Sample records for standards options recommandations

  1. Diagnostiquer l’hypertension artérielle

    PubMed Central

    Gelfer, Mark; Dawes, Martin; Kaczorowski, Janusz; Padwal, Raj; Cloutier, Lyne

    2015-01-01

    Résumé Objectif Mettre en lumière les recommandations 2015 du Programme éducatif canadien sur l’hypertension (PECH) sur le diagnostic et l’évaluation de l’hypertension artérielle (HTA). Qualité des données Une recherche systématique remontant à août 2014 a été effectuée par un bibliothécaire de la Collaboration Cochrane dans les banques de données MEDLINE et PubMed. Les résultats de la recherche ont fait l’objet d’une évaluation critique par le sous-comité du PECH sur la mesure de la pression artérielle (PA) et le diagnostic d’HTA, et les recommandations fondées sur les données probantes ont été soumises au Comité central d’examen du PECH aux fins d’examen indépendant et de classement. Finalement, les résultats et recommandations ont été présentés au Groupe de travail sur les recommandations aux fins de discussion, de débat, d’approbation et de vote. Les principales recommandations reposent sur des données probantes de niveau II. Message principal Selon les données probantes les plus récentes, le PECH a formulé 4 nouvelles recommandations classées dans 2 vastes catégories pour améliorer la mesure de la PA et la façon dont l’HTA est diagnostiquée en 2015. Il est fortement recommandé de mesurer la PA à l’aide d’appareils électroniques en clinique plutôt que par auscultation. Chez les patients dont les mesures en clinique sont élevées, le PECH recommande de se tourner précocement vers les mesures ambulatoires, préférablement le monitorage ambulatoire de la PA, afin d’identifier rapidement les patients atteints du syndrome du sarrau blanc. Conclusion Il est crucial d’améliorer la justesse diagnostique afin d’optimiser la prise en charge de l’HTA au Canada. Les mises à jour annuelles du PECH veillent à ce que les praticiens disposent de renseignements fondés sur les données probantes à jour pour éclairer leur pratique.

  2. Recommandations sur l’examen pelvien de dépistage systématique

    PubMed Central

    Tonelli, Marcello; Gorber, Sarah Connor; Moore, Ainsley; Thombs, Brett D.

    2016-01-01

    Résumé Objectif Examiner les lignes directrices de 2014 de l’American College of Physicians (ACP) en matière d’examens pelviens de dépistage du cancer (autre que du col), des maladies inflammatoires pelviennes ou d’autres affections gynécologiques bénignes afin de déterminer si les lignes directrices de l’ACP en matière d’examens pelviens systématiques sont conformes aux normes établies par le Groupe d’étude canadien sur les soins de santé préventifs (GECSSP) et peuvent être adaptées ou adoptées. Méthodologie La méthode SNAP-IT (Smooth National Adaptation and Presentation of Guidelines to Improve Thrombosis Treatment) a servi à déterminer si les lignes directrices de l’ACP étaient conformes aux normes du GECSSP et pouvaient être adaptées ou adoptées. Recommandations Le GECSSP recommande de ne pas effectuer un examen pelvien de dépistage des cancers non cervicaux, des maladies inflammatoires pelviennes ou d’autres affections gynécologiques chez les femmes asymptomatiques. Il s’agit d’une forte recommandation reposant sur des données probantes de qualité modérée. Conclusion Le GECSSP adopte la recommandation en matière d’examen pelvien de dépistage, comme publiée par l’ACP en 2014.

  3. Recommandations pour le dépistage de l’hypertension chez les adultes canadiens

    PubMed Central

    Lindsay, Patrice; Gorber, Sarah Connor; Joffres, Michel; Birtwhistle, Richard; McKay, Donald; Cloutier, Lyne

    2013-01-01

    Résumé Objectif Présenter des recommandations concernant le dépistage de l’hypertension chez les adultes de 18 ans et plus qui n’ont pas reçu antérieurement de diagnostic d’hypertension. Qualité des données Les données probantes sont tirées d’une recension systématique dans MEDLINE, EMBASE et la base de données des synthèses systématiques de la Collaboration Cochrane (EBM Reviews), de janvier 1985 à septembre 2011. Les types d’études retenues se limitaient aux études randomisées contrôlées, aux synthèses systématiques et aux études observationnelles avec groupes témoins. Message principal Trois fortes recommandations se sont dégagées de données probantes de qualité modérée. Il est recommandé de mesurer la pression artérielle à toutes les consultations appropriées en soins primaires, conformément aux techniques actuelles décrites dans les recommandations du Programme éducatif canadien sur l’hypertension pour la mesure de la pression artérielle en cabinet et en soins ambulatoires. Les critères du Programme éducatif canadien sur l’hypertension pour l’évaluation et le diagnostic de l’hypertension devraient s’appliquer aux personnes chez qui on observe une pression artérielle élevée. Conclusion À la suite d’un examen des plus récentes données probantes, le Groupe d’étude canadien sur les soins de santé préventifs continue de recommander la mesure de la pression artérielle lors des consultations périodiques auprès du médecin.

  4. Des recommandations probantes pour surveiller l’innocuité des antipsychotiques de deuxième génération chez les enfants et les adolescents

    PubMed Central

    Pringsheim, Tamara; Panagiotopoulos, Constadina; Davidson, Jana; Ho, Josephine

    2012-01-01

    HISTORIQUE : Au Canada, l’utilisation d’antipsychotiques, notamment les antipsychotiques de deuxième génération (ADG), a augmenté de façon considérable depuis cinq ans chez les enfants ayant des troubles de santé mentale. Ces médicaments ont le potentiel de causer de graves complications métaboliques et neurologiques lorsqu’on les utilise de manière chronique. OBJECTIF : Synthétiser les données probantes relatives aux effets secondaires métaboliques et neurologiques précis associés à l’usage d’ADG chez les enfants et fournir des recommandations probantes sur la surveillance de ces effets secondaires. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse systématique des essais cliniques contrôlés des ADG auprès d’enfants. Ils ont fait des recommandations à l’égard de la surveillance de l’innocuité des ADG d’après un modèle de classification fondé sur le système GRADE (système de notation de l’évaluation et de l’élaboration des recommandations). Lorsque les données probantes n’étaient pas suffisantes, ils fondaient leurs recommandations sur le consensus et l’avis d’experts. Un groupe consensuel multidisciplinaire a analysé toutes les données probantes pertinentes et est parvenu à un consensus à l’égard des recommandations. RÉSULTATS : Les recommandations probantes portant sur la surveillance de l’innocuité des ADG figurent dans les présentes lignes directrices. Les auteurs indiquent la qualité des recommandations relatives à des examens physiques et tests de laboratoire précis à l’égard de chaque ADG à des moments déterminés. CONCLUSION : De multiples essais aléatoires et contrôlés ont permis d’évaluer l’efficacité de bon nombre des ADG utilisés pour traiter les troubles de santé mentale en pédiatrie. Toutefois, leurs avantages ne sont pas sans risques : on observe à la fois des effets secondaires métaboliques et neurologiques chez les enfants traités au moyen d’ADG. Le risque de prise de poids, d’augmentation de l’indice de masse corporelle et de taux lipidiques anormaux est plus élevé à l’utilisation d’olanzapine, suivie de la clozapine et de la quétiapine. Quant au risque d’effets secondaires neurologiques des traitements, il est plus élevé à l’utilisation de rispéridone, d’olanzapine et d’aripiprazole. Des interventions de surveillance pertinentes des effets secondaires amélioreront la qualité des soins des enfants traités à l’aide de ces médicaments. PMID:24082813

  5. Bilan de santé chez l’adulte

    PubMed Central

    Ridley, Jane; Ischayek, Amanda; Dubey, Vinita; Iglar, Karl

    2016-01-01

    Résumé Objectif Décrire les mises à jour apportées à Soins préventifs - Fiche de contrôle© pour aider les médecins à se tenir au fait des plus récentes recommandations en matière de soins de santé préventifs. Qualité des données Une recension dans la base de données Ovid MEDLINE a été effectuée à l’aide de mots-clés et d’autres paradigmes pertinents au bilan de santé périodique. Des sources secondaires, comme le Groupe d’étude canadien sur les soins de santé préventifs, l’Agence de la santé publique du Canada, la base de données Trip et l’Infobanque de l’Association médicale canadienne, ont aussi fait l’objet d’une recherche. Nous avons révisé les recommandations relatives aux soins préventifs pour des adultes à risque moyen. Les recommandations de bonne qualité et passables sont présentées respectivement en caractères gras et italiques. Message principal La fiche de contrôle a été mise à jour en fonction des recommandations du Groupe d’étude canadien sur les soins de santé préventif relatives au dépistage de l’obésité (2015), du cancer du col (2013), de la dépression (2013), de l’ostéoporose (2013), de l’hypertension (2012), du diabète (2012, 2013) et du cancer du sein (2011). D’autres mises à jour se fondent sur les recommandations d’autres organisations canadiennes concernant le dépistage du VIH (2013), le dépistage des infections transmises sexuellement (2013), les immunisations (2012 à 2014), le dépistage de la dyslipidémie (2012), le counseling en fertilité chez la femme (2011, 2012) et le dépistage du cancer colorectal (2010). Certaines recommandations antérieures ont été éliminées et d’autres, peu étayées par des données probantes, n’ont pas été incluses. Conclusion Soins préventifs - Fiche de contrôle a été mise à jour pour inclure les recommandations récentes afin de permettre aux médecins de famille d’offrir des soins complets et fondés sur des données probantes aux patients durant les bilans de santé périodiques.

  6. Les recommandations relatives aux vaccins antigrippaux administrés aux enfants et aux adolescents pour la saison 2017-2018.

    PubMed

    Moore, Dorothy L

    2018-02-01

    La Société canadienne de pédiatrie continue d'encourager la vaccination antigrippale annuelle de TOUS les enfants et les adolescents, dès l'âge de six mois. Les recommandations du Comité consultatif national de l'immunisation (CCNI) pour la saison 2017-2018 n'ont pas subi de changements importants par rapport à la saison précédente. Le CCNI a analysé toutes les données sur l'efficacité du vaccin vivant atténué contre l'influenza (VVAI) sur le marché et conclut qu'elles en appuient l'utilisation au Canada, même si les États-Unis ne le recommandent pas en raison de doutes quant à son efficacité.

  7. Les recommandations thérapeutiques relatives aux effets secondaires extrapyramidaux associés à l’utilisation d’antipsychotiques de deuxième génération chez les enfants et les adolescents

    PubMed Central

    Pringsheim, Tamara; Doja, Asif; Belanger, Stacey; Patten, Scott

    2012-01-01

    HISTORIQUE ET OBJECTIF : L’utilisation d’antipsychotiques augmente chez les enfants. Le présent article visait à orienter les cliniciens quant à la prise en charge clinique des effets secondaires extrapyramidaux des antipsychotiques de deuxième génération. MÉTHODOLOGIE : Les publications, les entrevues avec des informateurs clés et des échanges avec les membres d’un groupe de discussion et les partenaires ont permis de déterminer les principaux secteurs cliniques d’orientation et les préférences quant à la structure des présentes recommandations. Les membres responsables des lignes directrices ont reçu le projet de recommandations, ont évalué l’information recueillie grâce à une analyse bibliographique systématique et ont utilisé un processus de groupe nominal pour parvenir à un consensus quant aux recommandations thérapeutiques. Les lignes directrices contiennent une description des anomalies neurologiques souvent observées avec l’utilisation d’antipsychotiques ainsi que les recommandations sur le moyen d’examiner et de quantifier ces anomalies. Une démarche séquentielle sur la prise en charge des anomalies neurologiques est présentée. RÉSULTATS : On peut observer plusieurs types de symptômes extrapyramidaux attribuables à l’utilisation d’antipsychotiques chez les enfants, y compris la dystonie aiguë, l’akathisie, le parkinsonisme et la dyskinésie tardive, toutes induites par les neuroleptiques, de même que la dystonie tardive, l’akathisie tardive et les dyskinésies de sevrage. La forte majorité des données probantes sur le traitement des troubles du mouvement induits par les antipsychotiques proviennent de patients adultes atteints de schizophrénie. Étant donné le peu de données pédiatriques, les recommandations découlent de publications portant tant sur des adultes que sur des enfants. Compte tenu des limites de généralisation des données provenant de sujets adultes pour des enfants, il faudrait évaluer ces recommandations d’après les avis d’experts plutôt que d’après les données probantes. CONCLUSION : Les cliniciens doivent savoir que les antipsychotiques de deuxième génération ont le potentiel d’induire des effets secondaires neurologiques et devraient faire preuve d’une extrême vigilance lorsqu’ils en prescrivent. PMID:24082814

  8. Executable Architecture of Net Enabled Operations: State Machine of Federated Nodes

    DTIC Science & Technology

    2009-11-01

    verbal descriptions from operators) of the current Command and Control (C2) practices into model form. In theory these should be Standard Operating...faudra une grande quantité de données pour faire en sorte que le modèle reflète les processus véritables, les auteurs recommandent que la machine à...descriptions from operators) of the current C2 practices into model form. In theory these should be SOPs that execute as a thread from start to finish. The

  9. Mise à jour sur la prévention et le dépistage selon l’âge à l’intention des médecins de soins primaires canadiens

    PubMed Central

    Shimizu, Tawnya; Bouchard, Manon; Mavriplis, Cleo

    2016-01-01

    Résumé Objectif Faire la synthèse des meilleures lignes directrices fondées sur des données probantes concernant la prévention et le dépistage chez les adultes canadiens selon l’âge. Qualité des données Les recommandations du Groupe d’étude canadien sur les soins de santé préventifs représentent la source principale des renseignements et sont complétées par les recommandations pertinentes du Preventive Services Task Force des États-Unis lorsque celles du Groupe d’étude canadien étaient inaccessibles ou désuètes. Les guides de pratique des principales organisations nationales axées spécifiquement sur une maladie ou une spécialité ont aussi fait l’objet d’une révision pour prendre en compte les données factuelles les plus récentes. Message principal Les interventions de dépistage recommandées selon l’âge et le sexe sont présentées dans un tableau de synthèse où est mise en évidence la qualité des données à l’appui de ces recommandations. Un exemple de modèle à suivre dans les dossiers médicaux électroniques ou sur papier est aussi proposé. Conclusion Qu’il s’agisse d’une visite consacrée à la prévention ou d’une occasion saisie autrement de faire du counseling et du dépistage de prévention chez leurs patients, les médecins de soins primaires peuvent se servir de cette synthèse des recommandations fondées sur des données probantes pour maximiser leur efficience et prévenir d’importantes omissions ou des dépistages inutiles.

  10. Collaboration between the Canadian Forces and the Public in Operations

    DTIC Science & Technology

    2011-03-01

    recueillir les recommandations relativement à la formation et à l’éducation dans le but d’accroître l’efficacité de la collaboration civilo-militaire en...intervenants en contexte public (p. ex., avec des ONG), et 2) recueillir les recommandations d’experts en la matière (EM) relativement aux possibilités de...CF might be the distribution of aid to those in need. On the other hand, an indirect impact of collaboration could be an “implicit ethical message

  11. Lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse

    PubMed Central

    Kahan, Meldon; Mailis-Gagnon, Angela; Wilson, Lynn; Srivastava, Anita

    2011-01-01

    Résumé Objectif Présenter aux médecins de famille un résumé clinique pratique des lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse, produites par le National Opioid Use Guideline Group. Qualité des données Pour produire les lignes directrices, les chercheurs ont effectué une synthèse critique de la littérature médicale sur l’efficacité et l’innocuité des opioïdes pour la douleur chronique non cancéreuse et ont rédigé une série de recommandations. Un panel de 49 cliniciens experts de toutes les régions du Canada ont passé en revue l’ébauche et ont atteint un consensus sur 24 recommandations. Message principal Il est recommandé de faire un dépistage du risque de dépendance avant de prescrire des opioïdes. On recommande des opioïdes faibles (codéine et tramadol) pour une douleur de légère à modérée qui n’a pas répondu aux traitements de première intention. On peut essayer l’oxycodone, l’hydromorphone et la morphine chez les patients qui n’ont pas eu de soulagement avec des opioïdes plus faibles. Une faible dose initiale et une lente hausse du titrage sont recommandées, ainsi qu’une étroite surveillance du patient qu’on a d’abord renseigné. Les médecins doivent surveiller l’apparition de complications comme l’apnée du sommeil. La dose optimale est celle qui améliore le fonctionnement ou atténue les cotes d’évaluation de la douleur d’au moins 30 %. Pour la grande majorité des patients, la dose optimale sera bien en deçà de l’équivalent de 200 mg de morphine par jour. On recommande le sevrage progressif pour les patients qui n’ont pas répondu à un essai d’opioïdes adéquat. Conclusion Les opioïdes jouent un rôle important dans la prise en charge de la douleur chronique non cancéreuse, mais il faut en prescrire avec prudence pour limiter les dommages potentiels. Les nouvelles lignes directrices canadiennes offrent des conseils dont les médecins avaient grand besoin pour les aider à en arriver à un juste équilibre entre le contrôle optimal de la douleur et la sécurité.

  12. [Structured treatment interruption in HIV-infected adolescents].

    PubMed

    Vidal, P; Lalande, M; Rodiere, M

    2009-07-01

    Structured treatment interruption in HIV is now being debated. There are 2 cases in which it may be discussed: when the initial treatment was started early and when there is no compliance to treatment [Yeni P, et al. Les nouvelles recommandations de prise en charge des personnes infectées par le VIH 2006. Paris: Flammarion médecine-sciences; 2006]. Noncompliant behavior is one of the characteristics of chronic illness during adolescence. In HIV infection, however, the prognosis is negatively influenced because the resulting resistance to the antiretroviral therapy can further reduce therapeutic options. Therefore, it is important in such a critical period to consider both what is consciously and unconsciously at stake and what responsible action could be taken when a specialist is faced with spontaneous (unplanned) treatment interruption. We report here examples of follow-up care, interruption, and resumption of treatment in 4 female adolescents.

  13. N° 342-L'hépatite B et la grossesse.

    PubMed

    Castillo, Eliana; Murphy, Kellie; van Schalkwyk, Julie

    2017-03-01

    Examiner l'épidémiologie, l'histoire naturelle, l'évaluation et le traitement de l'infection au virus de l'hépatite B (VHB) durant la grossesse. Cela aidera les fournisseurs de soins obstétricaux à conseiller leurs patientes quant aux risques périnataux et aux options de prise en charge offertes aux femmes enceintes atteintes de l'hépatite B. Les éléments évalués comprennent les seuils de traitement antiviral contre le VHB pour la prévention de la transmission périnatale et pour les interventions effractives durant la grossesse pour les femmes atteintes de l'hépatite B. RéSULTATS: Nous avons recherché dans MEDLINE, Embase et CINAHL des articles en anglais sur les sujets liés à l'infection par le VHB, à la grossesse et à la transmission périnatale publiés de 1966 à mars 2016. Nous n'avons tenu compte que des résultats qui proviennent de revues systématiques, d'essais contrôlés aléatoires ou d'essais cliniques contrôlés et d'études d'observation. Nous avons également étudié d'autres articles (non publiés) trouvés sur les sites Web d'organismes d'évaluation des technologies de la santé et d'autres organismes connexes, dans des collections de directives cliniques et dans des registres d'essais cliniques, et obtenus auprès d'associations nationales et internationales de médecins spécialistes. MéTHODES DE VALIDATION: La qualité des résultats a été évaluée au moyen des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs (Tableau 1). Les recommandations pour la pratique sont classées selon la méthode décrite dans ce rapport. MISE à JOUR DE DIRECTIVES CLINIQUES: La directive clinique sera évaluée cinq ans après sa publication afin de déterminer si une mise à jour est nécessaire. Cependant, si de nouvelles données probantes importantes sont publiées avant la fin du cycle de cinq ans, le processus peut être accéléré pour mettre à jour rapidement certaines recommandations. La présente directive clinique a été élaborée à l'aide de ressources financées par la Société des obstétriciens et gynécologues du Canada. RECOMMANDATIONS. Copyright © 2017. Published by Elsevier Inc.

  14. Déprescrire les inhibiteurs de la pompe à protons

    PubMed Central

    Farrell, Barbara; Pottie, Kevin; Thompson, Wade; Boghossian, Taline; Pizzola, Lisa; Rashid, Farah Joy; Rojas-Fernandez, Carlos; Walsh, Kate; Welch, Vivian; Moayyedi, Paul

    2017-01-01

    Résumé Objectif Formuler des lignes directrices fondées sur les données probantes pour aider les cliniciens à décider du moment et de la façon sécuritaire de réduire la dose des inhibiteurs de la pompe à protons (IPP) ou d’en arrêter le traitement; se concentrer sur le niveau le plus élevé des données disponibles et obtenir les commentaires des professionnels de première ligne durant le processus de rédaction, de révision et d’adoption des lignes directrices. Méthodologie L’équipe était formée de 5 professionnels de la santé (1 médecin de famille, 3 pharmaciens et 1 gastro-entérologue) et de 5 membres sans droit de vote; les membres ont divulgué tout conflit d’intérêts. Le processus d’élaboration des lignes directrices a eu recours à l’approche GRADE (Grading of Recommendations Assessment, Development and Evaluation), de même qu’à un examen minutieux des données probantes dans le cadre de rencontres en personne, au téléphone et en ligne. Particulièrement, le processus d’élaboration des lignes directrices a inclus une revue systématique d’essais portant sur la déprescription des IPP et un examen de comptes rendus sur les torts liés à l’emploi continu des IPP. Les synthèses narratives sur les préférences des patients ainsi que les publications traitant des répercussions sur les ressources ont éclairé les recommandations. L’équipe a peaufiné le texte sur le contenu et les recommandations des lignes directrices par consensus, et a synthétisé les considérations cliniques afin de répondre aux questions courantes des cliniciens de première ligne. Une version préliminaire des lignes directrices a été distribuée aux cliniciens, puis aux associations de professionnels de la santé aux fins d’examen, et des révisions ont été apportées au texte à chaque étape. Un algorithme d’appui décisionnel a été conçu de concert avec les lignes directrices. Recommandations Les présentes lignes directrices recommandent de déprescrire les IPP (réduire la dose, mettre fin au traitement ou passer à l’administration « sur demande ») chez les adultes qui ont terminé un traitement d’au moins 4 semaines avec un IPP contre le pyrosis, l’œsophagite ou le reflux gastro-œsophagien léger à modéré, et dont les symptômes sont disparus. Les recommandations ne s’appliquent pas aux patients atteints ou qui ont déjà été atteints de l’œsophage de Barrett, d’une œsophagite grave de stade C ou D, ou d’antécédents connus d’ulcères gastro-intestinaux hémorragiques. Conclusion Les présentes lignes directrices émettent des recommandations pratiques pour décider du moment et de la façon de réduire la dose des inhibiteurs de la pompe à protons (IPP) ou d’en arrêter le traitement. Elles visent à contribuer au processus de décision conjointement avec le patient et non à dicter la décision.

  15. Les recommandations de prise en charge des complications métaboliques associées aux antipsychotiques de deuxième génération chez les enfants et les adolescents

    PubMed Central

    Ho, Josephine; Panagiotopoulos, Constadina; McCrindle, Brian; Grisaru, Silviu; Pringsheim, Tamara

    2012-01-01

    HISTORIQUE : Les antipsychotiques de deuxième génération s’associent souvent à des complications métaboliques. Ces médicaments sont utilisés plus souvent pour le traitement des troubles de santé mentale chez les enfants, ce qui a requis l’élaboration de lignes directrices officielles sur la surveillance de leur innocuité et de leur efficacité. Des lignes directrices ont déjà été élaborées pour surveiller les complications métaboliques et neurologiques. Afin d’aider les praticiens qui effectuent ces interventions de surveillance, une série de recommandations thérapeutiques complémentaires a été élaborée pour les cas où l’on observe des mesures ou des résultats anormaux. OBJECTIF : Créer des recommandations probantes afin de contribuer à la prise en charge des complications métaboliques chez les enfants traités au moyen d’antipsychotiques de deuxième génération. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse systématique des publications sur les complications métaboliques des antipsychotiques de deuxième génération chez les enfants. Les membres du groupe consensuel ont évalué l’information recueillie grâce à l’analyse bibliographique systématique et ont fait appel à un processus de groupe nominal pour parvenir à un consensus à l’égard de recommandations thérapeutiques. Dans la mesure du possible, ils se sont reportés aux lignes directrices existantes sur l’évaluation et le traitement des anomalies métaboliques chez les enfants. RÉSULTATS : Des recommandations probantes sont présentées pour contribuer à la prise en charge des complications métaboliques, y compris la prise de poids, l’augmentation du tour de taille, l’élévation des taux de prolactine, de cholestérol, de triglycérides et de glucose, les épreuves de fonction hépatique anormales et les études thyroïdiennes anormales. CONCLUSION : Il faut recourir à des mesures de surveillance convenables lorsqu’on prescrit des antipsychotiques de deuxième génération. Les présentes lignes directrices thérapeutiques orientent les cliniciens quant à la prise en charge clinique des complications métaboliques lorsqu’elles se produisent. PMID:24082815

  16. Prise de suppléments multivitaminiques pour la prévention primaire des anomalies congénitalies

    PubMed Central

    Morin, Pascale; Demers, Karine; Giguère, Christine; Tribble, Denise St-Cyr; Lane, Julie

    2007-01-01

    RÉSUMÉ OBJECTIF Déterminer si les recommandations véhiculées par les professionnels de la santé sur l’importance de l’acide folique encouragent les femmes susceptibles de procréer de prendre les suppléments d’acide folique. CONCEPTION Enquête. CONTEXTE Centre de santé et de services sociaux, Institut universitaire de gériatrie de Sherbrooke, à Sherbrooke, Qué. PARTICIPANTS 323 femmes francophones âgées entre 18 et 45 ans. PRINCIPALES MESURES DES RÉSULTATS La consommation de suppléments de vitamines et de minéraux au cours de la dernière année. Des analyses statistiques descriptives et bivariées et une modélisation par régression logistique ont été effectuées pour déterminer si l’association observée entre la recommandation d’un professionnel de la santé et la consommation de vitamines et de minéraux persistait après avoir tenu compte de l’effet des variables de contrôle (consultation de documentation, connaissances, sources d’information, perception, âge, scolarité, revenu, état matrimonial, intention de devenir enceinte). RÉSULTATS Environ 41% des femmes rapportent que leur médecin leur avait recommandé de consommer un supplément de vitamines et de minéraux. Après avoir ajusté toutes les variables dans le modèle, il est apparu que le fait de se faire recommander par un professionnel de la santé de prendre un supplément de vitamines et de minéraux était significativement associé à la consommation de vitamines et de minéraux par les femmes susceptibles de devenir enceintes. CONCLUSION Les professionnels peuvent améliorer la santé de la population par une pratique clinique préventive. Nous soulignons l’importance de soutenir ces derniers dans leurs efforts d’intégrer puis d’appliquer des connaissances scientifiques dans leur pratique. PMID:18077754

  17. Lignes directrices simplifiées sur les lipides

    PubMed Central

    Allan, G. Michael; Lindblad, Adrienne J.; Comeau, Ann; Coppola, John; Hudson, Brianne; Mannarino, Marco; McMinis, Cindy; Padwal, Raj; Schelstraete, Christine; Zarnke, Kelly; Garrison, Scott; Cotton, Candra; Korownyk, Christina; McCormack, James; Nickel, Sharon; Kolber, Michael R.

    2015-01-01

    Résumé Objectif Produire un guide de pratique clinique comportant une approche simplifiée à la prévention primaire des maladies cardiovasculaires (MCV), en insistant sur l’estimation du risque de MCV et la prise en charge des profils lipidiques à l’intention des cliniciens de soins primaires et leurs équipes; nous avons recherché la contribution de professionnels des soins primaires qui n’avaient que peu ou pas de conflits d’intérêts et nous nous sommes concentrés sur les données probantes de la plus haute qualité accessibles. Méthodes Neuf professionnels de la santé (4 médecins de famille, 2 internistes, 1 infirmière praticienne, 1 infirmière autorisée et 1 pharmacienne) et 1 membre non votant (pharmacienne gestionnaire de projet) formaient le comité principal appelé le Lipid Pathway Committee (le comité). La sélection des membres s’est fondée sur la profession, le milieu de pratique et son emplacement. Les membres ont divulgué tous leurs conflits d’intérêts potentiels ou réels. Le processus d’élaboration des lignes directrices était itératif et s’appuyait sur des affichages en ligne, une révision détaillée des données probantes, des réunions par téléphone et en ligne. Le comité a cerné 12 questions prioritaires à répondre. Le groupe de révision des données probantes a répondu à ces questions. À la suite d’un examen des réponses, les principales recommandations ont été formulées par consensus du comité. Nous avons produit une ébauche des lignes directrices qui a ensuite été peaufinée, distribuée à un groupe de cliniciens (médecins de famille, autres spécialistes, pharmaciens, infirmières et infirmières praticiennes) et à des patients pour obtenir de la rétroaction, la réviser en conséquence et le comité l’a ensuite finalisée. Recommandations Des recommandations sont présentées concernant le dépistage et les analyses, les évaluations du risque, le suivi, de même que le rôle de l’acide acétylsalicylique en prévention primaire. Conclusion Ces lignes directrices simplifiées sur les lipides offrent des recommandations pratiques pour la prévention et le traitement des MCV à l’intention des professionnels des soins primaires. Toutes les recommandations ont pour but d’aider à la prise de décision conjointement avec les patients plutôt que de la dicter.

  18. N° 341-Diagnostic et prise en charge de la torsion annexielle chez les filles, les adolescentes et les femmes adultes.

    PubMed

    Kives, Sari; Gascon, Suzy; Dubuc, Élise; Van Eyk, Nancy

    2017-02-01

    Passer en revue les connaissances scientifiques actuelles et formuler des recommandations relatives au diagnostic et à la prise en charge de la torsion annexielle chez les filles, les adolescentes et les femmes adultes. L'étude porte sur les facteurs de risque, la précision diagnostique, les options de prise en charge et les issues de la torsion annexielle. RéSULTATS: Nous avons examiné les études publiées en faisant des recherches dans MEDLINE, Embase, CINAHL et la Bibliothèque Cochrane à l'aide d'une terminologie contrôlée et de mots-clés appropriés (« adnexal torsion », « ovarian torsion »). Nous avons limité les résultats aux revues systématiques, aux essais contrôlés aléatoires, aux essais cliniques contrôlés et aux études d'observation. Nous avons refait les recherches de façon régulière et intégré de nouvelles données à la directive jusqu'en décembre 2014. Nous avons également étudié la littérature grise (non publiée) trouvée sur les sites Web d'organismes d'évaluation des technologies de la santé et d'autres organismes connexes, dans des collections de directives cliniques et dans des registres d'essais cliniques, et obtenue auprès d'associations nationales et internationales de médecins spécialistes. Les résultats ont été examinés et évalués par le comité CANPAGO de la Société des obstétriciens et gynécologues du Canada (SOGC), sous la direction des auteures principales. Les recommandations ont été classées selon les critères établis par le Groupe d'étude canadien sur les soins de santé préventifs. AVANTAGES, DéSAVANTAGES ET COûTS: L'application de la directive devrait aider les praticiens à adopter une approche de diagnostic et de prise en charge optimale en matière de torsion annexielle, à réduire au minimum les effets néfastes et à améliorer l'issue qui attend les patientes. La présente directive a été évaluée et approuvée par le Comité de pratique - gynécologie de la SOGC, et approuvée par le Conseil de la SOGC. Parrainé par la Société des obstétriciens et gynécologues du Canada. DéCLARATIONS SOMMAIRES: RECOMMANDATIONS. Copyright © 2017. Published by Elsevier Inc.

  19. Lignes directrices sur la prise en charge en soins primaires des céphalées chez l’adulte

    PubMed Central

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Résumé Objectif Accroître l’utilisation d’approches éclairées par des données probantes pour diagnostiquer, investiguer et traiter en soins primaires les céphalées des patients. Qualité des données Une recherche documentaire exhaustive a été effectuée pour trouver des lignes directrices et des révisions systématiques publiées entre janvier 2000 et mai 2011. La grille d’évaluation de la qualité des recommandations pour la pratique clinique AGREE a servi à l’analyse critique des lignes directrices. Les 6 guides de pratique clinique de la plus grande qualité ont servi de base dans le processus d’adaptation. Message principal Un groupe d’élaboration multidisciplinaire de professionnels des soins primaires ont formulé 91 recommandations précises à l’aide d’un processus consensuel. Les recommandations portent sur le diagnostic, l’investigation et la prise en charge de la migraine, de la céphalée de tension, de la céphalée due à une surmédication et de la céphalée vasculaire de Horton. Conclusion Un guide de pratique clinique adapté au contexte des soins de santé au Canada a été produit en suivant un processus d’adaptation de lignes directrices dans le but d’aider les professionnels de toutes les disciplines des soins primaires à dispenser des soins éclairés par des données probantes aux patients souffrant de céphalées.

  20. [Estimation of survival rates: technics used (author's transl)].

    PubMed

    Rodary, C; Laplanche, A; Comnougue, C; Flamant, R

    1979-01-01

    The direct method and life-table methods (actuarial and Kaplan-Meier) for estimating survival rates are described here. The difference between direct method and lifetable method is the use of information about the patients who are still alive. Practical examples of calculation are given with recommandations for graphical displays.

  1. Lignes directrices canadiennes sur la rhinosinusite bactérienne aiguë

    PubMed Central

    Kaplan, Alan

    2014-01-01

    Résumé Objectif Faire un résumé clinique des lignes directrices canadiennes sur la rhinosinusite bactérienne aiguë (RSBA) qui présente des éléments d’intérêt pour les médecins de famille. Source des données Les auteurs des lignes directrices ont effectué une recherche documentaire systématique et ont rédigé des recommandations. Une cote a été donnée à la fois en fonction de la fiabilité des données probantes et de la solidité des recommandations. On a sollicité les commentaires d’experts en la matière venant de l’extérieur, ainsi que l’aval de sociétés médicales canadiennes (Association pour la microbiologie médicale et l’infectiologie Canada, Société canadienne d’allergie et d’immunologie clinique, Société canadienne d’otorhinolaryngologie et de chirurgie cervicofaciale, Association canadienne des médecins d’urgence et Regroupement canadien des médecins de famille en santé respiratoire). Message principal Le diagnostic de la RSBA repose sur la présence de symptômes particuliers et leur durée; l’imagerie ou une culture n’est pas nécessaire dans les cas peu compliqués. Le traitement dépend de la gravité des symptômes, notamment avec des corticostéroïdes intranasaux (CSIN) recommandés comme monothérapie pour les cas de légers à modérés, quoique leurs bienfaits soient modestes. Le recours à des CSIN accompagnés d’antibiotiques est réservé aux patients qui ne répondent pas aux CSIN après 72 heures et comme traitement initial des patients dont les symptômes sont graves. Le choix de l’antibiotique doit tenir compte du pathogène soupçonné, du risque de résistance, des problèmes concomitants et des tendances locales de la résistance aux antimicrobiens. Des thérapies d’appoint comme l’irrigation nasale avec une solution saline sont recommandées. En présence de cas réfractaires au traitement, d’épisodes récurrents et de signes de complications, on devrait demander une consultation en otorhinolaryngologie. Les lignes directrices portent sur les situations particulières à l’environnement canadien des soins de santé, y compris les actions à prendre durant les périodes d’attente prolongées pour avoir une consultation avec un spécialiste ou une imagerie. Conclusion Les lignes directrices canadiennes offrent des recommandations à jour pour le diagnostic et le traitement de la RSBA qui tiennent compte de la compréhension en évolution de la maladie. De plus, les lignes directrices présentent des outils utiles pour aider les cliniciens à cerner les épisodes viraux par opposition à ceux d’origine bactérienne, ainsi qu’à prendre en charge de manière optimale leurs patients atteints de RSBA.

