governments at the earliest time possible.

78 FR 78326 - Revision of the Land Management Plans for the Inyo, Sierra and Sequoia National Forests

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... posted to the Region 5 Web site at http://www.fs.usda.gov/main/r5/landmanagement/planning . The Forest... through press release and on the above Web site shown. The Web site will also provide recommended reading... inspection and copying. FOR FURTHER INFORMATION CONTACT: Debra Whitall, Regional Social Scientist, 707-562...

USACE Extreme Sea levels

DTIC Science & Technology

2014-03-14

with expected changes due to climate change. (tropicals and extra-tropicals) Ivan provided some good information on work being done on tropical...Pattiaratchi, C., Jensen, J., 2013. Estimating extreme water level probabilities: a comparison of the direct methods and recommendations for best practise ...sites: site-by-site analyses. Proudman Oceanographic Laboratory , Internal Document, No. 65, 229pp. Dixon, M.J., Tawn, J.A. (1995) Extreme sea-levels

Influence of low impact development construction on pollutant process of road-deposited sediments and associated heavy metals.

PubMed

Ma, Yukun; Gong, Manli; Zhao, Hongtao; Li, Xuyong

2018-02-01

Intense Low-Impact Development (LID) construction in China could lead to increasingly severe stormwater and receiving water pollution due to the lack of appropriate regulation for mitigating pollution from LID construction. Samples of road-deposited sediments (RDS) were collected from 50 study sites at seven LID construction stages and four road hierarchies to analyze the pollution process and determine the size of the region influenced by LID construction. Six heavy metals were analyzed, and the RDS index model was adopted to estimate the potential heavy metal load washed off by stormwater runoff. Analysis of variance revealed that the excavation and gravel filling of rain gardens and excavation of porous pavements were critical LID construction stages that contributed the largest masses of RDS per unit area to road surfaces. Although the concentration of heavy metals at LID construction sites was lower than at sites without LID construction, the load of heavy metals washed off from LID construction was much higher. In addition, the sizes of regions influenced by accumulated RDS from LID construction descended in the following order: arterial road (600-775m)>collector road (150-200m)>access road (100-150m)>laneway (20-30m). According to the characteristics of LID construction at the study sites, the potential total solid loads in stormwater throughout China were estimated to reach 36,694t by 2020 and 146,777t by 2030. According to the results of analysis, several recommendations are provided for designing LID construction regulations to mitigate stormwater pollution. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed

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

2012-05-01

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

Evaluation of Statistical Methodologies Used in U. S. Army Ordnance and Explosive Work

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

Ostrouchov, G

2000-02-14

Oak Ridge National Laboratory was tasked by the U.S. Army Engineering and Support Center (Huntsville, AL) to evaluate the mathematical basis of existing software tools used to assist the Army with the characterization of sites potentially contaminated with unexploded ordnance (UXO). These software tools are collectively known as SiteStats/GridStats. The first purpose of the software is to guide sampling of underground anomalies to estimate a site's UXO density. The second purpose is to delineate areas of homogeneous UXO density that can be used in the formulation of response actions. It was found that SiteStats/GridStats does adequately guide the sampling somore » that the UXO density estimator for a sector is unbiased. However, the software's techniques for delineation of homogeneous areas perform less well than visual inspection, which is frequently used to override the software in the overall sectorization methodology. The main problems with the software lie in the criteria used to detect nonhomogeneity and those used to recommend the number of homogeneous subareas. SiteStats/GridStats is not a decision-making tool in the classical sense. Although it does provide information to decision makers, it does not require a decision based on that information. SiteStats/GridStats provides information that is supplemented by visual inspections, land-use plans, and risk estimates prior to making any decisions. Although the sector UXO density estimator is unbiased regardless of UXO density variation within a sector, its variability increases with increased sector density variation. For this reason, the current practice of visual inspection of individual sampled grid densities (as provided by Site-Stats/GridStats) is necessary to ensure approximate homogeneity, particularly at sites with medium to high UXO density. Together with Site-Stats/GridStats override capabilities, this provides a sufficient mechanism for homogeneous sectorization and thus yields representative UXO density estimates. Objections raised by various parties to the use of a numerical ''discriminator'' in SiteStats/GridStats were likely because of the fact that the concerned statistical technique is customarily applied for a different purpose and because of poor documentation. The ''discriminator'', in Site-Stats/GridStats is a ''tuning parameter'' for the sampling process, and it affects the precision of the grid density estimates through changes in required sample size. It is recommended that sector characterization in terms of a map showing contour lines of constant UXO density with an expressed uncertainty or confidence level is a better basis for remediation decisions than a sector UXO density point estimate. A number of spatial density estimation techniques could be adapted to the UXO density estimation problem.« less

Yucca Mountain Project Subsurface Facilities Design

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

A. Linden; R.S. Saunders; R.J. Boutin

2002-11-19

Four units of the Topopah Springs formation (volcanic tuff) are considered for the proposed repository: the upper lithophysal, the middle non-lithophysal, the lower lithophysal, and the lower non-lithophysal. Yucca Mountain was recently designated the site for a proposed repository to dispose of spent nuclear fuel and high-level radioactive waste. Work is proceeding to advance the design of subsurface facilities to accommodate emplacing waste packages in the proposed repository. This paper summarized recent progress in the design of subsurface layout of the proposed repository. The original Site Recommendation (SR) concept for the subsurface design located the repository largely within the lowermore » lithophysal zone (approximately 73%) of the Topopah The Site Recommendation characterized area suitable for emplacement consisted of the primary upper block, the lower block and the southern upper block extension. The primary upper block accommodated the mandated 70,000 metric tons of heavy metal (MTHM) at a 1.45 kW/m hear heat load. Based on further study of the Site Recommendation concept, the proposed repository siting area footprint was modified to make maximum use of available site characterization data, and thus, reduce uncertainties associated with performance assessment. As a result of this study, a modified repository footprint has been proposed and is presently being review for acceptance by the DOE. A panel design concept was developed to reduce overall costs and reduce the overall emplacement schedule. This concept provides flexibility to adjust the proposed repository subsurface layout with time, as it makes it unnecessary to ''commit'' to development of a large single panel at the earliest stages of construction. A description of the underground layout configuration and influencing factors that affect the layout configuration are discussed in the report.« less

Archaeological investigations on the Buckboard Mesa Road Project

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

Amick, D.S.; Henton, G.H.; Pippin, L.C.

1991-10-01

In 1986, the Desert Research Institute (DRI) conducted an archaeological reconnaissance of a new alignment for the Buckboard Mesa Road on the Nevada Test Site for the Department of Energy (DOE). During this reconnaissance, several archaeological sites of National Register quality were discovered and recorded including a large quarry, site 26Ny4892, and a smaller lithic scatter, site 26Ny4894. Analysis of the debitage at 26Ny4892 indicates that this area was used primarily as a quarry for relatively small cobbles of obsidian found in the alluvium. Lithic reduction techniques used here are designed for efficiently reducing small pieces of toolstone and aremore » oriented towards producing flake blanks from small cores and bifacially reducing exhausted cores. Projectile point cross references indicate that the area has seen at least casual use for about 10,000 years and more sustained use for the last 3,000 years. Initial obsidian hydration measurements indicate sustained use of the quarry for about the last 3,000 years although the loci of activities appear to change over time. Based on this study, the DRI recommends that quarrying activities in the area of 26Ny4892 are sufficiently sampled and that additional investigations into that aspect of prehistoric activity in the area are not necessary. This does not apply to other aspects of prehistoric use. DRI recommends that preconstruction surveys continue to identify nonquarrying, prehistoric utilization of the area. With the increased traffic on the Buckboard Mesa Road, there is a greater potential for vandalism to sites of National Register-quality located near the road. The DRI recommends that during the orientation briefing the workers at the Test Site be educated about the importance of cultural resources and the need for their protection. 202 refs., 41 figs., 52 tabs.« less

Statistical and Economic Techniques for Site-specific Nematode Management.

PubMed

Liu, Zheng; Griffin, Terry; Kirkpatrick, Terrence L

2014-03-01

Recent advances in precision agriculture technologies and spatial statistics allow realistic, site-specific estimation of nematode damage to field crops and provide a platform for the site-specific delivery of nematicides within individual fields. This paper reviews the spatial statistical techniques that model correlations among neighboring observations and develop a spatial economic analysis to determine the potential of site-specific nematicide application. The spatial econometric methodology applied in the context of site-specific crop yield response contributes to closing the gap between data analysis and realistic site-specific nematicide recommendations and helps to provide a practical method of site-specifically controlling nematodes.

Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations

PubMed Central

Webb, Heather; Street, Jackie; Marshall, Helen

2014-01-01

Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was “ad hoc” and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful “template” for other vaccines. PMID:24509790

Research staff training in a multisite randomized clinical trial: Methods and recommendations from the Stimulant Reduction Intervention using Dosed Exercise (STRIDE) trial.

PubMed

Walker, Robrina; Morris, David W; Greer, Tracy L; Trivedi, Madhukar H

2014-01-01

Descriptions of and recommendations for meeting the challenges of training research staff for multisite studies are limited despite the recognized importance of training on trial outcomes. The STRIDE (STimulant Reduction Intervention using Dosed Exercise) study is a multisite randomized clinical trial that was conducted at nine addiction treatment programs across the United States within the National Drug Abuse Treatment Clinical Trials Network (CTN) and evaluated the addition of exercise to addiction treatment as usual (TAU), compared to health education added to TAU, for individuals with stimulant abuse or dependence. Research staff administered a variety of measures that required a range of interviewing, technical, and clinical skills. In order to address the absence of information on how research staff are trained for multisite clinical studies, the current manuscript describes the conceptual process of training and certifying research assistants for STRIDE. Training was conducted using a three-stage process to allow staff sufficient time for distributive learning, practice, and calibration leading up to implementation of this complex study. Training was successfully implemented with staff across nine sites. Staff demonstrated evidence of study and procedural knowledge via quizzes and skill demonstration on six measures requiring certification. Overall, while the majority of staff had little to no experience in the six measures, all research assistants demonstrated ability to correctly and reliably administer the measures throughout the study. Practical recommendations are provided for training research staff and are particularly applicable to the challenges encountered with large, multisite trials.

Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations.

PubMed

Webb, Heather; Street, Jackie; Marshall, Helen

2014-01-01

Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was "ad hoc" and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful 'template' for other vaccines.

Addendum to the Closure Report for Corrective Action Unit 355: Area 2 Cellars/Mud Pits Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the November 2003, Closure Report for Corrective Action Unit 355: Area 2 Cellars/Mud Pits as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of: • Thismore » cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the URs for: • CAS 02-37-01, Cellar & Mud Pit • CAS 02-37-03, Cellar & Mud Pit • CAS 02-37-04, Cellar & Mud Pit • CAS 02-37-05, Cellar & Mud Pit • CAS 02-37-06, Cellar & Mud Pit • CAS 02-37-07, Cellar & Mud Pit • CAS 02-37-10, Cellar & Mud Pit • CAS 02-37-11, Cellar & Mud Pit • CAS 02-37-12, Cellar & Mud Pit • CAS 02-37-13, Cellar & Mud Pit • CAS 02-37-14, Cellar & Mud Pit • CAS 02-37-15, Cellar & Mud Pit • CAS 02-37-16, Cellar & Mud Pit • CAS 02-37-17, Cellar • CAS 02-37-18, Cellar & Tanks These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Addendum to the Closure Report for Corrective Action Unit 271: Areas 25, 26, and 27 Septic Systems Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the August 2004, Closure Report for Corrective Action Unit 271, Areas 25, 26, and 27 Septic Systems as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consistsmore » of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the modification of the UR for CAS 27-05-02, Leachfield. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to modify the UR to an administrative UR. Administrative URs differ from standard URs in that they do not require onsite postings (i.e., signs) or other physical barriers (e.g., fencing, monuments), and they do not require periodic inspections (see Section 6.2 of the Industrial Sites Project Establishment of Final Action Levels [NNSA/NSO, 2006c]). This Administrative UR was based on an “Occasional Use Area” future land use scenario that was used to calculate the FAL. The administrative UR will protect workers from an exposure exceeding that used in the calculation of the FAL (i.e., 400 total work hours). Any proposed activity within this use restricted area that would potentially cause an exposure exceeding this exposure limit would require approval from the Nevada Division of Environmental Protection (NDEP). Requirements for inspecting and maintaining postings at this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Fertility preservation in children, adolescents, and young adults with cancer: Quality of clinical practice guidelines and variations in recommendations.

PubMed

Font-Gonzalez, Anna; Mulder, Renée L; Loeffen, Erik A H; Byrne, Julianne; van Dulmen-den Broeder, Eline; van den Heuvel-Eibrink, Marry M; Hudson, Melissa M; Kenney, Lisa B; Levine, Jennifer M; Tissing, Wim J E; van de Wetering, Marianne D; Kremer, Leontien C M

2016-07-15

Fertility preservation care for children, adolescents, and young adults (CAYAs) with cancer is not uniform among practitioners. To ensure high-quality care, evidence-based clinical practice guidelines (CPGs) are essential. The authors identified existing CPGs for fertility preservation in CAYAs with cancer, evaluated their quality, and explored differences in recommendations. A systematic search in PubMed (January 2000-October 2014); guideline databases; and Web sites of oncology, pediatric, and fertility organizations was performed. Two reviewers evaluated the quality of the identified CPGs using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). From high-quality CPGs, the authors evaluated concordant and discordant areas among the recommendations. A total of 25 CPGs regarding fertility preservation were identified. The average AGREE II domain scores (scale of 0%-100%) varied from 15% on applicability to 100% on clarity of presentation. The authors considered 8 CPGs (32%) to be of high quality, which was defined as scores ≥60% in any 4 domains. Large variations in the recommendations of the high-quality CPGs were observed, with 87.2% and 88.6%, respectively, of discordant guideline areas among the fertility preservation recommendations for female and male patients with cancer. Only approximately one-third of the identified CPGs were found to be of sufficient quality. Of these CPGs, the fertility preservation recommendations varied substantially, which can be a reflection of inadequate evidence for specific recommendations, thereby hindering the ability of providers to deliver high-quality care. CPGs including a transparent decision process for fertility preservation can help health care providers to deliver optimal and uniform care, thus improving the quality of life of CAYAs with cancer and cancer survivors. Cancer 2016;122:2216-23. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Public health assessment for Freeway Sanitary Landfill, Burnsville, Dakota County, Minnesota, Region 5. CERCLIS No. MND038384004. Final report

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

Not Available

1993-03-30

The Freeway Sanitary Landfill National Priorities List (NPL) site in Burnsville, Minnesota is situated in the Lower Minnesota River Valley. Shallow groundwater beneath the site is contaminated with low levels of volatile organic hydrocarbons and heavy metals. Under current conditions, no human exposures to site-related contaminants are known to occur at levels of health concern. Based on currently available information, the Minnesota Department of Health concludes that the site poses an indeterminate public health hazard under current conditions because exposure to volatile gases released to the air is possible, but cannot be evaluated from the very limited information available. Theremore » are also a few physical hazards on the site which pose a risk of accident or injury if trespassing occurs. Otherwise, there are no indications that people have been, or are being, exposed to site-related contaminants at levels that would be of health concern. The Agency For Toxic Substances and Disease Registry (ATSDR) Health Activities Recommendation Panel has evaluated the Freeway Sanitary Landfill Public Health Assessment for appropriate follow-up activities. The Panel has recommended that health education be considered to assist site workers in better understanding their potential for exposure to landfill gases.« less

Social Network Supported Process Recommender System

PubMed Central

Ye, Yanming; Yin, Jianwei; Xu, Yueshen

2014-01-01

Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced. PMID:24672309

75 FR 7591 - Guidance on Recommended Interim Preliminary Remediation Goals for Dioxin in Soil at CERCLA and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-22

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-SFUND-2009-0907; FRL-9114-6] RIN 2050-ZA05 Guidance on Recommended Interim Preliminary Remediation Goals for Dioxin in Soil at CERCLA and RCRA Sites; Extension of... Interim Preliminary Remediation Goals for Dioxin in Soil at Comprehensive Environmental Response...

RECOMMENDATIONS FOR SCHOOL HEALTH SERVICE UNIT WITH SUGGESTED PLANS.

ERIC Educational Resources Information Center

ANDERSON, JESSE T.; PEEPLES, G.S.T.

THIS REPORT DISCUSSES RECOMMENDATIONS FOR THE PLANNING AND USE OF SPACE ALLOCATED FOR RENDERING NEEDED SCHOOL HEALTH SERVICES. ITEMS FOR CONSIDERATION ARE--(1) PURPOSES, (2) SITE, (3) LOCATION, (4) SPECIAL FEATURES, (5) SUPPLIES AND EQUIPMENT, AND (6) SUGGESTED PLANS OR LAYOUT OF THE UNIT. FUNCTIONAL AREAS WITHIN THE UNITS MAY INCLUDE--(1) REST…

ADAAG Review Federal Advisory Committee Recommendations for a New ADAAG. Final Report.

ERIC Educational Resources Information Center

Architectural and Transportation Barriers Compliance Board, Washington, DC.

This report presents the final recommendations, in the form of a new set of guidelines, of a federal advisory committee concerning revisions to the Americans with Disabilities Act Accessibility Guidelines (ADAAG). The guidelines provide scoping and technical requirements for the design, construction, and alteration of sites, facilities, buildings,…

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

NASA Astrophysics Data System (ADS)

Cox, E. A.

1982-02-01

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

76 FR 62894 - Following Procedures When Going Between Rolling Equipment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

... Operations Fatality Analysis (SOFA) Working Group. In October 1999, the Working Group issued a report titled ``Findings and Recommendations of the SOFA Working Group.'' The report can be found on FRA's Web site at http... recommendation reads as follows: \\1\\ More recently, in March 2011, the SOFA Working Group issued a report titled...

Interdisciplinary Matchmaking: Choosing Collaborators by Skill, Acquaintance and Trust

NASA Astrophysics Data System (ADS)

Hupa, Albert; Rzadca, Krzysztof; Wierzbicki, Adam; Datta, Anwitaman

Social networks are commonly used to enhance recommender systems. Most of such systems recommend a single resource or a person. However, complex problems or projects usually require a team of experts that must work together on a solution. Team recommendation is much more challenging, mostly because of the complex interpersonal relations between members. This chapter presents fundamental concepts on how to score a team based on members' social context and their suitability for a particular project. We represent the social context of an individual as a three-dimensional social network (3DSN) composed of a knowledge dimension expressing skills, a trust dimension and an acquaintance dimension. Dimensions of a 3DSN are used to mathematically formalize the criteria for prediction of the team's performance. We use these criteria to formulate the team recommendation problem as a multi-criteria optimization problem. We demonstrate our approach on empirical data crawled from two web2.0 sites: onephoto.net and a social networking site. We construct 3DSNs and analyze properties of team's performance criteria.

Draft environmental assessment: Davis Canyon site, Utah. Nuclear Waste Policy Act (Section 112). [Contains glossary

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

Not Available

1984-12-01

In February 1983, the US Department of Energy (DOE) identified the Davis Canyon site in Utah, as one of nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. To determine their suitability, the Davis Canyon site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for Nuclear Waste Repositories. These evaluations are reported in this draft environmental assessment (EA), which is being issued for public review and comment. The DOE findings and determinations that are based on these evaluationsmore » are preliminary and subject to public review and comment. A final EA will be prepared after considering the comments received. On the basis of the evaluations reported in this draft EA, the DOE has found that the Davis Canyon site is not disqualified under the guidelines. The site is in the Paradox Basin, which is one of five distinct geohydrologic settings considered for the first repository. This setting contains one other potentially acceptable site - the Lavender Canyon site. Although the Lavender Canyon site appears to be suitable for site characterization, the DOE has concluded that the Davis Canyon site is the preferred site in the Paradox Basin. Furthermore, the DOE finds that the site is suitable for site characterization because the evidence does not support a conclusion that the site will not be able to meet each of the qualifying conditions specified in the guidelines. On the basis of these findings, the DOE is proposing to nominate the Davis Canyon site as one of five sites suitable for characterization. Having compared the Davis Canyon site with the other four sites proposed for nomination, the DOE has determined that the Davis Canyon site is not one of the three preferred sites for recommendation to the President as candidates for characterization.« less

Network-based recommendation algorithms: A review

NASA Astrophysics Data System (ADS)

Yu, Fei; Zeng, An; Gillard, Sébastien; Medo, Matúš

2016-06-01

Recommender systems are a vital tool that helps us to overcome the information overload problem. They are being used by most e-commerce web sites and attract the interest of a broad scientific community. A recommender system uses data on users' past preferences to choose new items that might be appreciated by a given individual user. While many approaches to recommendation exist, the approach based on a network representation of the input data has gained considerable attention in the past. We review here a broad range of network-based recommendation algorithms and for the first time compare their performance on three distinct real datasets. We present recommendation topics that go beyond the mere question of which algorithm to use-such as the possible influence of recommendation on the evolution of systems that use it-and finally discuss open research directions and challenges.

A novel process for updating recommendations for managing hypertension: rationale and methods.

PubMed

Zarnke, K B; Campbell, N R; McAlister, F A; Levine, M

2000-09-01

There are numerous hypertension consensus recommendations intended for practising physicians. However, recommendations in their current format have limited impact on improving hypertension control. A group of national societies, headed by the Canadian Hypertension Society, the Heart and Stroke Foundation of Canada, the Canadian Coalition for High Blood Pressure Prevention and Control, and Health Canada has developed strategies to maintain annually updated recommendations for hypertension management and to provide greater opportunities for their implementation into clinical practice. The process is overseen by a steering committee. Subcommittees have been formed for each of a list of topics seen as important to the control of hypertension. The subcommittees, with the aid of a central librarian, conduct annual literature reviews in accordance with Cochrane Collaboration strategies. Modified existing and new recommendations are forwarded to a group with expertise in clinical epidemiology. Grades of evidence are assigned to each recommendation. Revised recommendations based on the above process will be presented annually at the conjoint Canadian Hypertension Society/Canadian Cardiovascular Congress meeting. Under the leadership of the Cardiovascular Disease Division of the Laboratory Centre for Disease Control, Health Canada, a committee has been charged with the implementation process. The improvements of the current process over previous national hypertension recommendations are four-fold. First, the recommendations will be updated annually. Second, the methodology has been improved. Third, the grading system can be used in the evaluation of complex study designs. Finally, the implementation process is extended. The authors are optimistic that these changes will contribute to the improvement of hypertension control in the Canadian population.

Recommendations for elaboration, transcultural adaptation and validation process of tests in Speech, Hearing and Language Pathology.

PubMed

Pernambuco, Leandro; Espelt, Albert; Magalhães, Hipólito Virgílio; Lima, Kenio Costa de

2017-06-08

to present a guide with recommendations for translation, adaptation, elaboration and process of validation of tests in Speech and Language Pathology. the recommendations were based on international guidelines with a focus on the elaboration, translation, cross-cultural adaptation and validation process of tests. the recommendations were grouped into two Charts, one of them with procedures for translation and transcultural adaptation and the other for obtaining evidence of validity, reliability and measures of accuracy of the tests. a guide with norms for the organization and systematization of the process of elaboration, translation, cross-cultural adaptation and validation process of tests in Speech and Language Pathology was created.

Local antimicrobial administration for prophylaxis of surgical site infections.

PubMed

Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

2012-11-01

Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made. © 2012 Pharmacotherapy Publications, Inc.

Site Characterization To Support Use Of Monitored Natural Attentuation For Remediation Of Inorganic Contaminants In Groundwater

EPA Science Inventory

Technical recommendations have recently been published by the U.S. Environmental Protection Agency to address site characterization needed to support selection of Monitored Natural Attenuation (MNA) for cleanup of inorganic contaminant plumes in groundwater. Immobilization onto ...

Incorporating hydrologic data and ecohydrologic relationships in ecological site descriptions

USDA-ARS?s Scientific Manuscript database

The purpose of this paper is to recommend a framework and methodology for inclusion of key ecohydrologic feedbacks and relationships in Ecological Site Descriptions (ESDs) and thereby enhance the utility of ESDs for assessing rangelands and guiding resilience-based management strategies. Resilience...

Which Online Resources Are Right for Your Collection?