  2. Prise en charge des troubles de consommation d’opioïdes en première ligne

    PubMed Central

    Srivastava, Anita; Kahan, Meldon; Nader, Maya

    2017-01-01

    Résumé Objectif Conseiller les médecins quant aux options thérapeutiques à recommander à des populations précises de patients : approche axée sur l’abstinence, traitement d’entretien par la buprénorphine-naloxone ou traitement d’entretien par la méthadone. Sources d’information Une recherche sur PubMed a été effectuée, et on a relevé dans les publications les données sur l’efficacité, l’innocuité et le profil d’effets indésirables de l’approche axée sur l’abstinence, du traitement par la buprénorphine-naloxone et du traitement par la méthadone. Les études d’observation et interventionnelles ont été incluses. Message principal La méthadone et la buprénorphine-naloxone sont substantiellement plus efficaces que l’approche axée sur l’abstinence. La méthadone présente un taux de rétention plus élevé que la buprénorphine-naloxone, alors que la buprénorphine-naloxone présente un risque plus faible de surdose. Les médecins devraient recommander le traitement par la méthadone ou la buprénorphine-naloxone plutôt que l’approche axée sur l’abstinence, et ce, à tous les groupes de patients (données de niveau I). La méthadone est préférable à la buprénorphine-naloxone chez les patients qui présentent un risque élevé d’abandon, comme les usagers d’opioïdes par injection (données de niveau I). Les jeunes et les femmes enceintes qui font usage d’opioïdes par injection devraient aussi recevoir la méthadone d’abord (données de niveau III). Si la buprénorphine-naloxone est prescrite en premier, il faut faire passer rapidement le patient à la méthadone si les symptômes de sevrage, les fortes envies ou la consommation d’opioïdes persistent malgré une dose optimale de buprénorphine-naloxone (données de niveau II). La buprénorphine-naloxone est recommandée chez les usagers d’opioïdes sur ordonnance par voie orale socialement stables, surtout s’ils ont un emploi ou si leurs obligations familiales les empêchent de se rendre à la pharmacie tous les jours, s’ils ont une affection médicale ou psychiatrique exigeant des soins réguliers de première ligne (données de niveau IV), ou encore si leur emploi exige une fonction cognitive ou un rendement psychomoteur élevés (données de niveau III). La buprénorphine-naloxone est aussi recommandée chez les patients qui présentent un risque élevé de toxicité à la méthadone, tels que les personnes âgées, les personnes qui prennent de fortes doses de benzodiazépines ou d’autres sédatifs, les gros buveurs, les personnes dont la tolérance aux opioïdes est faible et les personnes à risque de prolongement de l’intervalle QT (données de niveau III). Conclusion Il faut tenir compte des caractéristiques et des préférences individuelles des patients lors de la sélection d’un traitement de première intention par un agoniste des opioïdes. Chez les patients qui présentent un risque élevé d’abandon (adolescents et patients socialement instables), la rétention en traitement doit avoir préséance sur les autres considérations cliniques. Chez les patients qui présentent un risque élevé de toxicité (comme les usagers abusifs d’alcool ou de benzodiazépines), la sécurité a sans doute préséance. Ce qu’il importe le plus de considérer toutefois, c’est que le traitement par un agoniste des opioïdes est beaucoup plus efficace que l’approche axée sur l’abstinence. PMID:28292811

  3. Quatrième conférence consensuelle sur le diagnostic et le traitement de la démence

    PubMed Central

    Moore, Ainsley; Patterson, Christopher; Lee, Linda; Vedel, Isabelle; Bergman, Howard

    2014-01-01

    Résumé Objectif Revoir les stratégies diagnostiques de la maladie d’Alzheimer, actualiser les recommandations concernant le traitement des symptômes de démence et proposer une approche thérapeutique à la démence d’apparition précoce et d’évolution rapide. Composition du comité Des spécialistes et des délégués de diverses régions du Canada et représentant diverses disciplines pertinentes ont discuté et se sont mis d’accord sur les révisions à apporter aux lignes directrices de 2006. Méthodologie On a eu recours au système GRADE (grading of recommendations, assessment, development, and evaluation) pour évaluer le consensus concernant les recommandations, lequel était défini comme suit : lorsque 80 % ou plus des participants ont voté en faveur de la recommandation. La cote des données probantes est rapportée lorsque cela est possible. Rapport important pour les médecins de famille, malgré les progrès effectués dans les domaines des biomarqueurs liquidiens et de la neuro-imagerie, le diagnostic de démence au Canada demeure fondamentalement clinique. De nouveaux critères cliniques essentiels de diagnostic de la maladie d’Alzheimer en reconnaissent dorénavant les formes moins fréquentes et non amnestiques. La démence précoce, une affection rare, mais importante, devrait inciter les médecins à aiguiller les patients vers un spécialiste ayant accès à des conseillers en génétique. La démence d’évolution rapide, mal définie dans la littérature, faciliterait le dépistage de cette affection rare, mais importante. Les inhibiteurs de la cholinestérase sont maintenant indiqués pour le traitement d’affections autres que la maladie d’Alzheimer. Des lignes directrices concernant l’arrêt du traitement, lesquelles n’existaient pas auparavant, sont également apparues. De nouvelles données probantes sur le recours à la mémantine, aux antidépresseurs et à d’autres agents psychotropes dans le traitement de la démence sont aussi présentées. Conclusion Plusieurs recommandations de la Quatrième conférence consensuelle sur le diagnostic et le traitement de la démence intéresseront les médecins de famille. Pour assurer l’utilité des lignes directrices, les médecins de famille devraient participer à toutes les étapes du processus de formulation continu, y compris à la sélection des sujets.

  4. Design of the Army Chargeback and Cost Accounting System. Study Recommendations Report (Final Design and Implementation Plan),

    DTIC Science & Technology

    1987-08-07

    0MB, and Congress. Vance recommands that the marketing strategy consist of meetings to attend, presentations to give, input to request, briefings to...6.2.3.1.6 Blue Ribbon Panel. Vance recommends that as part of the marketing strategy , the Army convene a panel of senior corporate officials and

  5. Mental Health and Well-Being across the Military Spectrum (Bien-etre et sante mentale dans le milieu militaire)

    DTIC Science & Technology

    2011-04-01

    il faut de toute urgence mener des actions complémentaires pour créer un environnement favorable pour l’ensemble des militaires. Dans le domaine du...changement souhaitable de comportement dans un environnement militaire de culture traditionnellement rude (macho) est un vrai défi, et il est recommandé

  6. Consensus formalisé: recommandations de pratiques cliniques pour la prise en charge de la lombalgie aiguë du patient africain

    PubMed Central

    Elleuch, Mohamed; El Maghraoui, Abdellah; Griene, Brahim; Nejmi, Mati; Ndongo, Souhaibou; Serrie, Alain

    2015-01-01

    La lombalgie aiguë est la pathologie rhumatismale la plus fréquente en Afrique. L’épidémiologie et la présentation clinique ne diffèrent pas de celles observées sur les autres continents. En revanche, les aspects psycho-sociaux, la disponibilité des traitements, l'accès aux soins et le poids culturel des médecines traditionnelles sont autant de spécificités qui ont conduit à la réalisation du 1er consensus d'experts en rhumatologie pour la prise en charge du patient africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 11 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique. Leur ambition est d'améliorer la prise en charge de la lombalgie aigue par une évaluation initiale clinique pertinente, une diminution des examens radiologiques inutiles, une prescription médicamenteuse adéquate et l'abandon de procédures invasives inappropriées. PMID:26955427

  7. Le don après un décès d'origine cardiocirculatoire au Canada

    PubMed Central

    Shemie, Sam D.; Baker, Andrew J.; Knoll, Greg; Wall, William; Rocker, Graeme; Howes, Daniel; Davidson, Janet; Pagliarello, Joe; Chambers-Evans, Jane; Cockfield, Sandra; Farrell, Catherine; Glannon, Walter; Gourlay, William; Grant, David; Langevin, Stéphan; Wheelock, Brian; Young, Kimberly; Dossetor, John

    2006-01-01

    Résumé Ces recommandations sont le fruit d'un processus multidisciplinaire national ayant duré un an et visant à déterminer si et comment l'on pourrait procéder au don d'organes après un décès d'origine cardiocirculatoire («don après le décès cardiocirculatoire», ou DDC) au Canada. Le forum national organisé en février 2005 a permis aux participants de discuter et d'élaborer des recommandations sur les principes, interventions et pratiques se rapportant au DDC. Les aspects éthiques et juridiques ont été abordés dans les discussions. À la fin du Forum, la majorité des participants ont été favorables à l'implantation de programmes de DDC au Canada. Les participants du Forum ont également convenu qu'il fallait formuler et prôner des valeurs fondamentales pour orienter l'élaboration de programmes et de protocoles basés sur le cadre médical, éthique et juridique établi lors de cette réunion. Même si la possibilité d'un don d'organes et de tissus doit faire partie intégrante des soins de fin de vie, il faut insister sur le fait que le devoir de diligence envers les patients mourants et leurs familles doit demeurer la priorité des équipes soignantes. La complexité et les répercussions profondes du décès sont reconnues et doivent être respectées, de même que les différences personnelles, ethnoculturelles et religieuses face à la mort et au don d'organes. Les décisions d'arrêter le traitement de maintien des fonctions vitales, la prise en charge des derniers moments de la vie et le diagnostic de décès selon des critères cardiocirculatoires doivent être distincts et indépendants des processus de don et transplantation. Ce rapport contient des recommandations destinées aux gestionnaires de program, aux autorités sanitaires régionales et aux instances appelés à élaborer les protocoles de DDC. Les programmes doivent être conçus en fonction des éléments suivants : direction et planification locales, éducation et engagement des intervenants, mécanismes d'assurance de la sécurité et de la qualité et information du public. Il est recommandé de commencer par un program de DDC contrôlé à l'unité de soins intensifs où, après une décision par consentement mutuel de cesser le traitement de maintien des fonctions vitales, la mort est attendue, mais n'est pas survenue, ce qui rend possible des discussions non précipitées sur le consentement. Un don non contrôlé, en cas de décès après un arrêt cardiaque non prévu, doit être envisagé seulement une fois que le program de DDC contrôlé a été établi. Bien qu'il soit recommandé de restreindre le programme initial au don de reins, le don d'autres organes peut aussi être envisagé selon l'expertise régionale en matière de transplantation. Les répercussions d'un DDC, y compris les interventions pratiquées avant et après le décès, sur la famille du donneur, la disponibilité des organes, la fonction du greffon et la survie du receveur doivent être documentées de façon méthodique et examinées.

  8. 78 FR 27271 - Self-Regulatory Organizations; BOX Options Exchange LLC; Order Granting Approval of Proposed Rule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... symbols (SPYJ) than the corresponding standard options on SPY.\\8\\ In addition, the Exchange proposes to list Jumbo SPY Options for all expirations applicable to standard options on SPY,\\9\\ and proposes that strike prices for Jumbo SPY Options be set at the same level as standard options on SPY.\\10\\ Bids and...

  9. Clinical practice guideline: management of acute pancreatitis

    PubMed Central

    Greenberg, Joshua A.; Hsu, Jonathan; Bawazeer, Mohammad; Marshall, John; Friedrich, Jan O.; Nathens, Avery; Coburn, Natalie; May, Gary R.; Pearsall, Emily; McLeod, Robin S.

    2016-01-01

    There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis. The purpose of the present guideline is to provide evidence-based recommendations for the management of both mild and severe acute pancreatitis as well as the management of complications of acute pancreatitis and of gall stone–induced pancreatitis. Une hausse de l’incidence de pancréatite aiguë a été constatée à l’échelle mondiale. Malgré l’amélioration de l’accès aux soins et aux techniques d’imagerie et d’intervention, la pancréatite aiguë est toujours associée à une morbidité et une mortalité importantes. Bien qu’il existe des guides de pratique clinique pour la prise en charge de la pancréatite aiguë, des études récentes sur la vérification de la prise en charge clinique de cette affection révèlent des lacunes importantes dans la conformité aux recommandations fondées sur des données probantes. Ces résultats mettent en relief l’importance de formuler des recommandations compréhensibles et applicables pour le diagnostic et la prise en charge de la pancréatite aiguë. La présente ligne directrice vise à fournir des recommandations fondées sur des données probantes pour la prise en charge de la pancréatite aiguë, qu’elle soit bénigne ou grave, ainsi que de ses complications et de celles de la pancréatite causée par un calcul biliaire. PMID:27007094

  10. Le bégaiement

    PubMed Central

    Perez, Hector R.; Stoeckle, James H.

    2016-01-01

    Résumé Objectif Fournir une mise à jour sur l’épidémiologie, l’hérédité, la physiopathologie, le diagnostic et le traitement du bégaiement développemental. Qualité des données Une recherche d’études récentes ou non portant sur l’épidémiologie, l’hérédité, la physiopathologie, le diagnostic et le traitement du bégaiement développemental a été effectuée dans les bases de données MEDLINE et Cochrane. La plupart des recommandations s’appuient sur des études de petite envergure, des données probantes de qualité limitée ou des consensus. Message principal Le bégaiement est un trouble d’élocution fréquent chez les personnes de tous âges, il altère la fluidité verbale normale et l’enchaînement du discours. Le bégaiement a été lié à des différences de l’anatomie, du fonctionnement et de la régulation dopaminergique du cerveau qui seraient de source génétique. Il importe de poser le diagnostic avec attention et de faire les recommandations qui conviennent chez les enfants, car de plus en plus, le consensus veut que l’intervention précoce par un traitement d’orthophonie soit cruciale chez les enfants bègues. Chez les adultes, le bégaiement est lié à une morbidité psychosociale substantielle, dont l’anxiété sociale et une piètre qualité de vie. Les traitements pharmacologiques ont soulevé l’intérêt depuis quelques années, mais les données cliniques sont limitées. Le traitement des enfants et des adultes repose sur l’orthophonie. Conclusion De plus en plus de recherches ont tenté de lever le voile sur la physiopathologie du bégaiement. La meilleure solution pour les enfants et les adultes bègues demeure la recommandation à un traitement d’orthophonie.

  11. 41 CFR 102-194.5 - What is the Standard and Optional Forms Management Program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the Standard and Optional Forms Management Program? 102-194.5 Section 102-194.5 Public Contracts and Property Management... PROGRAMS 194-STANDARD AND OPTIONAL FORMS MANAGEMENT PROGRAM § 102-194.5 What is the Standard and Optional...

  12. Evaluation of Unix-Based Integrated Office Automation Products.

    DTIC Science & Technology

    1994-04-01

    recipient preferences of networked UNIX users. An e-mail directory contains the preferred applications (e.g., FrameMaker , Excel) for each user, and e...Future Not Available (B) FrameMaker (UNIX) E-Optional I/E-Standard Future* (B) Interleaf (UNIX) I/E-Optional I/E-Standard Future* (B) IslandWrite Not...Optional Future Not Available DXF I-Optional Future Not Available (B) EPSI I-Standard Not Available Future (B) FrameMaker (MIF) E-Optional I/E-Standard Not

  13. 17 CFR 230.238 - Exemption for standardized options.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... options. 230.238 Section 230.238 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION... Exemption for standardized options. (a) Exemption. Except as expressly provided in paragraphs (b) and (c) of this section, the Act does not apply to any standardized option, as that term is defined by section 240...

  14. African Regional Symposium on Telematics for Development. Report and Recommendations = Colloque regional africain la telematique au service du developpement. Rapport et recommandations (Addis Ababa, Ethiopia, April 3-7, 1995).

    ERIC Educational Resources Information Center

    International Telecommunication Union, Geneva (Switzerland).

    The African Regional Symposium on Telematics for Development was organized in view of the special educational and communication needs of Africa in a time of accelerating change and development of information technologies. The symposium brought together more than 150 African specialists, and over 40 participants from other regions and development…

  15. Consensus formalisé: recommandations de pratiques cliniques pour la prise en charge de la migraine du patient adulte africain

    PubMed Central

    Ahmed, Mahmoud Ait Kaci; Haddad, Monia; Kouassi, Beugré; Ouhabi, Hamid; Serrie, Alain

    2016-01-01

    La migraine est une céphalée primaire (selon les derniers critères de l'International Headache Society) qui affecte environ 8% de la population africaine. Les femmes sont plus fréquemment touchées que les hommes et les crises apparaissent le plus souvent avant l’âge de 40 ans. Bien qu'un certain nombre de traitements, de mesure hygiéno-diététiques, et d'autres méthodes non pharmacologiques permettent de limiter l'intensité et la fréquence des crises, la prise en charge médicamenteuse de la crise de migraine est très souvent nécessaire. La disponibilité des traitements et l'accès aux soins diffèrent sur le continent africain et ont conduit à la réalisation du 1er consensus d'experts pour la prise en charge du patient adulte africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 16 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique. PMID:27642420

  16. Prescrire du cannabis fumé pour la douleur chronique non cancéreuse

    PubMed Central

    Kahan, Meldon; Srivastava, Anita; Spithoff, Sheryl; Bromley, Lisa

    2014-01-01

    Résumé Objectif Offrir des conseils préliminaires sur la prescription de cannabis fumé pour la douleur chronique avant la publication de lignes directrices officielles. Qualité des données Nous avons examiné les ouvrages scientifiques sur l’efficacité analgésique du cannabis fumé et les dommages causés par la consommation de cannabis à des fins médicales et récréatives. Nous avons élaboré des recommandations concernant les indications et les contre-indications du cannabis fumé, les précautions à prendre et son dosage et nous avons classé les recommandations en fonction du niveau des données probantes. La plupart des données probantes sont de niveau II (études observationnelles bien effectuées) et de niveau III (opinion d’experts). Message principal Le cannabis fumé pourrait être indiqué chez des patients souffrant de douleurs neuropathiques sévères qui n’ont pas répondu à des essais suffisants de cannabinoïdes pharmaceutiques et d’analgésiques standards (données probantes de niveau II). Le cannabis fumé est contre-indiqué chez les patients de 25 ans ou moins (données probantes de niveau II); ceux qui font actuellement ou ont fait par le passé une psychose ou encore ont de forts antécédents familiaux de psychose (données probantes de niveau II); ceux qui ont ou ont eu un problème de consommation de cannabis (données probantes de niveau III); ceux qui ont un problème actuel de toxicomanie ou d’alcoolisme (données probantes de niveau III); ceux qui ont une maladie cardiovasculaire ou respiratoire (données probantes de niveau III); ou celles qui sont enceintes ou planifient une grossesse (données probantes de niveau II). Il devrait être utilisé avec précaution par les patients qui fument du tabac (données probantes de niveau II), qui sont à risque accru de maladies cardiovasculaires (données probantes de niveau III), qui ont des troubles d’anxiété ou de l’humeur (données probantes de niveau II) ou qui prennent de fortes doses d’opioïdes ou de benzodiazépines (données probantes de niveau III). Il faut conseiller aux utilisateurs de cannabis d’attendre au moins 3 à 4 heures avant de conduire s’ils en ont fumé, au moins 6 heures s’ils en ont consommé par la bouche et au moins 8 heures s’ils ont ressenti un «high» subjectif (données probantes de niveau II). La dose maximale recommandée est de 1 inhalation 4 fois par jour (environ 400 mg par jour) de cannabis séché contenant 9 % de delta-9-tétrahydrocannabinol (données probantes de niveau III)). Les médecins devraient éviter de demander une consultation pour les patients auprès de cliniques «cannabinoïdes» (données probantes de niveau III). Conclusion Les lignes directrices futures devraient se fonder sur une révision systématique des ouvrages scientifiques sur la sécurité et l’efficacité du cannabis fumé. D’autres recherches sont nécessaires sur l’efficacité et la sécurité à long terme du cannabis fumé par rapport à d’autres cannabinoïdes pharmaceutiques, aux opioïdes et à d’autres analgésiques standards.

  17. High Angle-of-Attack Aerodynamics

    DTIC Science & Technology

    1982-12-01

    CONTRIBUTIONS DE TROIS MOUVEMENTS SIMPLES: UN MOUVEMENT DE BASE CONIQUE ET DES PERTURBATIONS OSCILLATOIRES DE CE MOUVEMENT DE BASE. RECOMMANDATIONS...Completes. Tome 1. 1879, p. CVI. 21. Poincari, H., "Les courbes d6finies par une 6quation dlffer~ntielle." Journal de Math6matigues 3 to 7, 1881, p...profila, ailes en flLche * corps fuselds, primes dWeir, aviona, complete, etc... im~ntrent que lee procidds adoptis aont en meaure de couvrir un domaine

  18. Déprescription des agonistes des récepteurs des benzodiazépines

    PubMed Central

    Pottie, Kevin; Thompson, Wade; Davies, Simon; Grenier, Jean; Sadowski, Cheryl A.; Welch, Vivian; Holbrook, Anne; Boyd, Cynthia; Swenson, Robert; Ma, Andy; Farrell, Barbara

    2018-01-01

    Résumé Objectif Formuler des lignes directrices fondées sur les données probantes visant à aider les cliniciens à décider du moment et de la façon sécuritaire de réduire la dose des agonistes des récepteurs des benzodiazépines (BZRA) pour mettre fin au traitement; se concentrer sur le niveau le plus élevé des données disponibles et obtenir les commentaires des professionnels de première ligne durant le processus de rédaction, de révision et d’adoption des lignes directrices. Méthodes L’équipe comptait 8 cliniciens (1 médecin de famille, 2 psychiatres, 1 psychologue clinique, 1 pharmacologue clinique, 2 pharmaciennes cliniques et 1 gériatre) et une spécialiste de la méthodologie; les membres ont divulgué tout conflit d’intérêts. Nous avons eu recours à un processus systématique, y compris l’approche GRADE (Grading of Recommendations Assessment, Development and Evaluation) pour formuler les lignes directrices. Les données ont été générées par une revue systématique d’études portant sur la déprescription des BZRA contre l’insomnie, de même que par une revue des revues sur les torts liés à la poursuite du traitement par BZRA et des synthèses narratives sur les préférences des patients et les répercussions sur les ressources. Ces données et le score GRADE de qualité des données ont servi à formuler les recommandations. L’équipe a peaufiné le texte sur le contenu et les recommandations des lignes directrices par consensus et a synthétisé les considérations cliniques afin de répondre aux questions des cliniciens de première ligne. Une version préliminaire des lignes directrices a été révisée par les cliniciens et les intervenants. Recommandations Nous recommandons d’offrir la déprescription (réduction lente de la dose) des BZRA à tous les patients âgés (≥ 65 ans) sous un BZRA, sans égard à la durée de l’usage, et suggérons d’offrir la déprescription (réduction lente de la dose) à tous les adultes de 18 à 64 qui prennent un BZRA depuis plus de 4 semaines. Ces recommandations visent les patients qui prennent un BZRA contre l’insomnie seule (insomnie primaire) ou l’insomnie comorbide lorsque les comorbidités sous-jacentes sont efficacement prises en charge. Ces lignes directrices ne visent pas les personnes atteintes d’autres troubles non traités du sommeil ou d’anxiété, de dépression, ou d’autres troubles physiques ou de santé mentale pouvant causer ou aggraver l’insomnie. Conclusion Les agonistes des récepteurs des benzodiazépines sont liés à des torts, et leur effet thérapeutique serait bref. La réduction graduelle de la dose de BZRA améliore le taux d’abandon comparativement aux soins habituels, et ce, sans causer de torts graves. Les patients seraient plus ouverts à une conversation sur la déprescription s’ils comprennent le pourquoi (potentiel de torts), participent à l’élaboration du plan de réduction de la dose et reçoivent des conseils en matière de comportement. Les présentes lignes directrices émettent des recommandations pour décider du moment et de la façon de réduire la dose de BZRA pour mettre fin au traitement. Elles visent à contribuer au processus de décision conjointement avec le patient et non à le dicter. PMID:29760269

  19. 24 CFR 3285.503 - Optional appliances.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.503 Optional... Manufactured Home Construction and Safety Standards in this chapter. (3) When the vent exhausts through the...

  20. 24 CFR 3285.503 - Optional appliances.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.503 Optional... Manufactured Home Construction and Safety Standards in this chapter. (3) When the vent exhausts through the...

  1. 24 CFR 3285.503 - Optional appliances.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.503 Optional... Manufactured Home Construction and Safety Standards in this chapter. (3) When the vent exhausts through the...

  2. New Language and Old Problems in Breast Cancer Radiotherapy.

    PubMed

    Chiricuţă, Ion Christian

    2017-01-01

    New developments in breast cancer radiotherapy make possible new standards in treatment recommandations based on international guidelines. Developments in radiotherapy irradiation techniques from 2D to 3D-Conformal RT and to IMRT (Intensity Modulated Arc Therapy) make possible to reduce the usual side effects on the organs at risk as: skin, lung, miocard, bone, esophagus and brahial plexus. Dispite of all these progresses acute and late side effects are present. Side effects are as old as the radiotherapy was used. New solutions are available now by improving irradiation techniques. New techniques as sentinel node procedure (SNP) or partial breast irradiation (PBRT) and immediate breast reconstruction with silicon implants (IBRIS) make necessary new considerations regarding the target volume delineations. A new language for definition of gross tumor volume (GTV), clinical target volume (CTV) based on the new diagnostic methods as PET/CT,nonaparticle MRI will have real impact on target delineation and irradiation techniques. "The new common language in breast cancer therapy" would be the first step to improve the endresults and finally the quality of life of the patients. Celsius.

  3. The Challenge of Declining Enrolments. Critical Emerging Problems and Recommendations for Immediate Action. Interim Report No. 2. [La Baisse des Effectifs Scolaires. Problemes Critiques et Recommandations pour une Action Immediate. Rapport Preliminaire No. 2].

    ERIC Educational Resources Information Center

    Jackson, Robert W. B.

    This second interim report on declining enrollment in Ontario identifies the major implications of the several factors associated with declining enrollments and makes recommendations for immediate action to contribute to the stability of the system while preparing and initiating long-term policies. The first part of the report deals with…

  4. 41 CFR 101-39.4901 - Obtaining standard and optional forms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VEHICLES 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.49-Forms § 101-39.4901 Obtaining standard and optional... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Obtaining standard and optional forms. 101-39.4901 Section 101-39.4901 Public Contracts and Property Management Federal Property...

  5. Déprescription des antihyperglycémiants chez les personnes âgées

    PubMed Central

    Farrell, Barbara; Black, Cody; Thompson, Wade; McCarthy, Lisa; Rojas-Fernandez, Carlos; Lochnan, Heather; Shamji, Salima; Upshur, Ross; Bouchard, Manon; Welch, Vivian

    2017-01-01

    Résumé Objectif Formuler des lignes directrices fondées sur les données probantes afin d’aider les cliniciens à décider du moment et de la façon sécuritaire de réduire la dose des antihyperglycémiants, de mettre fin au traitement ou de passer à un autre agent chez les personnes âgées. Méthodes Nous nous sommes concentrés sur les données les plus probantes disponibles et avons cherché à obtenir les commentaires des professionnels de première ligne durant le processus de rédaction, de révision et d’adoption des lignes directrices. L’équipe était formée de 7 professionnels de la santé (2 médecins de famille, 3 pharmaciens, 1 infirmière praticienne et 1 endocrinologue) et d’une spécialiste de la méthodologie; les membres ont divulgué tout conflit d’intérêts. Nous avons eu recours à un processus rigoureux, y compris l’approche GRADE (Grading of Recommendations Assessment, Development and Evaluation) pour formuler les lignes directrices. Nous avons effectué une revue systématique dans le but d’évaluer les données probantes indiquant les bienfaits et les torts liés à la déprescription des antihyperglycémiants. Nous avons révisé les revues des torts liés à la poursuite du traitement antihyperglycémiant, et effectué des synthèses narratives des préférences des patients et des répercussions sur les ressources. Ces synthèses et évaluations de la qualité des données selon l’approche GRADE ont servi à formuler les recommandations. L’équipe a peaufiné le texte sur le contenu et les recommandations des lignes directrices par consensus et a synthétisé les considérations cliniques afin de répondre aux questions courantes des cliniciens de première ligne. Une version préliminaire des lignes directrices a été distribuée aux cliniciens et aux intervenants aux fins d’examen, et des révisions ont été apportées au texte à chaque étape. Un algorithme d’appui décisionnel a été conçu pour accompagner les lignes directrices. Recommandations Nous recommandons de déprescrire les antihyperglycémiants reconnus pour contribuer à l’hypoglycémie chez les personnes âgées à risque ou dans les situations où les antihyperglycémiants pourraient causer d’autres effets indésirables, et d’individualiser les cibles et de déprescrire en conséquence chez les personnes frêles, atteintes de démence ou dont l’espérance de vie est limitée. Conclusion Les présentes lignes directrices émettent des recommandations pratiques pour décider du moment et de la façon de déprescrire les antihyperglycémiants. Elles visent à contribuer au processus de décision conjointement avec le patient et non à le dicter. PMID:29138168

  6. 78 FR 26413 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... Contracts from Saturday to Friday night. Eliminating Saturday expirations will allow OCC to streamline the... expiration date for Standard Expiration Contracts is moved to Friday night, expiration processing for standard options, quarterly options, and weekly options will all occur on the same day and will be a single...

  7. Harbour Siren: Technical Recommendations Report

    DTIC Science & Technology

    2011-05-01

    de recommandations et une feuille de route à court terme pour l’interopérabilité dans la gestion des urgences (IGU) et l’interopérabilité du système...Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC Atlantic CR 2010-179 i...maritime du Groupe de travail interministériel sur la sûreté maritime (GTISM). Le document présente un ensemble d’observations et de

  8. Simulation Tool for Optimizing Non-Combatant Evacuation (STONE): Optimization of Evacuation Time and Transportation Resource Utilization

    DTIC Science & Technology

    2015-05-01

    2015 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2015 Abstract A Non-Combatant Evacuation...Standing Senate Committee on Foreign Affairs and International Trade recommended that more frequent assessments of NEO plans be conducted...étrangères et du commerce international a recommandé que des évaluations dans ses missions à l’étranger soient faites plus fréquemment

  9. Canadian Forces Education and Training for Interagency Operational Contexts (Education et Instruction des Forces Canadiennes Pour les Contextes Operationnels Interorganisationnels)

    DTIC Science & Technology

    2009-11-01

    organismes gouvernementaux dans le processus de planification opérationnelle (PPO) des FC. Le rapport se termine par des recommandations de travaux...B.D., THOMSON, M.H., BROWN, A.L., SARTORI, J.A., TAYLOR, T.E., WALDHERR, S.U. 2008. Organizational trust in the Canadian Forces. DRDC T No. CR2008...enablers for distributed team collaboration. DRDC T No. CR2007-137. Toronto, ON: Defence Research and Development Canada. FUGLESTAD, P.T., SNYDER

  10. Il est interdit d'interdire! Il n'est pas interdit d'imposer! Il est recommande de promouvoir (It Is Forbidden to Forbid! It Is Not Forbidden to Set a Rule! It Is Recommended to Promote).

    ERIC Educational Resources Information Center

    Pupier, Paul

    1993-01-01

    Reflecting on the situation in Quebec, this paper attempts to offer a fair solution to the problem of the languages of signage. It is suggested that individuals and groups have the right to show their linguistic identity as well as to express themselves in the languages of their choice, provided that the rights of the addressees are also met. (VWL)

  11. 48 CFR 52.222-43 - Fair Labor Standards Act and Service Contract Act-Price Adjustment (Multiple Year and Option...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and Service Contract Act-Price Adjustment (Multiple Year and Option Contracts). 52.222-43 Section 52... Standards Act and Service Contract Act—Price Adjustment (Multiple Year and Option Contracts). As prescribed...—Price Adjustment (Multiple Year and Option Contracts) (SEP 2009) (a) This clause applies to both...

  12. 40 CFR 63.5820 - What are my options for meeting the standards for continuous lamination/casting operations?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...: Reinforced Plastic Composites Production Options for Meeting Standards § 63.5820 What are my options for... weight percent organic HAP emissions reduction limit in Table 3 to this subpart, you have the option of demonstrating that you achieve 95 percent reduction of all wet-out area organic HAP emissions. (d) Combination...

  13. Get ready for the new asbestos standard

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

    Onderick, W.A.

    On October 1, OSHA`s revised asbestos rules became law, and with them are many changes from the previous 1986 standard. The presumed asbestos-containing material (PACM) rule is one of the bigger changes in the revised standard. OSHA has declared that owners must presume that there are certain high-risk asbestos-containing materials (ACM) in facilities built prior to 1981, unless bulk sample results prove them to be nonasbestos. The impact of this provision forces companies to think carefully before presuming where asbestos is or where it is not. Companies must also heed the EPA Asbestos National Emission Standards for Hazardous Air Pollutantsmore » (NESHAP), which require inspections and bulk sampling to identify materials prior to renovation or demolition. Short and long term needs should be examined when analyzing how to comply with the PACM provision. There are four options available. Option 1: Ignore the standard and face potential enforcement fines. Option 2: Presume all materials in pre-1981 buildings contain asbestos and simply post additional warning signs. Option 3: Survey or resurvey the facilities to be in compliance with the PACM ruling. Option 4: Conduct more comprehensive surveys. Option 3 is discussed in some detail.« less

  14. 77 FR 37617 - Updating OSHA Standards Based on National Consensus Standards; Head Protection

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-22

    ... provisions in the 2009 edition permitting optional testing for helmets worn in the backwards position (``reverse wearing''), optional testing for helmets at colder temperatures than provided in previous editions, and optional testing for the high- visibility coloring of helmets. If manufacturers choose to evaluate...

  15. A Literature Review of Disinfectants: Effects When Used by CF Divers in Cleaning Rebreather Sets

    DTIC Science & Technology

    2002-11-01

    Cavicide ) and all were evaluated against the same criteria. In order to be recommended for use two mandatory criteria had to be complied with; the...Listerine, Cavicide ); ces produits ont tous 6t6 6valu6s en fonction des m~mes crit~res. Pour que l’utilisation d’un produit donn6 soit recommand6e... Cavicide ) and all were evaluated against the same criteria. In order to be recommended for use two mandatory criteria had to be complied with; the

  16. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... standards for open molding and centrifugal casting operations at new and existing sources? 63.5810 Section... Meeting Standards § 63.5810 What are my options for meeting the standards for open molding and centrifugal...) through (d) of this section to meet the standards for open molding or centrifugal casting operations in...

  17. 76 FR 39143 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... Rule Change To Increase the Position and Exercise Limit for Options on the Standard & Poor's[supreg... exercise limit applicable to options on the Standard and Poor's[supreg] Depositary Receipts (``SPDRs[supreg... increase the position and exercise limit applicable to options on SPDRs[supreg], which are trading under...

  18. 78 FR 36005 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... Clear Over-the-Counter Index Options on Underlying Indices Published by Standard & Poor's Financial... publishing this notice to solicit comments on the proposed rule change from interested persons. \\1\\ 15 U.S.C...-counter (``OTC'') index options on underlying indices published by Standard & Poor's Financial Services...

  19. 78 FR 70961 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Notice to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-27

    ... for OMB Review; Comment Request; Notice to Employees of Coverage Options Under Fair Labor Standards... Employees of Coverage Options Under Fair Labor Standards Act Section 18B,'' to the Office of Management and... and a related model notice of healthcare coverage options available under the Patient Protection and...

  20. 41 CFR 102-194.25 - What is an automated Standard or Optional format?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION ADMINISTRATIVE PROGRAMS 194-STANDARD AND OPTIONAL FORMS MANAGEMENT PROGRAM § 102-194.25 What is an automated Standard or... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is an automated...

  1. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... standards for open molding and centrifugal casting operations at new and existing sources? 63.5810 Section... § 63.5810 What are my options for meeting the standards for open molding and centrifugal casting... (d) of this section to meet the standards for open molding or centrifugal casting operations in Table...

  2. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... standards for open molding and centrifugal casting operations at new and existing sources? 63.5810 Section... § 63.5810 What are my options for meeting the standards for open molding and centrifugal casting... (d) of this section to meet the standards for open molding or centrifugal casting operations in Table...

  3. 48 CFR 2917.207 - Exercising options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Exercising options. 2917... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 2917.207 Exercising options. The contracting officer must use a standardized determination and finding before exercising an option in accordance with...

  4. 41 CFR 102-194.40 - For what Standard or Optional forms should an electronic version not be made available?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false For what Standard or... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION ADMINISTRATIVE PROGRAMS 194-STANDARD AND OPTIONAL FORMS MANAGEMENT PROGRAM § 102-194.40...

  5. 76 FR 58061 - Self-Regulatory Organizations; Options Clearing Corporation; Notice of Filing of Proposed Rule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... Organizations; Options Clearing Corporation; Notice of Filing of Proposed Rule Change To Adopt Fitness Standards... purpose of the proposed rule change is to establish fitness standards for directors, clearing members, and... Core Principle O requires DCOs to establish fitness standards for directors, clearing members and...

  6. 40 CFR 63.5830 - What are my options for meeting the standards for pultrusion operations subject to the 60 weight...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... standards for pultrusion operations subject to the 60 weight percent organic HAP emissions reductions... National Emissions Standards for Hazardous Air Pollutants: Reinforced Plastic Composites Production Options... operations subject to the 60 weight percent organic HAP emissions reductions requirement? You must use one or...

  7. [Recommandation for patient engagement promotion in care and cure for chronic conditions.

    PubMed

    Graffigna, Guendalina; Barello, Serena; Riva, Giuseppe; Castelnuovo, Gianluca; Corbo, Massimo; Coppola, Liliana; Daverio, Giovanni; Fauci, Alice; Iannone, Primiano; Ricciardi, Walter; Bosio, Albino Claudio

    2017-11-01

    The concept of patient engagement is receiving a growing attention in the healthcare field. The last decades have seen a deep revision of care models in the aim of a greater acknowledge of the patient role, seen as an expert actor, in the healthcare process. On the other side, healthcare systems are facing a growing request for participation expressed by citizens and patients. People claim for being more involved in all the crucial turning point of their healthcare journey and of being better aware of their right and duties. They require a deeper knowledge about all the different therapeutic options with the related risks and advantages. However, although all the different stakeholders agree in considering patient engagement a pragmatic further then ethical priority, a shared consensus related to the strategies and instrument to promote has still to come. Patients and healthcare professional perspective about the factors that may hinder or sustain patient engagement still need to be further studied and at shared recommendations - about the programs better effective and efficient in promoting patient engagement - are still missed. Based on these premises, Università Cattolica of Milano and DG Welfare of Regione Lombardia, under the methodological supervision of the Istituto Superiore di Sanità, promoted a consesus conference entitled "Recommendation for promoting patient engagement in healthcare for chronic conditions". This consensus conferences constituted the occasion of sharing and discussion among experts belonging to different clinical and institutional contexts as well as with representative of patients associations in order to identify good practices and effective tools to promote patient engagement in the care and cure process for chronic conditions.

  8. Pollution prevention options to meet impending MACT standards: A compendium

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

    Berglund, R.L.; Pickron, J.S.

    1997-12-31

    Under the Clean Air Act Amendments of 1990, the EPA was charged with developing MACT standards for a large group of operations representing a variety of different industry categories. While pollution prevention opportunities for meeting the requirements of the HON standards for the synthetic organic chemical manufacturing industry (SOCMI) and similar standards for the refining industry have drawn significant discussion and attention, little guidance for considering pollution prevention options for meeting other MACT standards have been provided. Yet, in working with companies to meet the requirements of proposed MACT standards for the shipbuilding, wood processing, plastics and gas processing industries,more » a number of pollution prevention opportunities for meeting these requirements were identified in early compliance strategies. This paper will provide a compendium of pollution prevention options for meeting these and other proposed and promulgated MACT standards.« less

  9. Paternité des articles et intérêts concurrents : une analyse des recommandations aux auteurs des journaux traitant de pratique pharmaceutique

    PubMed Central

    Courbon, Ève; Tanguay, Cynthia; Lebel, Denis; Bussières, Jean-François

    2014-01-01

    RÉSUMÉ Contexte : La présence d’auteurs honorifiques et fantômes ainsi que les intérêts concurrents représentent des difficultés bien documentées, liées à la publication d’articles scientifiques. Il existe des lignes directrices encadrant la rédaction et la publication de manuscrits scientifiques, notamment celles de l’International Committee of Medical Journal Editors (ICMJE). Objectifs : L’objectif principal de cette étude descriptive et transversale visait à recenser les instructions portant sur la paternité des articles et les intérêts concurrents provenant des recommandations aux auteurs des journaux traitant de pratique pharmaceutique. L’objectif secondaire visait à déterminer des mesures correctrices pour une paternité des articles plus transparente. Méthode : La recherche a débuté par l’identification des journaux traitant de pratique pharmaceutique. La consultation des instructions aux auteurs des journaux a permis ensuite de recenser les recommandations destinées à éviter les problèmes de paternité des articles et d’intérêts concurrents. Finalement, les membres de l’équipe de recherche se sont consultés afin de définir des mesures correctrices possibles à l’intention des chercheurs. Résultats : Des 232 journaux traitant de pharmacie, 33 ont été définis comme traitant de pratique pharmaceutique. Un total de 24 (73 %) journaux mentionnaient suivre la politique de l’ICMJE, 14 (42 %) demandaient aux auteurs de remplir un formulaire de déclaration d’intérêts concurrents au moment de la soumission de l’article, 17 (52 %) présentaient une définition de la qualité d’auteur et 5 (15 %) demandaient de détailler les contributions de chaque auteur. Une grille de 40 critères a été élaborée pour définir l’attribution du statut d’auteur. Conclusion : Moins de la moitié des journaux demandait aux auteurs de transmettre un formulaire de déclaration des intérêts concurrents au moment de la soumission d’un article et seulement la moitié des journaux avait donné une définition de la qualité d’auteur. La publication scientifique de travaux sur les pratiques pharmaceutiques n’est pas à l’abri des manques de transparence liés à la publication. L’utilisation d’une grille décrivant la contribution de chaque auteur et la publication en ligne des travaux peuvent contribuer à limiter ces risques. PMID:24970938

  10. 17 CFR 155.2 - Trading standards for floor brokers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... TRADING STANDARDS § 155.2 Trading standards for floor brokers. Each contract market shall adopt rules which shall, at a minimum, with respect to each member of the contract market acting as a floor broker... option, or (3) sale of any put option, in the same commodity which is executable at the market price or...

  11. 17 CFR 155.2 - Trading standards for floor brokers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) TRADING STANDARDS § 155.2 Trading standards for floor brokers. Each contract market shall adopt rules which shall, at a minimum, with respect to each member of the contract market acting as a floor... option, or (3) sale of any put option, in the same commodity which is executable at the market price or...

  12. 78 FR 17741 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate Effectiveness of Proposed Rule Change To Permit the Minimum Price Variation for Mini Options To Be the Same as Permitted for Standard Options on... Options Exchange LLC (the ``Exchange'') filed with the Securities and Exchange Commission (``Commission...

  13. 78 FR 28912 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... Proposed Rule Change Relating to Penny Pilot Options and Non-Penny Pilot Options May 10, 2013. Pursuant to... ``Options Pricing,'' at Section 2 governing pricing for NASDAQ members using the NASDAQ Options Market (``NOM''), NASDAQ's facility for executing and routing standardized equity and index options...

  14. 78 FR 35338 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ... trading option contracts overlying 1,000 SPDR[supreg] S&P 500[supreg] exchange-traded fund shares (``SPY''),\\3\\ or (``Jumbo SPY Options'').\\4\\ Whereas standard options contracts represent a deliverable of 100... the number of deliverable shares, Jumbo SPY Options have the same terms and contract characteristics...

  15. Profile development for the spatial data transfer standard

    USGS Publications Warehouse

    Szemraj, John A.; Fegeas, Robin G.; Tolar, Billy R.

    1994-01-01

    The Spatial Data Transfer Standard (SDTS), or Federal Information Processing Standard (FIPS) 173, is designed to support all types of spatial data. Implementing all of the standard's options at one time is impractical. Therefore, implementation of the SDTS is being accomplished through the use of profiles. Profiles are clearly defined, limited subsets of the SDTS created for use with a specific type or model of data and designed with as few options as possible. When a profile is proposed, specific choices are made for encoding possibilities that were not addressed, left optional, or left with numerous choices within the SDTS. Profile development is coordinated by the U.S. Geological Survey's SDTS Task Force. When completed, profiles are submitted to the National Institute of Standards and Technology (NIST) for approval as official amendments to the SDTS. The first profile, the Topological Vector Profile (TVP), has been completed. A Raster Profile has been tested and is being finalized for submission to the NIST. Other vector profiles, such as those for network and nontopological data, are also being considered as future implementation options for the SDTS.

  16. Ada Compiler Validation Summary Report. Certificate Number: 920918S1. 11274 U.S. Navy Ada/M, Version 4.5 (/NO OPTIMIZE) VAX 8550/8600/8650 (Cluster) = Enhanced Processor (EP) AN/UYK-44 (Bare Board)

    DTIC Science & Technology

    1992-10-27

    Institute of Standards and Technology Gaithersburg, MD USA 1 ELECTE I= 7 . PERFORMING ORGANIZATION NAME(S) AND ADDRESS(E JUN 3 1993U . , PERFORMING...Standard [Ada83) using the current Ada Compiler Validation Capability (ACVC). This Validation Summary Report ( VSR ) gives an account of the testing of... 7 - Control Part (Redirection) Options F.14 Compiler Options F-59 LINKER OPTIONS The linker options of this Ada implementation, as described inl this

  17. PubMed

    Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie

    2017-04-01

    Mettre à la disposition des fournisseurs de soins des lignes directrices concernant le recours à des méthodes contraceptives pour prévenir la grossesse et la promotion d'une sexualité saine. Efficacité globale des méthodes contraceptives citées : évaluation de l'innocuité, des effets indésirables et de la baisse du taux de grossesse; effet des méthodes contraceptives citées sur la santé sexuelle et le bien-être général; disponibilité des méthodes contraceptives citées au Canada. RéSULTATS: Des recherches ont été effectuées dans MEDLINE et la base de données Cochrane afin d'en tirer les articles en anglais publiés entre janvier 1994 et décembre 2015 traitant de sujets liés à la contraception, à la sexualité et à la santé sexuelle, dans le but de mettre à jour le consensus canadien sur la contraception paru de février à avril 2004. Nous avons également passé en revue les publications pertinentes du gouvernement canadien, ainsi que les déclarations de principes issues d'organisations compétentes vouées à la santé et à la planification familiale. La qualité des résultats a été évaluée au moyen des critères décrits par le Groupe d'étude canadien sur les soins de santé préventifs. Les recommandations quant à la pratique sont classées en fonction de la méthode décrite dans le rapport du Groupe. DéCLARATIONS SOMMAIRES: RECOMMANDATIONS. Copyright © 2017. Published by Elsevier Inc.

  18. 30 CFR 90.103 - Compensation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Dust Standards... under § 90.3 (Part 90 option; notice of eligibility; exercise of option). (b) Whenever a Part 90 miner...

  19. 40 CFR 63.4341 - How do I demonstrate initial compliance?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Printing, Coating, and Dyeing of... option, or the oxidizer outlet organic HAP concentration option. You do not need to redetermine the mass...

  20. 40 CFR 63.4341 - How do I demonstrate initial compliance?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Printing, Coating, and Dyeing of... option, or the oxidizer outlet organic HAP concentration option. You do not need to redetermine the mass...

  1. 40 CFR 63.4341 - How do I demonstrate initial compliance?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Printing, Coating, and Dyeing of... option, or the oxidizer outlet organic HAP concentration option. You do not need to redetermine the mass...

  2. Roadwaste : Issues and Options : appendices.

    DOT National Transportation Integrated Search

    1998-06-01

    The appendices belong to "Roadwaste : Issues and Options". : The Oregon Department of Transportation (ODOT) is conducting a study to determine roadwaste management options. Phase 1 consisted of a thorough review of regulations and standards, roadwast...

  3. 41 CFR 101-26.302 - Standard and optional forms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... forms. 101-26.302 Section 101-26.302 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.3-Procurement of GSA Stock Items § 101-26.302 Standard and optional forms. Agencies...

  4. 41 CFR 101-26.302 - Standard and optional forms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... forms. 101-26.302 Section 101-26.302 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.3-Procurement of GSA Stock Items § 101-26.302 Standard and optional forms. Agencies...

  5. 41 CFR 101-26.302 - Standard and optional forms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... forms. 101-26.302 Section 101-26.302 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.3-Procurement of GSA Stock Items § 101-26.302 Standard and optional forms. Agencies...

  6. 41 CFR 101-26.302 - Standard and optional forms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... forms. 101-26.302 Section 101-26.302 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.3-Procurement of GSA Stock Items § 101-26.302 Standard and optional forms. Agencies...

  7. 41 CFR 101-26.302 - Standard and optional forms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... forms. 101-26.302 Section 101-26.302 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.3-Procurement of GSA Stock Items § 101-26.302 Standard and optional forms. Agencies...

  8. 24 CFR 35.120 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Options. 35.120 Section 35.120... and Definitions for All Programs. § 35.120 Options. (a) Standard treatments. Where interim controls are required by this part, the designated party has the option to presume that lead-based paint or...

  9. 30 CFR 90.104 - Waiver of rights; re-exercise of option.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Waiver of rights; re-exercise of option. 90.104... PNEUMOCONIOSIS Dust Standards, Rights of Part 90 Miners § 90.104 Waiver of rights; re-exercise of option. (a) A... under Part 90 until the miner re-exercises the option in accordance with § 90.3(e) (Part 90 option...

  10. 30 CFR 90.104 - Waiver of rights; re-exercise of option.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Waiver of rights; re-exercise of option. 90.104... PNEUMOCONIOSIS Dust Standards, Rights of Part 90 Miners § 90.104 Waiver of rights; re-exercise of option. (a) A... under Part 90 until the miner re-exercises the option in accordance with § 90.3(e) (Part 90 option...

  11. 30 CFR 90.104 - Waiver of rights; re-exercise of option.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Waiver of rights; re-exercise of option. 90.104... PNEUMOCONIOSIS Dust Standards, Rights of Part 90 Miners § 90.104 Waiver of rights; re-exercise of option. (a) A... under Part 90 until the miner re-exercises the option in accordance with § 90.3(e) (Part 90 option...

  12. 30 CFR 90.104 - Waiver of rights; re-exercise of option.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Waiver of rights; re-exercise of option. 90.104... PNEUMOCONIOSIS Dust Standards, Rights of Part 90 Miners § 90.104 Waiver of rights; re-exercise of option. (a) A... under Part 90 until the miner re-exercises the option in accordance with § 90.3(e) (Part 90 option...

  13. 30 CFR 90.104 - Waiver of rights; re-exercise of option.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Waiver of rights; re-exercise of option. 90.104... PNEUMOCONIOSIS Dust Standards, Rights of Part 90 Miners § 90.104 Waiver of rights; re-exercise of option. (a) A... under Part 90 until the miner re-exercises the option in accordance with § 90.3(e) (Part 90 option...

  14. 77 FR 37587 - Updating OSHA Standards Based on National Consensus Standards; Head Protection

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-22

    ... testing for helmets worn in the backwards position (``reverse wearing''), optional testing for helmets at colder temperatures than provided in previous editions, and optional testing for the high- visibility coloring of helmets. If manufacturers choose to evaluate their helmets using any of these three testing...

  15. 48 CFR 22.404-12 - Labor standards for contracts containing construction requirements and option provisions that...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... contract price adjustment. An example of a contract pricing method that the contracting officer might... contracts containing construction requirements and option provisions that extend the term of the contract... SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Labor Standards for Contracts...

  16. Canadian Forces Training and Mental Preparation for Adversity: Empirical Review of Stoltz ’Adversity Quotient (AQ) Training for Optimal Response to Adversity’, A Review of the AQ Literature and Supporting Studies

    DTIC Science & Technology

    2002-07-01

    canadiennes. Enfin, nous faisons des recommandations aux FC sur la mise en ceuvre duS processus de d6veloppement du QA comme mesure proactive. Un examen...critique des ouvrages lies au QA et A d’autres sujets connexes a montr6 que le concept du QA est fond6 sur un certain nombre de thdories sens~es sur la...rdsilience. Cependant, m~me si le cadre th~orique et le programme de d6veloppement du QA pourraicnt 8tre valides dans un contexte industriel

  17. Urban Operations in the Year 2020 (Operations en zone urbaine en l’an 2020)

    DTIC Science & Technology

    2003-04-01

    d’un ennemi, l’accent étant alors mis sur la phase correspondante du concept. C’est ainsi que , pour mettre l’ennemi en échec, on a généralement...recommande que l’OTAN développe des capacités à utiliser dans des zones urbaines en se concentrant sur les besoins essentiels mis en évidence dans la... on peut citer les véhicules sans pilote et les armes non létales, qui permettent de réduire les pertes, ainsi que les dispositifs de largage de

  18. Alternative Submarine Watch Systems: Recommendation for a New CF Submarine Watch Schedule (Systemes Differents d’Horaire de Garde a Bord des Sous-Marins: Nouvel Horaire Recommande Pour les Sous-Marins des FC)

    DTIC Science & Technology

    2010-01-01

    comparativement à une efficacité cognitive de 96 % pour l’horaire de 1 tour sur trois de quatre heures ainsi que pour l’horaire de 1 tour sur trois de...tour sur 2 (8-4-4-8) comparativement à une efficacité cognitive de 96 % pour l’horaire de 1 tour sur trois de quatre heures ainsi que pour l’horaire...FAST™ (Fatigue Avoidance and Safety Tool), a computer application designed to predict and prevent fatigue in operational settings. The output of FAST

  19. Recommended Practices for Measurement of Gas Path Pressures and Temperatures for Performance Assessment of Aircraft Turbine Engines and Components (Les Methodes Recommandees pour la Mesure de la Pression et de la Temperature de la Veine Gazeuse en Vue de l’Evaluation des Performances des Turbines Aeronautiques et de leurs Composants

    DTIC Science & Technology

    1990-06-01

    reduction software , prior to converting all remaining test which requires internal compensation. T he r sidual effect is pressures to engineering units...Reduction Conversion of Millivolts to Engineering Units. Carrying out numerical integrations to obtain area and mass weighted averages for various...Performance Assessment of Aircraft Turbine Engines and Components (Les MWthodes Recommande’es pour la Mesure de la Pression et de ]a Temperature de la

  20. 78 FR 17738 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... customer bases of potential product users have indicated a preference that premium pricing for Mini Options... market participants clarity as to the minimum pricing increments for Mini Options, the filing would harmonize penny pricing between Mini Options and standard options on the same security. \\4\\ See Securities...

  1. 78 FR 17970 - Self-Regulatory Organizations; Miami International Securities Exchange LLC; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... product users and they have indicated a preference that premium pricing for mini-options match what is... market participants clarity as to the minimum pricing increments for mini-options, the filing would harmonize penny pricing between mini-options and standard options on the same security. \\3\\ See Securities...

  2. 17 CFR 155.4 - Trading standards for introducing brokers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the extent possible, that each order received from a customer or from an option customer which is... of the customer or option customer before any order in any future or in any commodity option in the... consent of the account owner, if the affiliated person has gained knowledge of the customer's or option...

  3. 77 FR 38362 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Withdrawal of Proposed Rule Change To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... Option Contracts Overlying 10 Shares of a Security (``Mini-Options Contracts'') and Implement Rule Text... Contracts and implement rule text necessary to distinguish Mini-Options Contracts from Standard Contracts...

  4. Bringing social standards into project evaluation under dynamic uncertainty.

    PubMed

    Knudsen, Odin K; Scandizzo, Pasquale L

    2005-04-01

    Society often sets social standards that define thresholds of damage to society or the environment above which compensation must be paid to the state or other parties. In this article, we analyze the interdependence between the use of social standards and investment evaluation under dynamic uncertainty where a negative externality above a threshold established by society requires an assessment and payment of damages. Under uncertainty, the party considering implementing a project or new technology must not only assess when the project is economically efficient to implement but when to abandon a project that could potentially exceed the social standard. Using real-option theory and simple models, we demonstrate how such a social standard can be integrated into cost-benefit analysis through the use of a development option and a liability option coupled with a damage function. Uncertainty, in fact, implies that both parties interpret the social standard as a target for safety rather than an inflexible barrier that cannot be overcome. The larger is the uncertainty, in fact, the greater will be the tolerance for damages in excess of the social standard from both parties.

  5. University Examinations and Standardized Testing: Principles, Experience, and Policy Options. World Bank Technical Paper Number 78. Proceedings of a Seminar on the Uses of Standardized Tests and Selection Examinations (Beijing, China, April 1985).

    ERIC Educational Resources Information Center

    Heyneman, Stephen P., Ed.; Fagerlind, Ingemar, Ed.

    In September 1984, the Chinese government asked the Economic Development Institute of the World Bank to assist the officials of the Chinese Ministry of Education in thinking through some policy options for examinations and standardized testing. This document summarizes the descriptions of testing programs and advice provided to these Chinese…

  6. 76 FR 68236 - Self-Regulatory Organizations; Options Clearing Corporation; Order Approving Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-03

    ... Organizations; Options Clearing Corporation; Order Approving Proposed Rule Change To Adopt Fitness Standards for... amended by the Dodd-Frank Act. In particular, new DCO Core Principle O requires DCOs to establish fitness...) establish and enforce appropriate fitness standards for (I) directors, (II) members of any disciplinary...

  7. 40 CFR 63.5701 - What are my options for complying with the open molding emission limit?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the open molding emission limit? 63.5701 Section 63.5701 Protection of Environment ENVIRONMENTAL... POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutants for Boat Manufacturing Standards for Open Molding Resin and Gel Coat Operations § 63.5701 What are my options for...

  8. 46 CFR 308.520 - Standard optional endorsement No. 3, Form MA-300-C.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Standard optional endorsement No. 3, Form MA-300-C. 308.520 Section 308.520 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Open Policy War Risk Cargo Insurance § 308.520...

  9. 46 CFR 308.519 - Standard optional endorsement No. 2, Form MA-300-B.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Standard optional endorsement No. 2, Form MA-300-B. 308.519 Section 308.519 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Open Policy War Risk Cargo Insurance § 308.519...

  10. 46 CFR 308.546 - Standard optional endorsement No. 1-A, Form MA-316-A.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Standard optional endorsement No. 1-A, Form MA-316-A. 308.546 Section 308.546 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Facultative War Risk Cargo Insurance § 308.546...

  11. 46 CFR 308.518 - Standard optional endorsement No. 1, Form MA-300-A.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Standard optional endorsement No. 1, Form MA-300-A. 308.518 Section 308.518 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Open Policy War Risk Cargo Insurance § 308.518...

  12. Medicare Advantage: options for standardizing benefits and information to improve consumer choice.

    PubMed

    O'Brien, Ellen; Hoadley, Jack

    2008-04-01

    The Medicare Advantage (MA) program offers beneficiaries a choice of private health plans as alternatives to the traditional fee-for-service Medicare program. MA plans potentially provide additional value, but as plan choices have proliferated, consumers contemplating their options have had difficulty understanding how they differ. Through "standardization" more consistent types of information and a limited number of dimensions along which plans vary--MA plans could reduce complexity and improve beneficiaries' ability to make informed choices. Such standardization steps would offer more meaningful variation in the health coverage options available to beneficiaries, Medicare officials and their community partners would find it far easier to educate beneficiaries about their health plan choices, and beneficiaries would better understand what they were buying. Standardization might also strengthen the ability of the market-based Medicare Advantage program to incorporate beneficiary preferences.

  13. 78 FR 10671 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ...-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of Proposed Rule Change To Permit the Minimum Price Variation for Mini-Options To Be the Same as Permitted for Standard Options on the Same Security February 8, 2013. Pursuant to Section 19(b)(1) of the Securities Exchange Act...

  14. 78 FR 28692 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... standard SPY options, (2) codify the minimum contract threshold requirement for the execution of Jumbo SPY... Fund (``IWM''). QQQQ, SPY and IWM are quoted in $0.01 increments for all options series. This proposed... Exchange believes that by reducing the minimum trading increments for Jumbo SPY Options to $0.01, the...

  15. 77 FR 28455 - National Standards for Traffic Control Devices; the Manual on Uniform Traffic Control Devices for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ... Options for design and applications of traffic control devices, this Manual should not be considered a... application of traffic control devices, as well as in the location and design of roads and streets that the..., while this Manual provides Standards, Guidance, and Options for design and applications of traffic...

  16. 40 CFR Table 10 to Subpart G of... - Wastewater-Compliance Options for Wastewater Tanks

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Wastewater-Compliance Options for Wastewater Tanks 10 Table 10 to Subpart G of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards...

  17. 40 CFR Table 10 to Subpart G of... - Wastewater-Compliance Options for Wastewater Tanks

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 10 2012-07-01 2012-07-01 false Wastewater-Compliance Options for Wastewater Tanks 10 Table 10 to Subpart G of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standard...

  18. 40 CFR Table 10 to Subpart G of... - Wastewater-Compliance Options for Wastewater Tanks

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 10 2014-07-01 2014-07-01 false Wastewater-Compliance Options for Wastewater Tanks 10 Table 10 to Subpart G of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standard...

  19. 40 CFR Table 10 to Subpart G of... - Wastewater-Compliance Options for Wastewater Tanks

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 10 2013-07-01 2013-07-01 false Wastewater-Compliance Options for Wastewater Tanks 10 Table 10 to Subpart G of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standard...

  20. 40 CFR Table 10 to Subpart G of... - Wastewater-Compliance Options for Wastewater Tanks

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Wastewater-Compliance Options for Wastewater Tanks 10 Table 10 to Subpart G of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards...

  1. 78 FR 59076 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    ... contracts (Rule 1057) and PHLX FOREX option contracts (Rules 1000C-1009C). Standard expiration contracts... apply only to series of option contracts opened for trading after the effective date of the OCC rule... trading of options in order to change the expiration date for most option contracts to the third Friday of...

  2. 75 FR 29893 - Business Reply Mail Online Application Option

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... POSTAL SERVICE 39 CFR Part 111 Business Reply Mail Online Application Option AGENCY: Postal Service TM . ACTION: Final rule. SUMMARY: The Postal Service TM will revise the Mailing Standards of the... option to obtain a Business Reply Mail[supreg] (BRM) permit online. Additionally, the electronic version...

  3. 77 FR 48580 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Granting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-14

    .... Description of the Proposal FLEX Options, unlike traditional standardized options, allow investors to..., settling, processing information with respect to, and facilitating transactions in securities, to remove... general, to protect investors and the public interest; and not be designed to permit unfair discrimination...

  4. 40 CFR 89.102 - Effective dates, optional inclusion, flexibility for equipment manufacturers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... COMPRESSION-IGNITION ENGINES Emission Standards and Certification Provisions § 89.102 Effective dates, optional inclusion, flexibility for equipment manufacturers. (a) This subpart applies to all engines... manufactured on or after January 1, 2000. (b) A manufacturer can optionally certify engines manufactured up to...

  5. 40 CFR 89.102 - Effective dates, optional inclusion, flexibility for equipment manufacturers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... COMPRESSION-IGNITION ENGINES Emission Standards and Certification Provisions § 89.102 Effective dates, optional inclusion, flexibility for equipment manufacturers. (a) This subpart applies to all engines... manufactured on or after January 1, 2000. (b) A manufacturer can optionally certify engines manufactured up to...

  6. 75 FR 51668 - Optional Mail Preparation Standards for Flat-Size Mailpieces in FSS Zones

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-23

    ... bundles of six or more addressed pieces each, subject to these standards: * * * * * [Revise item b of 13.2... combination. Mailers will then prepare bundles of uniform size from the pieces in the pool. Bundles must be... this option may be applied to the top piece of each bundle, unless otherwise required to be placed on...

  7. Hyperhidrosis: review of recent advances and new therapeutic options for primary hyperhidrosis.

    PubMed

    Brown, Ashley L; Gordon, Jennifer; Hill, Samantha

    2014-08-01

    Primary focal hyperhidrosis is a common condition that negatively impacts quality of life for many pediatric patients and can be challenging to treat. Standard treatments for hyperhidrosis can be used with success in many patients, and newer therapies and techniques offer options that have demonstrated efficacy and safety. This review highlights standard therapies for primary focal hyperhidrosis as well as the most recent technique advancements and alternative treatment options. The standard approach to treating primary focal hyperhidrosis remains initiation of topical preparations, followed by advancement to systemic medications, local administration of medication and/or surgical procedures. Recent studies focus on enhancing tolerability of topical preparations as well as evaluating the efficacy of neuromodulator injections, oral anticholinergic medications and laser therapy. Microwave technology has also been introduced for the treatment of focal hyperhidrosis with promising results. Many therapies exist for hyperhidrosis, and each treatment plan must be evaluated on a patient-by-patient basis. Advances in standard therapies and emergence of new treatment techniques are the main emphases of current published literature on hyperhidrosis. This article presents recent therapeutic options as well as updates on more established strategies to help practitioners treat this challenging condition.

  8. Other Remedy Options Evaluated

    EPA Pesticide Factsheets

    EPA considered several remedy options for reducing emissions from electric generating units (EGUs) that contribute significantly to nonattainment or interfere with maintenance of the air quality standards by downwind states.

  9. 42 CFR 435.4 - Definitions and use of terms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... disabled individual; Optional targeted low-income child means a child under age 19 who meets the financial and categorical standards described below. (1) Financial need. An optional targeted low-income child... optional targeted low-income child is not covered under a group health plan or health insurance coverage...

  10. Numerical Algorithm for Delta of Asian Option

    PubMed Central

    Zhang, Boxiang; Yu, Yang; Wang, Weiguo

    2015-01-01

    We study the numerical solution of the Greeks of Asian options. In particular, we derive a close form solution of Δ of Asian geometric option and use this analytical form as a control to numerically calculate Δ of Asian arithmetic option, which is known to have no explicit close form solution. We implement our proposed numerical method and compare the standard error with other classical variance reduction methods. Our method provides an efficient solution to the hedging strategy with Asian options. PMID:26266271

  11. Options in Education, Transcript for November 3, 1975: College Enrollment, Standardized Testing, Hyperactive Children, Teacher Strikes, and Training to Be a Professional Golfer.

    ERIC Educational Resources Information Center

    George Washington Univ., Washington, DC. Inst. for Educational Leadership.

    "Options in Education" is a radio news program which focuses on issues and developments in education. This transcript of the first show contains discussions of college enrollment, the controversy over standardized testing, hyperactivity in school children, the rash of teacher strikes, and how to become a professional golfer. Participants…

  12. Army Contracting: Training and Guidance Needed to Ensure Appropriate Use of the Option to Extend Services Clause

    DTIC Science & Technology

    2016-01-28

    reproduce this material separately. The Government Accountability Office, the audit , evaluation, and investigative arm of...Executive Director Army Contracting Command-Redstone Arsenal Army Contracting: Training and Guidance Needed to Ensure Appropriate Use of the Option to...which this report is based in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the

  13. Options in Education, Transcript for November 10, 1975: College Enrollment, Standardized Testing, Hyperactive School Children, Sex Discrimination in Education, Telephone Installation, and Adult Functional Competence.

    ERIC Educational Resources Information Center

    George Washington Univ., Washington, DC. Inst. for Educational Leadership.

    "Options in Education" is a radio news program which focuses on issues and developments in education. This transcript of the show contains discussions of college enrollment; standardized testing; hyperactivity in school children, the drugs given to these children, and the biochemical effects of artificial flavors and colors on…

  14. Effect of novel patient interaction on students’ performance of pregnancy options counseling

    PubMed Central

    Shaddeau, Angela; Nimz, Abigail; Sheeder, Jeanelle; Tocce, Kristina

    2015-01-01

    Background Although options counseling is a fundamental skill for medical providers, previous research has identified gaps in medical school reproductive health education. Purpose To determine if a 1-h novel patient interaction (NPI) improves student performance when caring for a standardized patient with an unintended pregnancy. Methods From September 2012 to June 2013 we randomized third-year medical students at the University of Colorado School of Medicine to the standard curriculum plus an NPI, or the standard curriculum only. The NPI consisted of a 1-h small-group session with a patient who discussed her experiences with options counseling and her decision to terminate her pregnancy. Students completed an Objective Structured Clinical Examination (OSCE) at the rotation's end, which included options counseling. The primary outcome was the proportion of participants achieving ‘excellence’ on the OSCE checklist. ‘Excellence’ was defined as a score ≥90%. Examinations were flagged as ‘unsatisfactory encounters’ if core competencies were not addressed. OSCE standardized patients and evaluators were blinded to group assignment. Results In total, 135 students were eligible and randomized: 75 to NPI; 60 to control. During the OSCE, few students achieved ‘excellence’ (24% NPI vs. 28% control, p=0.57). There were no differences between scores for components of options counseling. More students in the control group ‘appeared somewhat uncomfortable’ delivering the pregnancy test results (5% NPI vs. 18% control, p=0.006). More than half (54%) of the intervention group and 67% of controls had ‘unsatisfactory encounters’ (p=0.16), almost exclusively due to omission of adoption. Most students addressed abortion (96% NPI vs. 92% control, p=0.29). Conclusions A 1-h NPI does not improve medical students’ performance of pregnancy options counseling and the option of adoption is routinely omitted. Adoption is clearly an area that needs greater attention when designing comprehensive reproductive health curriculum for medical students. PMID:26654215

  15. Effect of novel patient interaction on students' performance of pregnancy options counseling.

    PubMed

    Shaddeau, Angela; Nimz, Abigail; Sheeder, Jeanelle; Tocce, Kristina

    2015-01-01

    Although options counseling is a fundamental skill for medical providers, previous research has identified gaps in medical school reproductive health education. To determine if a 1-h novel patient interaction (NPI) improves student performance when caring for a standardized patient with an unintended pregnancy. From September 2012 to June 2013 we randomized third-year medical students at the University of Colorado School of Medicine to the standard curriculum plus an NPI, or the standard curriculum only. The NPI consisted of a 1-h small-group session with a patient who discussed her experiences with options counseling and her decision to terminate her pregnancy. Students completed an Objective Structured Clinical Examination (OSCE) at the rotation's end, which included options counseling. The primary outcome was the proportion of participants achieving 'excellence' on the OSCE checklist. 'Excellence' was defined as a score ≥90%. Examinations were flagged as 'unsatisfactory encounters' if core competencies were not addressed. OSCE standardized patients and evaluators were blinded to group assignment. In total, 135 students were eligible and randomized: 75 to NPI; 60 to control. During the OSCE, few students achieved 'excellence' (24% NPI vs. 28% control, p=0.57).There were no differences between scores for components of options counseling. More students in the control group 'appeared somewhat uncomfortable' delivering the pregnancy test results (5% NPI vs. 18% control, p=0.006). More than half (54%) of the intervention group and 67% of controls had 'unsatisfactory encounters' (p=0.16), almost exclusively due to omission of adoption. Most students addressed abortion (96% NPI vs. 92% control, p=0.29). A 1-h NPI does not improve medical students' performance of pregnancy options counseling and the option of adoption is routinely omitted. Adoption is clearly an area that needs greater attention when designing comprehensive reproductive health curriculum for medical students.

  16. L’identification et traitement du trouble panique avec ou sans agoraphobie

    PubMed Central

    Foldes-Busque, Guillaume; Marchand, André; Landry, Pierre

    2007-01-01

    RÉSUMÉ OBJECTIF Renseigner les médecins de première ligne au sujet de l’identification précoce, du diagnostic et du traitement du trouble panique avec ou sans agoraphobie (TP/A). QUALITÉ DES DONNÉES Les données et recommandations présentées proviennent d’une recension des écrits scientifiques réalisée via les banques de données PsycLIT, PsyINFO et MEDLINE (1985 à 2006) en utilisant les descripteurs panic disorder, psychotherapy, psychosocial treatment, treatment et pharmacotherapy. Les recommandations formulées par les auteurs s’appuient sur des données probantes provenant d’études d’excellente qualité. Les informations concernant le diagnostic et l’évaluation du TP/A proviennent d’études épidémiologiques récentes, de consensus et d’opinions d’experts. PRINCIPAL MESSAGE Le TP/A est un trouble psychiatrique souvent rencontré en médecine de première ligne, mais il est fréquemment sous-diagnostiqué et sous-traité. L’identification précoce de ce trouble demande une attention particulière aux symptômes médicalement inexpliqués et, le cas échéant, le médecin doit utiliser des questions spécifiques permettant d’identifier d’éventuelles attaques de panique et de cerner leur signification pour le patient. Le traitement de premier choix pour ce trouble est une psychothérapie d’orientation cognitivo-comportementale administrée par un psychologue ou un psychiatre spécialisé. Si de telles ressources ne sont pas disponibles, le médecin peut opter pour un traitement psychopharmacologique. CONCLUSION Les médecins de famille peuvent jouer un rôle central dans l’identification et le traitement des patients souffrant d’un TP/A. PMID:17934032

  17. Soins primaires aux adultes ayant des déficiences intellectuelles et développementales

    PubMed Central

    Sullivan, William F.; Diepstra, Heidi; Heng, John; Ally, Shara; Bradley, Elspeth; Casson, Ian; Hennen, Brian; Kelly, Maureen; Korossy, Marika; McNeil, Karen; Abells, Dara; Amaria, Khush; Boyd, Kerry; Gemmill, Meg; Grier, Elizabeth; Kennie-Kaulbach, Natalie; Ketchell, Mackenzie; Ladouceur, Jessica; Lepp, Amanda; Lunsky, Yona; McMillan, Shirley; Niel, Ullanda; Sacks, Samantha; Shea, Sarah; Stringer, Katherine; Sue, Kyle; Witherbee, Sandra

    2018-01-01

    Résumé Objectif Mettre à jour les Lignes directrices consensuelles canadiennes 2011 en matière de soins primaires aux adultes ayant une déficience développementale. Méthodes Des médecins de famille et d’autres professionnels de la santé expérimentés dans les soins aux personnes ayant des DID ont examiné et synthétisé les récentes connaissances empiriques, d’écosystèmes, expertes et expérientielles. Un système a été conçu pour catégoriser la qualité des recommandations. Recommandations Les adultes ayant des DID sont un groupe hétérogène de patients qui présentent des affections médicales et des facteurs qui influent sur leur santé, qui diffèrent de ceux qui touchent les autres membres de la communauté de par leur nature, leurs manifestations, leur gravité ou leur complexité. Ces personnes nécessitent une approche de soins et des interventions adaptées à leurs besoins. Les présentes lignes directrices offrent des conseils en matière de normes de soins. Nous avons incorporé des références à des outils cliniques et à d’autres ressources pratiques. Les approches de soins décrites ici s’appliquent aussi à d’autres groupes de patients ayant un déficit cognitif ou de la communication, ou d’autres déficits des fonctions adaptatives. Conclusion À titre de fournisseurs de soins de première ligne, les médecins de famille jouent un rôle vital de promotion de la santé et de bien-être auprès des adultes ayant des DID. Ces lignes directrices peuvent les aider à prendre des décisions avec les patients et les aidants naturels. PMID:29650617

  18. 77 FR 21120 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change to List...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... Contracts Overlying 10 Shares of a Security (``Mini-Options Contracts'') and Implementing Rule Text... contracts'') and implement rule text necessary to distinguish mini-options contracts from option contracts overlying 100 shares of a security (``standard contracts''). The text of the proposed rule change is...