ERIC Educational Resources Information Center

Pearlmutter, Jane

1999-01-01

Discusses important considerations for library media specialists creating a virtual-resources-collection policy, including selecting the right resources, navigating licensing fees, and free, searchable online sources. A sidebar lists resources for evaluating Web sites and places that lead to recommended sites for students. (AEF)

Exposure prediction approaches used in air pollution epidemiology studies: Keyfindings and future recommendations

EPA Science Inventory

Many epidemiologic studies of the health effects of exposure to ambient air pollution use measurements from central-site monitors as their exposure estimate. However, measurements from central-site monitors may lack the spatial and temporal resolution required to capture exposure...

Prevention of 3 "never events" in the operating room: fires, gossypiboma, and wrong-site surgery.

PubMed

Zahiri, Hamid R; Stromberg, Jeffrey; Skupsky, Hadas; Knepp, Erin K; Folstein, Matthew; Silverman, Ronald; Singh, Devinder

2011-03-01

This study sought to identify and provide preventative recommendations for potentially devastating safety violations in the operating room. A Medline database search from 1950 to current using the terms patient safety and operating room was conducted. All topics identified were reviewed. Three patient safety violations with potential for immediate and devastating outcomes were selected for discussion using evidence-based literature. The search identified 2851 articles, 807 of which were directly related to patient safety in the operating room. Topics addressed by these 807 included infectious complications (26%), fires (11%), communication/teamwork (6%), retained foreign objects (3%), safety checklists (1%), and wrong-site surgery (1%). Fires, gossypiboma, and wrong-site surgery were selected for discussion. Although fire, gossypiboma, and wrong-site surgery should be "never events" in the operating room, they continue to persist as 3 common patient safety violations. This study provides the epidemiology, common etiologies, and evidence-based preventative recommendations for each.

Environmental impact reduction through ecological planning at Bahia Magdalena, Mexico.

PubMed

Malagrino, Giovanni; Lagunas, Magdalena; Rubio, Alfredo Ortega

2008-03-01

For analyzing basic marine and coastal characteristics we selected the potential sites where shrimp culture could be developed in a large coastal zone, Bahia Magdalena, Baja California Sur, Mexico. Based on our analysis, 6 sites were preselected and field stages of work were then developed to assess the precise suitability of each site in order to develop the proposed aquaculture activities. In ranking the suitability we were able to recommend the most appropriate places to develop shrimp culture in this region. Also, knowing the exact biological, physico-chemical and social environment, we determined the best species to cultivate, the recommended total area and the methodology to be used to lessen the environmental impact and to obtain the maximum profitability Our methodology could be used not only to select appropriate sites for shrimp culture in other coastal lagoons, but it also could be applied to assess the suitability in a quick and accurate way, of any other production activity in coastal zones.

Consensus Bundle on Prevention of Surgical Site Infections After Major Gynecologic Surgery.

PubMed

Pellegrini, Joseph E; Toledo, Paloma; Soper, David E; Bradford, William C; Cruz, Deborah A; Levy, Barbara S; Lemieux, Lauren A

2017-01-01

Surgical site infections are the most common complication of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection. This bundle was developed by a multidisciplinary team convened by the Council on Patient Safety in Women's Health Care. The bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. In addition to recommendations for practice, each of the domains stresses communication and teamwork between all members of the surgical team. Although the bundle components are designed to be adaptable to work in a variety of clinical settings, standardization within institutions is encouraged.

Management and protection protocols for the threatened Piping Plover (Charadrius Melodus) on Cape Hatteras National Seashore, North Carolina

USGS Publications Warehouse

Cohen, J.B.

2005-01-01

Executive Summary 1. The breeding population of the piping plover (Charadrius melodus), a federally-threatened shorebird, at Cape Hatteras National Seashore (CAHA) declined from 15 pairs/yr to 3 pairs/yr from 1989-2004. A population of this size may face immediate risk of extirpation from several sources. At several former breeding sites at CAHA, there have been no nesting pairs in recent years. 2. Only one plover chick has survived to fledging at CAHA, 2001-2004. While survival of eggs has often been moderate to high since 1989, survival of chicks has generally been low. Reproductive rate improved in 2005, with 6 chicks fledging from 2 pairs in conjunction with more actively managed closures in brood-rearing areas. 3. Inclement weather, predation, and recreational disturbance may negatively impact reproductive success of piping plovers at CAHA. Recreational disturbance and habitat loss caused by ORVs may discourage pairs from attempting to nest. 4. To recover the breeding plover population at CAHA, it will be necessary to create disturbance-free areas containing high-quality nesting and foraging habitat from the territory-establishment phase to the brood-rearing phase of the breeding cycle. We provide three management options to reduce risk of disturbance and mortality. They entail full closure of the seashore to recreation, closure of historical breeding sites to ORVs, or restriction of recreation to an oceanside corridor. 5. To reduce the risk of egg and chick mortality, we recommend continued efforts to trap and remove mammalian predators from all aforementioned sites and the continued use of predator exclosures around nests. We further recommend intensive monitoring and surveillance of protected areas to determine the extent and timing of threats to nests and broods, including nest overwash, predation, and disturbance or vandalism by humans. 6. Even if reproductive success improves under our recommendations, however, a population of this size will take several years to recover in the absence of immigrants from other sites, and there may not be a noticeable increase in population size in the short term. We recommend using an Adaptive Management approach, combining research, monitoring and management to assess the effectiveness of management actions in achieving our goals to recovery this threatened species at Cape Hatteras. 7. The size of nonbreeding flocks, their habitat use, their site tenacity, and sources of disturbance and mortality are not known with high precision. We recommend monitoring standards and research to address this problem, while at the same time restricting recreation adjacent to important migration and wintering sites to afford nonbreeding birds increased protection.

Memorandum of Understanding Between U.S. EPA Superfund and U.S. NRC

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

Walker, Stuart

2008-01-15

The Environmental Protection Agency (EPA) Office of Superfund Remediation and Technology Innovation (OSRTI) and the Nuclear Regulatory Commission (NRC) are responsible for implementing the 'Memorandum of Understanding Between the Environmental Protection Agency and the Nuclear Regulatory Commission: Consultation and Finality on Decommissioning and Decontamination of Contaminated Sites'. This paper provides a brief overview of the origin of the Memorandum of Understanding (MOU), the major features of the MOU, and how the MOU has been implemented site specifically. EPA and NRC developed the MOU in response to direction from the House Committee on Appropriations to EPA and NRC to work togethermore » to address the potential for dual regulation. The MOU was signed by EPA on September 30, 2002 and NRC on October 9, 2002. The two agencies had worked on the MOU since March 2000. While both EPA and NRC have statutory authority to clean up these sites, the MOU provides consultation procedures between EPA and NRC to eliminate dual regulation. Under the MOU, EPA and NRC identified the interactions of the two agencies for the decommissioning and decontamination of NRC-licensed sites and the ways in which those responsibilities will be exercised. Except for Section VI, which addresses corrective action under the Resource Conservation and Recovery Act (RCRA), this MOU is limited to the coordination between EPA, when acting under its CERCLA authority, and NRC, when a facility licensed by the NRC is undergoing decommissioning, or when a facility has completed decommissioning, and the NRC has terminated its license. EPA believes that implementation of the MOU between the two agencies will ensure that future confusion about dual regulation does not occur regarding the cleanup and reuse of NRC-licensed sites. NRC and EPA have so far exchanged MOU consultation letters on eight NRC-licensed sites. EPA has responded to each consultation request with a letter expressing its views on actions that NRC should consider that address the site-specific matter that triggered consultation. Over the course of consultations on the eight sites, there have been some reoccurring themes to EPA's views. Primarily, these are EPA: 1. Recommending that NRC consider selecting institutional controls to ensure that NRC's assumptions about future human exposure at the site are not exceeded. 2. Recommending that NRC consider using more site-specific information when conducting dose assessment modeling. 3. Recommending that NRC consider a flexible approach to groundwater protection that still ensures the public is not exposed to contamination levels over drinking water limits. 4. Recommending that NRC consider an approach similar to how EPA implements supplemental standards under 40 CFR 192 as an ARAR when the UMTRCA soil standard of 5 pCi/g is not being met.« less

Ocular hazards of industrial spot welding.

PubMed

Chou, B R; Cullen, A P

1996-06-01

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

Reusable Reentry Satellite (RRS): Recovery tradeoff study

NASA Technical Reports Server (NTRS)

1990-01-01

The main objectives of the Recovery Tradeoff Study were as follows: (1) to determine whether a land or water recovery best suits RRS system requirements; (2) what type of terminal recovery system is best suited for the RRS; and (3) what are the recovery access timelines after system landing. Based on the trade parameters and evaluation criteria used in this study, the land-landing configuration has an advantage over the water-landing configuration. It is recommended that a land-landing configuration be developed assuming WSMR as the landing site. It is also recommended that natural orbits be used for low inclination missions and any orbit adjustments for landing site targeting be performed at the end of the mission. Near-integer orbits should be used for high inclination missions and allow orbital decay to precess the ground track over the landing site range.

Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project.

PubMed

Hark, Lisa A; Leiby, Benjamin E; Waisbourd, Michael; Myers, Jonathan S; Fudemberg, Scott J; Mantravadi, Anand V; Dai, Yang; Gilligan, John P; Resende, Arthur F; Katz, L Jay

2017-08-01

To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project. Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated. Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence. This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.

Navy Aquatic Hazardous Waste Sites: The Problem and Possible Solutions

DTIC Science & Technology

1989-08-01

sensitive area. NEESA 13-013. Naval Weapons Station Concord , CA . This activity had 13 sites recommended for further study as having potential to impact the...also carry contaminants to the bay. NEESA 13-014. Naval Air Station Alameda, CA . Seven sites have the potential to impact San Francisco Bay. The West...addition, surface runoff may carry contaminants to the ponds or Kaneohe Bay. NEESA 13-040. Naval Weapons Station Charleston, SC. Four sites have the

Addendum to the Closure Report for Corrective Action Unit 262: Area 25 Septic Systems and Underground Discharge Point, Nevada Test Site, Nevada

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

Lynn Kidman

2008-10-01

This document constitutes an addendum to the July 2003, Closure Report for Corrective Action Unit 262: Area 25 Septic Systems and Underground Discharge Point as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications.

The Readability of Online Patient Information About Mohs Micrographic Surgery.

PubMed

Vargas, Christina R; DePry, Jennifer; Lee, Bernard T; Bordeaux, Jeremy S

2016-10-01

Mohs micrographic surgery has become increasingly used in the treatment of cutaneous malignancies over the past decade. Concurrently, more patients are using the Internet as a resource for medical information than ever before. The average American adult reads at an eighth grade level. The American Medical Association and National Institutes of Health have recommended a sixth grade target reading level for patient health materials. This study evaluates the readability of currently available online information about Mohs micrographic surgery in the context of these recommendations. An Internet search for the term "Mohs surgery" was performed and the first 10 results were identified. Patient information from each primary site was downloaded and formatted into plain text. Readability was assessed using 9 established tests; text was analyzed both overall and by Web site for comparison. A total of 101 articles were collected from the first 10 Web site search results; the overall average reading level was 14.4. All articles exceeded the recommended sixth grade reading level. Online resources about Mohs micrographic surgery are too difficult for many patients to read. The paucity of appropriately written patient information available on the Internet may hinder informed decision-making, participation, and subsequent postoperative satisfaction.

Progress Report on the US Critical Zone Observatory Program

NASA Astrophysics Data System (ADS)

Barrera, E. C.

2014-12-01

The Critical Zone Observatory (CZO) program supported by the National Science Foundation originated from the recommendation of the Earth Science community published in the National Research Council report "Basic Research Opportunities in Earth Sciences" (2001) to establish natural laboratories to study processes and systems of the Critical Zone - the surface and near-surface environment sustaining nearly all terrestrial life. After a number of critical zone community workshops to develop a science plan, the CZO program was initiated in 2007 with three sites and has now grown to 10 sites and a National Office, which coordinates research, education and outreach activities of the network. Several of the CZO sites are collocated with sites supported by the US Long Term Ecological Research (LTER) and the Long Term Agricultural Research (LTAR) programs, and the National Ecological Observatory Network (NEON). Future collaboration with additional sites of these networks will add to the potential to answer questions in a more comprehensive manner and in a larger regional scale about the critical zone form and function. At the international level, CZOs have been established in many countries and strong collaborations with the US program have been in place for many years. The next step is the development of a coordinated international program of critical zone research. The success of the CZO network of sites can be measured in transformative results that elucidate properties and processes controlling the critical zone and how the critical zone structure, stores and fluxes respond to climate and land use change. This understanding of the critical zone can be used to enhance resilience and sustainability, and restore ecosystem function. Thus, CZO science can address major societal challenges. The US CZO network is a facility open to research of the critical zone community at large. Scientific data and information about the US program are available at www.criticalzone.org.

Mobilisation of toxic trace elements under various beach nourishments.

PubMed

Pit, Iris R; Dekker, Stefan C; Kanters, Tobias J; Wassen, Martin J; Griffioen, Jasper

2017-12-01

To enhance protection and maintain wide beaches for recreation, beaches are replenished with sand: so-called beach nourishments. We compared four sites: two traditional beach nourishments, a mega beach nourishment and a reference without beach nourishment. Two sites contain calcareous-rich sand, whereas the other two sites have calcareous-poor sand. We aimed to understand hydrogeochemical processes to indicate factors critical for the mobility of trace elements at nourishments. We therefore analysed the chemical characteristics of sediment and pore water to ascertain the main drivers that mobilise toxic trace elements. With Dutch Quality Standards for soil and groundwater, the characteristics of sediment and pore water were compared to Target Values (the values at which there is a sustainable soil quality) and Intervention Values (the threshold above which the soil's functions are at risk). The pore water characteristics revealed that Target Values were regularly exceeded, especially for the nourishment sites and mainly for Mo (78%), Ni (24%), Cr (55%), and As (21%); Intervention Values for shallow groundwater were occasionally exceeded for As (2%), Cr (2%) and Zn (2%). The sediment characteristics did not exceed the Target Values and showed that trace elements were mainly present in the fine fraction of <150 μm. The oxidation of sulphide minerals such as pyrite resulted into the elevated concentration for all nourishment sites, especially when an unsaturated zone was present and influence of rainwater was apparent. To prevent trace metal mobility at a mega beach nourishment it is important to retain seawater influences and limit oxidation processes. In this respect, a shoreface nourishment is recommended rather than a mega beach nourishment with a thick unsaturated zone. Consequently, we conclude that whether a site is carbonate-rich or carbonate-poor is unimportant, as the influence of seawater will prevent decalcification, creating a low risk of mobilisation of trace elements. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Measure Guideline: Optimizing the Configuration of Flexible Duct Junction Boxes

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

Beach, R.; Burdick, A.

2014-03-01

This measure guideline offers additional recommendations to heating, ventilation, and air conditioning (HVAC) system designers for optimizing flexible duct, constant-volume HVAC systems using junction boxes within Air Conditioning Contractors of America (ACCA) Manual D guidance (Rutkowski, H. Manual D -- Residential Duct Systems, 3rd edition, Version 1.00. Arlington, VA: Air Conditioning Contractors of America, 2009.). IBACOS used computational fluid dynamics software to explore and develop guidance to better control the airflow effects of factors that may impact pressure losses within junction boxes among various design configurations (Beach, R., Prahl, D., and Lange, R. CFD Analysis of Flexible Duct Junction Boxmore » Design. Golden, CO: National Renewable Energy Laboratory, submitted for publication 2013). These recommendations can help to ensure that a system aligns more closely with the design and the occupants' comfort expectations. Specifically, the recommendations described herein show how to configure a rectangular box with four outlets, a triangular box with three outlets, metal wyes with two outlets, and multiple configurations for more than four outlets. Designers of HVAC systems, contractors who are fabricating junction boxes on site, and anyone using the ACCA Manual D process for sizing duct runs will find this measure guideline invaluable for more accurately minimizing pressure losses when using junction boxes with flexible ducts.« less

Personalized recommendation via unbalance full-connectivity inference

NASA Astrophysics Data System (ADS)

Ma, Wenping; Ren, Chen; Wu, Yue; Wang, Shanfeng; Feng, Xiang

2017-10-01

Recommender systems play an important role to help us to find useful information. They are widely used by most e-commerce web sites to push the potential items to individual user according to purchase history. Network-based recommendation algorithms are popular and effective in recommendation, which use two types of elements to represent users and items respectively. In this paper, based on consistence-based inference (CBI) algorithm, we propose a novel network-based algorithm, in which users and items are recognized with no difference. The proposed algorithm also uses information diffusion to find the relationship between users and items. Different from traditional network-based recommendation algorithms, information diffusion initializes from users and items, respectively. Experiments show that the proposed algorithm is effective compared with traditional network-based recommendation algorithms.

The New World Health Organization Recommendations on Perioperative Administration of Oxygen to Prevent Surgical Site Infections: A Dangerous Reductionist Approach?

PubMed

Wenk, Manuel; Van Aken, Hugo; Zarbock, Alexander

2017-08-01

In October 2016, the World Health Organization (WHO) published recommendations for preventing surgical site infections (SSIs). Among those measures is a recommendation to administer oxygen at an inspired fraction of 80% intra- and postoperatively for up to 6 hours. SSIs have been identified as a global health problem, and the WHO should be commended for their efforts. However, this recommendation focuses only on the patient's "wound," ignores other organ systems potentially affected by hyperoxia, and may ultimately worsen patient outcomes.The WHO advances a "strong recommendation" for the use of a high inspired oxygen fraction even though the quality of evidence is only moderate. However, achieving this goal by disregarding other potentially lethal complications seems inappropriate, particularly in light of the weak evidence underpinning the use of high fractions of oxygen to prevent SSI. Use of such a strategy thus should be intensely discussed by anesthesiologists and perioperative physicians.Normovolemia, normotension, normoglycemia, normothermia, and normoventilation can clearly be safely applied to most patients in most clinical scenarios. But the liberal application of hyperoxemia intraoperatively and up to 6 hours postoperatively, as suggested by the WHO, is questionable from the viewpoint of anesthesia and perioperative medicine, and its effects will be discussed in this article.

Hospital web-site marketing: analysis, issues, and trends.

PubMed

Sanchez, P M; Maier-Donati, P

1999-01-01

As hospitals continue to incorporate web technology into their overall marketing and communications strategies, they face several issues which we explore in this paper. Hospitals' effectiveness in dealing with these issues will affect the benefits received from this technology. We provide an exploratory analysis of current hospital web sites and develop implications for future web site development. Likewise, recommendations based on our research are also provided.

Recommended metric for tracking visibility progress in the Regional Haze Rule.

PubMed

Gantt, Brett; Beaver, Melinda; Timin, Brian; Lorang, Phil

2018-05-01

For many national parks and wilderness areas with special air quality protections (Class I areas) in the western United States (U.S.), wildfire smoke and dust events can have a large impact on visibility. The U.S. Environmental Protection Agency's (EPA) 1999 Regional Haze Rule used the 20% haziest days to track visibility changes over time even if they are dominated by smoke or dust. Visibility on the 20% haziest days has remained constant or degraded over the last 16 yr at some Class I areas despite widespread emission reductions from anthropogenic sources. To better track visibility changes specifically associated with anthropogenic pollution sources rather than natural sources, the EPA has revised the Regional Haze Rule to track visibility on the 20% most anthropogenically impaired (hereafter, most impaired) days rather than the haziest days. To support the implementation of this revised requirement, the EPA has proposed (but not finalized) a recommended metric for characterizing the anthropogenic and natural portions of the daily extinction budget at each site. This metric selects the 20% most impaired days based on these portions using a "delta deciview" approach to quantify the deciview scale impact of anthropogenic light extinction. Using this metric, sulfate and nitrate make up the majority of the anthropogenic extinction in 2015 on these days, with natural extinction largely made up of organic carbon mass in the eastern U.S. and a combination of organic carbon mass, dust components, and sea salt in the western U.S. For sites in the western U.S., the seasonality of days selected as the 20% most impaired is different than the seasonality of the 20% haziest days, with many more winter and spring days selected. Applying this new metric to the 2000-2015 period across sites representing Class I areas results in substantial changes in the calculated visibility trend for the northern Rockies and southwest U.S., but little change for the eastern U.S. Changing the approach for tracking visibility in the Regional Haze Rule allows the EPA, states, and the public to track visibility on days when reductions in anthropogenic emissions have the greatest potential to improve the view. The calculations involved with the recommended metric can be incorporated into the routine IMPROVE (Interagency Monitoring of Protected Visual Environments) data processing, enabling rapid analysis of current and future visibility trends. Natural visibility conditions are important in the calculations for the recommended metric, necessitating the need for additional analysis and potential refinement of their values.

Assessment of launch site accommodations versus Spacelab payload requirements

NASA Technical Reports Server (NTRS)

1977-01-01

The Kennedy launch site capability for accommodating spacelab payload operations was assessed. Anomalies between facility accommodations and requirements for the Spacelab III (Strawman), OA Mission 83-2, Dedicated Life Sciences, and Combined Astronomy missions are noted. Recommendations for revision of the accommodations handbook are summarized.

76 FR 5365 - Environmental Management Site-Specific Advisory Board, Nevada

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... related activities. Tentative Agenda: 1. Recommendation Development--Industrial Sites, CAU 566 Rail Cars 2... presentations pertaining to agenda items should contact Denise Rupp at the telephone number listed above. The... the presentation in the agenda. The Deputy Designated Federal Officer is empowered to conduct the...

EPA GROUND WATER ISSUE: Ground Water Sample Preservation at ISCO Sites – Recommended Guidelines

EPA Science Inventory

In-situ chemical oxidation (ISCO) involves the introduction of a chemical oxidant into the subsurface for the purpose of transforming ground water contaminants into harmless byproducts. Due to oxidant persistence, ground water samples collected at hazardous waste sites may contai...

Linking Course Web Sites to Library Collections and Services

ERIC Educational Resources Information Center

Rieger, Oya Y.; Horne, Angela K.; Revels, Ira

2004-01-01

A five-month research study at Cornell University Library (CUL) confirmed the strategic importance of a library presence in faculty-created course Web sites. It sparked specific recommendations to support the seamless integration of the CUL digital library within the virtual learning environments created by faculty.

The Role of the Environmental Management Site Specific Advisory Board under the Federal Advisory Committee Act, With Emphasis on the Northern New Mexico Citizens' Advisory Board - 12482

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

Santistevan, Menice B.

2012-07-01

The Environmental Management Site Specific Advisory Board (EM SSAB) is comprised of eight Citizens' Advisory Boards, chartered under the Federal Advisory Committee Act (FACA) by the Assistant Secretary for Environmental Management for the U. S. Department of Energy (DOE). The purpose of the EM SSAB is to provide the DOE with recommendations regarding Environmental Management issues from legacy waste produced at major sites across the DOE Complex. The Northern New Mexico Citizens' Advisory Board (NNMCAB) is the site specific advisory board to the DOE on issues of environmental monitoring, remediation, waste management and long-term stewardship at Los Alamos National Laboratorymore » (LANL). The other boards are located at: Hanford, Idaho, Nevada, Paducah, Portsmouth, Oak Ridge and Savannah River. Using broad citizen outreach and input, the SSAB provides an official mechanism for the citizenry at each of these sites to monitor current activities affecting the region and also to have input into the prioritization of future activities. 'The mission of the EM SSAB is to more directly involve stakeholders in EM Planning and decision-making processes for the nuclear weapons complex cleanup. DOE has various means of involving the public in its planning and decision-making processes; the EM SSAB is only one component of EM's public participation program, and is not intended to be an exclusive means of public participation. It is the policy of DOE and EM to conduct it programs in an open and responsive manner, thereby encouraging and providing the opportunity for public participation in its planning and decision-making processes. EM SSAB members are appointed to a two year term and may serve up to three terms. During this time, members are able to hear many presentation from subject matter experts, attend several site tours at their site and across the DOE complex and are able to express their concerns and give input to the prioritization of clean up at each site. It is an excellent education and it is hoped that these members will go out to their communities, friends and family and discuss these issues in an informed manner. Many times our citizens rely only on newspaper articles or the Internet, which are sometimes replete with fear and misinformation. The more stakeholders are able to be truly informed, the more accurate the discourse will be at each of the DOE sites. (author)« less

Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial.