  19. 78 FR 17985 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... with customer bases of potential product users have indicated a preference that premium pricing for... options on the same security. In addition to giving market participants clarity as to the minimum pricing increments for Mini Options, the filing would harmonize penny pricing between Mini Options and standard...

  20. 76 FR 9696 - Equipment Price Forecasting in Energy Conservation Standards Analysis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... for particular efficiency design options, an empirical experience curve fit to the available data may be used to forecast future costs of such design option technologies. If a statistical evaluation indicates a low level of confidence in estimates of the design option cost trend, this method should not be...

  1. 7 CFR 51.3418 - Optional test for fry color.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Optional test for fry color. 51.3418 Section 51.3418... § 51.3418 Optional test for fry color. Fry color may be determined in accordance with contract specifications by using the Munsell Color Standards for Frozen French Fried Potatoes, Third Edition, 1972, 64-1...

  2. 7 CFR 51.3418 - Optional test for fry color.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Optional test for fry color. 51.3418 Section 51.3418... § 51.3418 Optional test for fry color. Fry color may be determined in accordance with contract specifications by using the Munsell Color Standards for Frozen French Fried Potatoes, Third Edition, 1972, 64-1...

  3. 76 FR 79748 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ..., confirming that ``iShares[supreg]'' is a registered trademark of BlackRock Institutional Trust Company, N.A...''), NYSEArca (``Arca''), BATS Global Markets (``BATS''), Boston Options Exchange (``BOX''), Chicago Board... to the applicable ETF option interval standards of other options markets.\\6\\ \\6\\ See, for example...

  4. Reducing the number of options on multiple-choice questions: response time, psychometrics and standard setting.

    PubMed

    Schneid, Stephen D; Armour, Chris; Park, Yoon Soo; Yudkowsky, Rachel; Bordage, Georges

    2014-10-01

    Despite significant evidence supporting the use of three-option multiple-choice questions (MCQs), these are rarely used in written examinations for health professions students. The purpose of this study was to examine the effects of reducing four- and five-option MCQs to three-option MCQs on response times, psychometric characteristics, and absolute standard setting judgements in a pharmacology examination administered to health professions students. We administered two versions of a computerised examination containing 98 MCQs to 38 Year 2 medical students and 39 Year 3 pharmacy students. Four- and five-option MCQs were converted into three-option MCQs to create two versions of the examination. Differences in response time, item difficulty and discrimination, and reliability were evaluated. Medical and pharmacy faculty judges provided three-level Angoff (TLA) ratings for all MCQs for both versions of the examination to allow the assessment of differences in cut scores. Students answered three-option MCQs an average of 5 seconds faster than they answered four- and five-option MCQs (36 seconds versus 41 seconds; p = 0.008). There were no significant differences in item difficulty and discrimination, or test reliability. Overall, the cut scores generated for three-option MCQs using the TLA ratings were 8 percentage points higher (p = 0.04). The use of three-option MCQs in a health professions examination resulted in a time saving equivalent to the completion of 16% more MCQs per 1-hour testing period, which may increase content validity and test score reliability, and minimise construct under-representation. The higher cut scores may result in higher failure rates if an absolute standard setting method, such as the TLA method, is used. The results from this study provide a cautious indication to health professions educators that using three-option MCQs does not threaten validity and may strengthen it by allowing additional MCQs to be tested in a fixed amount of testing time with no deleterious effect on the reliability of the test scores. © 2014 John Wiley & Sons Ltd.

  5. Roadwaste : issues and options.

    DOT National Transportation Integrated Search

    1998-06-01

    The Oregon Department of Transportation (ODOT) is conducting a study to determine roadwaste management options. Phase 1 consisted of a thorough review of regulations and standards, roadwaste characterization, current management practices, and new tec...

  6. Exponential model for option prices: Application to the Brazilian market

    NASA Astrophysics Data System (ADS)

    Ramos, Antônio M. T.; Carvalho, J. A.; Vasconcelos, G. L.

    2016-03-01

    In this paper we report an empirical analysis of the Ibovespa index of the São Paulo Stock Exchange and its respective option contracts. We compare the empirical data on the Ibovespa options with two option pricing models, namely the standard Black-Scholes model and an empirical model that assumes that the returns are exponentially distributed. It is found that at times near the option expiration date the exponential model performs better than the Black-Scholes model, in the sense that it fits the empirical data better than does the latter model.

  7. 78 FR 66796 - Self-Regulatory Organizations: Miami International Securities Exchange LLC; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-06

    ... transaction fee for executions in standard option contracts and $0.008 transaction fee for Mini Option... Exchange for purposes of the transaction fee and Section 1(a)(i) of the Fee Schedule include: (i... (``DPLMM''). See MIAX Options Fee Schedule, Section 1(a)(i)--Market Maker Transaction Fees. The current...

  8. 78 FR 42577 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... for institutional investors. Trading in Jumbo SPY Options is entirely voluntary and Participants can... contracts. While there are no position limit requirements for Jumbo SPY, Mini SPY or standard SPY options,\\6... believes that the proposal is consistent with the requirements of Section 6(b) of the Securities Exchange...

  9. 17 CFR 240.19c-5 - Governing the multiple listing of options on national securities exchanges.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of options on national securities exchanges. 240.19c-5 Section 240.19c-5 Commodity and Securities... of Exchange Members § 240.19c-5 Governing the multiple listing of options on national securities exchanges. (a) The rules of each national securities exchange that provides a trading market in standardized...

  10. 17 CFR 3.13 - Registration of agricultural trade option merchants and their associated persons.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... accepted accounting principles; (ii) The agricultural trade option merchant must identify each of the... accepted auditing standards prepared within the prior 12 months. (3) These applications must be...

  11. 40 CFR 63.4293 - What work practice standards must I meet?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... option, the organic HAP overall control efficiency option, or the oxidizer outlet organic HAP... must be conveyed from one location to another in closed containers or pipes. (4) Mixing vessels which...

  12. New options for optical quality tolerances

    NASA Astrophysics Data System (ADS)

    Aikens, Dave

    2017-11-01

    The optics community has long recognized the problems of misinterpretation of the surface quality specification and the potential for conflict1-2. Finally in 2017 there are new versions of the ISO and ANSI standards for surface imperfection tolerances which provide vastly improved alternatives to the existing options, especially the use of the US Military standard for specifying optical quality tolerances. This paper will review the existing standards in common use for specifying surface imperfections, and then describe in detail the new versions of the ISO and ANSI standards which are available in 2017. The details of the notations and inspection methods for each of the optics specifications will be provided, and the differences between the various alternatives will be discussed.

  13. Should Title 24 Ventilation Requirements Be Amended to include an Indoor Air Quality Procedure?

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

    Dutton, Spencer M.; Mendell, Mark J.; Chan, Wanyu R.

    Minimum outdoor air ventilation rates (VRs) for buildings are specified in standards, including California?s Title 24 standards. The ASHRAE ventilation standard includes two options for mechanically-ventilated buildings ? a prescriptive ventilation rate procedure (VRP) that specifies minimum VRs that vary among occupancy classes, and a performance-based indoor air quality procedure (IAQP) that may result in lower VRs than the VRP, with associated energy savings, if IAQ meeting specified criteria can be demonstrated. The California Energy Commission has been considering the addition of an IAQP to the Title 24 standards. This paper, based on a review of prior data and newmore » analyses of the IAQP, evaluates four future options for Title 24: no IAQP; adding an alternate VRP, adding an equivalent indoor air quality procedure (EIAQP), and adding an improved ASHRAE-like IAQP. Criteria were established for selecting among options, and feedback was obtained in a workshop of stakeholders. Based on this review, the addition of an alternate VRP is recommended. This procedure would allow lower minimum VRs if a specified set of actions were taken to maintain acceptable IAQ. An alternate VRP could also be a valuable supplement to ASHRAE?s ventilation standard.« less

  14. Confidence limits for data mining models of options prices

    NASA Astrophysics Data System (ADS)

    Healy, J. V.; Dixon, M.; Read, B. J.; Cai, F. F.

    2004-12-01

    Non-parametric methods such as artificial neural nets can successfully model prices of financial options, out-performing the Black-Scholes analytic model (Eur. Phys. J. B 27 (2002) 219). However, the accuracy of such approaches is usually expressed only by a global fitting/error measure. This paper describes a robust method for determining prediction intervals for models derived by non-linear regression. We have demonstrated it by application to a standard synthetic example (29th Annual Conference of the IEEE Industrial Electronics Society, Special Session on Intelligent Systems, pp. 1926-1931). The method is used here to obtain prediction intervals for option prices using market data for LIFFE “ESX” FTSE 100 index options ( http://www.liffe.com/liffedata/contracts/month_onmonth.xls). We avoid special neural net architectures and use standard regression procedures to determine local error bars. The method is appropriate for target data with non constant variance (or volatility).

  15. Cost effectiveness analysis of effluent limitations guidelines and standards for the centralized waste treament industry

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

    Wheeler, W.

    1998-12-01

    EPA has proposed effluent limitations guidelines and standards for the centralized waste treatment (CWT) industry. This report investigates the cost-effectiveness of all possible combinations of proposed control options for the three subcategories of CWT operations. EPA considered three control options for metals, two for oils and two for organics, with 12 possible combinations of these options. The report measures cost-effectiveness through a comparison of compliance costs to the quantity of pollutants removed under each combination of control options. The effectiveness of the regulations is measured in terms of reductions in the pounds of pollutants discharged to surface waters, weighted tomore » account for the pollutants` toxicity. Some pollutants removed are specifically addressed by the regulation, while others and not directly regulated but are removed incidentally as a result of controlling for other pollutants.« less

  16. 45 CFR 155.730 - Application standards for SHOP.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 155.730 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.730 Application standards for SHOP...

  17. 45 CFR 155.710 - Eligibility standards for SHOP.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 155.710 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.710 Eligibility standards for SHOP...

  18. 45 CFR 155.710 - Eligibility standards for SHOP.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 155.710 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.710 Eligibility standards for SHOP...

  19. 77 FR 20472 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... ``Fitness Standards for Directors, Clearing Members and Others'' (``Fitness Standards'') to bring such standards into conformity with the proposed amendments to OCC's By-Laws. The Fitness Standards were... regulations, OCC's Fitness Standards, as described above, were constructed in part to comply with core...

  20. Does availability of AIR insulin increase insulin use and improve glycemic control in patients with type 2 diabetes?

    PubMed

    Bergenstal, Richard M; Freemantle, Nick; Leyk, Malgorzata; Cutler, Gordon B; Hayes, Risa P; Muchmore, Douglas B

    2009-09-01

    In the concordance model, physician and patient discuss treatment options, explore the impact of treatment decisions from the patient's perspective, and make treatment choices together. We tested, in a concordance setting, whether the availability of AIR inhaled insulin (developed by Alkermes, Inc. [Cambridge, MA] and Eli Lilly and Company [Indianapolis, IN]; AIR is a registered trademark of Alkermes, Inc.), as compared with existing treatment options alone, leads to greater initiation and maintenance of insulin therapy and improves glycemic control in patients with type 2 diabetes. This was a 9-month, multicenter, parallel, open-label study in adult, nonsmoking patients with diabetes not optimally controlled by two or more oral antihyperglycemic medications. Patients were randomized to the Standard Options group (n = 516), in which patients chose a regimen from drugs in each major treatment class excluding inhaled insulin, or the Standard Options + AIR insulin group (n = 505), in which patients had the same choices plus AIR insulin. The primary end points were the proportion of patients in each group using insulin at end point and change in hemoglobin A1C (A1C) from baseline to end point. At end point, 53% of patients in the Standard Options group and 59% in the Standard Options + AIR insulin group were using insulin (P = 0.07). Both groups reduced A1C by about 1.2% and reported increased well-being and treatment satisfaction. The most common adverse event with AIR insulin was transient cough. The opportunity to choose AIR insulin did not affect overall use of insulin at end point or A1C outcomes. Regardless of group assignment, utilizing a shared decision-making approach to treatment choices (concordance model), resulted in improved treatment satisfaction and A1C values at end point. Therefore, increasing patient involvement in treatment decisions may improve outcomes.

  1. Compliance Options Diagrams for the Paper and Other Web Coating National Emission Standards for Hazardous Air Pollutants (NESHAP)

    EPA Pesticide Factsheets

    This January 2004 document contains 14 diagrams illustrating the different compliance options available for those facilities that fall under the Paper and Web Coating Maximum Achievable control Technology (MACT).

  2. Assessing Window Replacement Options | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  3. Summary of Texas highway funding options and alternatives.

    DOT National Transportation Integrated Search

    2013-07-01

    During the 20122013 academic year, The University of : Texas at Austins Lyndon B. Johnson School of Public : Affairs offered a Policy Research Project (PRP) course : on Texas highway funding options. PRPs are a standard : course in the LBJ Scho...

  4. 78 FR 62722 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Order Granting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... proposed rule change is intended to apply to any OCC Cleared OTC Option.\\7\\ \\5\\ See Securities Exchange Act... standardized index option.\\38\\ FINRA Rule 2330(b)(5)(A)(i)(b) generally requires only those members that are... FINRA, as is the case for all conventional options.\\40\\ \\37\\ Id. \\38\\ Id. See also FINRA Rule 2360(b)(5...

  5. 78 FR 36812 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... are not discussed below, are and shall continue to be \\1/10\\th of the fees for standard options.\\4\\ \\3... charge fees for regular orders in mini options at a rate that is \\1/10\\th the rate of fees the Exchange... light of the fact that mini options have a smaller exercise and assignment value, specifically \\1/ 10\\th...

  6. An Evaluation of the Wake County Public School System Alternative Educational Options, 2009-10. E&R Report No. 10.15

    ERIC Educational Resources Information Center

    Rhea, Anisa

    2010-01-01

    The purpose of this study is to evaluate the Wake County Public School System (WCPSS) alternative educational options. The WCPSS options are similar to those in other North Carolina districts. WCPSS student outcomes based on state assessments and federal standards are also equivalent or higher than other districts, although the capacity for WCPSS…

  7. 77 FR 35944 - Renewal of the Global Markets Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... international standards for regulating futures, swaps, options, and derivatives markets, as well as..., competitive, and financially sound futures and options markets. Meetings of the Global Markets Advisory... COMMODITY FUTURES TRADING COMMISSION Renewal of the Global Markets Advisory Committee AGENCY...

  8. 40 CFR 80.1342 - What compliance options are available to small refiners under this subpart?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Benzene Small Refiner Provisions § 80.1342 What compliance options are available to small refiners under... this section must comply with the applicable benzene standards at § 80.1230 beginning with the first...

  9. 40 CFR 80.1342 - What compliance options are available to small refiners under this subpart?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Benzene Small Refiner Provisions § 80.1342 What compliance options are available to small refiners under... this section must comply with the applicable benzene standards at § 80.1230 beginning with the first...

  10. 40 CFR 80.1342 - What compliance options are available to small refiners under this subpart?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Benzene Small Refiner Provisions § 80.1342 What compliance options are available to small refiners under... this section must comply with the applicable benzene standards at § 80.1230 beginning with the first...

  11. Technical Options for Energy Conservation in Buildings. National Conference of States on Building Codes and Standards and National Bureau of Standards Joint Emergency Workshop on Energy Conservation in Buildings. (Washington, D.C., June 19, 1973) NBS Technical Note 789.

    ERIC Educational Resources Information Center

    National Bureau of Standards (DOC), Washington, DC. Inst. for Applied Technology.

    The purpose of this report is to provide reference material on the technical options for energy conservation in buildings. Actions pertinent to existing buildings and new buildings are considered separately. Regarding existing buildings, principal topics include summer cooling, winter heating, and other energy-related features such as insulation,…

  12. Standardization Documents

    DTIC Science & Technology

    2011-08-01

    Specifications and Standards; Guide Specifications; CIDs; and NGSs . Learn. Perform. Succeed. STANDARDIZATION DOCUMENTS Federal Specifications Commercial...national or international standardization document developed by a private sector association, organization, or technical society that plans ...Maintain lessons learned • Examples: Guidance for application of a technology; Lists of options Learn. Perform. Succeed. DEFENSE HANDBOOK

  13. 45 CFR 155.700 - Standards for the establishment of a SHOP.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Section 155.700 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.700 Standards for the establishment...

  14. 45 CFR 155.700 - Standards for the establishment of a SHOP.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Section 155.700 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.700 Standards for the establishment...

  15. Le domaine des co-infections et des maladies concomitantes du Réseau canadien pour les essais VIH des IRSC : lignes directrices canadiennes pour la prise en charge et le traitement de la co-infection par le VIH et l’hépatite C chez les adultes

    PubMed Central

    Hull, Mark; Giguère, Pierre; Klein, Marina; Shafran, Stephen; Tseng, Alice; Côté, Pierre; Poliquin, Marc; Cooper, Curtis

    2014-01-01

    HISTORIQUE : De 20 % à 30 % des Canadiens qui vivent avec le VIH sont co-infectés par le virus de l’hépatite C (VHC), lequel est responsable d’une morbidité et d’une mortalité importantes. La prise en charge du VIH et du VHC est plus complexe en raison de l’évolution accélérée de la maladie hépatique, du choix et des critères d’initiation de la thérapie antirétrovirale et du traitement anti-VHC, de la prise en charge de la santé mentale et des toxicomanies, des obstacles socioéconomiques et des interactions entre les nouvelles thérapies antivirales à action directe du VHC et les antirétroviraux OBJECTIF : Élaborer des normes nationales de prise en charge des adultes co-infectés par le VHC et le VIH dans le contexte canadien. MÉTHODOLOGIE : Le Réseau canadien pour les essais VIH des Instituts de recherche en santé du Canada a réuni un groupe d’experts possédant des compétences cliniques en co-infection par le VIH et le VHC pour réviser les publications à jour ainsi que les lignes directrices et les protocoles en place. Après une vaste sollicitation afin d’obtenir des points de vue, le groupe de travail a approuvé des recommandations consensuelles, qu’il a caractérisées au moyen d’une échelle de qualité des preuves fondée sur la classe (bienfaits par rapport aux préjudices) et sur la catégorie (degré de certitude). RÉSULTATS : Toutes les personnes co-infectées par le VIH et le VHC devraient subir une évaluation en vue de recevoir un traitement du VHC. Les personnes qui ne sont pas en mesure d’entreprendre un traitement du VHC devraient être soignées pour le VIH afin de ralentir l’évolution de la maladie hépatique. La norme de traitement du VHC de génotype 1 est un régime comprenant de l’interféron pégylé et de la ribavirine dosée en fonction du poids, associés à un inhibiteur de la protéase du VHC. Pour les génotypes 2 ou 3, une bithérapie classique est recommandée pendant 24 semaines s’il y a clairance virologique à la semaine 4 ou, pour les génotypes 2 à 6, à 48 semaines. On peut envisager de reporter le traitement chez les personnes ayant une maladie hépatique légère. Le VIH ne devrait pas être considéré comme un obstacle à la transplantation hépatique chez les patients co-infectés. EXPOSÉ : Les recommandations ne se substituent pas au jugement clinique personnel. PMID:24634688

  16. Le rôle de l’omalizumab dans le traitement de l’asthme allergique grave

    PubMed Central

    Chapman, Kenneth R; Cartier, André; Hébert, Jacques; McIvor, R Andrew; Schellenberg, R Robert

    2006-01-01

    CONTEXTE : Un nouveau traitement anti-immunoglobuline E (anti-IgE) contre l’asthme, l’omalizumab, a été approuvé au Canada. OBJECTIF : Passer en revue les données fondamentales et cliniques sur l’omalizumab et examiner le rôle possible de ce médicament dans la prise en charge de l’asthme au Canada. MÉTHODOLOGIE : Une recherche documentaire a été effectuée dans MEDLINE afin de repérer les études menées de 1960 à 2006 sur l’omalizumab. La recherche a également porté sur les résumés de réunions scientifiques récentes dans le domaine des maladies respiratoires et des allergies; par ailleurs, toute donnée non publiée a été demandée au fabricant. Après avoir revu et résumé les données, un comité mixte constitué de spécialistes des maladies respiratoires et des allergies a rédigé un ensemble de recommandations relatives à l’utilisation de l’omalizumab. RÉSULTATS : L’omalizumab est un anticorps monoclonal humanisé qui se lie au domaine C epsilon 3 de la molécule d’IgE pour former des complexes immuns solubles qui sont éliminés par le système réticulo-endothélial. L’administration d’injections sous-cutanées espacées de deux ou de quatre semaines à la dose recommandée entraîne une diminution rapide des taux d’IgE circulantes libres. Lors de deux essais cliniques de phase III menés auprès de 1 405 adultes et adolescents atteints d’asthme modéré à grave qui recevaient des doses moyennes stables de corticostéroïdes en inhalation (CSI), l’omalizumab a diminué les taux d’exacerbation par rapport au placebo et a été associé à une amélioration des symptômes ainsi qu’à une épargne plus importante des corticostéroïdes. Dans un essai mené auprès de 419 patients atteints d’asthme grave non maîtrisé malgré l’utilisation de doses élevées de CSI et de la prise concomitante d’agonistes bêta-2 à action prolongée, les exacerbations graves étaient de 50 % moins fréquentes chez les patients traités par l’omalizumab que chez les sujets témoins. Des analyses rétrospectives ont permis d’identifier les caractéristiques des patients les plus susceptibles de répondre au traitement par l’omalizumab. RECOMMANDATIONS : L’omalizumab pourrait être envisagé comme traitement d’appoint dans les cas atopiques d’asthme grave non maîtrisé avec des traitements classiques par des doses optimales de CSI et un traitement d’appoint approprié (p. ex. : agonistes bêta-2 à action prolongée). En général, les patients sont classés en fonction de leur recours – traitement court et fréquent ou continu et oral – aux corticostéroïdes. Il ne faut amorcer le traitement qu’après avoir consulté un spécialiste pour confirmer le diagnostic et s’assurer que le traitement classique est optimal.

  17. 24 CFR 3285.501 - Home installation manual supplements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Home installation manual... HOUSING AND URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.501 Home installation manual supplements. Supplemental instructions for optional equipment or features must...

  18. 24 CFR 3285.501 - Home installation manual supplements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 5 2013-04-01 2013-04-01 false Home installation manual... HOUSING AND URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.501 Home installation manual supplements. Supplemental instructions for optional equipment or features must...

  19. 24 CFR 3285.501 - Home installation manual supplements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Home installation manual... HOUSING AND URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.501 Home installation manual supplements. Supplemental instructions for optional equipment or features must...

  20. 24 CFR 3285.501 - Home installation manual supplements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Home installation manual... HOUSING AND URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.501 Home installation manual supplements. Supplemental instructions for optional equipment or features must...

  1. 24 CFR 3285.501 - Home installation manual supplements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 5 2012-04-01 2012-04-01 false Home installation manual... HOUSING AND URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.501 Home installation manual supplements. Supplemental instructions for optional equipment or features must...

  2. NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

    EPA Science Inventory

    The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

  3. 77 FR 31048 - Self-Regulatory Organizations; the Options Clearing Corporation; Order Approving Proposed Rule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... made changes to OCC's ``Fitness Standard for Directors, Clearing Members and Others'' to conform it to... to statutory disqualifications. The proposed rule change will amend OCC's ``Fitness Standards for Directors, Clearing Members and Others'' (``Fitness Standards'') to bring such standards into conformity...

  4. [Standards, options, and recommendations for initial management of patients with malignant ovarian epithelial tumors].

    PubMed

    Kerbrat, P; Lhommé, C; Fervers, B; Guastalla, J P; Thomas, L; Basuyau, J P; Duvillard, P; Cohen-Solal, C; Dauplat, J; Tournemaine, N

    2000-12-09

    Suprapubic and transvaginal pelvic ultrasound exploration is indicated for suspected ovarian tumor (standard). Diagnosis and search for extension require surgery and pathology examination. Systematic preoperative computed tomography is not recommended (standard). Surgery for cancer of the ovary is a specialized procedure requiring skill in cancer, gynecology, visceral surgery and laparoscopic surgery. If the patient is referred to a specialized center after a primary procedure considered to be inadequate, a new procedure is recommended for staging. Residual tumor volume after the primary procedure has prognostic value. Systematic second look procedures are not recommended for routine practice (standard). For patients with grade IA G1 tumors, there is no indication for complementary treatment (standard). For patients with grade IA G2-3 or clear cell tumors, IB, IC, IIA, there is no standard. no complementary treatment, complementary chemotherapy using platinum, complementary external abdominopelvic radiotherapy. A complementary treatment is recommended for grades IC and IIA. Complementary treatment for grades IIB (no residual tissue), IIC (with residual tissue), III (no residual tissue), is based on: complementary chemotherapy with platinium, complementary external abdominopelvic radiotherapy (options). Complementary treatment for advanced forms (IIB (with residual tissue), IIC (with residual tissue), III (with residual tissue) and IV) is based on polychemotherapy with platinium (standard). platinium combined with paclitaxel (intravenous), platinium combined with cyclophosphamide and/or doxorubicin (intravenous) or intraperitoneal cisplatin combined with cyclophosphamide (intravenous). The chemotherapy work-up includes physical examination, assay of serum markers (particularly CA125) and abdominopelvic computed tomography (proof level B) (standard). Physical examination is recommended for monitoring patients in complete remission with no sign of suspected recurrence (standard). This document was reviewed in April 1977. The working group again validated the Standards, OPTIONS and Recommendations, without modifications in June 1999.

  5. Comparison of the Josephson Voltage Standards of the NIMT and the BIPM (part of the ongoing BIPM key comparison BIPM.EM-K10.b)

    NASA Astrophysics Data System (ADS)

    Solve, S.; Chayramy, R.; Stock, M.; Pimsut, S.; Rujirat, N.

    2016-01-01

    A comparison of the Josephson array voltage standards of the Bureau International des Poids et Mesures (BIPM) and the National Institute of Metrology - (Thailand), NIMT, was carried out in November 2015 at the level of 10 V. For this exercise, options A and B of the BIPM.EM-K10.b comparison protocol were applied. Option B required the BIPM to provide a reference voltage for measurement by the NIMT using its Josephson standard with its own measuring device. Option A required the NIMT to provide a reference voltage with its Josephson voltage standard for measurement by the BIPM using an analogue nanovoltmeter and associated measurement loop. In all cases the BIPM array was kept floating from ground. The final results were in good agreement within the combined relative standard uncertainty of 2.6 parts in 1010 for the nominal voltage of 10 V. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  6. Qu’est-ce que l’hidradénite suppurée?

    PubMed Central

    Lee, Erika Yue; Alhusayen, Raed; Lansang, Perla; Shear, Neil; Yeung, Jensen

    2017-01-01

    Résumé Objectif Permettre aux médecins de famille de comprendre l’épidémiologie, le tableau clinique, le diagnostic et la prise en charge de l’hidradénite suppurée. Sources d’information Une recherche de la littérature a été effectuée sur PubMed à l’aide des mots-clés MeSH hidradenitis suppurativa. Message principal L’hidradénite suppurée est une affection cutanée chronique, récidivante et incapacitante. C’est un trouble inflammatoire de l’épithélium folliculaire, bien qu’une infection bactérienne secondaire se produise souvent. Le diagnostic, posé en clinique, repose sur les lésions typiques (nodules, abcès, tractus sinusal), le siège (plis cutanés), la nature des rechutes et le caractère chronique. De nombreuses comorbidités sont associées à l’hidradénite suppurée, y compris l’obésité, le syndrome métabolique, la maladie intestinale inflammatoire et la spondylarthropathie. Même si l’absence de traitement curatif et la nature récidivante de l’hidradénite suppurée en compliquent le traitement, il existe des options efficaces pour prendre en charge les symptômes. Conclusion Les médecins de famille doivent soupçonner l’hidradénite suppurée chez les patients qui présentent des abcès cutanés récidivants dans les plis cutanés. Les médecins de famille jouent un rôle important dans le diagnostic précoce, l’instauration du traitement et la recommandation en dermatologie avant que l’hidradénite suppurée ne progresse vers une atteinte terminale incapacitante. PMID:28209697

  7. Feynman perturbation expansion for the price of coupon bond options and swaptions in quantum finance. I. Theory

    NASA Astrophysics Data System (ADS)

    Baaquie, Belal E.

    2007-01-01

    European options on coupon bonds are studied in a quantum field theory model of forward interest rates. Swaptions are briefly reviewed. An approximation scheme for the coupon bond option price is developed based on the fact that the volatility of the forward interest rates is a small quantity. The field theory for the forward interest rates is Gaussian, but when the payoff function for the coupon bond option is included it makes the field theory nonlocal and nonlinear. A perturbation expansion using Feynman diagrams gives a closed form approximation for the price of coupon bond option. A special case of the approximate bond option is shown to yield the industry standard one-factor HJM formula with exponential volatility.

  8. Feynman perturbation expansion for the price of coupon bond options and swaptions in quantum finance. I. Theory.

    PubMed

    Baaquie, Belal E

    2007-01-01

    European options on coupon bonds are studied in a quantum field theory model of forward interest rates. Swaptions are briefly reviewed. An approximation scheme for the coupon bond option price is developed based on the fact that the volatility of the forward interest rates is a small quantity. The field theory for the forward interest rates is Gaussian, but when the payoff function for the coupon bond option is included it makes the field theory nonlocal and nonlinear. A perturbation expansion using Feynman diagrams gives a closed form approximation for the price of coupon bond option. A special case of the approximate bond option is shown to yield the industry standard one-factor HJM formula with exponential volatility.

  9. 7 CFR 457.111 - Pear crop insurance provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., section equivalents, FSA farm serial number, or on non-contiguous land, optional units may be established... applicable state grading standard. Ton. Two thousand (2,000) pounds avoirdupois. Varietal group. Types of... non-irrigated practices are not applicable. (b) Instead of establishing optional units by section...

  10. 7 CFR 457.111 - Pear crop insurance provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., section equivalents, FSA farm serial number, or on non-contiguous land, optional units may be established... applicable state grading standard. Ton. Two thousand (2,000) pounds avoirdupois. Varietal group. Types of... non-irrigated practices are not applicable. (b) Instead of establishing optional units by section...

  11. 7 CFR 457.111 - Pear crop insurance provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., section equivalents, FSA farm serial number, or on non-contiguous land, optional units may be established... applicable state grading standard. Ton. Two thousand (2,000) pounds avoirdupois. Varietal group. Types of... non-irrigated practices are not applicable. (b) Instead of establishing optional units by section...

  12. MENU OF NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

    EPA Science Inventory

    The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

  13. 24 CFR 3285.504 - Skirting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.504 Skirting. (a) Skirting, if... skirting within 6 inches of the ground must be pressure-treated in accordance with AWPA Standard U1...

  14. 24 CFR 3285.504 - Skirting.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.504 Skirting. (a) Skirting, if... skirting within 6 inches of the ground must be pressure-treated in accordance with AWPA Standard U1...

  15. 24 CFR 3285.504 - Skirting.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.504 Skirting. (a) Skirting, if... skirting within 6 inches of the ground must be pressure-treated in accordance with AWPA Standard U1...

  16. Fertility preservation options in breast cancer patients.

    PubMed

    Kasum, Miro; von Wolff, Michael; Franulić, Daniela; Čehić, Ermin; Klepac-Pulanić, Tajana; Orešković, Slavko; Juras, Josip

    2015-01-01

    The purpose of this review is to analyse current options for fertility preservation in young women with breast cancer (BC). Considering an increasing number of BC survivors, owing to improvements in cancer treatment and delaying of childbearing, fertility preservation appears to be an important issue. Current fertility preservation options in BC survivors range from well-established standard techniques to experimental or investigational interventions. Among the standard options, random-start ovarian stimulation protocol represents a new technique, which significantly decreases the total time of the in vitro fertilisation cycle. However, in patients with oestrogen-sensitive tumours, stimulation protocols using aromatase inhibitors are currently preferred over tamoxifen regimens. Cryopreservation of embryos and oocytes are nowadays deemed the most successful techniques for fertility preservation in BC patients. GnRH agonists during chemotherapy represent an experimental method for fertility preservation due to conflicting long-term outcome results regarding its safety and efficacy. Cryopreservation of ovarian tissue, in vitro maturation of immature oocytes and other strategies are considered experimental and should only be offered within the context of a clinical trial. An early pretreatment referral to reproductive endocrinologists and oncologists should be suggested to young BC women at risk of infertility, concerning the risks and benefits of fertility preservation options.

  17. Default Options In Advance Directives Influence How Patients Set Goals For End-Of-Life Care

    PubMed Central

    Halpern, Scott D.; Loewenstein, George; Volpp, Kevin G.; Cooney, Elizabeth; Vranas, Kelly; Quill, Caroline M.; Mckenzie, Mary S.; Harhay, Michael O.; Gabler, Nicole B.; Silva, Tatiana; Arnold, Robert; Angus, Derek C.; Bryce, Cindy

    2015-01-01

    Although decisions regarding end-of-life care are personal and important, they may be influenced by the ways in which options are presented. To test this hypothesis, we randomly assigned 132 seriously ill patients to complete one of three types of advance directives. Two types had end-of-life care options already checked—a default choice—but one of these favored comfort-oriented care, and the other, life-extending care. The third type was a standard advance directive with no options checked. We found that most patients preferred comfort-oriented care, but the defaults influenced those choices. For example, 77 percent of patients in the comfort-oriented group retained that choice, while 43 percent of those in the life-extending group rejected the default choice and selected comfort-oriented care instead. Among the standard advance directive group, 61 percent of patients selected comfort-oriented care. Our findings suggest that patients may not hold deep-seated preferences regarding end-of-life care. The findings provide motivation for future research examining whether using default options in advance directives may improve important outcomes, including patients’ receipt of wanted and unwanted services, resource use, survival, and quality of life. PMID:23381535

  18. 21 CFR 164.110 - Mixed nuts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CONSUMPTION TREE NUT AND PEANUT PRODUCTS Requirements for Specific Standardized Tree Nut and Peanut Products... shelled tree nut ingredients, with or without one or more of the optional shelled peanut ingredients, of... is packed in transparent containers, three or more of the optional tree nut ingredients shall be...

  19. Fast Track Option: An Accelerated Associate's Degree Program.

    ERIC Educational Resources Information Center

    Price, J. Randall

    1998-01-01

    Alternative instructional delivery options such as self-paced and flexible enrollment courses are designed to increase enrollment, promote retention, and encourage student success without lowering academic standards. The Fast Track Associate's Degree Program, developed by a team of faculty, staff, and administrators at Richland Community College,…

  20. 24 CFR 965.505 - Standards for allowances for utilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PHA installs air conditioning, it shall provide, to the maximum extent economically feasible, systems... systems that offer each resident the option to choose air conditioning shall include retail meters or... allowances. For systems that offer residents the option to choose air conditioning but cannot be checkmetered...