PubMed

Munce, Sarah E P; Graham, Ian D; Salbach, Nancy M; Jaglal, Susan B; Richards, Carol L; Eng, Janice J; Desrosiers, Johanne; MacKay-Lyons, Marilyn; Wood-Dauphinee, Sharon; Korner-Bitensky, Nicol; Mayo, Nancy E; Teasell, Robert W; Zwarenstein, Merrick; Mokry, Jennifer; Black, Sandra; Bayley, Mark T

2017-06-26

The Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE-IT) was a cluster randomized controlled trial that evaluated two knowledge translation (KT) interventions for the promotion of the uptake of best practice recommendations for interventions targeting upper and lower extremity function, postural control, and mobility. Twenty rehabilitation centers across Canada were randomly assigned to either the facilitated or passive KT intervention. The objective of the current study was to understand the factors influencing the implementation of the recommended treatments and KT interventions from the perspective of nurses, occupational therapists and physical therapists, and clinical managers following completion of the trial. A qualitative descriptive approach involving focus groups was used. Thematic analysis was used to understand the factors influencing the implementation of the recommended treatments and KT interventions. The Clinical Practice Guidelines Framework for Improvement guided the analysis. Thirty-three participants were interviewed from 11 of the 20 study sites (6 sites from the facilitated KT arm and 5 sites from the passive KT arm). The following factors influencing the implementation of the recommended treatments and KT interventions emerged: facilitation, agreement with the intervention - practical, familiarity with the recommended treatments, and environmental factors, including time and resources. Each of these themes includes the sub-themes of facilitator and/or barrier. Improved team communication and interdisciplinary collaboration emerged as an unintended outcome of the trial across both arms in addition to a facilitator to the implementation of the treatment recommendations. Facilitation was identified as a facilitator to implementation of the KT interventions in the passive KT intervention arm despite the lack of formally instituted facilitators in this arm of the trial. This is one of the first studies to examine the factors influencing the implementation of stroke recommendations and associated KT interventions within the context of a trial. Findings highlight the important role of self-selected facilitators to implementation efforts. Future research should seek to better understand the specific characteristics of facilitators that are associated with successful implementation and clinical outcomes, especially within the context of stroke rehabilitation.

Corrective Action Investigation Plan for Corrective Action Unit 375: Area 30 Buggy Unit Craters, Nevada Test Site, Nevada

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

Patrick Matthews

2010-03-01

Corrective Action Unit (CAU) 375 is located in Areas 25 and 30 of the Nevada Test Site, which is approximately 65 miles northwest of Las Vegas, Nevada. Corrective Action Unit 375 comprises the two corrective action sites (CASs) listed below: • 25-23-22, Contaminated Soils Site • 30-45-01, U-30a, b, c, d, e Craters Existing information on the nature and extent of potential contamination present at the CAU 375 CASs is insufficient to evaluate and recommend corrective action alternatives (CAAs). This document details an investigation plan that will provide for the gathering of sufficient information to evaluate and recommend CAAs. Correctivemore » Action Site 25-23-22 is composed of the releases associated with nuclear rocket testing at Test Cell A (TCA). Test Cell A was used to test and develop nuclear rocket motors as part of the Nuclear Rocket Development Station from its construction in 1958 until 1966, when rocket testing began being conducted at Test Cell C. The rocket motors were built with an unshielded nuclear reactor that produced as much as 1,100 kilowatts (at full power) to heat liquid hydrogen to 4,000 degrees Fahrenheit, at which time the expanded gases were focused out a nozzle to produce thrust. The fuel rods in the reactor were not clad and were designed to release fission fragments to the atmosphere, but due to vibrations and loss of cooling during some operational tests, fuel fragments in excess of planned releases became entrained in the exhaust and spread in the immediate surrounding area. Cleanup efforts have been undertaken at times to collect the fuel rod fragments and other contamination. Previous environmental investigations in the TCA area have resulted in the creation of a number of use restrictions. The industrial area of TCA is encompassed by a fence and is currently posted as a radioactive material area. Corrective Action Site 30-45-01 (releases associated with the Buggy Plowshare test) is located in Area 30 on Chukar Mesa. It was a Plowshare test where five nuclear devices were buried 140 feet (ft) deep in a row at 150-ft intervals. These devices were detonated on March 12, 1968, to produce a trench 254 ft wide, 865 ft long, and 70 ft deep. The mesa where the test was conducted is surrounded on three sides by ravines, and the entire end of the mesa is fenced and posted as a contamination area. These sites are being investigated because existing information on the nature and extent of potential contamination is insufficient to evaluate and recommend CAAs. Additional information will be obtained by conducting a corrective action investigation before evaluating CAAs and selecting the appropriate corrective action for each CAS. The results of the field investigation will support a defensible evaluation of viable CAAs that will be presented in the Corrective Action Decision Document. The sites will be investigated based on the data quality objectives (DQOs) developed on December 2, 2009, by representatives of the Nevada Division of Environmental Protection and the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office. The DQO process was used to identify and define the type, amount, and quality of data needed to develop and evaluate appropriate corrective actions for CAU 375.« less

An investigation of site diversity and comparison with ITU-R recommendations

NASA Astrophysics Data System (ADS)

Callaghan, S. A.; Boyes, B.; Couchman, A.; Waight, J.; Walden, C. J.; Ventouras, S.

2008-08-01

Earth-space radio systems operating at frequencies of 10 GHz and above are badly attenuated by rain, cloud, and atmospheric gases. As the frequencies of operational systems increase, it becomes increasingly uneconomic to compensate for the effects of fading through the use of a fixed fade margin, hence the implementation of fade mitigation techniques (FMT). The spatial and temporal variation of rain provides the justification for the use of site diversity as an FMT. Site diversity employs two or more ground stations receiving the same satellite signal with a separation distance such that the sites encounter intense rainfall at different times, and switching to the site experiencing the least fading improves system performance considerably. Measurements of the 20.7 GHz beacon carried as part of the Global Broadcast Service (GBS) payload on the U.S. Department of Defense satellite UFO-9 have been made at three sites: two are located in the South of England (˜8 km apart), and the third receiver was located in Scotland. These beacon measurements have produced long term attenuation exceedance and site diversity gain and improvement statistics. This attenuation time series data can simulate the performance of an Earth-space system using site diversity, indicating the optimum method of implementing this FMT. In this paper, unbalanced site diversity is investigated, as this is a more likely scenario than the balanced site diversity modeled by the ITU-R recommendations. This paper also investigates the implementation of site diversity from a commercial context, including cost-benefit analysis and technical feasibility.

Testing Nine Archaeological Sites in the Downstream Corridor, Saylorville Lake, Iowa. 1982.

DTIC Science & Technology

1983-04-01

cultivated field (fallow since 1981), covering an area of approximately 2 acres . The site is bordered on the west by the river bank and on the north by...sites in the project area. What Middle Archaic period sites in alluvial contexts are likely to yield is an unanswered question at this time, but it is ...13PK410 and 13PK413 be preserved in place, except for minor construction on 13PK413. Site 13PK407, an Oneota occupation, is recommended either for

40 CFR 240.200-2 - Recommended procedures: Design.

Code of Federal Regulations, 2013 CFR

2013-07-01

... processing. These include: Certain bulky wastes (e.g., combustible demolition and construction debris, tree... WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-2 Recommended procedures: Design. (a) In addition to the residential and commercial wastes...

Using Data From Ontario's Episode-Based Funding Model to Assess Quality of Chemotherapy.

PubMed

Kaizer, Leonard; Simanovski, Vicky; Lalonde, Carlin; Tariq, Huma; Blais, Irene; Evans, William K

2016-10-01

A new episode-based funding model for ambulatory systemic therapy was implemented in Ontario, Canada on April 1, 2014, after a comprehensive knowledge transfer and exchange strategy with providers and administrators. An analysis of the data from the first year of the new funding model provided an opportunity to assess the quality of chemotherapy, which was not possible under the old funding model. Options for chemotherapy regimens given with adjuvant/curative intent or palliative intent were informed by input from disease site groups. Bundles were developed and priced to enable evidence-informed best practice. Analysis of systemic therapy utilization after model implementation was performed to assess the concordance rate of the treatments chosen with recommended practice. The actual number of cycles of treatment delivered was also compared with expert recommendations. Significant improvement compared with baseline was seen in the proportion of adjuvant/curative regimens that aligned with disease site group-recommended options (98% v 90%). Similar improvement was seen for palliative regimens (94% v 89%). However, overall, the number of cycles of adjuvant/curative therapy delivered was lower than recommended best practice in 57.5% of patients. There was significant variation by disease site and between facilities. Linking funding to quality, supported by knowledge transfer and exchange, resulted in a rapid improvement in the quality of systemic treatment in Ontario. This analysis has also identified further opportunities for improvement and the need for model refinement.

Pesticides data-collection activities of the U.S. Geological Survey in Texas

USGS Publications Warehouse

Manigold, Douglas B.

1974-01-01

In 1965, the U.S. Geological Survey initiated a monthly monitoring program on 3 streams in Texas, screening for 9 of the more commonly used organochlorine insecticides: Aldrin, DDD, DDE , DDT, dieldrin, endrin, heptachlor, heptachlor epoxide, and lindane. Later, the herbicides 2,4-D; 2,4,5-T; and silvex were added. In 1967 a quarterly monitoring program was initiated at 26 sites on the principal streams of the State and a survey of the occurrence of pesticide residues in ground water. By 1970, the Geological Survey had developed methods for measuring pesticide residues in sediment, and in that year, the quarterly analysis of stream-bottom materials at 39 sites was added to the data collection program. Geological Survey pesticide data for 108 sites on nontidal reaches of streams in Texas have been summarized by Rawson (1974). The pesticides studied are widely distributed in surface waters in Texas. The most widely distributed chlorinated-hydrocarbon insecticides were dieldrin at 77 sites, DDT at 67 sites, lindane at 59 sites, and chlordane at 38 sites. The most widely distributed phosphorothioate insecticide was diazinon, which was detected at 80 sites. Small amounts of each of the chlorinated-hydrocarbon herbicides were widely distributed (2,4,5-T at 96 sites, 2,4-D at 78 sites, and Silvex at 47 sites). Although only chlordane, in 2 samples from 1 site exceeded the maximum limit recommended for water to be used for public supply, 1 or more pesticides in at least 1 sample from 57 sites exceeded the maximum environmental level for marine waters recommended by the National Technical Advisory Committee. (Woodard-USGS)

Accolades and Recommendations: A Longitudinal Analysis of Monitoring Reports for Two Charter Schools Serving Native American Students

ERIC Educational Resources Information Center

Anderson, Derek L.; Holder, K. C.

2012-01-01

This longitudinal case study examines 10 years' worth of annual monitoring reports for two rural Native American Charter Schools. Using data from multiple sources including interviews, site visits, and document analyses, the authors used provisional coding and constant comparison analysis to categorize the accolades and recommendations embedded in…

The Effect of an On-Site Vision Examination on Adherence to Vision Screening Recommendations

ERIC Educational Resources Information Center

Chu, Raymond; Huang, Kristine; Barnhardt, Carmen; Chen, Angela

2015-01-01

Vision screenings are intended to efficiently identify students with possible visual impairment and initiate a referral for diagnosis and treatment. In many cases, at-risk students do not access the recommended care or experience delays in receiving care. The purpose of this article is to report the effect on adherence to vision screening…

Recommender system based on scarce information mining.

PubMed

Lu, Wei; Chung, Fu-Lai; Lai, Kunfeng; Zhang, Liang

2017-09-01

Guessing what user may like is now a typical interface for video recommendation. Nowadays, the highly popular user generated content sites provide various sources of information such as tags for recommendation tasks. Motivated by a real world online video recommendation problem, this work targets at the long tail phenomena of user behavior and the sparsity of item features. A personalized compound recommendation framework for online video recommendation called Dirichlet mixture probit model for information scarcity (DPIS) is hence proposed. Assuming that each clicking sample is generated from a representation of user preferences, DPIS models the sample level topic proportions as a multinomial item vector, and utilizes topical clustering on the user part for recommendation through a probit classifier. As demonstrated by the real-world application, the proposed DPIS achieves better performance in accuracy, perplexity as well as diversity in coverage than traditional methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Analytical Impact Assessment Framework for Wildlife to Inform the Siting and Permitting of Wind Energy Facilities

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

Schwartz, Jesse D.M.

In the United States overall electrical generation capacity is expected to increase by 10-25 gigawatts (GW) per year to meet increases in demand. Wind energy is a key component of state and federal renewable energy standards, and central to the Department of Energy’s 20% by 2030 wind production goals. Increased wind energy development may present increased resource conflict with avian wildlife, and environmental permitting has been identified as a potential obstacle to expansion in the sector. ICF developed an analytical framework to help applicants and agencies examine potential impacts in support of facility siting and permitting. A key objective ofmore » our work was to develop a framework that is scalable from the local to the national level, and one that is generalizable across the different scales at which biological communities operate – from local influences to meta-populations. The intent was to allow natural resource managers to estimate the cumulative impacts of turbine strikes and habitat changes on long-term population performance in the context of a species demography, genetic potential, and life history. We developed three types of models based on our literature review and participation in the scientific review processes. First, the conceptual model was developed as a general description of the analytical framework. Second, we developed the analytical framework based on the relationships between concepts, and the functions presented in the scientific literature. Third, we constructed an application of the model by parameterizing the framework using data from and relevant to the Altamont Pass Wind Resource Area (APWRA), and an existing golden eagle population model. We developed managed source code, database create statements, and written documentation to allow for the reproduction of each phase of the analysis. ICF identified a potential template adaptive management system in the form of the US Fish & Wildlife Service (USFWS) Adaptive Harvest Management (AHM) program, and developed recommendations for the structure and function of a similar wind-facility related program. We provided a straw-man implementation of the analytical framework based on assumptions for APWRA-wide golden eagle fatalities, and presented a statistical examination of the model performance. APWRA-wide fatality rates appear substantial at all scales examined from the local APWRA population to the Bird Conservation Region. Documented fatality rates significantly influenced population performance in terms of non-territorial non-breeding birds. Breeder, Juvenile, Subadult, and Adult abundance were mostly unaffected by Baseline APWRA-wide fatality rates. However, increased variability in fatality rates would likely have impacts on long-term population performance, and would result in a substantially larger loss of resources. We developed four recommendations for future study. First, we recommend establishment of concept experts through the existing system of non-profits, regulatory agencies, academia, and industry in the wind energy sector. Second, we recommend the development of a central or distributed shared data repository, and establish guidelines for data sharing and transparency. Third, we recommend development a forum and process for model selection at the local and national level. Last, we recommend experimental implementation of the prescribed system at broader scales, and refinement the expectations for modeling and adaptive management.« less

Development of in-structure design spectra for dome mounted equipment on underground waste storage tanks at the Hanford Site

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

Julyk, L.J.

1995-09-01

In-structure response spectra for dome mounted equipment on underground waste storage tanks at the Hanford Site are developed on the basis of recent soil-structure-interaction analyses. Recommended design spectra are provided for various locations on the tank dome.

Incorporating hydrologic data and ecohydrologic relationships into ecological site descriptions

Treesearch

C. Jason Williams; Frederick B. Pierson; Kenneth E. Spaeth; Joel R. Brown; Osama Z. Al-Hamdan; Mark A. Weltz; Mark A. Nearing; Jeffrey E. Herrick; Jan Boll; Pete Robichaud; David C. Goodrich; Phillip Heilman; D. Phillip Guertin; Mariano Hernandez; Haiyan Wei; Stuart P. Hardegree; Eva K. Strand; Jonathan D. Bates; Loretta J. Metz; Mary H. Nichols

2016-01-01

The purpose of this paper is to recommend a framework and methodology for incorporating hydrologic data and ecohydrologic relationships in Ecological Site Descriptions (ESDs) and thereby enhance the utility of ESDs for assessing rangelands and guiding resilience-based management strategies. Resilience-based strategies assess and manage ecological state...

10 CFR 960.3-1-3 - Regionality.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Regionality. 960.3-1-3 Section 960.3-1-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-3 Regionality. In making site recommendations for repository...

10 CFR 960.3-1-3 - Regionality.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Regionality. 960.3-1-3 Section 960.3-1-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-3 Regionality. In making site recommendations for repository...

10 CFR 960.3-1-3 - Regionality.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Regionality. 960.3-1-3 Section 960.3-1-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-3 Regionality. In making site recommendations for repository...

10 CFR 960.3-1-3 - Regionality.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Regionality. 960.3-1-3 Section 960.3-1-3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-3 Regionality. In making site recommendations for repository...

Report: EPA Has Implemented Corrective Actions to Improve Conditions at Asheville, North Carolina Superfund Site

EPA Pesticide Factsheets

Report #12-P-0362, March 21, 2012. Region 4 took actions to implement all recommendations made in EPA OIG Report No. 10-P-0130, EPA Activities Provide Limited Assurance of the Extent of Contamination and Risk at a North Carolina Hazardous Waste Site.

1 CFR 301.1 - Establishment and location.

Code of Federal Regulations, 2012 CFR

2012-01-01

... information about the Conference either by accessing its Web site at http://www.acus.gov, by calling the Conference offices at (202) 480-2080, or by contacting [email protected]gov. The Conference's recommendations may be obtained by accessing its Web site or by visiting the reading room at its offices. ...

The Role of the Professional Field Naturalist in Planning Outdoor Education Facilities.

ERIC Educational Resources Information Center

Blythe, Chris

1994-01-01

Discusses the role of consulting firms in site development for outdoor education centers and recreational camps. Services include inventories of flora and fauna to assess the site's potential for environmental education, and design recommendations to minimize detrimental effects of development on the environment. (LP)

Remediation technologies for heavy metal contaminated groundwater.

PubMed

Hashim, M A; Mukhopadhyay, Soumyadeep; Sahu, Jaya Narayan; Sengupta, Bhaskar

2011-10-01

The contamination of groundwater by heavy metal, originating either from natural soil sources or from anthropogenic sources is a matter of utmost concern to the public health. Remediation of contaminated groundwater is of highest priority since billions of people all over the world use it for drinking purpose. In this paper, thirty five approaches for groundwater treatment have been reviewed and classified under three large categories viz chemical, biochemical/biological/biosorption and physico-chemical treatment processes. Comparison tables have been provided at the end of each process for a better understanding of each category. Selection of a suitable technology for contamination remediation at a particular site is one of the most challenging job due to extremely complex soil chemistry and aquifer characteristics and no thumb-rule can be suggested regarding this issue. In the past decade, iron based technologies, microbial remediation, biological sulphate reduction and various adsorbents played versatile and efficient remediation roles. Keeping the sustainability issues and environmental ethics in mind, the technologies encompassing natural chemistry, bioremediation and biosorption are recommended to be adopted in appropriate cases. In many places, two or more techniques can work synergistically for better results. Processes such as chelate extraction and chemical soil washings are advisable only for recovery of valuable metals in highly contaminated industrial sites depending on economical feasibility. Copyright © 2011 Elsevier Ltd. All rights reserved.

Candidate locations for SPS rectifying antennas

NASA Technical Reports Server (NTRS)

Eberhardt, A. W.

1977-01-01

The feasibility of placing 120 Satellite Power System (SPS) rectifying antenna (rectenna) sites across the U.S. was studied. An initial attempt is made to put two land sites in each state using several land site selection criteria. When only 69 land sites are located, it is decided to put the remaining sites in the sea and sea site selection criteria are identified. An estimated projection of electrical demand distribution for the year 2000 is then used to determine the distribution of these sites along the Pacific, Atlantic, and Gulf Coasts. A methodology for distributing rectenna sites across the country and for fine-tuning exact locations is developed, and recommendations on rectenna design and operations are made.

Solid waste management complex site development plan

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

Greager, T.M.

1994-09-30

The main purpose of this Solid Waste Management Complex Site Development Plan is to optimize the location of future solid waste treatment and storage facilities and the infrastructure required to support them. An overall site plan is recommended. Further, a series of layouts are included that depict site conditions as facilities are constructed at the SWMC site. In this respect the report serves not only as the siting basis for future projects, but provides siting guidance for Project W-112, as well. The plan is intended to function as a template for expected growth of the site over the next 30more » years so that future facilities and infrastructure will be properly integrated.« less

Recommendations report for the platanares geothermal site, Department of Copan, Honduras. Reporte de recomendaciones para el sitio geotermico de platanares, Departamento de Copan, Honduras (in EN;SP)

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

Not Available

1988-11-01

A geothermal assessment of six previously identified sites in Honduras has been conducted by a team comprised of staff from the Los Alamos National Laboratory, the US Geological Survey, and the Empresa Nacional de Energia Electrica. The application of both reconnaissance and detailed scale techniques lead to the selection of Platanares in the Department of Copan as the highest potential site. Additional work resulted in the completion of a prefeasibility study at Platanares. We present here a tabulation of the work completed and short summaries of the results from these technical studies. We also present a brief model of themore » geothermal system and recommendations for additional feasibility work. Both English and Spanish versions of this report are provided in the same document. 18 figs., 5 tabs.« less

Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

PubMed Central

Anderson, Deverick J.; Podgorny, Kelly; Berríos-Torres, Sandra I.; Bratzler, Dale W.; Dellinger, E. Patchen; Greene, Linda; Nyquist, Ann-Christine; Saiman, Lisa; Yokoe, Deborah S.; Maragakis, Lisa L.; Kaye, Keith S.

2014-01-01

PURPOSE Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,”1 published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.2 PMID:24799638

International Commission for Mountain Emergency Medicine Consensus Guidelines for On-Site Management and Transport of Patients in Canyoning Incidents.

PubMed

Strapazzon, Giacomo; Reisten, Oliver; Argenone, Fabien; Zafren, Ken; Zen-Ruffinen, Greg; Larsen, Gordon L; Soteras, Inigo

2018-06-01

Canyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Assessment of current practice and barriers to antimicrobial prophylaxis in peritoneal dialysis patients.

PubMed

Campbell, Denise J; Brown, Fiona G; Craig, Jonathan C; Gallagher, Martin P; Johnson, David W; Kirkland, Geoffrey S; Kumar, Subramanian K; Lim, Wai H; Ranganathan, Dwarakanathan; Saweirs, Walaa; Sud, Kamal; Toussaint, Nigel D; Walker, Rowan G; Williams, Lesley A; Yehia, Maha; Mudge, David W

2016-04-01

Existing Australasian and international guidelines outline antibiotic and antifungal measures to prevent the development of treatment-related infection in peritoneal dialysis (PD) patients. Practice patterns and rates of PD-related infection vary widely across renal units in Australia and New Zealand and are known to vary significantly from guideline recommendations, resulting in PD technique survival rates that are lower than those achieved in many other countries. The aim of this study was to determine if there is an association between current practice and PD-related infection outcomes and to identify the barriers and enablers to good clinical practice. This is a multicentre network study involving eight PD units in Australia and New Zealand, with a focus on adherence to guideline recommendations on antimicrobial prophylaxis in PD patients. Current practice was established by asking the PD unit heads to respond to a short survey about practice/protocols/policies and a 'process map' was constructed following a face-to-face interview with the primary PD nurse at each unit. The perceived barriers/enablers to adherence to the relevant guideline recommendations were obtained from the completion of 'cause and effect' diagrams by the nephrologist and PD nurse at each unit. Data on PD-related infections were obtained for the period 1 January 2011 to 31 December 2011. Perceived barriers that may result in reduced adherence to guideline recommendations included lack of knowledge, procedural lapses, lack of a centralized patient database, patients with non-English speaking background, professional concern about antibiotic resistance, medication cost and the inability of nephrologists and infectious diseases staff to reach consensus on unit protocols. The definitions of PD-related infections used by some units varied from those recommended by the International Society for Peritoneal Dialysis, particularly with exit-site infection (ESI). Wide variations were observed in the rates of ESI (0.06-0.53 episodes per patient-year) and peritonitis (0.31-0.86 episodes per patient-year). Despite the existence of strongly evidence-based guideline recommendations, there was wide variation in adherence to these recommendations between PD units which might contribute to PD-related infection rates, which varied widely between units. Although individual patient characteristics may account for some of this variability, inconsistencies in the processes of care to prevent infection in PD patients also play a role. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Comparison of performance and operation of side-by-side integrated fixed-film and conventional activated sludge processes at demonstration scale.