  1. La prévention et le traitement des infections bactériennes chez les enfants aspléniques ou hypospléniques

    PubMed Central

    1999-01-01

    L’asplénie, qu’elle soit fonctionnelle ou anatomique, s’associe à un accroissement du risque d’infection potentiellement fatale ou constituant un danger de septicémie postsplénectomie (SPS). En raison du risque accru de bactériémie par des bactéries encapsulées chez les enfants aspléniques, la vaccination visant à prévenir une infection au Streptococcus pneumoniae, à l’Haemophilus influenzae de type b (Hib) et au Neiserria meningitidis est recommandée. Malgré la prévalence croissante de S pneumoniae pénicillinorésistant, on recommande aussi l’usage de pénicilline prophylactique chez les enfants aspléniques de moins de cinq ans, et pendant au moins un an après une splénectomie. La poursuite de la prophylaxie antibiotique après cette période dépend de la situation clinique de chaque enfant et de la prévalence de S pneumoniae pénicillinorésistant au sein de la collectivité. Lorsque des enfants aspléniques font de la fièvre ou présentent des symptômes non spécifiques, ils devraient faire l’objet d’une évaluation immédiate. Si on présume la présence de septicémie bactérienne, il faut procéder à une analyse du sang et des autres liquides organiques pertinents et entreprendre sur-le-champ une antibiothérapie à large spectre par voie parentérale, laquelle doit agir également contre les souches de S pneumoniae présentes dans la collectivité. Chez les enfants aspléniques souffrant d’une septicémie foudroyante à S pneumoniae, le taux de mortalité est élevé, malgré l’utilisation rapide d’une antibiothérapie convenable, d’où l’importance des mesures préventives.

  2. Guide de pratique clinique pour les lésions cérébrales traumatiques légères et les symptômes persistants

    PubMed Central

    Marshall, Shawn; Bayley, Mark; McCullagh, Scott; Velikonja, Diana; Berrigan, Lindsay

    2012-01-01

    Résumé Objectif Présenter les nouvelles lignes directrices sur la prise en charge des lésions cérébrales traumatiques légères (LCTL) et les symptômes persistants post-commotion (SPPC) afin de renseigner et d’orienter les médecins qui prennent en charge des patients qui se remettent d’une LCTL. Qualité des données On a effectué une recherche des guides de pratique clinique existants portant sur les LCTL et une synthèse critique des ouvrages scientifiques évaluant le traitement des SPPC. Étant donné la rareté des conseils sur la prise en charge des SPPC dans les travaux sur les lésions cérébrales traumatiques, une deuxième recherche documentaire a été faite pour recenser les guides de pratique clinique et les synthèses critiques concernant la prise en charge de ces symptômes communs dans la population en général. On a convoqué des professionnels de la santé provenant de différentes disciplines et régions du Canada et de l’étranger à une conférence consensuelle d’experts pour examiner les lignes directrices et les données probantes existantes et élaborer un guide complet pour la prise en charge des LCTL et des SPPC. Message principal À l’aide d’un processus Delphi modifié, on a produit 71 recommandations portant sur le diagnostic et la prise en charge des LCTL et des SPPC. De plus, on a inclus dans le guide de nombreuses ressources et des outils pour faciliter la mise en œuvre des recommandations. Conclusion Un guide de pratique clinique a été élaboré pour aider les professionnels de la santé à fournir des soins fondés sur les données probantes et les pratiques exemplaires à la population complexe de personnes qui ont des SPPC à la suite d’une LCTL.

  3. Médecine des voyages

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Résumé Objectif Définir la pratique de la médecine des voyages, présenter les éléments fondamentaux d’une consultation complète préalable aux voyages à des voyageurs internationaux et aider à identifier les patients qu’il vaudrait mieux envoyer en consultation auprès de professionnels de la médecine des voyages. Sources des données Les lignes directrices et les recommandations sur la médecine des voyages et les maladies liées aux voyages publiées par les autorités sanitaires nationales et internationales ont fait l’objet d’un examen. Une recension des ouvrages connexes dans MEDLINE et EMBASE a aussi été effectuée. Message principal La médecine des voyages est une spécialité très dynamique qui se concentre sur les soins préventifs avant un voyage. Une évaluation exhaustive du risque pour chaque voyageur est essentielle pour mesurer avec exactitude les risques particuliers au voyageur, à son itinéraire et à sa destination et pour offrir des conseils sur les interventions les plus appropriées en gestion du risque afin de promouvoir la santé et prévenir les problèmes médicaux indésirables durant le voyage. Des vaccins peuvent aussi être nécessaires et doivent être personnalisés en fonction des antécédents d’immunisation du voyageur, de son itinéraire et du temps qu’il reste avant son départ. Conclusion La santé et la sécurité d’un voyageur dépendent du degré d’expertise du médecin qui offre le counseling préalable à son voyage et les vaccins, au besoin. On recommande à ceux qui donnent des conseils aux voyageurs d’être conscients de l’ampleur de cette responsabilité et de demander si possible une consultation auprès de professionnels de la médecine des voyages pour tous les voyageurs à risque élevé.

  4. Maladie des vibrations

    PubMed Central

    Shen, Shixin (Cindy); House, Ronald A.

    2017-01-01

    Résumé Objectif Permettre aux médecins de famille de comprendre l’épidémiologie, la pathogenèse, les symptômes, le diagnostic et la prise en charge de la maladie des vibrations, une maladie professionnelle importante et courante au Canada. Sources d’information Une recherche a été effectuée sur MEDLINE afin de relever les recherches et comptes rendus portant sur la maladie des vibrations. Une recherche a été effectuée sur Google dans le but d’obtenir la littérature grise qui convient au contexte canadien. D’autres références ont été tirées des articles relevés. Message principal La maladie des vibrations est une maladie professionnelle répandue touchant les travailleurs de diverses industries qui utilisent des outils vibrants. La maladie est cependant sous-diagnostiquée au Canada. Elle compte 3 éléments : vasculaire, sous la forme d’un phénomène de Raynaud secondaire; neurosensoriel; et musculosquelettique. Aux stades les plus avancés, la maladie des vibrations entraîne une invalidité importante et une piètre qualité de vie. Son diagnostic exige une anamnèse minutieuse, en particulier des antécédents professionnels, un examen physique, des analyses de laboratoire afin d’éliminer les autres diagnostics, et la recommandation en médecine du travail aux fins d’investigations plus poussées. La prise en charge consiste à réduire l’exposition aux vibrations, éviter les températures froides, abandonner le tabac et administrer des médicaments. Conclusion Pour assurer un diagnostic rapide de la maladie des vibrations et améliorer le pronostic et la qualité de vie, les médecins de famille devraient connaître cette maladie professionnelle courante, et pouvoir obtenir les détails pertinents durant l’anamnèse, recommander les patients aux cliniques de médecine du travail et débuter les demandes d’indemnisation de manière appropriée. PMID:28292812

  5. Etude critique de la prise en charge de 159 personnes âgées en consultation de psychiatrie

    PubMed Central

    Ben Thabet, Jihène; Ammar, Yousra; Charfi, Nada; Zouari, Lobna; Zouari, Nasreddine; Gaha, Lotfi; Maalej, Mohamed

    2014-01-01

    Introduction Le phénomène de vieillissement des populations est associé à une augmentation de la prévalence de la morbidité liée à l’âge. La prescription des psychotropes chez le sujet âgé est de plus en plus fréquente dans les institutions, les doses sont de plus en plus élevées, avec un recours fréquent à une poly pharmacothérapie. Nous nous sommes proposé de décrire les conduites thérapeutiques chez le sujet âgé consultant en psychiatrie, en vue de les confronter aux dernières recommandations en la matière. Méthodes L’étude était de type rétrospectif et descriptif. Elle a concerné les sujets âgés d'au moins 60 ans ayant consulté pour la première fois en psychiatrie, au CHU Hédi Chaker à Sfax, en 2010 ou 2011. Résultats Nous avons colligé 159 dossiers. L’âge moyen était de 73 ans. La démence et les troubles de l'humeur étaient les diagnostics les plus fréquents. Sur le plan thérapeutique, une poly thérapie faite d'au moins deux psychotropes de familles différentes a été prescrite pour 55,9%. Chez 60.3% des sujets, le traitement a été prescrit d'emblée à dose complète. Aucun dossier ne faisait état d'une prise en charge psychothérapeutique. Conclusion La prise en charge des malades de notre étude n’était pas conforme aux recommandations, notamment en matière d'association médicamenteuse, de progression des doses et d'association de la psychothérapie à la pharmacothérapie. L'information des médecins et leur sensibilisation aux particularités du sujet âgé contribuerait à optimiser les soins qui leur sont prodigués, y compris en psychiatrie. PMID:25120873

  6. Treatment Option Overview (Prostate Cancer)

    MedlinePlus

    ... from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of ... or better than the standard treatment . Many of today's standard treatments for cancer are based on earlier ...

  7. Wake Forest U. Joins Ranks of Test-Optional Colleges

    ERIC Educational Resources Information Center

    Hoover, Eric; Supiano, Beckie

    2008-01-01

    Wake Forest University will no longer require applicants to submit standardized test scores, the university announced last week. The move makes Wake Forest, in Winston-Salem, North Carolina, one of the most prominent institutions with a "test optional" admissions policy. The university's decision reveals the increasing complexity of the…

  8. Effects of Employing Ridge Regression in Structural Equation Models.

    ERIC Educational Resources Information Center

    McQuitty, Shaun

    1997-01-01

    LISREL 8 invokes a ridge option when maximum likelihood or generalized least squares are used to estimate a structural equation model with a nonpositive definite covariance or correlation matrix. Implications of the ridge option for model fit, parameter estimates, and standard errors are explored through two examples. (SLD)

  9. Treatment Options by Stage (Prostate Cancer)

    MedlinePlus

    ... from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of ... or better than the standard treatment . Many of today's standard treatments for cancer are based on earlier ...

  10. 76 FR 13851 - National Emission Standards for Hazardous Air Pollutants: Mercury Emissions From Mercury Cell...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-14

    ...This action proposes amendments to the national emission standards for hazardous air pollutants (NESHAP) for mercury emissions from mercury cell chlor-alkali plants (Mercury Cell NESHAP). On June 11, 2008, EPA proposed amendments to this NESHAP in response to a petition for reconsideration filed by the Natural Resources Defense Council (NRDC). This action is a supplement to the June 11, 2008, proposal. Specifically, this action proposes two options for amending the NESHAP for mercury emissions from mercury cell chlor-alkali plants. The first option would require the elimination of mercury emissions and thus encourage the conversion to non-mercury technology. The second option would require the measures proposed in 2008. These measures, which included significant improvements in the work practices to reduce fugitive emissions from the cell room, would result in near-zero levels of mercury emissions while still allowing the mercury cell facilities to continue to operate. We are specifically requesting comment on which of these options is more appropriate, and may finalize either option or a combination of elements from them. In addition, this action proposes several amendments that would apply regardless of which option we select. These proposed amendments are provisions of the existing NESHAP that would apply to periods of startup, shutdown, and malfunction (SSM), and corrections to compliance errors in the currently effective rule.

  11. 45 CFR 155.710 - Eligibility standards for SHOP.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Eligibility standards for SHOP. 155.710 Section... Exchange Functions: Small Business Health Options Program (SHOP) § 155.710 Eligibility standards for SHOP. (a) General requirement. The SHOP must permit qualified employers to purchase coverage for qualified...

  12. Alternative Fuels Data Center: E85 Codes and Standards

    Science.gov Websites

    Development Equipment Options Equipment Installation Codes, Standards, & Safety Vehicles Laws & ; Incentives Ethanol Codes, Standards, and Safety The U.S. Environmental Protection Agency's (EPA) Office of -Gasoline Blends. The Occupational Safety and Health Administration (OSHA) regulates some fuel-dispensing

  13. Comparison of the Josephson Voltage Standards of the DMDM and the BIPM (part of the ongoing BIPM key comparison BIPM.EM-K10.b)

    NASA Astrophysics Data System (ADS)

    Solve, S.; Chayramy, R.; Stock, M.; Pantelic-Babic, J.; Sofranac, Z.; Cincar Vujovic, T.

    2016-01-01

    A comparison of the Josephson array voltage standards of the Bureau International des Poids et Mesures (BIPM) and the Directorate of Measures and Precious Metals (DMDM), Belgrade, Serbia, was carried out in June 2015 at the level of 10 V. For this exercise, options A and B of the BIPM.EM-K10.b comparison protocol were applied. Option B required the BIPM to provide a reference voltage for measurement by the DMDM using its Josephson standard with its own measuring device. Option A required the DMDM to provide a reference voltage with its Josephson voltage standard for measurement by the BIPM using an analogue nanovoltmeter and associated measurement loop. Since no sufficiently stable voltage could be achieved in this configuration, a digital detector was used. In all cases the BIPM array was kept floating from ground. The final results were in good agreement within the combined relative standard uncertainty of 1.5 parts in 1010 for the nominal voltage of 10 V. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  14. Advancing Educational Diversity: Antifragility, Standardization, Democracy, and a Multitude of Education Options

    ERIC Educational Resources Information Center

    Fortunato, Michael W. P.

    2017-01-01

    This essay is a response to a paper by Avery and Hains that raises questions about the often unintended effects of knowledge standardization in an educational setting. While many K-12 schools are implementing common core standards, and many institutions of higher education are implementing their own standardized educational practices, the question…

  15. 40 CFR 63.4893 - What work practice standards must I meet?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Limitations § 63.4893 What work practice standards must I meet? (a) For any coating operation or group of... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What work practice standards must I... controls option to demonstrate compliance, you are not required to meet any work practice standards. (b...

  16. 76 FR 79609 - Federal Acquisition Regulation; Clarification of Standards for Computer Generation of Forms

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... Regulation; Clarification of Standards for Computer Generation of Forms AGENCY: Department of Defense (DoD... American National Standards Institute X12, as the valid standard to use for computer-generated forms. FAR... optional forms on their computers. In addition to clarifying that FIPS 161 is no longer in use, public...

  17. Balance and Gait Impairment: Sensor-Based Assessment for Patients With Peripheral Neuropathy.

    PubMed

    Campbell, Grace; Skubic, Marjorie A

    2018-06-01

    Individuals with peripheral neuropathy (PN) frequently experience balance and gait impairments that can lead to poor physical function, falls, and injury. Nurses are aware that patients with cancer experience balance and gait impairments but are unsure of optimal assessment and management strategies. This article reviews options for balance and gait assessment for patients diagnosed with cancer experiencing PN, describes advantages and limitations of the various options, and highlights innovative, clinically feasible technologies to improve clinical assessment and management. The literature was reviewed to identify and assess the gold standard quantitative measures for assessing balance and gait. Gold standard quantitative measures are burdensome for patients and not often used in clinical practice. Sensor-based technologies improve balance and gait assessment options by calculating precise impairment measures during performance of simple clinical tests at the point of care.

  18. Are food and drink retailers within NHS venues adhering to NICE Quality standard 94 guidance on childhood obesity? A cross-sectional study of two large secondary care NHS hospitals in England

    PubMed Central

    James, Alice; Birch, Laura; Fletcher, Peter; Pearson, Sally; Boyce, Catherine; Ness, Andy R; Hamilton-Shield, Julian P; Lithander, Fiona E

    2017-01-01

    Objective To assess whether the food and drink retail outlets in two major National Health Service (NHS) district general hospitals in England adhere to quality statements 1–3 of the UK National Institute for Health and Care Excellence (NICE) quality standard 94. Design Cross-sectional, descriptive study to assess the food and drink options available in vending machines, restaurants, cafes and shops in two secondary care hospitals. Main outcome measures Adherence to quality statement 1 whereby the food and drink items available in the vending machines were classified as either healthy or less healthy using the Nutrient Profiling Model (NPM). Compliance with quality statements 2 and 3 was assessed through the measurement of how clearly the shops, cafes and restaurants displayed nutrition information on menus, and the availability and prominent display of healthy food and drink options in retail outlets, respectively. Results Adherence to quality statement 1 was poor. Of the 18 vending machines assessed, only 7 (39%) served both a healthy food and a healthy drink option. Neither hospital was compliant with quality statement 2 wherein nutritional information was not available on menus of food providers in either hospital. There was inconsistent compliance with quality standard 3 whereby healthy food and drink options were prominently displayed in the two main hospital restaurants, but all shops and cafes prioritised the display of unhealthy items. Conclusions Neither hospital was consistently compliant with quality statements 1–3 of the NICE quality standard 94. Improving the availability of healthy foods and drinks while reducing the display and accessibility to less healthy options in NHS venues may improve family awareness of healthy alternatives. Making it easier for parents to direct their children to healthier choices is an ostensibly central component of our healthcare system. PMID:29150472

  19. A new system for understanding modes of mechanical ventilation.

    PubMed

    Chatburn, R L; Primiano, F P

    2001-06-01

    Numerous ventilation modes and ventilation options have become available as new mechanical ventilators have reached the market. Ventilator manufacturers have no standardized terminology for ventilator modes and ventilation options, and ventilator operator's manuals do not help the clinician compare the modes of ventilators from different manufacturers. This article proposes a standardized system for classifying ventilation modes, based on general engineering principles and a small set of explicit definitions. Though there may be resistance by ventilator manufacturers to a standardized system of ventilation terminology, clinicians and health care equipment purchasers should adopt such a system in the interest of clear communication--the lack of which prevents clinicians from fully understanding the therapies they administer and could compromise the quality of patient care.

  20. [Principles of health economic evaluation for use by caregivers].

    PubMed

    Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine

    2017-01-01

    The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. La prévention des infections par le virus respiratoire syncytial

    PubMed Central

    Robinson, JL

    2011-01-01

    RÉSUMÉ L’infection par le virus respiratoire syncytial (VRS) est la principale cause d’infections des voies respiratoires inférieures chez les jeunes enfants. Le palivizumab, un anticorps monoclonal anti-VRS, réduit le taux d’hospitalisation des enfants à haut risque mais est très coûteux. Le présent document de principes remplace les trois précédents documents de principes de la Société canadienne de pédiatrie sur le sujet et est mis à jour principalement pour traiter des récentes modifications aux lignes directrices de l’American Academy of Pediatrics dans le contexte canadien. Il contient une analyse des publications ainsi que des recommandations au sujet de l’utilisation du palivizumab chez les enfants à haut risque

  2. 21 CFR 137.170 - Instantized flours.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... standard sieve (840-micron opening), and not more than 20 percent will pass through a 200 mesh U.S standard sieve (74-micron opening). (b) The optional procedures referred to in paragraph (a) of this section are...

  3. 21 CFR 137.170 - Instantized flours.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... standard sieve (840-micron opening), and not more than 20 percent will pass through a 200 mesh U.S standard sieve (74-micron opening). (b) The optional procedures referred to in paragraph (a) of this section are...

  4. 21 CFR 137.170 - Instantized flours.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... standard sieve (840-micron opening), and not more than 20 percent will pass through a 200 mesh U.S standard sieve (74-micron opening). (b) The optional procedures referred to in paragraph (a) of this section are...

  5. 21 CFR 137.170 - Instantized flours.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... standard sieve (840-micron opening), and not more than 20 percent will pass through a 200 mesh U.S standard sieve (74-micron opening). (b) The optional procedures referred to in paragraph (a) of this section are...

  6. 21 CFR 137.170 - Instantized flours.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... standard sieve (840-micron opening), and not more than 20 percent will pass through a 200 mesh U.S standard sieve (74-micron opening). (b) The optional procedures referred to in paragraph (a) of this section are...

  7. Study of the Alsys implementation of the Catalogue of Interface Features and Options for the Ada language for 80386 Unix

    NASA Technical Reports Server (NTRS)

    Gibson, James S.; Barnes, Michael J.; Ostermiller, Daniel L.

    1993-01-01

    A set of programs was written to test the functionality and performance of the Alsys Ada implementation of the Catalogue of Interface Features and Options (CIFO), a set of optional Ada packages for real-time applications. No problems were found with the task id, preemption control, or shared-data packages. Minor problems were found with the dispatching control, dynamic priority, events, non-waiting entry call, semaphore, and scheduling packages. The Alsys implementation is derived mostly from Release 2 of the CIFO standard, but includes some of the features of Release 3 and some modifications unique to Alsys. Performance measurements show that the semaphore and shared-data features are an order-of-magnitude faster than the same mechanisms using an Ada rendezvous. The non-waiting entry call is slightly faster than a standard rendezvous. The existence of errors in the implementation, the incompleteness of the documentation from the published standard impair the usefulness of this implementation. Despite those short-comings, the Alsys CIFO implementation might be of value in the development of real-time applications.

  8. Evaluating Mobile Survey Tools (MSTs) for Field-Level Monitoring and Data Collection: Development of a Novel Evaluation Framework, and Application to MSTs for Rural Water and Sanitation Monitoring

    PubMed Central

    Fisher, Michael B.; Mann, Benjamin H.; Cronk, Ryan D.; Shields, Katherine F.; Klug, Tori L.; Ramaswamy, Rohit

    2016-01-01

    Information and communications technologies (ICTs) such as mobile survey tools (MSTs) can facilitate field-level data collection to drive improvements in national and international development programs. MSTs allow users to gather and transmit field data in real time, standardize data storage and management, automate routine analyses, and visualize data. Dozens of diverse MST options are available, and users may struggle to select suitable options. We developed a systematic MST Evaluation Framework (EF), based on International Organization for Standardization/International Electrotechnical Commission (ISO/IEC) software quality modeling standards, to objectively assess MSTs and assist program implementers in identifying suitable MST options. The EF is applicable to MSTs for a broad variety of applications. We also conducted an MST user survey to elucidate needs and priorities of current MST users. Finally, the EF was used to assess seven MSTs currently used for water and sanitation monitoring, as a validation exercise. The results suggest that the EF is a promising method for evaluating MSTs. PMID:27563916

  9. Evaluating Mobile Survey Tools (MSTs) for Field-Level Monitoring and Data Collection: Development of a Novel Evaluation Framework, and Application to MSTs for Rural Water and Sanitation Monitoring.

    PubMed

    Fisher, Michael B; Mann, Benjamin H; Cronk, Ryan D; Shields, Katherine F; Klug, Tori L; Ramaswamy, Rohit

    2016-08-23

    Information and communications technologies (ICTs) such as mobile survey tools (MSTs) can facilitate field-level data collection to drive improvements in national and international development programs. MSTs allow users to gather and transmit field data in real time, standardize data storage and management, automate routine analyses, and visualize data. Dozens of diverse MST options are available, and users may struggle to select suitable options. We developed a systematic MST Evaluation Framework (EF), based on International Organization for Standardization/International Electrotechnical Commission (ISO/IEC) software quality modeling standards, to objectively assess MSTs and assist program implementers in identifying suitable MST options. The EF is applicable to MSTs for a broad variety of applications. We also conducted an MST user survey to elucidate needs and priorities of current MST users. Finally, the EF was used to assess seven MSTs currently used for water and sanitation monitoring, as a validation exercise. The results suggest that the EF is a promising method for evaluating MSTs.

  10. 45 CFR 155.730 - Application standards for SHOP.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Application standards for SHOP. 155.730 Section... Exchange Functions: Small Business Health Options Program (SHOP) § 155.730 Application standards for SHOP. (a) General requirements. Application forms used by the SHOP must meet the requirements set forth in...

  11. 45 CFR 155.730 - Application standards for SHOP.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Application standards for SHOP. 155.730 Section... Exchange Functions: Small Business Health Options Program (SHOP) § 155.730 Application standards for SHOP. (a) General requirements. Application forms used by the SHOP must meet the requirements set forth in...

  12. DIFFERENTIATING PASSENGER VEHICLES BY FUEL ECONOMY: STRATEGIC INCENTIVES AND THE COST-EFFECTIVENESS OF TRADABLE CAFE STANDARDS

    EPA Science Inventory

    The welfare and distributional effects of alternative fuel economy regulations will be compared, including an increase in existing CAFE standards, allowing for tradable credits, and implementing other design options in a trading scheme, such as sliding standards based on ve...

  13. 40 CFR 63.4941 - How do I demonstrate initial compliance with the emission limitations?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutants: Surface Coating of... material option is not required to comply with the operating limits or work practice standards required in...

  14. 40 CFR 63.4141 - How do I demonstrate initial compliance with the emission limitations?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants... option is not required to meet the operating limits or work practice standards required in §§ 63.4092 and...

  15. 40 CFR 63.3521 - How do I demonstrate initial compliance with the emission limitations?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutants: Surface Coating of... compliant material option is not required to meet the operating limits or work practice standards required...

  16. 17 CFR 155.3 - Trading standards for futures commission merchants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Insure, to the extent possible, that each order received from a customer or from an option customer which... the affiliated person has gained knowledge of the customer's or option customer's order prior to the... merchant or any of its affiliated persons by reason of their relationship to such other person, except with...

  17. 77 FR 74043 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Granting Approval of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-12

    ... (``OCC'') submitted to the Securities and Exchange Commission (``Commission''), pursuant to Rule 9b-1... of trading standardized options. In September 2012, the Commission approved proposed rule changes...\\ The Commission recently approved a proposed rule change by the OCC to make similar changes to its By...

  18. 40 CFR 86.1832-01 - Optional equipment and air conditioning for test vehicles.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) General Compliance Provisions for Control of Air Pollution From New and In... group, will be equipped with an item (whether that item is standard equipment or an option), the full...

  19. 40 CFR 86.1832-01 - Optional equipment and air conditioning for test vehicles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) General Compliance Provisions for Control of Air Pollution From New and In... group, will be equipped with an item (whether that item is standard equipment or an option), the full...

  20. 40 CFR 63.138 - Process wastewater provisions-performance standards for treatment processes managing Group 1...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... each treatment process. (b) Control options: Group 1 wastewater streams for Table 9 compounds. The... section. (c) Control options: Group 1 wastewater streams for Table 8 compounds. The owner or operator...) Residuals. For each residual removed from a Group 1 wastewater stream, the owner or operator shall control...

  1. 40 CFR 86.1832-01 - Optional equipment and air conditioning for test vehicles.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) General Compliance Provisions for Control of Air Pollution From New and In... group, will be equipped with an item (whether that item is standard equipment or an option), the full...

  2. 40 CFR 86.1832-01 - Optional equipment and air conditioning for test vehicles.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) General Compliance Provisions for Control of Air Pollution From New and In... group, will be equipped with an item (whether that item is standard equipment or an option), the full...

  3. 40 CFR 63.138 - Process wastewater provisions-performance standards for treatment processes managing Group 1...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... each treatment process. (b) Control options: Group 1 wastewater streams for Table 9 compounds. The... section. (c) Control options: Group 1 wastewater streams for Table 8 compounds. The owner or operator...) Residuals. For each residual removed from a Group 1 wastewater stream, the owner or operator shall control...

  4. 40 CFR 63.138 - Process wastewater provisions-performance standards for treatment processes managing Group 1...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... each treatment process. (b) Control options: Group 1 wastewater streams for Table 9 compounds. The... section. (c) Control options: Group 1 wastewater streams for Table 8 compounds. The owner or operator...) Residuals. For each residual removed from a Group 1 wastewater stream, the owner or operator shall control...

  5. 76 FR 64174 - Public Input on the Report to Congress on How To Modernize and Improve the System of Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... examples, supporting any opinions or conclusions; (2) approaches and options toward improvement or... out such approaches or options. FOR FURTHER INFORMATION CONTACT: Federal Insurance Office, Department... submit views on: 1. Systemic risk regulation with respect to insurance; 2. Capital standards and the...

  6. 17 CFR 155.3 - Trading standards for futures commission merchants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Insure, to the extent possible, that each order received from a customer or from an option customer which... the affiliated person has gained knowledge of the customer's or option customer's order prior to the... merchant or any of its affiliated persons by reason of their relationship to such other person, except with...

  7. 17 CFR 155.3 - Trading standards for futures commission merchants.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Insure, to the extent possible, that each order received from a customer or from an option customer which... the affiliated person has gained knowledge of the customer's or option customer's order prior to the... merchant or any of its affiliated persons by reason of their relationship to such other person, except with...

  8. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements

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

    Not Available

    2013-03-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  9. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements (Brochure)

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

    Not Available

    2014-06-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  10. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements

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

    Sears, Ted

    2014-06-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  11. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements (Book)

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

    Not Available

    2010-11-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  12. 40 CFR 270.235 - Options for incinerators, cement kilns, lightweight aggregate kilns, solid fuel boilers, liquid...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Technology (MACT) Standards § 270.235 Options for incinerators, cement kilns, lightweight aggregate kilns... malfunction plan, design, and operating history. (2) Retain or add these permit requirements to the permit to... information including the source's startup, shutdown, and malfunction plan, design, and operating history; and...

  13. Space station data system analysis/architecture study. Task 2: Options development, DR-5. Volume 3: Programmatic options

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Task 2 in the Space Station Data System (SSDS) Analysis/Architecture Study is the development of an information base that will support the conduct of trade studies and provide sufficient data to make design/programmatic decisions. This volume identifies the preferred options in the programmatic category and characterizes these options with respect to performance attributes, constraints, costs, and risks. The programmatic category includes methods used to administrate/manage the development, operation and maintenance of the SSDS. The specific areas discussed include standardization/commonality; systems management; and systems development, including hardware procurement, software development and system integration, test and verification.

  14. Attraction Effect in Risky Choice Can Be Explained by Subjective Distance Between Choice Alternatives.

    PubMed

    Mohr, Peter N C; Heekeren, Hauke R; Rieskamp, Jörg

    2017-08-21

    Individuals make decisions under risk throughout daily life. Standard models of economic decision making typically assume that people evaluate choice options independently. There is, however, substantial evidence showing that this independence assumption is frequently violated in decision making without risk. The present study extends these findings to the domain of decision making under risk. To explain the independence violations, we adapted a sequential sampling model, namely Multialternative Decision Field Theory (MDFT), to decision making under risk and showed how this model can account for the observed preference shifts. MDFT not only better predicts choices compared with the standard Expected Utility Theory, but it also explains individual differences in the size of the observed context effect. Evidence in favor of the chosen option, as predicted by MDFT, was positively correlated with brain activity in the medial orbitofrontal cortex (mOFC) and negatively correlated with brain activity in the anterior insula (aINS). From a neuroscience perspective, the results of the present study show that specific brain regions, such as the mOFC and aINS, not only code the value or risk of a single choice option but also code the evidence in favor of the best option compared with other available choice options.

  15. 7 CFR 51.1416 - Optional determinations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 FRESH FRUITS, VEGETABLES AND OTHER PRODUCTS 1,2 (INSPECTION, CERTIFICATION, AND...

  16. 7 CFR 51.1416 - Optional determinations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 FRESH FRUITS, VEGETABLES AND OTHER PRODUCTS 1,2 (INSPECTION, CERTIFICATION, AND...

  17. Determining a sustainable and economically optimal wastewater treatment and discharge strategy.

    PubMed

    Hardisty, Paul E; Sivapalan, Mayuran; Humphries, Robert

    2013-01-15

    Options for treatment and discharge of wastewater in regional Western Australia (WA) are examined from the perspective of overall sustainability and social net benefit. Current practice in the state has typically involved a basic standard of treatment deemed to be protective of human health, followed by discharge to surface water bodies. Community and regulatory pressure to move to higher standards of treatment is based on the presumption that a higher standard of treatment is more protective of the environment and society, and thus is more sustainable. This analysis tests that hypothesis for Western Australian conditions. The merits of various wastewater treatment and discharge strategies are examined by quantifying financial costs (capital and operations), and by monetising the wider environmental and social costs and benefits of each option over an expanded planning horizon (30 years). Six technical treatment-disposal options were assessed at a test site, all of which met the fundamental criterion of protecting human health. From a financial perspective, the current business-as-usual option is preferred - it is the least cost solution. However, valuing externalities such as water, greenhouse gases, ecological impacts and community amenity, the status quo is revealed as sub-optimal. Advanced secondary treatment with stream disposal improves water quality and provides overall net benefit to society. All of the other options were net present value (NPV) negative. Sensitivity analysis shows that the favoured option outperforms all of the others under a wide range of financial and externality values and assumptions. Expanding the findings across the state reveals that moving from the identified socially optimal level of treatment to higher (tertiary) levels of treatment would result in a net loss to society equivalent to several hundred million dollars. In other words, everyone benefits from improving treatment to the optimum point. But society, the environment, and the Corporation are all worse off when treatment levels are pushed beyond what is economic and sustainable. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Using simulation to study difficult clinical issues: prenatal counseling at the threshold of viability across American and Dutch cultures.

    PubMed

    Geurtzen, Rosa; Hogeveen, Marije; Rajani, Anand K; Chitkara, Ritu; Antonius, Timothy; van Heijst, Arno; Draaisma, Jos; Halamek, Louis P

    2014-06-01

    Prenatal counseling at the threshold of viability is a challenging yet critically important activity, and care guidelines differ across cultures. Studying how this task is performed in the actual clinical environment is extremely difficult. In this pilot study, we used simulation as a methodology with 2 aims as follows: first, to explore the use of simulation incorporating a standardized pregnant patient as an investigative methodology and, second, to determine similarities and differences in content and style of prenatal counseling between American and Dutch neonatologists. We compared counseling practice between 11 American and 11 Dutch neonatologists, using a simulation-based investigative methodology. All subjects performed prenatal counseling with a simulated pregnant patient carrying a fetus at the limits of viability. The following elements of scenario design were standardized across all scenarios: layout of the physical environment, details of the maternal and fetal histories, questions and responses of the standardized pregnant patient, and the time allowed for consultation. American subjects typically presented several treatment options without bias, whereas Dutch subjects were more likely to explicitly advise a specific course of treatment (emphasis on partial life support). American subjects offered comfort care more frequently than the Dutch subjects and also discussed options for maximal life support more often than their Dutch colleagues. Simulation is a useful research methodology for studying activities difficult to assess in the actual clinical environment such as prenatal counseling at the limits of viability. Dutch subjects were more directive in their approach than their American counterparts, offering fewer options for care and advocating for less invasive interventions. American subjects were more likely to offer a wider range of therapeutic options without providing a recommendation for any specific option.

  19. 45 CFR 155.700 - Standards for the establishment of a SHOP.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standards for the establishment of a SHOP. 155.700... Exchange Functions: Small Business Health Options Program (SHOP) § 155.700 Standards for the establishment of a SHOP. (a) General requirement. An Exchange must provide for the establishment of a SHOP that...

  20. Standards-Driven Reform Years 1-10: Moderation an Optional Extra?

    ERIC Educational Resources Information Center

    Klenowski, Val; Wyatt-Smith, Claire

    2010-01-01

    While externally moderated standards-based assessment has been practised in Queensland senior schooling for more than three decades, there has been no such practice in the middle years. With the introduction of standards at state and national levels in these years, teacher judgement as developed in moderation practices is now vital. This paper…

  1. 48 CFR 53.105 - Computer generation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Data Interchange or a format that can be translated into one of those standards. (b) The standards listed in paragraph (a)(2) of this section may also be used for submission of data set forth in other..., content, or sequence of the data elements, and the form carries the Standard or Optional Form number and...

  2. 48 CFR 53.105 - Computer generation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Data Interchange or a format that can be translated into one of those standards. (b) The standards listed in paragraph (a)(2) of this section may also be used for submission of data set forth in other..., content, or sequence of the data elements, and the form carries the Standard or Optional Form number and...

  3. 48 CFR 53.105 - Computer generation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Data Interchange or a format that can be translated into one of those standards. (b) The standards listed in paragraph (a)(2) of this section may also be used for submission of data set forth in other..., content, or sequence of the data elements, and the form carries the Standard or Optional Form number and...

  4. Acceptance Factors Influencing Adoption of National Institute of Standards and Technology Information Security Standards: A Quantitative Study

    ERIC Educational Resources Information Center

    Kiriakou, Charles M.

    2012-01-01

    Adoption of a comprehensive information security governance model and security controls is the best option organizations may have to protect their information assets and comply with regulatory requirements. Understanding acceptance factors of the National Institute of Standards and Technology (NIST) Risk Management Framework (RMF) comprehensive…

  5. The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses

    PubMed Central

    Aurora, R. Nisha; Chowdhuri, Susmita; Ramar, Kannan; Bista, Sabin R.; Casey, Kenneth R.; Lamm, Carin I.; Kristo, David A.; Mallea, Jorge M.; Rowley, James A.; Zak, Rochelle S.; Tracy, Sharon L.

    2012-01-01

    The International Classification of Sleep Disorders, Second Edition (ICSD-2) distinguishes 5 subtypes of central sleep apnea syndromes (CSAS) in adults. Review of the literature suggests that there are two basic mechanisms that trigger central respiratory events: (1) post-hyperventilation central apnea, which may be triggered by a variety of clinical conditions, and (2) central apnea secondary to hypoventilation, which has been described with opioid use. The preponderance of evidence on the treatment of CSAS supports the use of continuous positive airway pressure (CPAP). Much of the evidence comes from investigations on CSAS related to congestive heart failure (CHF), but other subtypes of CSAS appear to respond to CPAP as well. Limited evidence is available to support alternative therapies in CSAS subtypes. The recommendations for treatment of CSAS are summarized as follows: CPAP therapy targeted to normalize the apnea-hypopnea index (AHI) is indicated for the initial treatment of CSAS related to CHF. (STANDARD)Nocturnal oxygen therapy is indicated for the treatment of CSAS related to CHF. (STANDARD)Adaptive Servo-Ventilation (ASV) targeted to normalize the apnea-hypopnea index (AHI) is indicated for the treatment of CSAS related to CHF. (STANDARD)BPAP therapy in a spontaneous timed (ST) mode targeted to normalize the apnea-hypopnea index (AHI) may be considered for the treatment of CSAS related to CHF only if there is no response to adequate trials of CPAP, ASV, and oxygen therapies. (OPTION)The following therapies have limited supporting evidence but may be considered for the treatment of CSAS related to CHF after optimization of standard medical therapy, if PAP therapy is not tolerated, and if accompanied by close clinical follow-up: acetazolamide and theophylline. (OPTION)Positive airway pressure therapy may be considered for the treatment of primary CSAS. (OPTION)Acetazolamide has limited supporting evidence but may be considered for the treatment of primary CSAS. (OPTION)The use of zolpidem and triazolam may be considered for the treatment of primary CSAS only if the patient does not have underlying risk factors for respiratory depression. (OPTION)The following possible treatment options for CSAS related to end-stage renal disease may be considered: CPAP, supplemental oxygen, bicarbonate buffer use during dialysis, and nocturnal dialysis. (OPTION) Citation: Aurora RN; Chowdhuri S; Ramar K; Bista SR; Casey KR; Lamm CI; Kristo DA; Mallea JM; Rowley JA; Zak RS; Tracy SL. The treatment of central sleep apnea syndromes in adults: practice parameters with an evidence-based literature review and meta-analyses. SLEEP 2012;35(1):17-40. PMID:22215916

  6. Performance Standards for Windows | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  7. 7 CFR 51.1416 - Optional determinations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT FRESH FRUITS, VEGETABLES AND OTHER PRODUCTS 1 2...

  8. 7 CFR 51.1416 - Optional determinations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT FRESH FRUITS, VEGETABLES AND OTHER PRODUCTS 1,2...

  9. 7 CFR 58.727 - Adding optional ingredients.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION...

  10. 7 CFR 58.727 - Adding optional ingredients.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION...

  11. Learning relative values in the striatum induces violations of normative decision making

    PubMed Central

    Klein, Tilmann A.; Ullsperger, Markus; Jocham, Gerhard

    2017-01-01

    To decide optimally between available options, organisms need to learn the values associated with these options. Reinforcement learning models offer a powerful explanation of how these values are learnt from experience. However, human choices often violate normative principles. We suggest that seemingly counterintuitive decisions may arise as a natural consequence of the learning mechanisms deployed by humans. Here, using fMRI and a novel behavioural task, we show that, when suddenly switched to novel choice contexts, participants’ choices are incongruent with values learnt by standard learning algorithms. Instead, behaviour is compatible with the decisions of an agent learning how good an option is relative to an option with which it had previously been paired. Striatal activity exhibits the characteristics of a prediction error used to update such relative option values. Our data suggest that choices can be biased by a tendency to learn option values with reference to the available alternatives. PMID:28631734

  12. Improved Fast Centralized Retransmission Scheme for High-Layer Functional Split in 5G Network

    NASA Astrophysics Data System (ADS)

    Xu, Sen; Hou, Meng; Fu, Yu; Bian, Honglian; Gao, Cheng

    2018-01-01

    In order to satisfy the varied 5G critical requirements and the virtualization of the RAN hardware, a two-level architecture for 5G RAN has been studied in 3GPP 5G SI stage. The performance of the PDCP-RLC split option and intra-RLC split option, two mainly concerned options for high layer functional split, exist an ongoing debate. This paper firstly gives an overview of CU-DU split study work in 3GPP. By the comparison of implementation complexity, the standardization impact and system performance, our evaluation result shows the PDCP-RLC split Option outperforms the intra-RLC split option. Aiming to how to reduce the retransmission delay during the intra-CU inter-DU handover, the mainly drawback of PDCP-RLC split option, this paper proposes an improved fast centralized retransmission solution with a low implementation complexity. Finally, system level simulations show that the PDCP-RLC split option with the proposed scheme can significantly improve the UE’s experience.

  13. 77 FR 57618 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-18

    ... Proposed Rule Change Relating to the Customer Rebate To Add Liquidity and Non-Customer Fees for Removing... routing standardized equity and index options. Specifically, NOM proposes to amend the Customer Rebate to Add Liquidity and Non-Customer Fees for Removing Liquidity in Penny Pilot \\3\\ Options. \\3\\ The Penny...

  14. 76 FR 71395 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... Exchange proposes to amend its Customer and Professional Routing Fees governing pricing for Exchange members using the Phlx XL II system,\\3\\ for routing standardized equity and index option Customer and...) (SR-Phlx-2009-32). The instant proposed fees will apply only to option orders entered into, and routed...

  15. 77 FR 3026 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... proposes to amend its Customer and Professional Routing Fees governing pricing for Exchange members using the Phlx XL II system,\\3\\ for routing standardized equity and index option Customer and Professional...-32). The instant proposed fees will apply only to option orders entered into, and routed by, the Phlx...

  16. 75 FR 48391 - Self-Regulatory Organizations; NASDAQ OMX PHLX, Inc.; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... system,\\3\\ for routing standardized equity and index option customer and professional orders to away... No. 59995 (May 28, 2009), 74 FR 26750 (June 3, 2009) (SR-Phlx-2009-32). The instant proposed fees... and executing customer and professional orders in equity and index options to away markets. In May...

  17. 7 CFR 51.3418 - Optional test for fry color.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Optional test for fry color. 51.3418 Section 51.3418... color. Fry color may be determined in accordance with contract specifications by using the Munsell Color...°F or 21/2 minutes at 375°F. 5 Munsell Color Standards for Frozen French Fried Potatoes, Third...

  18. 7 CFR 51.3418 - Optional test for fry color.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Optional test for fry color. 51.3418 Section 51.3418... color. Fry color may be determined in accordance with contract specifications by using the Munsell Color...°F or 21/2 minutes at 375°F. 5 Munsell Color Standards for Frozen French Fried Potatoes, Third...

  19. 78 FR 4526 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... securities, each with a unit of trading ten times lower than that of standard-sized option contracts, or 10... that are designed to ease the likelihood of any investor confusion. First, the premium multiplier for... the clarity of this approach is appropriate and transparent and the Exchange believes that the terms...

  20. 40 CFR 60.5408 - What is an optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... measuring hydrogen sulfide in acid gas-Tutwiler Procedure? 60.5408 Section 60.5408 Protection of Environment... § 60.5408 What is an optional procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure... of titrating hydrogen sulfide in a gas sample directly with a standard solution of iodine. (b...

  1. 40 CFR 60.5408 - What is an optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... measuring hydrogen sulfide in acid gas-Tutwiler Procedure? 60.5408 Section 60.5408 Protection of Environment... § 60.5408 What is an optional procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure... of titrating hydrogen sulfide in a gas sample directly with a standard solution of iodine. (b...

  2. 75 FR 34509 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... Commission staff to provide for uniform market- wide trading pause standards for certain individual stocks..., consistent with its existing rotation processes, the Exchange would accept opening-only orders during the... reopening, a rotation shall be held in the options on CBOE in accordance with Rule 6.2B, Hybrid Opening...

  3. Compliance Timeline, Compliance Options, and Required Notifications for Surface Coating of Wood Building Products National Emission Standards for Hazardous Air Pollutants (NESHAP)

    EPA Pesticide Factsheets

    This January 2005 document contains a diagram of dates and events for compliance with the NESHAP for surface coating of wood building products. Also on this page is a January 2005 document with flow charts to demonstrate compliance options for the NESHAP

  4. Exploring Options in Early Childhood Care in Singapore: Programs and Roles

    ERIC Educational Resources Information Center

    Zhang, Kaili C.

    2016-01-01

    Early childhood care options and practices differ around the world, as influenced by societal perspectives and needs. As early educators and policymakers around the world work to improve education and care services to better serve young children and their families, we must consider context-specific values and standards of quality to ensure early…

  5. 75 FR 11957 - Self-Regulatory Organizations; NASDAQ OMX PHLX, Inc.; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... system,\\3\\ for routing standardized equity and index option customer orders to away markets for execution... and index options to certain better-priced away markets. In May 2009, the Exchange adopted Rule 1080(m... the Exchange when orders are routed to these away markets. The Exchange is proposing a $.36...

  6. 48 CFR 22.404-12 - Labor standards for contracts containing construction requirements and option provisions that...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... contract price as a result of the incorporation of a new or revised wage determination at the exercise of... contracting officer may include in the contract a separately specified pricing method that permits an... term of the contract. At the time of option exercise, the contracting officer must incorporate a new...

  7. Test-Optional Admission Policies and Their Effect on the Composition of the Student Body at King's College

    ERIC Educational Resources Information Center

    Schmude, Michelle

    2011-01-01

    This study examined test-optional admission policies and their effect on the composition of the student body at King's College. According to the College Board (2009), students from underrepresented populations do not perform as well as White students on standardized tests. Therefore, higher education institutions have established test-optional…

  8. 7 CFR 51.3418 - Optional test for fry color.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Optional test for fry color. 51.3418 Section 51.3418... color. Fry color may be determined in accordance with contract specifications by using the Munsell Color...°F or 21/2 minutes at 375°F. 5 Munsell Color Standards for Frozen French Fried Potatoes, Third...

  9. Optimizing parameter choice for FSL-Brain Extraction Tool (BET) on 3D T1 images in multiple sclerosis.

    PubMed

    Popescu, V; Battaglini, M; Hoogstrate, W S; Verfaillie, S C J; Sluimer, I C; van Schijndel, R A; van Dijk, B W; Cover, K S; Knol, D L; Jenkinson, M; Barkhof, F; de Stefano, N; Vrenken, H

    2012-07-16

    Brain atrophy studies often use FSL-BET (Brain Extraction Tool) as the first step of image processing. Default BET does not always give satisfactory results on 3DT1 MR images, which negatively impacts atrophy measurements. Finding the right alternative BET settings can be a difficult and time-consuming task, which can introduce unwanted variability. To systematically analyze the performance of BET in images of MS patients by varying its parameters and options combinations, and quantitatively comparing its results to a manual gold standard. Images from 159 MS patients were selected from different MAGNIMS consortium centers, and 16 different 3DT1 acquisition protocols at 1.5 T or 3T. Before running BET, one of three pre-processing pipelines was applied: (1) no pre-processing, (2) removal of neck slices, or (3) additional N3 inhomogeneity correction. Then BET was applied, systematically varying the fractional intensity threshold (the "f" parameter) and with either one of the main BET options ("B" - bias field correction and neck cleanup, "R" - robust brain center estimation, or "S" - eye and optic nerve cleanup) or none. For comparison, intracranial cavity masks were manually created for all image volumes. FSL-FAST (FMRIB's Automated Segmentation Tool) tissue-type segmentation was run on all BET output images and on the image volumes masked with the manual intracranial cavity masks (thus creating the gold-standard tissue masks). The resulting brain tissue masks were quantitatively compared to the gold standard using Dice overlap coefficient (DOC). Normalized brain volumes (NBV) were calculated with SIENAX. NBV values obtained using for SIENAX other BET settings than default were compared to gold standard NBV with the paired t-test. The parameter/preprocessing/options combinations resulted in 20,988 BET runs. The median DOC for default BET (f=0.5, g=0) was 0.913 (range 0.321-0.977) across all 159 native scans. For all acquisition protocols, brain extraction was substantially improved for lower values of "f" than the default value. Using native images, optimum BET performance was observed for f=0.2 with option "B", giving median DOC=0.979 (range 0.867-0.994). Using neck removal before BET, optimum BET performance was observed for f=0.1 with option "B", giving median DOC 0.983 (range 0.844-0.996). Using the above BET-options for SIENAX instead of default, the NBV values obtained from images after neck removal with f=0.1 and option "B" did not differ statistically from NBV values obtained with gold-standard. Although default BET performs reasonably well on most 3DT1 images of MS patients, the performance can be improved substantially. The removal of the neck slices, either externally or within BET, has a marked positive effect on the brain extraction quality. BET option "B" with f=0.1 after removal of the neck slices seems to work best for all acquisition protocols. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. CYBER-205 Devectorizer

    NASA Technical Reports Server (NTRS)

    Lakeotes, Christopher D.

    1990-01-01

    DEVECT (CYBER-205 Devectorizer) is CYBER-205 FORTRAN source-language-preprocessor computer program reducing vector statements to standard FORTRAN. In addition, DEVECT has many other standard and optional features simplifying conversion of vector-processor programs for CYBER 200 to other computers. Written in FORTRAN IV.

  11. Comparison of High Performance Network Options: EDR InfiniBand vs.100Gb RDMA Capable Ethernet

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

    Kachelmeier, Luke Anthony; Van Wig, Faith Virginia; Erickson, Kari Natania

    These are the slides for a presentation at the HPC Mini Showcase. This is a comparison of two different high performance network options: EDR InfiniBand and 100Gb RDMA capable ethernet. The conclusion of this comparison is the following: there is good potential, as shown with the direct results; 100Gb technology is too new and not standardized, thus deployment effort is complex for both options; different companies are not necessarily compatible; if you want 100Gb/s, you must get it all from one place.

  12. Ankle arthritis: review of diagnosis and operative management.

    PubMed

    Grunfeld, Robert; Aydogan, Umur; Juliano, Paul

    2014-03-01

    The diagnostic and therapeutic options for ankle arthritis are reviewed. The current standard of care for nonoperative options include the use of nonsteroidal antiinflammatory drugs, corticosteroid injections, orthotics, and ankle braces. Other modalities lack high-quality research studies to delineate their appropriateness and effectiveness. The gold standard for operative intervention in end-stage degenerative arthritis remains arthrodesis, but evidence for the superiority in functional outcomes of total ankle arthroplasty is increasing. The next few years will enable more informed decisions and, with more prospective high-quality studies, the most appropriate patient population for total ankle arthroplasty can be identified. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Chapter 4- Fertility preservation in women with breast cancer

    PubMed Central

    Rodriguez-Wallberg, Kenny A.; Oktay, Kutluk

    2010-01-01

    Fertility preservation is an important issue for young women diagnosed with breast cancer. The most well-established options for fertility preservation in cancer patients, embryo and oocyte cryopreservation, have not been traditionally offered to breast cancer patients as estradiol rise during standard stimulation protocols may not be safe for those patients. Potentially safer stimulation protocols using tamoxifen and aromatase inhibitors induce lower levels of estradiol while similar results in terms of number of oocyte and embryo obtained to standard protocols. Cryopreservation of immature oocytes and ovarian cortical tissue, both still experimental methods, are also fertility preservation options for breast cancer patients. PMID:21048442

  14. La prévention de l’infection par le virus respiratoire syncytial

    PubMed Central

    Samson, L

    2009-01-01

    L’infection par le virus respiratoire syncytial (VRS) est la principale cause d’infection des voies respiratoires inférieures chez les jeunes enfants et pour cette raison, bon nombre des prématurés et des enfants présentant d’autres facteurs de risque doivent être hospitalisés chaque année au Canada. Le palivizumab, un anticorps monoclonal anti-VRS, peut réduire le taux d’hospitalisation et la gravité de la maladie d’un petit groupe de prématurés ou de nourrissons à haut risque pendant leur première saison de VRS. Le présent document de principes contient une analyse des publications ainsi que des recommandations à l’intention des médecins canadiens au sujet de son utilisation chez les prématurés et les autres nourrissons à risque.

  15. 25 CFR 547.16 - What are the minimum standards for game artwork, glass, and rules?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false What are the minimum standards for game artwork, glass... the minimum standards for game artwork, glass, and rules? (a) Rules, instructions, and prize schedules...: (1) Game name, rules, and options such as the purchase or wager amount stated clearly and...

  16. 25 CFR 547.16 - What are the minimum standards for game artwork, glass, and rules?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false What are the minimum standards for game artwork, glass... the minimum standards for game artwork, glass, and rules? (a) Rules, instructions, and prize schedules...: (1) Game name, rules, and options such as the purchase or wager amount stated clearly and...

  17. 45 CFR 155.705 - Functions of a SHOP.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.705 Functions of a SHOP. (a) Exchange...

  18. 45 CFR 155.715 - Eligibility determination process for SHOP.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....715 Section 155.715 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.715 Eligibility...

  19. 45 CFR 155.705 - Functions of a SHOP.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.705 Functions of a SHOP. (a) Exchange...

  20. 45 CFR 155.715 - Eligibility determination process for SHOP.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....715 Section 155.715 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.715 Eligibility...

  1. 14 CFR 1214.117 - Launch and orbit parameters for a standard launch.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) Launch at a time, selected by NASA, from a launch window of not less than 1 hour (a more restrictive launch window may be provided as an optional service). (b) For shared flights from KSC to the standard...

  2. 76 FR 35256 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-16

    ... Exchange proposes to amend its Customer Routing Fee governing pricing for Exchange members using the Phlx XL II system,\\3\\ for routing standardized equity and index option Customer orders to the C2 Options... Exchange Act Release No. 59995 (May 28, 2009), 74 FR 26750 (June 3, 2009) (SR-Phlx-2009-32). The instant...

  3. 75 FR 67798 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ...,\\3\\ for routing standardized equity and index option Customer and Professional orders to away markets.... 59995 (May 28, 2009), 74 FR 26750 (June 3, 2009) (SR-Phlx-2009-32). The instant proposed fees will apply... Customer and Professional orders in equity and index options to away markets. In May 2009, the Exchange...

  4. 77 FR 40928 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Order Granting Approval of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-11

    ..., thus there would be geographic diversity between the DRF and the main C2 trading system.\\9\\ The... listed and traded one ELO: SPXPM, which are Standard & Poor's 500 Index options with third- Friday-of-the-month expiration dates for which the exercise settlement value is based on the index value derived from...

  5. Rationalization and Student/School Personhood in U.S. College Admissions: The Rise of Test-Optional Policies, 1987 to 2015

    ERIC Educational Resources Information Center

    Furuta, Jared

    2017-01-01

    This article examines the rise of "test-optional" college admissions policies since the 1990s. I argue that the rationalization of college admissions policies after World War II contributed to the rise of "meritocratic" stratification (in policy) and standardized tests, like the SAT, but it also led to the expansion and…

  6. 78 FR 30944 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of an Advance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ... ``expiration time'' in Article I of OCC's By-Laws. \\7\\ Examples of options with Non-standard Expiration... its clearing members as well as its service bureaus and learned that a significant majority of those... proposes to amend the definition of ``expiration date'' in Article I and certain other articles of the By...

  7. Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

    PubMed Central

    Ramirez, Pedro T.; Pareja, Rene; Rendón, Gabriel J.; Millan, Carlos; Frumovitz, Michael; Schmeler, Kathleen M.

    2014-01-01

    The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies have explored less radical surgical options for early-stage cervical cancer, including simple hysterectomy, simple trachelectomy, and cervical conization with or without sentinel lymph node biopsy and pelvic lymph node dissection. Such options may be available for patients with low-risk early-stage cervical cancer. Criteria that define this low-risk group include: squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma, tumor size <2 cm, stromal invasion <10mm, and no lymph-vascular space invasion. In this report, we provide a review of the existing literature on the conservative management of cervical cancer and describe ongoing multi-institutional trials evaluating the role of conservative surgery in selected patients with early-stage cervical cancer. PMID:24041877

  8. The option value of innovative treatments for non-small cell lung cancer and renal cell carcinoma.

    PubMed

    Thornton Snider, Julia; Batt, Katharine; Wu, Yanyu; Tebeka, Mahlet Gizaw; Seabury, Seth

    2017-10-01

    To develop a model of the option value a therapy provides by enabling patients to live to see subsequent innovations and to apply the model to the case of nivolumab in renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC). A model of the option value of nivolumab in RCC and NSCLC was developed and estimated. Data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry and published clinical trial results were used to estimate survival curves for metastatic cancer patients with RCC, squamous NSCLC, or nonsquamous NSCLC. To estimate the conventional value of nivolumab, survival with the pre-nivolumab standard of care was compared with survival with nivolumab assuming no future innovation. To estimate the option value of nivolumab, long-term survival trends in RCC and squamous and nonsquamous NSCLC were measured in SEER to forecast mortality improvements that nivolumab patients may live to see. Compared with the previous standard of care, nivolumab extended life expectancy by 6.3 months in RCC, 7.5 months in squamous NSCLC, and 4.5 months in nonsquamous NSCLC, according to conventional methods. Accounting for expected future mortality trends, nivolumab patients are likely to gain an additional 1.2 months in RCC, 0.4 months in squamous NSCLC, and 0.5 months in nonsquamous NSCLC. These option values correspond to 18%, 5%, and 10% of the conventional value of nivolumab, respectively. Option value is important when valuing therapies like nivolumab that extend life in a rapidly evolving area of care.

  9. 45 CFR 155.725 - Enrollment periods under SHOP.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....725 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.725 Enrollment periods under SHOP. (a) General...

  10. 40 CFR 63.1505 - Emission standards for affected sources and emission units.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Emissions in excess of 0.023 grams (g) of PM per dry standard cubic meter (dscm) (0.010 grain (gr) of PM per dry standard cubic foot (dscf)); and (2) Visible emissions (VE) in excess of 10 percent opacity from... device if a COM is chosen as the monitoring option. (h) Rotary dross cooler. On and after the compliance...

  11. 40 CFR 63.1505 - Emission standards for affected sources and emission units.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Emissions in excess of 0.023 grams (g) of PM per dry standard cubic meter (dscm) (0.010 grain (gr) of PM per dry standard cubic foot (dscf)); and (2) Visible emissions (VE) in excess of 10 percent opacity from... device if a COM is chosen as the monitoring option. (h) Rotary dross cooler. On and after the compliance...

  12. Basic Materials for Electromagnetic Field Standards

    DTIC Science & Technology

    2003-03-04

    Stepanov. “Problem of population electromagnetic safety”. In- ternational Medical Congress “New technologies in medicine. National and interna- tional...Rubtcova N.B. Harmonization options EMF standards: proposals of Russian national committee on non-ionazing radiation protection (RNCNIRP). 3rd...international and national EMF standards of different countries as well as to evaluate the population health danger of electromag- netic fields of

  13. Multi-mesh gear dynamics program evaluation and enhancements

    NASA Technical Reports Server (NTRS)

    Boyd, L. S.; Pike, J.

    1985-01-01

    A multiple mesh gear dynamics computer program was continually developed and modified during the last four years. The program can handle epicyclic gear systems as well as single mesh systems with internal, buttress, or helical tooth forms. The following modifications were added under the current funding: variable contact friction, planet cage and ring gear rim flexibility options, user friendly options, dynamic side bands, a speed survey option and the combining of the single and multiple mesh options into one general program. The modified program was evaluated by comparing calculated values to published test data and to test data taken on a Hamilton Standard turboprop reduction gear-box. In general, the correlation between the test data and the analytical data is good.

  14. Mise à jour sur le nouveau vaccin 9-valent pour la prévention du virus du papillome humain

    PubMed Central

    Yang, David Yi; Bracken, Keyna

    2016-01-01

    Résumé Objectif Informer les médecins de famille quant à l’efficacité, à l’innocuité, aux effets sur la santé publique et à la rentabilité du vaccin 9-valent contre le virus du papillome humain (VPH). Qualité des données Des articles pertinents publiés dans PubMed jusqu’en mai 2015 ont été examinés et analysés. La plupart des données citées sont de niveau I (essais randomisés et contrôlés et méta-analyses) ou de niveau II (études transversales, cas-témoins et épidémiologiques). Des rapports et recommandations du gouvernement sont aussi cités en référence. Message principal Le vaccin 9-valent contre le VPH, qui offre une protection contre les types 6, 11, 16, 18, 31, 33, 45, 52 et 58 du VPH, est sûr et efficace et réduira encore plus l’incidence des infections à VPH, de même que les cas de cancer lié au VPH. Il peut également protéger indirectement les personnes non immunisées par l’entremise du phénomène d’immunité collective. Un programme d’immunisation efficace peut prévenir la plupart des cancers du col de l’utérus. Les analyses montrent que la rentabilité du vaccin 9-valent chez les femmes est comparable à celle du vaccin quadrivalent original contre le VPH (qui protège contre les types 6, 11, 16 et 18 du VPH) en usage à l’heure actuelle. Toutefois, il faut investiguer plus en profondeur l’utilité d’immuniser les garçons avec le vaccin 9-valent contre le VPH. Conclusion en plus d’être sûr, le vaccin 9-valent protège mieux contre le VPH que le vaccin quadrivalent. Une analyse coûtefficacité en favorise l’emploi, du moins chez les adolescentes. Ainsi, les médecins devraient recommander le vaccin 9-valent à leurs patients plutôt que le vaccin quadrivalent contre le VPH.

  15. Mise à jour technique sur la physiologie et l'évaluation du liquide amniotique.

    PubMed

    Lim, Kenneth I; Butt, Kimberly; Naud, Kentia; Smithies, Mila

    2017-01-01

    RéSULTATS: SOURCES DES DONNéES PROBANTES: Nous avons effectué une recherche sur MEDLINE et Kfinder pour trouver des articles pertinents, puis avons examiné les bibliographies des articles retenus, notamment des revues Cochrane et des articles de revue récents. Les données recueillies ont été analysées par le Comité d'imagerie diagnostique de la Société des obstétriciens et gynécologues du Canada. Les recommandations ont été classées selon les critères établis par le Groupe d'étude canadien sur les soins de santé préventifs (Tableau 1). AVANTAGES, DéSAVANTAGES ET COûTS: En obstétrique moderne, l'évaluation du volume de liquide amniotique par échographie fait partie intégrante de l'évaluation fœtale. Toute anomalie donne lieu à une intervention obstétricale et à des examens approfondis. Au Canada, il n'existe aucune définition normalisée associée à l'estimation du volume de liquide amniotique ni aucune approche d'évaluation uniforme. Plusieurs essais randomisés semblent indiquer que l'évaluation de poche unique, plutôt que de plusieurs poches (indice de liquide amniotique), diminue les interventions obstétricales sans augmenter l'incidence de résultats indésirables. La littérature récente laisse croire que des changements légers, mais détectables du liquide amniotique peuvent survenir une heure ou deux suivant des manœuvres physiologiques normales, ce qui pourrait expliquer la variabilité et le manque de cohérence des résultats d'évaluations répétées en peu de temps et ainsi créer de la confusion et donner lieu à d'autres examens. Le présent article vise à décrire les limites de l'évaluation du volume de liquide amniotique, à promouvoir une méthode d'évaluation normalisée et à proposer un ensemble commun de définitions. DéCLARATIONS SOMMAIRES: RECOMMANDATION. Copyright © 2017. Published by Elsevier Inc.

  16. Decision-Making in Healthy Children, Adolescents and Adults Explained by the Use of Increasingly Complex Proportional Reasoning Rules

    ERIC Educational Resources Information Center

    Huizenga, Hilde M.; Crone, Eveline A.; Jansen, Brenda J.

    2007-01-01

    In the standard Iowa Gambling Task (IGT), participants have to choose repeatedly from four options. Each option is characterized by a constant gain, and by the frequency and amount of a probabilistic loss. Crone and van der Molen (2004) reported that school-aged children and even adolescents show marked deficits in IGT performance. In this study,…

  17. 78 FR 22591 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-16

    ... comments on the proposed rule change from interested persons. \\1\\ 15 U.S.C. 78s(b)(1). \\2\\ 17 CFR 240.19b-4... applicable to simple orders in the options class under Exchange Rule 6.42--Minimum Increments of Bids and..., with the increment of trading being the standard trading increment applicable to simple orders in the...

  18. The use of subjective expert opinions in cost optimum design of aerospace structures. [probabilistic failure models

    NASA Technical Reports Server (NTRS)

    Thomas, J. M.; Hanagud, S.

    1975-01-01

    The results of two questionnaires sent to engineering experts are statistically analyzed and compared with objective data from Saturn V design and testing. Engineers were asked how likely it was for structural failure to occur at load increments above and below analysts' stress limit predictions. They were requested to estimate the relative probabilities of different failure causes, and of failure at each load increment given a specific cause. Three mathematical models are constructed based on the experts' assessment of causes. The experts' overall assessment of prediction strength fits the Saturn V data better than the models do, but a model test option (T-3) based on the overall assessment gives more design change likelihood to overstrength structures than does an older standard test option. T-3 compares unfavorably with the standard option in a cost optimum structural design problem. The report reflects a need for subjective data when objective data are unavailable.

  19. Public Access Workstations in the Library: New Trends.

    ERIC Educational Resources Information Center

    Beecher, Henry

    1991-01-01

    Discusses the use of microcomputer-based workstations that are provided for public access in libraries. Criteria for workstations are discussed, including standard hardware, open-design software, scalable interface, and connectivity options for networking; systems that provide full-text access are described; and the need for standards is…

  20. 45 CFR 155.720 - Enrollment of employees into QHPs under SHOP.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....720 Section 155.720 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.720 Enrollment of employees...

  1. 45 CFR 155.720 - Enrollment of employees into QHPs under SHOP.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....720 Section 155.720 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Exchange Functions: Small Business Health Options Program (SHOP) § 155.720 Enrollment of employees...

  2. Nonreconstruction Options for Treating Medial Ulnar Collateral Ligament Injuries of the Elbow in Overhead Athletes.

    PubMed

    Clark, Nicholas J; Desai, Vishal S; Dines, Joshua D; Morrey, Mark E; Camp, Christopher L

    2018-03-01

    This review aims to describe the nonreconstructive options for treating ulnar collateral ligament (UCL) injuries ranging from nonoperative measures, including physical therapy and biologic injections, to ligament repair with and without augmentation. Nonoperative options for UCL injuries include guided physical therapy and biologic augmentation with platelet-rich plasma (PRP). In some patients, repair of the UCL has shown promising return to sport rates by using modern suture and suture anchor techniques. Proximal avulsion injuries have shown the best results after repair. Currently, there is growing interest in augmentation of UCL repair with an internal brace. The treatment of UCL injuries involves complex decision making. UCL reconstruction remains the gold standard for attritional injuries and complete tears, which occur commonly in professional athletes. However, nonreconstructive options have shown promising results for simple avulsion or partial thickness UCL injuries. Future research comparing reconstructive versus nonreconstructive options is necessary.

  3. A DG approach to the numerical solution of the Stein-Stein stochastic volatility option pricing model

    NASA Astrophysics Data System (ADS)

    Hozman, J.; Tichý, T.

    2017-12-01

    Stochastic volatility models enable to capture the real world features of the options better than the classical Black-Scholes treatment. Here we focus on pricing of European-style options under the Stein-Stein stochastic volatility model when the option value depends on the time, on the price of the underlying asset and on the volatility as a function of a mean reverting Orstein-Uhlenbeck process. A standard mathematical approach to this model leads to the non-stationary second-order degenerate partial differential equation of two spatial variables completed by the system of boundary and terminal conditions. In order to improve the numerical valuation process for a such pricing equation, we propose a numerical technique based on the discontinuous Galerkin method and the Crank-Nicolson scheme. Finally, reference numerical experiments on real market data illustrate comprehensive empirical findings on options with stochastic volatility.

  4. Spacelab experiment computer study. Volume 1: Executive summary (presentation)

    NASA Technical Reports Server (NTRS)

    Lewis, J. L.; Hodges, B. C.; Christy, J. O.

    1976-01-01

    A quantitative cost for various Spacelab flight hardware configurations is provided along with varied software development options. A cost analysis of Spacelab computer hardware and software is presented. The cost study is discussed based on utilization of a central experiment computer with optional auxillary equipment. Groundrules and assumptions used in deriving the costing methods for all options in the Spacelab experiment study are presented. The groundrules and assumptions, are analysed and the options along with their cost considerations, are discussed. It is concluded that Spacelab program cost for software development and maintenance is independent of experimental hardware and software options, that distributed standard computer concept simplifies software integration without a significant increase in cost, and that decisions on flight computer hardware configurations should not be made until payload selection for a given mission and a detailed analysis of the mission requirements are completed.

  5. Relevé postnatal Rourke 2014

    PubMed Central

    Riverin, Bruno; Li, Patricia; Rourke, Leslie; Leduc, Denis; Rourke, James

    2015-01-01

    Résumé Objectif Mettre à jour la version de 2011 du Relevé postnatal Rourke (RPR) à la suite d’une révision des meilleures données probantes récentes sur le suivi de la santé des nourrissons et des enfants de la naissance jusqu’à l’âge de 5 ans. Qualité des données La qualité des données a été cotée en fonction de l’ancien système de classification du Groupe d’étude canadien sur les soins de santé préventifs (jusqu’à 2006) et l’approche de détermination, d’élaboration et d’évaluation des recommandations (GRADE). Message principal De nouveaux faits scientifiques ont été pris en compte dans les recommandations du RPR 2014 en ce qui a trait au suivi de la croissance, à la nutrition, à l’éducation et aux conseils, au développement, à l’examen physique et à l’immunisation. La croissance est surveillée à l’aide des courbes de l’Organisation mondiale de la Santé qui ont été révisées en 2014. On devrait introduire les aliments solides en fonction de l’état de préparation du nourrisson et ces produits devraient contenir du fer. Il n’est actuellement plus recommandé de retarder l’introduction des allergènes alimentaires courants pour prévenir les allergies. Il faut promouvoir l’utilisation d’une tasse sans couvercle au lieu d’une tasse à bec dès l’âge de 12 mois. La section sur l’éducation et les conseils porte sur les blessures causées par du mobilier instable, ainsi que l’utilisation d’un siège d’auto orienté vers l’arrière jusqu’à 2 ans. Elle comporte aussi de l’information sur les saines habitudes de sommeil, la prévention de la maltraitance des enfants, la vie saine et active et la sédentarité de la famille, de même que l’hygiène buccale. On a aussi ajouté à cette section une nouvelle catégorie consacrée à la santé environnementale pour tenir compte des effets des dangers environnementaux sur la santé des enfants. Le RPR a recours à une surveillance développementale globale pour reconnaître les enfants qui pourraient être à risque de retards de développement. La vérification de la mobilité de la langue et de la perméabilité de l’anus est incluse dans l’examen physique du premier bilan de santé du bébé. Le RPR présente aussi les mises à jour concernant le vaccin contre la rougeole, les oreillons et la rubéole, le vaccin atténué vivant contre la grippe et celui contre le virus du papillome humain. Conclusion Le RPR 2014 représente la mise à jour de l’outil d’application pratique des connaissances, fondé depuis longtemps sur des données probantes, accompagné de ses ressources connexes dans le web, à l’intention des professionnels de la santé et des parents pour les soins de santé préventifs durant la petite enfance. La Société canadienne de pédiatrie, le Collège des médecins de famille du Canada et Les diététistes du Canada ont donné leur aval au RPR 2014. Des versions nationales et adaptées à l’Ontario du RPR sont accessibles en français et en anglais.

  6. Study of a Secondary Power System Based on an Intermediate Bus Converter and POLs

    NASA Astrophysics Data System (ADS)

    Santoja, Almudena; Fernandez, Arturo; Tonicello, Ferdinando

    2014-08-01

    Secondary power systems in satellites are everything but standard nowadays. All sorts of options can be found and, in the end, a new custom design is used in most of the cases. Even though this might be interesting in some specific cases, for most of them it would be more convenient to have a straightforward system based on standard components. One of the options to achieve this is to design the secondary power system with an Intermediate Bus Converter (IBC) and Point of Load converters (POLs). This paper presents a study of this architecture and some experimental verifications to establish some basic rules devoted to achieve an optimum design of this system.

  7. Effectiveness of Standardized Patient Simulations in Teaching Clinical Communication Skills to Dental Students.

    PubMed

    McKenzie, Carly T; Tilashalski, Ken R; Peterson, Dawn Taylor; White, Marjorie Lee

    2017-10-01

    The aim of this study was to investigate dental students' long-term retention of clinical communication skills learned in a second-year standardized patient simulation at one U.S. dental school. Retention was measured by students' performance with an actual patient during their fourth year. The high-fidelity simulation exercise focused on clinical communication skills took place during the spring term of the students' second year. The effect of the simulation was measured by comparing the fourth-year clinical performance of two groups: those who had participated in the simulation (intervention group; Class of 2016) and those who had not (no intervention/control group; Class of 2015). In the no intervention group, all 47 students participated; in the intervention group, 58 of 59 students participated. Both instructor assessments and students' self-assessments were used to evaluate the effectiveness of key patient interaction principles as well as comprehensive presentation of multiple treatment options. The results showed that students in the intervention group more frequently included cost during their treatment option presentation than did students in the no intervention group. The instructor ratings showed that the intervention group included all key treatment option components except duration more frequently than did the no intervention group. However, the simulation experience did not result in significantly more effective student-patient clinical communication on any of the items measured. This study presents limited evidence of the effectiveness of a standardized patient simulation to improve dental students' long-term clinical communication skills with respect to thorough presentation of treatment options to a patient.