PubMed

Stricker, Anne-Emmanuelle; Barrie, Ashley; Maas, Carol L A; Fernandes, William; Lishman, Lori

2009-03-01

A full-scale demonstration of an integrated fixed-film activated sludge (IFFAS) process with floating carriers has been conducted in Ontario, Canada, since August 2003. In this study, data collected on-site from July 2005 to December 2006 are analyzed and compared with the performance of a conventional activated sludge train operated in parallel. Both trains received similar loadings and maintained comparable mixed liquor concentrations; however, the IFFAS had 50% more biomass when the attached growth was considered. In the winter, the conventional train operated at the critical solids retention time (SRT) and had fluctuating partial nitrification. The IFFAS nitrified more consistently and had a doubled average capacity. In the summer, the suspended SRT was less limiting, and the benefit of IFFAS for nitrification was marginal. The lessons learned from the operational requirements and challenges of the IFFAS process (air flow, carrier management, and seasonal foaming) are discussed, and design recommendations are proposed for whole plant retrofit.

Strategic planning: the basics and benefits.

PubMed

Hansen, R D

1999-01-01

Strategic planning can help a medical practice take an honest look at itself in light of the changes taking place in its environment and within the practice itself. The objective is for the group to design a plan, or road map, to its envisioned future. For medical practices, strategic planning is a four part process: 1) gaining buy-in for the process itself from the leadership and physicians; 2) gathering pertinent data about the group's environment through external resources, and about the group itself through interviews and surveys of physicians; 3) conducting a facilitated off-site retreat of key physicians and leaders in order to review data, discuss issues and develop a one to two year action plan; and, 4) carrying out the action plan developed at the retreat and measuring its outcomes. A follow-up mini-retreat about six months after the first retreat is highly recommended, as is instituting a process of sharing of the results and outcomes of the plan with all members of the organization.

Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes

PubMed Central

Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L.; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

2016-01-01

The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team’s processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team’s self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR. PMID:27429512

Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes.

PubMed

Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

2015-11-01

The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.

Are patterns of fine-scale spatial genetic structure consistent between sites within tropical tree species?

PubMed Central

Smith, James R.; Ghazoul, Jaboury; Burslem, David F. R. P.; Itoh, Akira; Khoo, Eyen; Lee, Soon Leong; Maycock, Colin R.; Nanami, Satoshi; Ng, Kevin Kit Siong; Kettle, Chris J.

2018-01-01

Documenting the scale and intensity of fine-scale spatial genetic structure (FSGS), and the processes that shape it, is relevant to the sustainable management of genetic resources in timber tree species, particularly where logging or fragmentation might disrupt gene flow. In this study we assessed patterns of FSGS in three species of Dipterocarpaceae (Parashorea tomentella, Shorea leprosula and Shorea parvifolia) across four different tropical rain forests in Malaysia using nuclear microsatellite markers. Topographic heterogeneity varied across the sites. We hypothesised that forests with high topographic heterogeneity would display increased FSGS among the adult populations driven by habitat associations. This hypothesis was not supported for S. leprosula and S. parvifolia which displayed little variation in the intensity and scale of FSGS between sites despite substantial variation in topographic heterogeneity. Conversely, the intensity of FSGS for P. tomentella was greater at a more topographically heterogeneous than a homogeneous site, and a significant difference in the overall pattern of FSGS was detected between sites for this species. These results suggest that local patterns of FSGS may in some species be shaped by habitat heterogeneity in addition to limited gene flow by pollen and seed dispersal. Site factors can therefore contribute to the development of FSGS. Confirming consistency in species’ FSGS amongst sites is an important step in managing timber tree genetic diversity as it provides confidence that species specific management recommendations based on species reproductive traits can be applied across a species’ range. Forest managers should take into account the interaction between reproductive traits and site characteristics, its consequences for maintaining forest genetic resources and how this might influence natural regeneration across species if management is to be sustainable. PMID:29547644

Determination of a risk management primer at petroleum-contaminated sites: developing new human health risk assessment strategy.

PubMed

Park, In-Sun; Park, Jae-Woo

2011-01-30

Total petroleum hydrocarbon (TPH) is an important environmental contaminant that is toxic to human and environmental receptors. However, human health risk assessment for petroleum, oil, and lubricant (POL)-contaminated sites is especially challenging because TPH is not a single compound, but rather a mixture of numerous substances. To address this concern, this study recommends a new human health risk assessment strategy for POL-contaminated sites. The strategy is based on a newly modified TPH fractionation method and includes an improved analytical protocol. The proposed TPH fractionation method is composed of ten fractions (e.g., aliphatic and aromatic EC8-10, EC10-12, EC12-16, EC16-22 and EC22-40). Physicochemical properties and toxicity values of each fraction were newly defined in this study. The stepwise ultrasonication-based analytical process was established to measure TPH fractions. Analytical results were compared with those from the TPH Criteria Working Group (TPHCWG) Direct Method. Better analytical efficiencies in TPH, aliphatic, and aromatic fractions were achieved when contaminated soil samples were analyzed with the new analytical protocol. Finally, a human health risk assessment was performed based on the developed tiered risk assessment framework. Results showed that a detailed quantitative risk assessment should be conducted to determine scientifically and economically appropriate cleanup target levels, although the phase II process is useful for determining the potency of human health risks posed by POL-contamination. Copyright © 2010 Elsevier B.V. All rights reserved.

Post-precipitation bias in band-tailed pigeon surveys conducted at mineral sites

USGS Publications Warehouse

Overton, C.T.; Schmitz, R.A.; Casazza, Michael L.

2005-01-01

Many animal surveys to estimate populations or index trends include protocol prohibiting counts during rain but fail to address effects of rainfall preceding the count. Prior research on Pacific Coast band-tailed pigeons (Patagioenas fasciata monilis) documented declines in use of mineral sites during rainfall. We hypothesized that prior precipitation was associated with a short-term increase in use of mineral sites following rain. We conducted weekly counts of band-tailed pigeons at 19 Pacific Northwest mineral sites in 2001 and 20 sites in 2002. Results from regression analysis indicated higher counts ???2 days after rain (11.31??5.00% [x????SE]) compared to ???3 days. Individual index counts conducted ???2 days after rain were biased high, resulting in reduced ability to accurately estimate population trends. Models of band-tailed pigeon visitation rates throughout the summer showed increased mineral-site counts during both June and August migration periods, relative to the July breeding period. Our research supported previous studies recommending that mineral-site counts used to index the band-tailed pigeon population be conducted during July. We further recommend conducting counts >3 days after rain to avoid weather-related bias in index estimation. The design of other population sampling strategies that rely on annual counts should consider the influence of aberrant weather not only coincident with but also preceding surveys if weather patterns are thought to influence behavior or detection probability of target species.

Readability of ASPS and ASAPS educational web sites: an analysis of consumer impact.

PubMed

Aliu, Oluseyi; Chung, Kevin C

2010-04-01

Patients use the Internet to educate themselves about health-related topics, and learning about plastic surgery is a common activity for enthusiastic consumers in the United States. How to educate consumers regarding plastic surgical procedures is a continued concern for plastic surgeons when faced with the growing portion of the American population having relatively low health care literacy. The usefulness of health-related education materials on the Internet depends largely on their comprehensibility and understandability for all who visit the Web sites. The authors studied the readability of patient education materials related to common plastic surgery procedures from the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) Web sites and compared them with materials on similar topics from 10 popular health information-providing sites. The authors found that all analyzed documents on the ASPS and ASAPS Web sites targeted to the consumers were rated to be more difficult than the recommended reading grade level for most American adults, and these documents were consistently among the most difficult to read when compared with the other health information Web sites. The Internet is an increasingly popular avenue for patients to educate themselves about plastic surgery procedures. Patient education material provided on ASPS and ASAPS Web sites should be written at recommended reading grade levels to ensure that it is readable and comprehensible to the targeted audience.

Tug fleet and ground operations schedules and controls. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1975-01-01

This study presents Tug Fleet and Ground Operations Schedules and Controls plan. This plan was developed and optimized out of a combination of individual Tug program phased subplans, special emphasis studies, contingency analyses and sensitivity analyses. The subplans cover the Tug program phases: (1) Tug operational, (2) Interim Upper Stage (IUS)/Tug fleet utilization, (3) and IUS/Tug payload integration, (4) Tug site activation, (5) IUS/Tug transition, (6) Tug acquisition. Resource requirements (facility, GSE, TSE, software, manpower, logistics) are provided in each subplan, as are appropriate Tug processing flows, active and total IUS and Tug fleet requirements, fleet management and Tug payload integration concepts, facility selection recommendations, site activation and IUS to Tug transition requirements. The impact of operational concepts on Tug acquisition is assessed and the impact of operating Tugs out of KSC and WTR is analyzed and presented showing WTR as a delta. Finally, cost estimates for fleet management and ground operations of the DDT&E and operational phases of the Tug program are given.

Savannah River Site generic data base development

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

Blanton, C.H.; Eide, S.A.

This report describes the results of a project to improve the generic component failure data base for the Savannah River Site (SRS). A representative list of components and failure modes for SRS risk models was generated by reviewing existing safety analyses and component failure data bases and from suggestions from SRS safety analysts. Then sources of data or failure rate estimates were identified and reviewed for applicability. A major source of information was the Nuclear Computerized Library for Assessing Reactor Reliability, or NUCLARR. This source includes an extensive collection of failure data and failure rate estimates for commercial nuclear powermore » plants. A recent Idaho National Engineering Laboratory report on failure data from the Idaho Chemical Processing Plant was also reviewed. From these and other recent sources, failure data and failure rate estimates were collected for the components and failure modes of interest. This information was aggregated to obtain a recommended generic failure rate distribution (mean and error factor) for each component failure mode.« less

Evaluating the effectiveness of student assistance programs in Pennsylvania.

PubMed

Fertman, C I; Fichter, C; Schlesinger, J; Tarasevich, S; Wald, H; Zhang, X

2001-01-01

This article presents data from an evaluation of the Pennsylvania Student Assistance Program (SAP). Focusing on both program process and effectiveness, the evaluation was conducted to determine the overall efficacy of SAPs in Pennsylvania and, more specifically, how SAP is currently being implemented. Five data collection strategies were employed: statewide surveys of SAP team members and county administrators, focus groups, site visits, and the Pennsylvania Department of Education SAP Database. A total of 1204 individual team members from 154 school buildings completed the team member survey. Fifty-three county administrators completed the county administrator survey. Focus groups were comprised of SAP coordinators, school board personnel and community agency staff. Site visits were conducted at five schools. The findings of the evaluation indicate that SAP in Pennsylvania is being implemented as designed. Recommended is the development of benchmarks and indicators that focus on the best SAP practices and the extent to which various indicators of the effectiveness of SAP are occurring at appropriate levels.

Future Research Opportunities in Peri-Prosthetic Joint Infection Prevention.

PubMed

Berbari, Elie; Segreti, John; Parvizi, Javad; Berríos-Torres, Sandra I

Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty. A panel of PJI content experts identified nine PJI prevention research opportunities based on both evidence gaps identified through the guideline development process (transfusion, immunosuppressive therapy, anticoagulation, orthopedic space suit, and biofilm) and expert opinion (anesthesia, operative room environment, glycemic control, and Staphylococcus aureus nasal screening and decolonization. This article offers a road map for PJI prevention research.

NANA Geothermal Assessment Program Final Report

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

Jay Hermanson

2010-06-22

In 2008, NANA Regional Corporation (NRC) assessed geothermal energy potential in the NANA region for both heat and/or electricity production. The Geothermal Assessment Project (GAP) was a systematic process that looked at community resources and the community's capacity and desire to develop these resources. In October 2007, the US Department of Energy's Tribal Energy Program awarded grant DE-FG36-07GO17075 to NRC for the GAP studies. Two moderately remote sites in the NANA region were judged to have the most potential for geothermal development: (1) Granite Mountain, about 40 miles south of Buckland, and (2) the Division Hot Springs area in themore » Purcell Mountains, about 40 miles south of Shungnak and Kobuk. Data were collected on-site at Granite Mountain Hot Springs in September 2009, and at Division Hot Springs in April 2010. Although both target geothermal areas could be further investigated with a variety of exploration techniques such as a remote sensing study, a soil geochemical study, or ground-based geophysical surveys, it was recommended that on-site or direct heat use development options are more attractive at this time, rather than investigations aimed more at electric power generation.« less

Using qualitative mixed methods to study small health care organizations while maximising trustworthiness and authenticity.