  8. Management of obstructive sleep apnea in the indigent population: a deviation of standard of care?

    PubMed

    Hamblin, John S; Sandulache, Vlad C; Alapat, Philip M; Takashima, Masayoshi

    2014-03-01

    Comprehensive management of patients with obstructive sleep apnea (OSA) typically is managed best via a multidisciplinary approach, involving otolaryngologists, sleep psychologists/psychiatrists, pulmonologists, neurologists, oral surgeons, and sleep trained dentists. By utilizing these resources, one could fashion a treatment individualized to the patient, giving rise to the holistic phrase of "personalized medicine." Unfortunately, in situations and environments with limited resources, the treatment options in an otolaryngologist's armamentarium are restricted--typically to continuous positive airway pressure (CPAP) versus sleep surgery. However, a recent patient encounter highlighted here shows how a hospital's reimbursement policy effectively dictated a patient's medical management to sleep surgery. This occurred although the current gold standard for the initial treatment of OSA is CPAP. Changing the course of medical/surgical management by selectively restricting funding is a cause of concern, especially when it promotes patients to choose a treatment option that is not considered the current standard of care.

  9. Dual mobility cups provide biomechanical advantages in situations at risk for dislocation: a finite element analysis.

    PubMed

    Terrier, Alexandre; Latypova, Adeliya; Guillemin, Maika; Parvex, Valérie; Guyen, Olivier

    2017-03-01

    Constrained devices, standard implants with large heads, and dual mobility systems have become popular options to manage instability after total hip arthroplasty (THA). Clinical results with these options have shown variable success rates and significant higher rates of aseptic loosening and mechanical failures with constrained implants. Literature suggests potential advantages of dual mobility, however little is known about its biomechanics. We present a comparative biomechanical study of a standard implant, a constrained implant, and a dual mobility system. A finite element analysis was developed to assess and compare these acetabular options with regard to the range of motion (ROM) to impingement, the angle of dislocation, the resistive torque, the volume of polyethylene (PE) with a stress above 80% of the elastic limit, and the interfacial cup/bone stress. Dual mobility implants provided the greatest ROM to impingement and allowed delaying subluxation and dislocation when compared to standard and constrained implants. Dual mobility also demonstrated the lowest resistive torque at subluxation while the constrained implant provided the greatest one. The lowest critical PE volume was observed with the dual mobility implant, and the highest stress at the interfaces was observed with the constrained implant. This study highlights the biomechanical advantages of dual mobility systems over constrained and standard implants, and is supported by the clinical results reported. Therefore, the use of dual mobility systems in situations at risk for instability should be advocated and constrained implants should be restricted to salvage situations.

  10. Enjeux de fin de vie dans les cas de démence avancée

    PubMed Central

    Arcand, Marcel

    2015-01-01

    Résumé Objectif Répondre aux questions souvent posées sur la prise en charge de la pneumonie en phase terminale, de l’apport nutritionnel insuffisant et de la déshydratation dans les cas de démence avancée. Sources des données Une recherche a été effectuée dans MEDLINE sur Ovid pour des articles pertinents publiés jusqu’en février 2015. Aucune étude de niveau I n’a été relevée; la plupart des articles fournissaient des preuves de niveaux III. Les suggestions en matière de prise en charge des symptômes s’appuient en partie sur une récente participation à une approche Delphi visant à concevoir une directive pour le soulagement optimal des symptômes chez les patients atteints de pneumonie et de démence. Message principal Les sondes d’alimentation ne sont pas recommandés chez les patients atteints de démence terminale. L’alimentation de confort manuelle est préférable. L’hydratation parentérale pourrait être utile, mais elle peut aussi contribuer à l’inconfort à la fin de la vie. Si les soins buccaux sont adéquats, l’abstention ou la cessation de l’alimentation et de l’hydratation artificielles ne sont généralement pas associées à des manifestations d’inconfort. Puisque la pneumonie est habituellement très inconfortable, les cliniciens doivent être attentifs à la maîtrise des symptômes. La sédation pour maîtriser l’agitation est souvent utile chez les patients atteints de démence terminale. Conclusion Les soins à visée symptomatique sont une option appropriée pour les manifestations terminales de la démence avancée. Les lignes directrices de prise en charge des symptômes proposées s’appuient sur une revue de la littérature et sur un consensus d’experts.

  11. Advancing non-directive pregnancy options counseling skills: A pilot Study on the use of blended learning with an online module and simulation.

    PubMed

    Lupi, Carla; Ward-Peterson, Melissa; Chang, Winnie

    2016-10-01

    Limitations on didactic time pose barriers to teaching non-directive pregnancy options counseling. This study set out to explore the use of an online module to support trainee performance in a pregnancy options counseling standardized-patient exercise implemented among third-year medical students, and to examine the effect of clinical experience on student performance. An online module was developed. A convenience sample of forty-six student performances in a family medicine clerkship participated in a standardized patient exercise. Trained faculty rated performances. Students completed a self-assessment and provided feedback on the online module. Chi-square and Mann-Whitney-U tests were used to analyze data. Three coders qualitatively examined narrative student comments. Thirty-four students passed, 11 achieved a minimal pass, and one failed. The mean global rating from faculty was 2.8 (pass). Students with prior clinical experience significantly outperformed those without on the global rating scale with mean scores of 3.1 compared to 2.7, respectively (p=.044). All students agreed that the online module helped prepare them for the exercise. Qualitative analysis of students' feedback on the module revealed strengths in content and pedagogy. In their self-assessments, all but two students referred to content explicitly conveyed in the module. All students agreed that an online module supported their performance of non-directive pregnancy options counseling skills. Prior clinical experience was associated with improved performance. This module, along with the simulated exercise, can be implemented as a blended learning exercise without additional faculty teaching effort in standardized patient resource centers. Students agreed that an online module facilitates simulated performance of non-directive pregnancy options counseling skills. Future work should compare the impact of this approach to others, and explore the additional training needed to maintain and build on initial learning. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. 7 CFR 58.336 - Frequency of sampling for quality control of cream, butter and related products.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... temperature of 72 °F. to establish and maintain a satisfactory keeping quality history. Optionally 98 °F. for...

  13. Using Data-Informed Instruction to Drive Education: Keeping Catholic Education a Viable and Educationally Sound Option in Challenging Times

    ERIC Educational Resources Information Center

    Niemeyer, Kristen; Casey, Laura B.; Williamson, Robert; Casey, Cort; Elswick, Susan E.; Black, Tom; Winsor, Denise

    2016-01-01

    Teachers in Catholic schools are not immune from pressures to improve students' scores on high stakes tests, and standards-based education is not new to Catholic schools. Nationally, many public school systems have moved to implement Common Core State Standards (CCSS) or other similar standards. Assessment, in turn, has been tied to these…

  14. Impact of Renewable Fuels Standard/MTBE Provisions of S. 1766

    EIA Publications

    2002-01-01

    This service report addresses the Renewable Fuels Standard (RFS)/methyl tertiary butyl ether (MTBE) provisions of S. 1766. The 'S. 1766' Case reflects provisions of S. 1766 including a renewable fuels standard (RFS) reaching five billion gallons by 2012, a complete phase-out of MTBE within four years, and the option for states to waive the oxygen requirement for reformulated gasoline (RFG).

  15. The development of a highly constrained health level 7 implementation guide to facilitate electronic laboratory reporting to ambulatory electronic health record systems.

    PubMed

    Sujansky, Walter V; Overhage, J Marc; Chang, Sophia; Frohlich, Jonah; Faus, Samuel A

    2009-01-01

    Electronic laboratory interfaces can significantly increase the value of ambulatory electronic health record (EHR) systems by providing laboratory result data automatically and in a computable form. However, many ambulatory EHRs cannot implement electronic laboratory interfaces despite the existence of messaging standards, such as Health Level 7, version 2 (HL7). Among several barriers to implementing laboratory interfaces is the extensive optionality within the HL7 message standard. This paper describes the rationale for and development of an HL7 implementation guide that seeks to eliminate most of the optionality inherent in HL7, but retain the information content required for reporting outpatient laboratory results. A work group of heterogeneous stakeholders developed the implementation guide based on a set of design principles that emphasized parsimony, practical requirements, and near-term adoption. The resulting implementation guide contains 93% fewer optional data elements than HL7. This guide was successfully implemented by 15 organizations during an initial testing phase and has been approved by the HL7 standards body as an implementation guide for outpatient laboratory reporting. Further testing is required to determine whether widespread adoption of the implementation guide by laboratories and EHR systems can facilitate the implementation of electronic laboratory interfaces.

  16. Framing Options as Choice or Opportunity: Does the Frame Influence Decisions?

    PubMed

    Abhyankar, Purva; Summers, Barbara A; Velikova, Galina; Bekker, Hilary L

    2014-07-01

    Health professionals must enable patients to make informed decisions about health care choices through unbiased presentation of all options. This study examined whether presenting the decision as "opportunity" rather than "choice" biased individuals' preferences in the context of trial participation for cancer treatment. Self-selecting healthy women (N = 124) were randomly assigned to the following decision frames: opportunity to take part in the trial (opt-in), opportunity to be removed from the trial (opt-out), and choice to have standard treatment or take part in the trial (choice). The computer-based task required women to make a hypothetical choice about a real-world cancer treatment trial. The software presented the framed scenario, recorded initial preference, presented comprehensive and balanced information, traced participants' use of information during decision making, and recorded final decision. A posttask paper questionnaire assessed perceived risk, attitudes, subjective norm, perceived behavioral control, and satisfaction with decision. Framing influenced women's immediate preferences. Opportunity frames, whether opt-in or opt-out, introduced a bias as they discouraged women from choosing standard treatment. Using the choice frame avoided this bias. The opt-out opportunity frame also affected women's perceived social norm; women felt that others endorsed the trial option. The framing bias was not present once participants had had the opportunity to view detailed information on the options within a patient decision aid format. There were no group differences in information acquisition and final decisions. Sixteen percent changed their initial preference after receiving full information. A "choice" frame, where all treatment options are explicit, is less likely to bias preferences. Presentation of full information in parallel, option-by-attribute format is likely to "de-bias" the decision frame. Tailoring of information to initial preferences would be ill-advised as preferences may change following detailed information. © The Author(s) 2014.

  17. California-Wyoming Grid Integration Study: Phase 1 -- Economic Analysis

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

    Corbus, D.; Hurlbut, D.; Schwabe, P.

    This study presents a comparative analysis of two different renewable energy options for the California energy market between 2017 and 2020: 12,000 GWh per year from new California in-state renewable energy resources; and 12,000 GWh per year from Wyoming wind delivered to the California marketplace. Either option would add to the California resources already existing or under construction, theoretically providing the last measure of power needed to meet (or to slightly exceed) the state's 33% renewable portfolio standard. Both options have discretely measurable differences in transmission costs, capital costs (due to the enabling of different generation portfolios), capacity values, andmore » production costs. The purpose of this study is to compare and contrast the two different options to provide additional insight for future planning.« less

  18. MIUS community conceptual design study

    NASA Technical Reports Server (NTRS)

    Fulbright, B. E.

    1976-01-01

    The feasibility, practicality, and applicability of the modular integrated utility systems (MIUS) concept to a satellite new-community development with a population of approximately 100,000 were analyzed. Two MIUS design options, the 29-MIUS-unit (option 1) and the 8-MIUS-unit (option 2) facilities were considered. Each resulted in considerable resource savings when compared to a conventional utility system. Economic analyses indicated that the total cash outlay and operations and maintenance costs for these two options were considerably less than for a conventional system. Computer analyses performed in support of this study provided corroborative data for the study group. An environmental impact assessment was performed to determine whether the MIUS meets or will meet necessary environmental standards. The MIUS can provide improved efficiency in the conservation of natural resources while not adversely affecting the physical environment.

  19. 49 CFR 268.11 - Project eligibility standards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MAGNETIC LEVITATION TRANSPORTATION TECHNOLOGY DEPLOYMENT PROGRAM... from the technology (e.g. energy consumption compared to other transportation options); generic noise...

  20. 49 CFR 268.11 - Project eligibility standards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MAGNETIC LEVITATION TRANSPORTATION TECHNOLOGY DEPLOYMENT PROGRAM... from the technology (e.g. energy consumption compared to other transportation options); generic noise...

  1. 49 CFR 268.11 - Project eligibility standards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MAGNETIC LEVITATION TRANSPORTATION TECHNOLOGY DEPLOYMENT PROGRAM... from the technology (e.g. energy consumption compared to other transportation options); generic noise...

  2. Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report.

    PubMed

    Morgenthaler, Timothy I; Lee-Chiong, Teofilo; Alessi, Cathy; Friedman, Leah; Aurora, R Nisha; Boehlecke, Brian; Brown, Terry; Chesson, Andrew L; Kapur, Vishesh; Maganti, Rama; Owens, Judith; Pancer, Jeffrey; Swick, Todd J; Zak, Rochelle

    2007-11-01

    The expanding science of circadian rhythm biology and a growing literature in human clinical research on circadian rhythm sleep disorders (CRSDs) prompted the American Academy of Sleep Medicine (AASM) to convene a task force of experts to write a review of this important topic. Due to the extensive nature of the disorders covered, the review was written in two sections. The first review paper, in addition to providing a general introduction to circadian biology, addresses "exogenous" circadian rhythm sleep disorders, including shift work disorder (SWD) and jet lag disorder (JLD). The second review paper addresses the "endogenous" circadian rhythm sleep disorders, including advanced sleep phase disorder (ASPD), delayed sleep phase disorder (DSPD), irregular sleep-wake rhythm (ISWR), and the non-24-hour sleep-wake syndrome (nonentrained type) or free-running disorder (FRD). These practice parameters were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the AASM to present recommendations for the assessment and treatment of CRSDs based on the two accompanying comprehensive reviews. The main diagnostic tools considered include sleep logs, actigraphy, the Morningness-Eveningness Questionnaire (MEQ), circadian phase markers, and polysomnography. Use of a sleep log or diary is indicated in the assessment of patients with a suspected circadian rhythm sleep disorder (Guideline). Actigraphy is indicated to assist in evaluation of patients suspected of circadian rhythm disorders (strength of recommendation varies from "Option" to "Guideline," depending on the suspected CRSD). Polysomnography is not routinely indicated for the diagnosis of CRSDs, but may be indicated to rule out another primary sleep disorder (Standard). There is insufficient evidence to justify the use of MEQ for the routine clinical evaluation of CRSDs (Option). Circadian phase markers are useful to determine circadian phase and confirm the diagnosis of FRD in sighted and unsighted patients but there is insufficient evidence to recommend their routine use in the diagnosis of SWD, JLD, ASPD, DSPD, or ISWR (Option). Additionally, actigraphy is useful as an outcome measure in evaluating the response to treatment for CRSDs (Guideline). A range of therapeutic interventions were considered including planned sleep schedules, timed light exposure, timed melatonin doses, hypnotics, stimulants, and alerting agents. Planned or prescribed sleep schedules are indicated in SWD (Standard) and in JLD, DSPD, ASPD, ISWR (excluding elderly-demented/nursing home residents), and FRD (Option). Specifically dosed and timed light exposure is indicated for each of the circadian disorders with variable success (Option). Timed melatonin administration is indicated for JLD (Standard); SWD, DSPD, and FRD in unsighted persons (Guideline); and for ASPD, FRD in sighted individuals, and for ISWR in children with moderate to severe psychomotor retardation (Option). Hypnotic medications may be indicated to promote or improve daytime sleep among night shift workers (Guideline) and to treat jet lag-induced insomnia (Option). Stimulants may be indicated to improve alertness in JLD and SWD (Option) but may have risks that must be weighed prior to use. Modafinil may be indicated to improve alertness during the night shift for patients with SWD (Guideline).

  3. Roadmap for Testing and Validation of Electric Vehicle Communication Standards

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

    Pratt, Richard M.; Tuffner, Francis K.; Gowri, Krishnan

    Vehicle to grid communication standards are critical to the charge management and interoperability among plug-in electric vehicles (PEVs), charging stations and utility providers. The Society of Automobile Engineers (SAE), International Organization for Standardization (ISO), International Electrotechnical Commission (IEC) and the ZigBee Alliance are developing requirements for communication messages and protocols. While interoperability standards development has been in progress for more than two years, no definitive guidelines are available for the automobile manufacturers, charging station manufacturers or utility backhaul network systems. At present, there is a wide range of proprietary communication options developed and supported in the industry. Recent work bymore » the Electric Power Research Institute (EPRI), in collaboration with SAE and automobile manufacturers, has identified performance requirements and developed a test plan based on possible communication pathways using power line communication (PLC). Though the communication pathways and power line communication technology options are identified, much work needs to be done in developing application software and testing of communication modules before these can be deployed in production vehicles. This paper presents a roadmap and results from testing power line communication modules developed to meet the requirements of SAE J2847/1 standard.« less

  4. All of the above: When multiple correct response options enhance the testing effect.

    PubMed

    Bishara, Anthony J; Lanzo, Lauren A

    2015-01-01

    Previous research has shown that multiple choice tests often improve memory retention. However, the presence of incorrect lures often attenuates this memory benefit. The current research examined the effects of "all of the above" (AOTA) options. When such options are correct, no incorrect lures are present. In the first three experiments, a correct AOTA option on an initial test led to a larger memory benefit than no test and standard multiple choice test conditions. The benefits of a correct AOTA option occurred even without feedback on the initial test; for both 5-minute and 48-hour retention delays; and for both cued recall and multiple choice final test formats. In the final experiment, an AOTA question led to better memory retention than did a control condition that had identical timing and exposure to response options. However, the benefits relative to this control condition were similar regardless of the type of multiple choice test (AOTA or not). Results suggest that retrieval contributes to multiple choice testing effects. However, the extra testing effect from a correct AOTA option, rather than being due to more retrieval, might be due simply to more exposure to correct information.

  5. A Protocol-Based Decision for Choosing a Proper Surgical Treatment Option for Carotid Artery Stenosis.

    PubMed

    Jang, E-Wook; Chung, Joonho; Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Lee, Kyung-Yul

    2015-06-01

    There are two established surgical treatment options for carotid artery stenosis. Carotid endarterectomy (CEA) has been accepted as a gold standard for surgical treatment while carotid artery stenting (CAS) has recently become an alternative option. Each treatment option has advantages and disadvantages for the treatment outcomes. We propose a protocol for selection of a proper surgical treatment option for carotid artery stenosis. A total of 192 published articles on management of carotid artery stenosis were reviewed. Preoperatively considerable factors which had been repeatedly noted in those articles for the risk/benefits of CEA or CAS were selected. According to those factors, a protocol with four categories was established. CEA or CAS is indicated when the patient has a symptomatic stenosis ≥ 50%, or when the patient has an asymptomatic stenosis ≥ 80%. Each treatment option has absolute indications and favorable indications. Each absolute indication is scored with three points, and each favorable indication, one point. Based on the highest scores, a proper treatment option (CEA or CAS) is selected. We have been treating patients according to this protocol and evaluating the outcomes of our protocol-based decision because this protocol might be helpful in assessment of risk/benefit for selection of a proper surgical treatment option in patients with carotid artery stenosis.

  6. A Delphi study and ranking exercise to support commissioning services: future delivery of Thrombectomy services in England.

    PubMed

    Halvorsrud, Kristoffer; Flynn, Darren; Ford, Gary A; McMeekin, Peter; Bhalla, Ajay; Balami, Joyce; Craig, Dawn; White, Phil

    2018-02-22

    Intra-arterial thrombectomy is the gold standard treatment for large artery occlusive stroke. However, the evidence of its benefits is almost entirely based on trials delivered by experienced neurointerventionists working in established teams in neuroscience centres. Those responsible for the design and prospective reconfiguration of services need access to a comprehensive and complementary array of information on which to base their decisions. This will help to ensure the demonstrated effects from trials may be realised in practice and account for regional/local variations in resources and skill-sets. One approach to elucidate the implementation preferences and considerations of key experts is a Delphi survey. In order to support commissioning decisions, we aimed using an electronic Delphi survey to establish consensus on the options for future organisation of thrombectomy services among physicians with clinical experience in managing large artery occlusive stroke. A Delphi survey was developed with 12 options for future organisation of thrombectomy services in England. A purposive sampling strategy established an expert panel of stroke physicians from the British Association of Stroke Physicians (BASP) Clinical Standards and/or Executive Membership that deliver 24/7 intravenous thrombolysis. Options with aggregate scores falling within the lowest quartile were removed from the subsequent Delphi round. Options reaching consensus following the two Delphi rounds were then ranked in a final exercise by both the wider BASP membership and the British Society of Neuroradiologists (BSNR). Eleven stroke physicians from BASP completed the initial two Delphi rounds. Three options achieved consensus, with subsequently wider BASP (97%, n = 43) and BSNR members (86%, n = 21) assigning the highest approval rankings in the final exercise for transferring large artery occlusive stroke patients to nearest neuroscience centre for thrombectomy based on local CT/CT Angiography. The initial Delphi rounds ensured optimal reduction of options by an expert panel of stroke physicians, while subsequent ranking exercises allowed remaining options to be ranked by a wider group of experts within stroke to reach consensus. The preferred implementation option for thrombectomy is investigating suspected acute stroke patients by CT/CT Angiography and secondary transfer of large artery occlusive stroke patients to the nearest neuroscience (thrombectomy) centre.

  7. Electric Vehicle Communication Standards Testing and Validation Phase I: SAE J2847/1

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

    Pratt, Richard M.; Tuffner, Francis K.; Gowri, Krishnan

    Executive Summary Vehicle to grid communication standards are critical to the charge management and interoperability among vehicles, charging stations and utility providers. Several standards initiatives by the Society of Automobile Engineers (SAE), International Standards Organization and International Electrotechnical Commission (ISO/IEC), and ZigBee / HomePlug Alliance are developing requirements for communication messages and protocols. While the standard development is in progress for more than two years, no definitive guidelines are available for the automobile manufacturers, charging station manufacturers and utility backhaul network systems. At present, there is a wide range of proprietary communication options developed and supported in the industry. Recentmore » work by the Electric Power Research Institute (EPRI) in collaboration with SAE and automobile manufacturers has identified performance requirements and test plan based on possible communication pathways using power line communication over the control pilot and mains. Though the communication pathways and power line communication technology options are identified, much work needs to be done in developing application software and testing of communication modules before these can be deployed in production vehicles. This report presents a test plan and results from initial testing of two power line communication modules developed to meet the requirements of SAE J2847/1 standard.« less

  8. Standard spacecraft economic analysis. Volume 2: Findings and conclusions

    NASA Technical Reports Server (NTRS)

    Harris, E. D.; Large, J. P.

    1976-01-01

    The comparative program costs associated with use of various standardized spacecraft for Air Force space test program missions to be flown on the space shuttle were studied in two phases. In the first phase, a variety of procurement mixes composed of existing or programmed NASA standard spacecraft designs and an Air Force standard spacecraft design were considered. The second phase dealt with additional procurement options using an upgraded version of an existing NASA design. The results of both phases are discussed.

  9. GMSEC Interface Specification Document 2016 March

    NASA Technical Reports Server (NTRS)

    Handy, Matthew

    2016-01-01

    The GMSEC Interface Specification Document contains the standard set of defined messages. Each GMSEC standard message contains a GMSEC Information Bus Header section and a Message Contents section. Each message section identifies required fields, optional fields, data type and recommended use of the fields. Additionally, this document includes the message subjects associated with the standard messages. The system design of the operations center should ensure the components that are selected use both the API and the defined standard messages in order to achieve full interoperability from component to component.

  10. Option pricing: Stock price, stock velocity and the acceleration Lagrangian

    NASA Astrophysics Data System (ADS)

    Baaquie, Belal E.; Du, Xin; Bhanap, Jitendra

    2014-12-01

    The industry standard Black-Scholes option pricing formula is based on the current value of the underlying security and other fixed parameters of the model. The Black-Scholes formula, with a fixed volatility, cannot match the market's option price; instead, it has come to be used as a formula for generating the option price, once the so called implied volatility of the option is provided as additional input. The implied volatility not only is an entire surface, depending on the strike price and maturity of the option, but also depends on calendar time, changing from day to day. The point of view adopted in this paper is that the instantaneous rate of return of the security carries part of the information that is provided by implied volatility, and with a few (time-independent) parameters required for a complete pricing formula. An option pricing formula is developed that is based on knowing the value of both the current price and rate of return of the underlying security which in physics is called velocity. Using an acceleration Lagrangian model based on the formalism of quantum mathematics, we derive the pricing formula for European call options. The implied volatility of the market can be generated by our pricing formula. Our option price is applied to foreign exchange rates and equities and the accuracy is compared with Black-Scholes pricing formula and with the market price.

  11. 76 FR 57745 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... Information Collection: Standardized Pharmacy Notice: Your Prescription Cannot be Filled (f/k/a Medicare... eliminate the previously available option of posting the standardized notice at the pharmacy. Revised 423.562(a)(3) and an associated regulatory provision at Sec. 423.128(b)(7)(iii) require the pharmacy to...

  12. 40 CFR 63.8236 - How do I demonstrate initial compliance with the emission limitations and work practice standards?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...). (2) You choose the continuous cell room monitoring program option, you certify in your Notification... Hazardous Air Pollutants: Mercury Emissions From Mercury Cell Chlor-Alkali Plants Initial Compliance... standards? (a) For each mercury cell chlor-alkali production facility, you have demonstrated initial...

  13. 78 FR 71731 - 2014 Standards for the Renewable Fuel Standard Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... of E85 Consumption c. Proposed Projection of E85 Consumption in 2014 d. Estimating Total Ethanol Consumption in 2014 2. Estimating Availability of Non-Ethanol Renewable Fuel Volumes a. Non-Ethanol Cellulosic... Biofuel c. Option 3: Availability, Growth, and Limits on Ethanol Consumption D. Summary of Proposed Volume...

  14. Now What? Imperatives & Options for "Common Core" Implementation & Governance

    ERIC Educational Resources Information Center

    Finn, Chester E., Jr.; Petrilli, Michael J.

    2010-01-01

    Over the past year, the nation's governors and state school chiefs have achieved laudable consensus around a set of math and English standards, developed voluntarily and without federal involvement through the Common Core State Standards Initiative (CCSSI). Most states have signed on to them. More recently, the states have again teamed up--this…

  15. 76 FR 15903 - Federal Motor Vehicle Safety Standards; Roof Crush Resistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... documents in that rulemaking, NHTSA discussed the history of issues related to the certification of vehicles... thought a proposed option for certain multi-stage vehicles to meet the requirements of FMVSS No. 220... rule that upgraded the agency's safety standard on roof crush resistance. The petition was submitted by...

  16. Higher Education Standards Panel: Consultation on the Transparency of Higher Education Admissions Processes

    ERIC Educational Resources Information Center

    Australian Government Department of Education and Training, 2016

    2016-01-01

    This document is the result of the Australian Minister for Education and Training's request to the Higher Education Standards Panel for advisement of options to improve the transparency of higher education student admission policies, while minimizing regulatory impact. The Minister intends to improve the accessibility and comparability of…

  17. Design Options for Multimodal Web Applications

    NASA Astrophysics Data System (ADS)

    Stanciulescu, Adrian; Vanderdonckt, Jean

    The capabilities of multimodal applications running on the web are well de-lineated since they are mainly constrained by what their underlying standard mark up language offers, as opposed to hand-made multimodal applications. As the experience in developing such multimodal web applications is growing, the need arises to identify and define major design options of such application to pave the way to a structured development life cycle. This paper provides a design space of independent design options for multimodal web applications based on three types of modalities: graphical, vocal, tactile, and combined. On the one hand, these design options may provide designers with some explicit guidance on what to decide or not for their future user interface, while exploring various design alternatives. On the other hand, these design options have been implemented as graph transformations per-formed on a user interface model represented as a graph. Thanks to a transformation engine, it allows designers to play with the different values of each design option, to preview the results of the transformation, and to obtain the corresponding code on-demand

  18. When Middle Really Means "Top" or "Bottom": An Analysis of the 16PF5 Using Bock's Nominal Response Model.

    PubMed

    Murray, Aja Louise; Booth, Tom; Molenaar, Dylan

    2016-01-01

    When self-report items with a Likert-type scale include a middle response option (e.g., Unsure, Neither agree nor disagree, or ?), this middle option is assumed to measure a level of the trait intermediate between the high and low response categories. In this study, we tested this assumption in the 16 Personality Factor Questionnaire, Version 5 (16PF5) by fitting Bock's nominal response model in the U.S. and UK standardization samples of the 16PF5. We found that in many cases, the middle option was indicative of higher levels of the latent trait than the ostensibly highest response option. In certain other cases, it was indicative of lower levels of the latent trait than the ostensibly lowest response option. This undermines the use of a simple successive integer scoring scheme where responses in adjacent response categories are assigned scores of 0, 1, and 2. Recommendations for alternative scoring schemes are provided. Results also suggested that certain personality traits, especially neurotic traits, are associated with a tendency toward selecting the middle option.

  19. Pricing Employee Stock Options (ESOs) with Random Lattice

    NASA Astrophysics Data System (ADS)

    Chendra, E.; Chin, L.; Sukmana, A.

    2018-04-01

    Employee Stock Options (ESOs) are stock options granted by companies to their employees. Unlike standard options that can be traded by typical institutional or individual investors, employees cannot sell or transfer their ESOs to other investors. The sale restrictions may induce the ESO’s holder to exercise them earlier. In much cited paper, Hull and White propose a binomial lattice in valuing ESOs which assumes that employees will exercise voluntarily their ESOs if the stock price reaches a horizontal psychological barrier. Due to nonlinearity errors, the numerical pricing results oscillate significantly so they may lead to large pricing errors. In this paper, we use the random lattice method to price the Hull-White ESOs model. This method can reduce the nonlinearity error by aligning a layer of nodes of the random lattice with a psychological barrier.

  20. Cone beam volume tomography: an imaging option for diagnosis of complex mandibular third molar anatomical relationships.

    PubMed

    Danforth, Robert A; Peck, Jerry; Hall, Paul

    2003-11-01

    Complex impacted third molars present potential treatment complications and possible patient morbidity. Objectives of diagnostic imaging are to facilitate diagnosis, decision making, and enhance treatment outcomes. As cases become more complex, advanced multiplane imaging methods allowing for a 3-D view are more likely to meet these objectives than traditional 2-D radiography. Until recently, advanced imaging options were somewhat limited to standard film tomography or medical CT, but development of cone beam volume tomography (CBVT) multiplane 3-D imaging systems specifically for dental use now provides an alternative imaging option. Two cases were utilized to compare the role of CBVT to these other imaging options and to illustrate how multiplane visualization can assist the pretreatment evaluation and decision-making process for complex impacted mandibular third molar cases.

  1. For the last time: stock options are an expense.

    PubMed

    Bodie, Zvi; Kaplan, Robert S; Merton, Robert C

    2003-03-01

    Should stock options be recorded as an expense on a company's income statement and balance sheet, or should they remain where they are, relegated to footnotes? The extraordinary boom in share prices during the Internet bubble made critics of option expensing look like spoilsports. But since the crash, the debate has returned with a vengeance. And no wonder: The authors believe the case for expensing options is overwhelming. In this article, Nobel Iaureate Robert Merton, one of the inventors of the Black-Scholes option-pricing model; his coauthor on the classic textbook Finance, Zvi Bodie; and Robert Kaplan, creator of the Balanced Scorecard, examine and dismiss the principal claims put forward by those who continue to oppose options expensing. They demonstrate that stock-option grants do indeed have real cash-flow implications that need to be reported. They show that effective ways certainly exist to quantify those implications. They detail the distortions that relegating stock-option accounting to footnotes creates. And they show why reporting option costs should in no way hamper young companies in their efforts to provide incentives. Options are indeed a powerful incentive, the authors agree, and failing to record a transaction that creates such powerful effects is economically indefensible. Worse, it encourages companies to favor options over alternative incentive systems. It is not the proper role of accounting standards, the authors argue, to distort executive and employee compensation by subsidizing one particular form of compensation and no other. Companies should choose compensation methods according to their economic benefits--not the way they are reported.

  2. The challenge of Propionibacterium acnes and revision shoulder arthroplasty: a review of current diagnostic options.

    PubMed

    Shields, Margaret V; Abdullah, Leath; Namdari, Surena

    2016-06-01

    Propionibacterium acnes is the most common cause of infection after shoulder arthroplasty. Whereas there are several methods that can aid in the diagnosis of P. acnes infection, there is not a single "gold standard" because of the difficulties inherent in identifying this bacterium. We present an evidence-based discussion of the demographic, clinical, and radiographic predictors of P. acnes infection and review the current options for diagnosis. This review was written after a comprehensive analysis of the current literature related to shoulder periprosthetic joint infection and P. acnes identification. Of the techniques reviewed, α-defensin had the highest sensitivity in detecting P. acnes infection (63%). C-reactive protein level and erythrocyte sedimentation rate were often normal in cases of infection. Whereas P. acnes can be challenging to successfully diagnose, there are several options that are considered preferable because of their higher sensitivities and specificities. The current gold standard is intraoperative culture, but major advances in molecular techniques may provide future improvements in diagnostic accuracy. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. Transputer parallel processing at NASA Lewis Research Center

    NASA Technical Reports Server (NTRS)

    Ellis, Graham K.

    1989-01-01

    The transputer parallel processing lab at NASA Lewis Research Center (LeRC) consists of 69 processors (transputers) that can be connected into various networks for use in general purpose concurrent processing applications. The main goal of the lab is to develop concurrent scientific and engineering application programs that will take advantage of the computational speed increases available on a parallel processor over the traditional sequential processor. Current research involves the development of basic programming tools. These tools will help standardize program interfaces to specific hardware by providing a set of common libraries for applications programmers. The thrust of the current effort is in developing a set of tools for graphics rendering/animation. The applications programmer currently has two options for on-screen plotting. One option can be used for static graphics displays and the other can be used for animated motion. The option for static display involves the use of 2-D graphics primitives that can be called from within an application program. These routines perform the standard 2-D geometric graphics operations in real-coordinate space as well as allowing multiple windows on a single screen.

  4. Dyadic OPTION: Measuring perceptions of shared decision-making in practice.

    PubMed

    Melbourne, Emma; Roberts, Stephen; Durand, Marie-Anne; Newcombe, Robert; Légaré, France; Elwyn, Glyn

    2011-04-01

    Current models of the medical consultation emphasize shared decision-making (SDM), whereby the expertise of both the doctor and the patient are recognised and seen to equally contribute to the consultation. The evidence regarding the desirability and effectiveness of the SDM approach is often conflicting. It is proposed that the conflicts are due to the nature of assessment, with current assessments from the perspective of an outside observer. To empirically assess perceived involvement in the medical consultation using the dyadic OPTION instrument. 36 simulated medical consultations were organised between general practitioners and standardized- patients, using the observer OPTION and the newly developed dyadic OPTION instruments. SDM behaviours observed in the consultations were seen to depend on both members of the doctor and patient dyad, rather than each in isolation. Thus a dyadic approach to measurement is supported. This current study highlights the necessity for a dyadic approach to assessment and introduces a novel research instrument: the dyadic OPTION instrument. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Green Building Standards

    EPA Pesticide Factsheets

    Many organizations have developed model codes or rating systems that communities may use to develop green building programs or revise building ordinances. Some of the major options are listed on this page.

  6. Présentation d'une formule pratique d'estimation de l'évaporation potentielle, conforme aux nouvelles recommandations internationales

    NASA Astrophysics Data System (ADS)

    Lhomme, J. P.; Monteny, B.

    1982-03-01

    This paper begins to recall new concepts concerning evapotranspiration as they have been specified by the round-table conference of Budapest in May 1977. The potential evaporation ( EP) is now defined as the evaporation of a crop whose all exchange surfaces (leaves, stalks,...) are saturated, i.e., covered with a thin film of water. It can be calculated by a theoretical formula of Penman type. We give the reasons why it is interesting to use grass potential evaporation ( EP g ) as reference. The empirical relationships to estimate in this case the net radiation and the aerodynamic component of the formula have been derived from measurements made in Ivory Coast (West Africa). The relationship (8) has been obtained. It gives the daily value of EP g in millimeters of water per day (mm/d). The values calculated by this formula are compared to measurements of grass maximal evapotranspiration ( ETM g ).

  7. CONCLUSIONS ET RECOMMANDATIONS À L’ISSUE DE LA CONSULTATION DE L’OMS SUR LA LUTTE CONTRE LA CARENCE MARTIALE CHEZ LE NOURRISSON ET LE JEUNE ENFANT DANS LES PAYS D’ENDÉMIE PALUSTRE

    PubMed Central

    Allen, L.; Black, R.E.; Brandes, N.; Brittenham, G.; Chazot, G.; Chunming, C.; Crawley, J.; de Benoist, B.; Dalmiya, N.; Darnton-Hill, I.; Dewey, K.; El-Arifeen, S.; Fontaine, O.; Geissler, C.; Haberle, H.; Harvey, P.; Hasler, J.; Hershko, C.; Hurrell, R.; Juma, M.A.; Lönnerdal, B.; Lozoff, B.; Lynch, S.; Salgado, H. Martines; McLean, E.; Metz, J.; Oppenheimer, S.; Premji, Z.; Prentice, A.; Ramsan, M.; Ratledge, C.; Stoltzfus, R.; Tielsch, J.; Winachagoon, P.