PubMed

Phillips, Christine B; Dwan, Kathryn; Hepworth, Julie; Pearce, Christopher; Hall, Sally

2014-11-19

The primary health care sector delivers the majority of health care in western countries through small, community-based organizations. However, research into these healthcare organizations is limited by the time constraints and pressure facing them, and the concern by staff that research is peripheral to their work. We developed Q-RARA-Qualitative Rapid Appraisal, Rigorous Analysis-to study small, primary health care organizations in a way that is efficient, acceptable to participants and methodologically rigorous. Q-RARA comprises a site visit, semi-structured interviews, structured and unstructured observations, photographs, floor plans, and social scanning data. Data were collected over the course of one day per site and the qualitative analysis was integrated and iterative. We found Q-RARA to be acceptable to participants and effective in collecting data on organizational function in multiple sites without disrupting the practice, while maintaining a balance between speed and trustworthiness. The Q-RARA approach is capable of providing a richly textured, rigorous understanding of the processes of the primary care practice while also allowing researchers to develop an organizational perspective. For these reasons the approach is recommended for use in small-scale organizations both within and outside the primary health care sector.

Investigation of Some Metals in Leaves and Leaf Extracts of Lippia javanica: Its Daily Intake

PubMed Central

Florence, Kunsamala

2017-01-01

Consumption of plant extracts can be a source of essential elements or a route of human exposure to toxicants. Metal concentrations in leaves, leaf brew, and infusion of L. javanica collected from five sites were determined by atomic absorption spectrometry after acid and aqueous extraction. Estimated daily intakes of metals in extracts were compared with recommended dietary allowances. Total metal concentrations in leaves varied with sampling sites (p < 0.05): Mn > Fe > Cu > Cr > Pb for sites SS2–SS5. The highest metal concentrations in leaves were recorded for SS3 (Cu: 15.32 ± 4.53 and Mn: 734.99 ± 105.49), SS5 (Fe: 210.27 ± 17.17), SS2 (Pb: 3.11 ± 0.21), and SS4 (Cr: 4.40 ± 0.75 mg/kg). Leaf infusion appeared to release higher Cu and Mn concentrations in leaves across sites (Cu: 21.65; Mn: 28.01%) than leaf brew (Cu: 11.95; Mn: 19.74%). Lead was not detected in leaf extracts. Estimated dietary intakes of Cr, Cu, Fe, and Mn were below recommended dietary allowances. A 250 ml cup of leaf infusion contributed 0.30–1.18% Cu and 4.46–13.83% Mn to the recommended dietary allowances of these elements per day. Lead did not pose any potential hazard when consumed in tea beverage made from brew and infusion of leaves of L. javanica. PMID:28781598

Field-scale investigations on the biodegradation of chlorinated aromatic compounds and HCH in the subsurface environment

NASA Astrophysics Data System (ADS)

Feidieker, Doris; Kämpfer, Peter; Dott, Wolfgang

1995-08-01

The biological in situ remediation of a former pesticide production site, highly contaminated with chlorobenzenes, chlorophenols and hexachlorocyclohexanes, was studied for a period of one year. Field experiments testing the remediation technology were carried out in the subsurface to a depth of 5.5 m. Detailed monitoring of several chemical and microbiological parameters was made in order to evaluate the remediation success. The initial pollution of this site ranged from 0.03-0.30 g EOX (extractable halogenated organic compounds)/kg soil in the saturated layer to 1-20 g kg -1 EOX in the unsaturated layer, whereas the impounded water was polluted with 8-13 mg L -1 AOX (adsorbable halogenated organic compounds). No significant decrease of the pollutants in the subsoil was observed, although oxygen and nutrients were supplied in sufficient concentrations. In contrast, several of the chlorinated organic compounds were eliminated from the water treatment plant, either by physical or biological processes. Based on measurements of AOX in different parts of the plant, 26% of the pollutants was found adsorbed on the activated carbon and 3% was found in the sludge of the filter back-wash. Dependent on these measurements, elimination of ˜ 70% of the pollutants was attributed to microbial degradation. The latter fact is supported by oxygen consumption data, by increase in the microbial counts and by changes in the distribution of the pollutants in the plant effluent. Among the chlorobenzenes, 1,2,4-trichlorobenzene, and among the hexachlorocyclohexanes, a-hexachlorocyclohexane were eliminated preferentially. The results suggest that an in situ remediation of a site polluted with chlorinated organic compounds cannot be recommended; however, an on site circulation water treatment is possible by a combination of physical and biological processes.

Ultrasensitivity and sharp threshold theorems for multisite systems

NASA Astrophysics Data System (ADS)

Dougoud, M.; Mazza, C.; Vinckenbosch, L.

2017-02-01

This work studies the ultrasensitivity of multisite binding processes where ligand molecules can bind to several binding sites. It considers more particularly recent models involving complex chemical reactions in allosteric phosphorylation processes and for transcription factors and nucleosomes competing for binding on DNA. New statistics-based formulas for the Hill coefficient and the effective Hill coefficient are provided and necessary conditions for a system to be ultrasensitive are exhibited. It is first shown that the ultrasensitivity of binding processes can be approached using sharp-threshold theorems which have been developed in applied probability theory and statistical mechanics for studying sharp threshold phenomena in reliability theory, random graph theory and percolation theory. Special classes of binding process are then introduced and are described as density dependent birth and death process. New precise large deviation results for the steady state distribution of the process are obtained, which permits to show that switch-like ultrasensitive responses are strongly related to the multi-modality of the steady state distribution. Ultrasensitivity occurs if and only if the entropy of the dynamical system has more than one global minimum for some critical ligand concentration. In this case, the Hill coefficient is proportional to the number of binding sites, and the system is highly ultrasensitive. The classical effective Hill coefficient I is extended to a new cooperativity index I q , for which we recommend the computation of a broad range of values of q instead of just the standard one I  =  I 0.9 corresponding to the 10%-90% variation in the dose-response. It is shown that this single choice can sometimes mislead the conclusion by not detecting ultrasensitivity. This new approach allows a better understanding of multisite ultrasensitive systems and provides new tools for the design of such systems.

Report on Discussions of the Task Force on the Manpower Distribution Project of the National Health Council.

ERIC Educational Resources Information Center

National Health Council, New York, NY.

Twenty-six health manpower experts met to: (1) recommend criteria for selecting proposals for local/regional demonstration projects; (2) recommend criteria for selection of areas or sites in which to implement demonstration projects, and (3) develop guidelines for a national program to involve the health professions in alleviating the problem of…

Online availability and safety of drugs in shortage: a descriptive study of internet vendor characteristics.

PubMed

Liang, Bryan A; Mackey, Tim K

2012-02-09

Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online. To assess the prevalence of online marketing for current FDA shortage drugs and potential patient safety risks. We performed a descriptive study of the prevalence of online marketing for shortage drugs-that is, offers for sale of each drug, including characteristics of online drug sellers and intermediary sites marketing these drugs. Of the 72 FDA shortage-listed drugs, 68 (94%) were offered for sale online. We found 291 offers for these drugs, the vast majority (n = 207, 71.1%) by online drug sellers selling direct to consumers. Intermediary sites included data aggregators (n = 22, 8%), forum links (n = 23, 8%), and personal page data links (n = 34, 12%), as well as Flickr social media links (n = 5, 2%), all advertising drugs without a prescription. Of the 91 online drug sellers identified, 31 (34%) had more than 1 shortage drug offered for sale, representing most (n = 148, 71%) of all online drug seller sales offers. The majority of these online drug sellers (n = 21, 68%) were on the National Association of Boards of Pharmacy (NABP) Not Recommended Sites list. Finally, for shortage drugs with an online drug seller (n = 58, 85%), 53 (91%) had at least one site on the Not Recommended list and 21 (36%) had only sites on the Not Recommended list. FDA shortage drugs are widely marketed over the Internet. Suspect online drug sellers and intermediaries dominate these sales offers. As a critical risk management issue, patients, providers, and policymakers should be extremely cautious in procuring shortage drugs through Internet sourcing.

Online Availability and Safety of Drugs in Shortage: A Descriptive Study of Internet Vendor Characteristics

PubMed Central

Mackey, Tim K

2012-01-01

Background Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online. Objective To assess the prevalence of online marketing for current FDA shortage drugs and potential patient safety risks. Methods We performed a descriptive study of the prevalence of online marketing for shortage drugs—that is, offers for sale of each drug, including characteristics of online drug sellers and intermediary sites marketing these drugs. Results Of the 72 FDA shortage-listed drugs, 68 (94%) were offered for sale online. We found 291 offers for these drugs, the vast majority (n = 207, 71.1%) by online drug sellers selling direct to consumers. Intermediary sites included data aggregators (n = 22, 8%), forum links (n = 23, 8%), and personal page data links (n = 34, 12%), as well as Flickr social media links (n = 5, 2%), all advertising drugs without a prescription. Of the 91 online drug sellers identified, 31 (34%) had more than 1 shortage drug offered for sale, representing most (n = 148, 71%) of all online drug seller sales offers. The majority of these online drug sellers (n = 21, 68%) were on the National Association of Boards of Pharmacy (NABP) Not Recommended Sites list. Finally, for shortage drugs with an online drug seller (n = 58, 85%), 53 (91%) had at least one site on the Not Recommended list and 21 (36%) had only sites on the Not Recommended list. Conclusions FDA shortage drugs are widely marketed over the Internet. Suspect online drug sellers and intermediaries dominate these sales offers. As a critical risk management issue, patients, providers, and policymakers should be extremely cautious in procuring shortage drugs through Internet sourcing. PMID:22321731

Readability assessment of internet-based patient education materials related to uterine artery embolization.

PubMed

Shukla, Pratik; Sanghvi, Saurin P; Lelkes, Valdis M; Kumar, Abhishek; Contractor, Sohail

2013-04-01

To determine the readability of Internet-based patient education materials (IPEMs) created by United States hospitals and universities and clinical practices and miscellaneous health care-associated Web sites regarding uterine artery embolization (UAE) as a marker for IPEMs in general. Two hundred unique Web sites were evaluated for patient-related articles on UAE. Web sites produced by US hospitals and universities and clinical practices, as well as miscellaneous health care-associated Web sites meeting the Health on the Net Foundation Code of Conduct criteria were included in the database. By using mathematical regression algorithms based on word and sentence length to quantitatively analyze reading materials for language intricacy, readability of 40 UAE-related IPEMs was assessed with four indices: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (GFOG). Scores were evaluated against national recommendations, and intergroup analysis was performed. None of the IPEMs were written at or below the sixth-grade reading level, based on FKGL. The mean readability scores were as follows: FRES, 43.98; FKGL, 10.76; SMOG, 13.63; and GFOG, 14.55. These scores indicate that the readability of UAE IPEMs is written at an advanced level, significantly above the recommended 6th grade reading level (P<.05) determined by the United States Department of Health and Human Services. IPEMs related to UAE generated by hospitals, clinical practices, and miscellaneous health care-associated Web sites are written above the recommended sixth grade level. IPEMs for other disease entities may also reflect similar results. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care

PubMed Central

Caine, Vera; Mill, Judy; O’Brien, Kelly; Solomon, Patricia; Worthington, Catherine; Dykeman, Margaret; Gahagan, Jacqueline; Maina, Geoffrey; De Padua, Anthony; Arneson, Cheryl; Rogers, Tim; Chaw-Kant, Jean

2016-01-01

We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations. PMID:26644019

Features of Online Health Communities for Adolescents With Type 1 Diabetes

PubMed Central

Ho, Yun-Xian; O’Connor, Brendan H.; Mulvaney, Shelagh A.

2014-01-01

The aim of this exploratory study was to examine diabetes online health communities (OHCs) available to adolescents with type 1 diabetes (T1D). We sought to identify and classify site features and relate them to evidence-based processes for improving self-management. We reviewed 18 OHCs and identified the following five feature categories: social learning and networking, information, guidance, engagement, and personal health data sharing. While features that have been associated with improved self-management were present, such as social learning, results suggest that more guidance or structure would be helpful to ensure that those processes were focused on promoting positive beliefs and behaviors. Enhancing guidance-related features and structure to existing OHCs could provide greater opportunity for effective diabetes self-management support. To support clinical recommendations, more research is needed to quantitatively relate features and participation in OHCs to patient outcomes. PMID:24473058