    2011-01-01

    Cet article présentent les résultats d'une Consultation d'Experts dont l'objectif était d'évaluer l'efficacité et l'innocuité des suppléments de fer administrés aux nourrissons et aux jeunes enfants dans les zones d’endémie palustre, ainsi que les conséquences d’une telle mesure pour la santé publique. Les participants à cette Consultation, qui s’est déroulée à Lyon (France) les 12–14 juin 2006, se sont entendus sur plusieurs questions importantes concernant l’administration d’une supplémentation martiale aux nourrissons et aux jeunes enfants dans les zones d’endémie palustre. Les conclusions du présent rapport s’appliquent plus particulièrement aux pays où le paludisme est endémique. PMID:18630054

  8. Principles, Standards, and Procedures for the Accreditation of School Districts. [and] A List of Supplemental Resources.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Prior to the enactment of House Bill 1126 (sixty-fourth Texas legislature) accreditation was optional for local districts. That statute now requires that each local district be accredited in order to receive financial support from the state. This booklet presents a compendium of principles, standards, and indicators that address school…

  9. Characteristics of States' Alternate Assessments Based on Modified Academic Achievement Standards in 2008. Synthesis Report 72

    ERIC Educational Resources Information Center

    Albus, Deb; Lazarus, Sheryl S.; Thurlow, Martha L.; Cormier, Damien

    2009-01-01

    In April 2007, Federal No Child Left Behind regulations were finalized that provided states with additional flexibility for assessing some students with disabilities. The regulations allowed states to offer another assessment option, alternate assessments based on modified academic achievement standards (AA-MAS). States are not required to have…

  10. Comparison of test protocols for standard room/corner tests

    Treesearch

    R. H. White; M. A. Dietenberger; H. Tran; O. Grexa; L. Richardson; K. Sumathipala; M. Janssens

    1998-01-01

    As part of international efforts to evaluate alternative reaction-to-fire tests, several series of room/comer tests have been conducted. This paper reviews the overall results of related projects in which different test protocols for standard room/corner tests were used. Differences in the test protocols involved two options for the ignition burner scenario and whether...

  11. 49 CFR 571.202 - Standard No. 202; Head restraints; Applicable at the manufacturers option until September 1, 2009.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... seat back; or, (ii) Application of a load of 890N. S4.3[Reserved] S4.4.Except for school buses, a head... comply with, at the manufacturer's option, S4.2, S4.4 or S4.5 of this section. S4.2Except for school... outboard front designated seating position. For school buses, a head restraint that conforms to either S4.2...

  12. 49 CFR 571.202 - Standard No. 202; Head restraints; Applicable at the manufacturers option until September 1, 2009.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... seat back; or, (ii) Application of a load of 890N. S4.3[Reserved] S4.4.Except for school buses, a head... comply with, at the manufacturer's option, S4.2, S4.4 or S4.5 of this section. S4.2Except for school... outboard front designated seating position. For school buses, a head restraint that conforms to either S4.2...

  13. 49 CFR 571.202 - Standard No. 202; Head restraints; Applicable at the manufacturers option until September 1, 2009.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... seat back; or, (ii) Application of a load of 890N. S4.3[Reserved] S4.4.Except for school buses, a head... comply with, at the manufacturer's option, S4.2, S4.4 or S4.5 of this section. S4.2Except for school... outboard front designated seating position. For school buses, a head restraint that conforms to either S4.2...

  14. Navy DDG-1000 and DDG-51 Destroyer Programs: Background, Oversight Issues, and Options for Congress

    DTIC Science & Technology

    2009-06-04

    Aegis combat system and the arming of the ship with the SM-3, a version of the Navy’s Standard Missile that is designed for BMD operations.6 Total...and assigning the construction of those ships to GD/BIW and/or NGSB; • procuring AGS- armed versions of the basic LPD-17 class hull—another option...subcommittee of the House Armed Services Committee.24 22 Christopher P. Cavas, “All

  15. Parents’ Online Portrayals of Pediatric Treatment and Research Options

    PubMed Central

    Schaffer, Rebecca; Henderson, Gail E.; Churchill, Larry R.; King, Nancy M. P.; Rothschild, Barbra B.; Lohser, Sara; Davis, Arlene M.

    2012-01-01

    Parents of seriously ill children face difficult decisions when standard therapies are limited or ineffective. In their search for information, they may turn to websites created by other parents facing similar experiences. We conducted a qualitative content analysis of 21 websites created by families with children affected by cancer or genetic disease, two serious conditions with a range of treatment and clinical trial options. Our research questions address how parent authors portray serious pediatric illness, available options, parties to decision making, and sources of influence. In addition, we examine what these sites reveal about family vulnerability to various risks, particularly the risk of misunderstanding the distinction between standard treatment and research and the risk of overestimating the likely benefits of research participation, as well as whether vulnerability varies by type of condition. Our results demonstrate typically favorable views on research, but with inadequate distinctions between research and treatment and a complex set of trade-offs in consideration of research risks and potential benefits. While portraits of vulnerability emerge for both parents and children, so do portraits of strength and resilience. As a result, parents describe frustration with both under- and over-protection from research participation. Our discussion of these findings clarifies the potential for parent-authored websites to inform and influence families considering research and treatment options for their seriously ill children. PMID:19754237

  16. A mathematical model for Vertical Attitude Takeoff and Landing (VATOL) aircraft simulation. Volume 3: User's manual for VATOL simulation program

    NASA Technical Reports Server (NTRS)

    Fortenbaugh, R. L.

    1980-01-01

    Instructions for using Vertical Attitude Takeoff and Landing Aircraft Simulation (VATLAS), the digital simulation program for application to vertical attitude takeoff and landing (VATOL) aircraft developed for installation on the NASA Ames CDC 7600 computer system are described. The framework for VATLAS is the Off-Line Simulation (OLSIM) routine. The OLSIM routine provides a flexible framework and standardized modules which facilitate the development of off-line aircraft simulations. OLSIM runs under the control of VTOLTH, the main program, which calls the proper modules for executing user specified options. These options include trim, stability derivative calculation, time history generation, and various input-output options.

  17. Using real options analysis to support strategic management decisions

    NASA Astrophysics Data System (ADS)

    Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

    2013-12-01

    Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

  18. MQSA National Statistics

    MedlinePlus

    ... Standards Act and Program MQSA Insights MQSA National Statistics Share Tweet Linkedin Pin it More sharing options ... but should level off with time. Archived Scorecard Statistics 2018 Scorecard Statistics 2017 Scorecard Statistics 2016 Scorecard ...

  19. Practice Parameters for the Respiratory Indications for Polysomnography in Children

    PubMed Central

    Aurora, R. Nisha; Zak, Rochelle S.; Karippot, Anoop; Lamm, Carin I.; Morgenthaler, Timothy I.; Auerbach, Sanford H.; Bista, Sabin R.; Casey, Kenneth R.; Chowdhuri, Susmita; Kristo, David A.; Ramar, Kannan

    2011-01-01

    Background: There has been marked expansion in the literature and practice of pediatric sleep medicine; however, no recent evidence-based practice parameters have been reported. These practice parameters are the first of 2 papers that assess indications for polysomnography in children. This paper addresses indications for polysomnography in children with suspected sleep related breathing disorders. These recommendations were reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. Methods: A systematic review of the literature was performed, and the American Academy of Neurology grading system was used to assess the quality of evidence. Recommendations for PSG Use: Polysomnography in children should be performed and interpreted in accordance with the recommendations of the AASM Manual for the Scoring of Sleep and Associated Events. (Standard) Polysomnography is indicated when the clinical assessment suggests the diagnosis of obstructive sleep apnea syndrome (OSAS) in children. (Standard) Children with mild OSAS preoperatively should have clinical evaluation following adenotonsillectomy to assess for residual symptoms. If there are residual symptoms of OSAS, polysomnography should be performed. (Standard) Polysomnography is indicated following adenotonsillectomy to assess for residual OSAS in children with preoperative evidence for moderate to severe OSAS, obesity, craniofacial anomalies that obstruct the upper airway, and neurologic disorders (e.g., Down syndrome, Prader-Willi syndrome, and myelomeningocele). (Standard) Polysomnography is indicated for positive airway pressure (PAP) titration in children with obstructive sleep apnea syndrome. (Standard) Polysomnography is indicated when the clinical assessment suggests the diagnosis of congenital central alveolar hypoventilation syndrome or sleep related hypoventilation due to neuromuscular disorders or chest wall deformities. It is indicated in selected cases of primary sleep apnea of infancy. (Guideline) Polysomnography is indicated when there is clinical evidence of a sleep related breathing disorder in infants who have experienced an apparent life-threatening event (ALTE). (Guideline) Polysomnography is indicated in children being considered for adenotonsillectomy to treat obstructive sleep apnea syndrome. (Guideline) Follow-up PSG in children on chronic PAP support is indicated to determine whether pressure requirements have changed as a result of the child's growth and development, if symptoms recur while on PAP, or if additional or alternate treatment is instituted. (Guideline) Polysomnography is indicated after treatment of children for OSAS with rapid maxillary expansion to assess for the level of residual disease and to determine whether additional treatment is necessary. (Option) Children with OSAS treated with an oral appliance should have clinical follow-up and polysomnography to assess response to treatment. (Option) Polysomnography is indicated for noninvasive positive pressure ventilation (NIPPV) titration in children with other sleep related breathing disorders. (Option) Children treated with mechanical ventilation may benefit from periodic evaluation with polysomnography to adjust ventilator settings. (Option) Children treated with tracheostomy for sleep related breathing disorders benefit from polysomnography as part of the evaluation prior to decannulation. These children should be followed clinically after decannulation to assess for recurrence of symptoms of sleep related breathing disorders. (Option) Polysomnography is indicated in the following respiratory disorders only if there is a clinical suspicion for an accompanying sleep related breathing disorder: chronic asthma, cystic fibrosis, pulmonary hypertension, bronchopulmonary dysplasia, or chest wall abnormality such as kyphoscoliosis. (Option) Recommendations against PSG Use: 16. Nap (abbreviated) polysomnography is not recommended for the evaluation of obstructive sleep apnea syndrome in children. (Option) 17. Children considered for treatment with supplemental oxygen do not routinely require polysomnography for management of oxygen therapy. (Option) Conclusions: Current evidence in the field of pediatric sleep medicine indicates that PSG has clinical utility in the diagnosis and management of sleep related breathing disorders. The accurate diagnosis of SRBD in the pediatric population is best accomplished by integration of polysomnographic findings with clinical evaluation. Citation: Aurora RN; Zak RS; Karippot A; Lamm CI; Morgenthaler TI; Auerbach SH; Bista SR; Casey KR; Chowdhuri S; Kristo DA; Ramar K. Practice parameters for the respiratory indications for polysomnography in children. SLEEP 2011;34(3):379-388. PMID:21359087

  20. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults.

    PubMed

    Aurora, R Nisha; Casey, Kenneth R; Kristo, David; Auerbach, Sanford; Bista, Sabin R; Chowdhuri, Susmita; Karippot, Anoop; Lamm, Carin; Ramar, Kannan; Zak, Rochelle; Morgenthaler, Timothy I

    2010-10-01

    Practice parameters for the treatment of obstructive sleep apnea syndrome (OSAS) in adults by surgical modification of the upper airway were first published in 1996 by the American Academy of Sleep Medicine (formerly ASDA). The following practice parameters update the previous practice parameters. These recommendations were reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. A systematic review of the literature was performed, and the GRADE system was used to assess the quality of evidence. The findings from this evaluation are provided in the accompanying review paper, and the subsequent recommendations have been developed from this review. The following procedures have been included: tracheostomy, maxillo-mandibular advancement (MMA), laser assisted uvulopalatoplasty (LAUP), uvulopalatopharyngoplasty (UPPP), radiofrequency ablation (RFA), and palatal implants. The presence and severity of obstructive sleep apnea must be determined before initiating surgical therapy (Standard). The patient should be advised about potential surgical success rates and complications, the availability of alternative treatment options such as nasal positive airway pressure and oral appliances, and the levels of effectiveness and success rates of these alternative treatments (Standard). The desired outcomes of treatment include resolution of the clinical signs and symptoms of obstructive sleep apnea and the normalization of sleep quality, the apnea-hypopnea index, and oxyhemoglobin saturation levels (Standard). Tracheostomy has been shown to be an effective single intervention to treat obstructive sleep apnea. This operation should be considered only when other options do not exist, have failed, are refused, or when this operation is deemed necessary by clinical urgency (Option). MMA is indicated for surgical treatment of severe OSA in patients who cannot tolerate or who are unwilling to adhere to positive airway pressure therapy, or in whom oral appliances, which are more often appropriate in mild and moderate OSA patients, have been considered and found ineffective or undesirable (Option). UPPP as a sole procedure, with or without tonsillectomy, does not reliably normalize the AHI when treating moderate to severe obstructive sleep apnea syndrome. Therefore, patients with severe OSA should initially be offered positive airway pressure therapy, while those with moderate OSA should initially be offered either PAP therapy or oral appliances (Option). Use of multi-level or stepwise surgery (MLS), as a combined procedure or as stepwise multiple operations, is acceptable in patients with narrowing of multiple sites in the upper airway, particularly if they have failed UPPP as a sole treatment (Option). LAUP is not routinely recommended as a treatment for obstructive sleep apnea syndrome (Standard). RFA can be considered as a treatment in patients with mild to moderate obstructive sleep apnea who cannot tolerate or who are unwilling to adhere to positive airway pressure therapy, or in whom oral appliances have been considered and found ineffective or undesirable (Option). Palatal implants may be effective in some patients with mild obstructive sleep apnea who cannot tolerate or who are unwilling to adhere to positive airway pressure therapy, or in whom oral appliances have been considered and found ineffective or undesirable (Option). Postoperatively, after an appropriate period of healing, patients should undergo follow-up evaluation including an objective measure of the presence and severity of sleep-disordered breathing and oxygen saturation, as well as clinical assessment for residual symptoms. Additionally, patients should be followed over time to detect the recurrence of disease (Standard). While there has been significant progress made in surgical techniques for the treatment of OSA, there is a lack of rigorous data evaluating surgical modifications of the upper airway. Systematic and methodical investigations are needed to improve the quality of evidence, assess additional outcome measures, determine which populations are most likely to benefit from a particular procedure or procedures, and optimize perioperative care.

  1. Exposure Assessment of Livestock Carcass Management ...

    EPA Pesticide Factsheets

    Report This report describes relative exposures and hazards for different livestock carcass management options in the event of a natural disaster. A quantitative exposure assessment by which livestock carcass management options are ranked relative to one another for a hypothetical site setting, a standardized set of environmental conditions (e.g., meteorology), and following a single set of assumptions about how the carcass management options are designed and implemented. These settings, conditions, and assumptions are not necessarily representative of site-specific carcass management efforts. Therefore, the exposure assessment should not be interpreted as estimating levels of chemical and microbial exposure that can be expected to result from the management options evaluated. The intent of the relative rankings is to support scientifically-based livestock carcass management decisions that consider potential hazards to human health, livestock, and the environment. This exposure assessment also provides information to support choices about mitigation measures to minimize or eliminate specific exposure pathways.

  2. Autoimmune hepatitis: Standard treatment and systematic review of alternative treatments

    PubMed Central

    Terziroli Beretta-Piccoli, Benedetta; Mieli-Vergani, Giorgina; Vergani, Diego

    2017-01-01

    Autoimmune hepatitis is a rare chronic inflammatory liver disease, affecting all ages, characterised by elevated transaminase and immunoglobulin G levels, positive autoantibodies, interface hepatitis at liver histology and good response to immunosuppressive treatment. If untreated, it has a poor prognosis. The aim of this review is to summarize the evidence for standard treatment and to provide a systematic review on alternative treatments for adults and children. Standard treatment is based on steroids and azathioprine, and leads to disease remission in 80%-90% of patients. Alternative first line treatment has been attempted with budesonide or cyclosporine, but their superiority compared to standard treatment remains to be demonstrated. Second-line treatments are needed for patients not responding or intolerant to standard treatment. No randomized controlled trials have been performed for second-line options. Mycophenolate mofetil is the most widely used second-line drug, and has good efficacy particularly for patients intolerant to azathioprine, but has the major disadvantage of being teratogenic. Only few and heterogeneous data on cyclosporine, tacrolimus, everolimus and sirolimus are available. More recently, experience with the anti-tumour necrosis factor-alpha infliximab and the anti-CD20 rituximab has been published, with ambivalent results; these agents may have severe side-effects and their use should be restricted to specialized centres. Clinical trials with new therapeutic options are ongoing. PMID:28970719

  3. Exploring the Housing Needs of Older People in Standard and Sheltered Social Housing

    PubMed Central

    Fox, Siobhan; Kenny, Lorna; Day, Mary Rose; O’Connell, Cathal; Finnerty, Joe; Timmons, Suzanne

    2017-01-01

    Objective: Our home can have a major impact on our physical and mental health; this is particularly true for older people who may spend more time at home. Older people in social (i.e., public) housing are particularly vulnerable. Housing options for older people in social housing include standard design dwellings or specially designed “sheltered housing.” The most suitable housing model should be identified, with older people consulted in this process. Method: Survey of older people (aged ≥60) living in standard or sheltered social housing. Data were analyzed using descriptive and inferential statistics in SPSS Version 22. Results: Overall, 380 surveys were returned (response rate = 47.2%). All older people had similar housing needs. Those in sheltered housing were more satisfied with the physical home design and reported more positive outcomes. Older people in standard housing were less likely to have necessary adaptations to facilitate aging-in-place. Discussion: Older people in standard housing reported more disability/illnesses, are worried about the future, and felt less safe at home. However, few wanted to move, and very few viewed sheltered housing as an alternative, suggesting limited knowledge about their housing options. Future social housing designs should be flexible, that is, adaptable to the needs of the tenants over time. PMID:28491914

  4. Analysis of Shroud Options in Support of the Human Exploration of Mars

    NASA Technical Reports Server (NTRS)

    Feldman, Stuart; Borowski, Stanley; Engelund, Walter; Hundley, Jason; Monk, Timothy; Munk, Michelle

    2010-01-01

    In support of the Mars Design Reference Architecture (DRA) 5.0, the NASA study team analyzed several shroud options for use on the Ares V launch vehicle.1,2 These shroud options included conventional "large encapsulation" shrouds with outer diameters ranging from 8.4 to 12.9 meters (m) and overall lengths of 22.0 to 54.3 meters, along with a "nosecone-only" shroud option used for Mars transfer vehicle component delivery. Also examined was a "multi-use" aerodynamic encapsulation shroud used for launch, Mars aerocapture, and entry, descent, and landing of the cargo and habitat landers. All conventional shroud options assessed for use on the Mars launch vehicles were the standard biconic design derived from the reference shroud utilized in the Constellation Program s lunar campaign. It is the purpose of this paper to discuss the technical details of each of these shroud options including material properties, structural mass, etc., while also discussing both the volume and mass of the various space transportation and surface system payload elements required to support a "minimum launch" Mars mission strategy, as well as the synergy, potential differences and upgrade paths that may be required between the Lunar and Mars mission shrouds.

  5. Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

    PubMed Central

    Dobie, Robert A; Wojcik, Nancy C

    2015-01-01

    Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999–2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Methods Regression analysis was used to derive new age-correction values using audiometric data from the 1999–2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20–75 years. Results The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20–75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61–75 years. Conclusions Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. PMID:26169804

  6. Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

    PubMed

    Dobie, Robert A; Wojcik, Nancy C

    2015-07-13

    The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. L’évaluation du risque cardiaque avant l’utilisation de stimulants chez les enfants et les adolescents

    PubMed Central

    Bélanger, SA; Warren, AE; Hamilton, RM; Gray, C; Gow, RM; Sanatani, S; Côté, J-M; Lougheed, J; LeBlanc, J; Martin, S; Miles, B; Mitchell, C; Gorman, DA; Weiss, M; Schachar, R

    2009-01-01

    Les décisions en matière de réglementation et les documents scientifiques au sujet de la prise en charge du trouble de déficit de l’attention avec hyperactivité (TDAH) soulèvent des questions quant à l’innocuité des médicaments et à l’évaluation convenable à effectuer avant le traitement afin de déterminer la pertinence d’une pharmacothérapie. Ce constat est particulièrement vrai en présence de cardiopathies structurelles ou fonctionnelles. Le présent article contient l’analyse des données disponibles, y compris les publications révisées par des pairs, des données tirées du site Web de la Food and Drug Administration des États-Unis au sujet des réactions indésirables déclarées chez des enfants qui prennent des stimulants, ainsi que des données de Santé Canada sur le même problème. Des lignes directrices consensuelles sur l’évaluation pertinente sont proposées d’après l’apport des membres de la Société canadienne de pédiatrie, de la Société canadienne de cardiologie et de l’Académie canadienne de psychiatrie de l’enfant et de l’adolescent, qui possèdent notamment des compétences et des connaissances précises tant dans le secteur du TDAH que de la cardiologie pédiatrique. Le présent document de principes prône une anamnèse et un examen physique détaillés avant la prescription de stimulants et s’attarde sur le dépistage des facteurs de risque de mort subite, mais il ne contient pas de recommandations systématiques de dépistage électrocardiographique ou de consultations avec un spécialiste en cardiologie, à moins que les antécédents ou que l’examen physique ne le justifient. Le document contient un questionnaire pour repérer les enfants potentiellement vulnérables à une mort subite (quel que soit le type de TDAH ou les médicaments utilisés pour le traiter). Même si les recommandations dépendent des meilleures données probantes disponibles, le comité s’entend pour affirmer que d’autres recherches s’imposent pour optimiser l’approche de ce scénario clinique courant.

  8. Vulvovaginite : Dépistage et prise en charge de la trichomonase, de la candidose vulvovaginale et de la vaginose bactérienne.

    PubMed

    van Schalkwyk, Julie; Yudin, Mark H

    2016-12-01

    Analyser les données probantes et formuler des recommandations quant au dépistage et à la prise en charge de la candidose vulvovaginale, de la trichomonase et de la vaginose bactérienne. Parmi les issues évaluées, on trouve l'efficacité de l'antibiothérapie, les taux de guérison en ce qui concerne les infections simples et compliquées, et les implications de ces pathologies pendant la grossesse. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans MEDLINE, EMBASE, CINAHL et The Cochrane Library en juin 2013 au moyen d'un vocabulaire contrôlé (p. ex. « vaginitis », « trichomoniasis », « vaginal candidiasis ») et de mots clés (p. ex. « bacterial vaginosis », « yeast », « candidiasis », « trichomonas vaginalis », « trichomoniasis », « vaginitis », « treatment ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n'a été appliquée en matière de date, mais les résultats ont été limités aux documents rédigés en anglais ou en français. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en mai 2014. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques et auprès de sociétés de spécialité médicale nationales et internationales. La qualité des résultats est évaluée au moyen des critères décrits par le Groupe d'étude canadien sur les soins de santé préventifs (Tableau 1). DéCLARATIONS SOMMAIRES: RECOMMANDATIONS. Copyright © 2016. Published by Elsevier Inc.

  9. Results of antiretroviral treatment interruption and intensification in advanced multi-drug resistant HIV infection from the OPTIMA trial.

    PubMed

    Holodniy, Mark; Brown, Sheldon T; Cameron, D William; Kyriakides, Tassos C; Angus, Brian; Babiker, Abdel; Singer, Joel; Owens, Douglas K; Anis, Aslam; Goodall, Ruth; Hudson, Fleur; Piaseczny, Mirek; Russo, John; Schechter, Martin; Deyton, Lawrence; Darbyshire, Janet

    2011-03-31

    Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR) and limited retreatment options. We assessed two novel antiretroviral (ARV) treatment approaches in this setting. We conducted a 2×2 factorial randomized open label controlled trial in patients with a CD4 count≤300 cells/µl who had ARV treatment (ART) failure requiring retreatment, to two options (a) re-treatment with either standard (≤4 ARVs) or intensive (≥5 ARVs) ART and b) either treatment starting immediately or after a 12-week monitored ART interruption. Primary outcome was time to developing a first AIDS-defining event (ADE) or death from any cause. Analysis was by intention to treat. From 2001 to 2006, 368 patients were randomized. At baseline, mean age was 48 years, 2% were women, median CD4 count was 106/µl, mean viral load was 4.74 log(10) copies/ml, and 59% had a prior AIDS diagnosis. Median follow-up was 4.0 years in 1249 person-years of observation. There were no statistically significant differences in the primary composite outcome of ADE or death between re-treatment options of standard versus intensive ART (hazard ratio 1.17; CI 0.86-1.59), or between immediate retreatment initiation versus interruption before re-treatment (hazard ratio 0.93; CI 0.68-1.30), or in the rate of non-HIV associated serious adverse events between re-treatment options. We did not observe clinical benefit or harm assessed by the primary outcome in this largest and longest trial exploring both ART interruption and intensification in advanced MDR HIV infection with poor retreatment options. Clinicaltrials.gov NCT00050089.

  10. Results of Antiretroviral Treatment Interruption and Intensification in Advanced Multi-Drug Resistant HIV Infection from the OPTIMA Trial

    PubMed Central

    Holodniy, Mark; Brown, Sheldon T.; Cameron, D. William; Kyriakides, Tassos C.; Angus, Brian; Babiker, Abdel; Singer, Joel; Owens, Douglas K.; Anis, Aslam; Goodall, Ruth; Hudson, Fleur; Piaseczny, Mirek; Russo, John; Schechter, Martin; Deyton, Lawrence; Darbyshire, Janet

    2011-01-01

    Background Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR) and limited retreatment options. We assessed two novel antiretroviral (ARV) treatment approaches in this setting. Methods and Findings We conducted a 2×2 factorial randomized open label controlled trial in patients with a CD4 count ≤300 cells/µl who had ARV treatment (ART) failure requiring retreatment, to two options (a) re-treatment with either standard (≤4 ARVs) or intensive (≥5 ARVs) ART and b) either treatment starting immediately or after a 12-week monitored ART interruption. Primary outcome was time to developing a first AIDS-defining event (ADE) or death from any cause. Analysis was by intention to treat. From 2001 to 2006, 368 patients were randomized. At baseline, mean age was 48 years, 2% were women, median CD4 count was 106/µl, mean viral load was 4.74 log10 copies/ml, and 59% had a prior AIDS diagnosis. Median follow-up was 4.0 years in 1249 person-years of observation. There were no statistically significant differences in the primary composite outcome of ADE or death between re-treatment options of standard versus intensive ART (hazard ratio 1.17; CI 0.86–1.59), or between immediate retreatment initiation versus interruption before re-treatment (hazard ratio 0.93; CI 0.68–1.30), or in the rate of non-HIV associated serious adverse events between re-treatment options. Conclusions We did not observe clinical benefit or harm assessed by the primary outcome in this largest and longest trial exploring both ART interruption and intensification in advanced MDR HIV infection with poor retreatment options. Trial Registration Clinicaltrials.gov NCT00050089 PMID:21483491

  11. The Effect of Data Format on Integration of Performance Data into Angoff Judgments

    ERIC Educational Resources Information Center

    Clauser, Brian E.; Mee, Janet; Margolis, Melissa J.

    2013-01-01

    This study investigated the extent to which the performance data format impacted data use in Angoff standard setting exercises. Judges from two standard settings (a total of five panels) were randomly assigned to one of two groups. The full-data group received two types of data: (1) the proportion of examinees selecting each option and (2) plots…

  12. 48 CFR 52.222-43 - Fair Labor Standards Act and Service Contract Act-Price Adjustment (Multiple Year and Option...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... rates, or fixed hourly labor rates will be adjusted to reflect the Contractor's actual increase or... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Fair Labor Standards Act... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.222-43 Fair Labor...

  13. Is There a Standard Default Keyword Operator? A Bibliometric Analysis of Processing Options Chosen by Libraries To Execute Keyword Searches in Online Public Access Catalogs.

    ERIC Educational Resources Information Center

    Klein, Gary M.

    1994-01-01

    Online public access catalogs from 67 libraries using NOTIS software were searched using Internet connections to determine the positional operators selected as the default keyword operator on each catalog. Results indicate the lack of a processing standard for keyword searches. Five tables provide information. (Author/AEF)

  14. States' Flexibility Waiver Plans for Alternate Assessments Based on Alternate Achievement Standards (AA-AAS). Synthesis Report 96

    ERIC Educational Resources Information Center

    Lazarus, Sheryl S.; Edwards, Lynn M.; Thurlow, Martha L.; Hodgson, Jennifer R.

    2014-01-01

    All states have alternate assessments based on alternate achievement standards (AA-AAS) for students with the most significant cognitive disabilities. For accountability purposes, the Elementary and Secondary Education Act (ESEA) allows up to 1% of students to be counted as proficient with this assessment option. In 2011 the U.S. Department of…

  15. State Perspectives on Implementing, or Choosing Not to Implement, an Alternate Assessment Based on Modified Academic Achievement Standards

    ERIC Educational Resources Information Center

    Palmer, Porter W.

    2009-01-01

    Since Federal regulations have given states the option to implement alternate assessments based on modified academic achievement standards (AA-MAS) as part of their accountability systems for a small group of students with disabilities, a number of states have made decisions about whether or not to develop and implement such an assessment.…

  16. 48 CFR 908.7115 - Forms.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... be obtained by DOE offices in accordance with the DOE Guide 242.1-1, DOE Forms Management, for use with DOE Order 200.1, Information Management Program. (b) Standard, optional, and certain other agency...

  17. 48 CFR 908.7115 - Forms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... be obtained by DOE offices in accordance with the DOE Guide 242.1-1, DOE Forms Management, for use with DOE Order 200.1, Information Management Program. (b) Standard, optional, and certain other agency...

  18. 48 CFR 908.7115 - Forms.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... be obtained by DOE offices in accordance with the DOE Guide 242.1-1, DOE Forms Management, for use with DOE Order 200.1, Information Management Program. (b) Standard, optional, and certain other agency...

  19. 48 CFR 908.7115 - Forms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... be obtained by DOE offices in accordance with the DOE Guide 242.1-1, DOE Forms Management, for use with DOE Order 200.1, Information Management Program. (b) Standard, optional, and certain other agency...

  20. 48 CFR 908.7115 - Forms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... be obtained by DOE offices in accordance with the DOE Guide 242.1-1, DOE Forms Management, for use with DOE Order 200.1, Information Management Program. (b) Standard, optional, and certain other agency...

  1. SEER Data & Software

    Cancer.gov

    Options for accessing datasets for incidence, mortality, county populations, standard populations, expected survival, and SEER-linked and specialized data. Plus variable definitions, documentation for reporting and using datasets, statistical software (SEER*Stat), and observational research resources.

  2. Implied adjusted volatility functions: Empirical evidence from Australian index option market

    NASA Astrophysics Data System (ADS)

    Harun, Hanani Farhah; Hafizah, Mimi

    2015-02-01

    This study aims to investigate the implied adjusted volatility functions using the different Leland option pricing models and to assess whether the use of the specified implied adjusted volatility function can lead to an improvement in option valuation accuracy. The implied adjusted volatility is investigated in the context of Standard and Poor/Australian Stock Exchange (S&P/ASX) 200 index options over the course of 2001-2010, which covers the global financial crisis in the mid-2007 until the end of 2008. Both in- and out-of-sample resulted in approximately similar pricing error along the different Leland models. Results indicate that symmetric and asymmetric models of both moneyness ratio and logarithmic transformation of moneyness provide the overall best result in both during and post-crisis periods. We find that in the different period of interval (pre-, during and post-crisis) is subject to a different implied adjusted volatility function which best explains the index options. Hence, it is tremendously important to identify the intervals beforehand in investigating the implied adjusted volatility function.

  3. Option volatility and the acceleration Lagrangian

    NASA Astrophysics Data System (ADS)

    Baaquie, Belal E.; Cao, Yang

    2014-01-01

    This paper develops a volatility formula for option on an asset from an acceleration Lagrangian model and the formula is calibrated with market data. The Black-Scholes model is a simpler case that has a velocity dependent Lagrangian. The acceleration Lagrangian is defined, and the classical solution of the system in Euclidean time is solved by choosing proper boundary conditions. The conditional probability distribution of final position given the initial position is obtained from the transition amplitude. The volatility is the standard deviation of the conditional probability distribution. Using the conditional probability and the path integral method, the martingale condition is applied, and one of the parameters in the Lagrangian is fixed. The call option price is obtained using the conditional probability and the path integral method.

  4. Space station systems analysis study. Part 2, volume 3: Appendixes, Book 2: Supporting data (7 through 18)

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Topics discussed include: (1) design considerations for a MARS sample return laboratory module for space station investigations; (2) crew productivity as a function of work shift arrangement; (3) preliminary analysis of the local logistics problem on the space construction base; (4) mission hardware construction operational flows and timelines; (5) orbit transfer vehicle concept definition; (6) summary of results and findings of space processing working review; (7) crew and habitability subsystem (option L); (8) habitability subsystem considerations for shuttle tended option L; (9) orbiter utilization in manned sortie missions; (10) considerations in definition of space construction base standard module configuration (option L); (11) guidance, control, and navigation subsystems; and (12) system and design tradeoffs.

  5. Roadwaste management : a tool for developing district plans.

    DOT National Transportation Integrated Search

    2000-10-01

    The Oregon Department of Transportation (ODOT) conducted a study to examine roadwaste management options. Phase 1 consisted of a thorough review of regulations and standards, roadwaste characterization, current management practices, and new technolog...

  6. Feasibility Study of Economics and Performance of Solar Photovoltaics at the Standard Chlorine of Delaware Superfund Site in Delaware City, Delaware. A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites

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

    Salasovich, J.; Geiger, J.; Mosey, G.

    2013-06-01

    The U.S. Environmental Protection Agency (EPA), in accordance with the RE-Powering America's Land initiative, selected the Standard Chlorine of Delaware site in Delaware City, Delaware, for a feasibility study of renewable energy production. The National Renewable Energy Laboratory (NREL) provided technical assistance for this project. The purpose of this report is to assess the site for a possible photovoltaic (PV) system installation and estimate the cost, performance, and site impacts of different PV options. In addition, the report recommends financing options that could assist in the implementation of a PV system at the site.

  7. Justifying Clinical Nudges.

    PubMed

    Gorin, Moti; Joffe, Steven; Dickert, Neal; Halpern, Scott

    2017-03-01

    The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably affect people's choices. Choice-affecting features of the decision environment that do not restrict the range of choices or significantly alter the incentives have come to be known as "nudges." Although some have criticized conscious efforts to influence choice, we believe that clinical nudges may often be morally justified. The most straightforward justification for nudge interventions is that they help people bypass their cognitive limitations-for example, the tendency to choose the first option presented even when that option is not the best for them-thereby allowing people to make choices that best align with their rational preferences or deeply held values. However, we argue that this justification is problematic. We argue that, if physicians wish to use nudges to shape their patients' choices, the justification for doing so must appeal to an ethical and professional standard, not to patients' preferences. We demonstrate how a standard with which clinicians and bioethicists already are quite familiar-the best-interest standard-offers a robust justification for the use of nudges. © 2017 The Hastings Center.

  8. The rapid reproducers paradox: population control and individual procreative rights.

    PubMed

    Wissenburg, M

    1998-01-01

    This article argues that population policies need to be evaluated from macro and micro perspectives and to consider individual rights. Ecological arguments that are stringent conditions of liberal democracy are assessed against a moral standard. The moral standard is applied to a series of reasons for limiting procreative rights in the cause of sustainability. The focus is directly on legally enforced antinatalist measures and not on indirect policies with incentives and disincentives. The explicit assumption is that population policy violates the fairness to individuals for societal gain and that population policies are incompatible with stringent conditions of liberal democracy. The author identifies the individual-societal tradeoff as the "rapid reproducers paradox." The perfect sustainable population level is either not possible or is a repugnant alternative. 12 ecological arguments are presented, and none are found compatible with notions of a liberal democracy. Three alternative antinatalist options are the acceptance of less rigid and still coercive policies, amendments to the conception of liberal democracy, or loss of hope and choice of noncoercive solutions to sustainability, none of which is found viable. If voluntary abstinence and distributive solutions fail, then frugal demand options and technological supply options both will be necessary.

  9. Current Status and Future Prospects for Esophageal Cancer Treatment

    PubMed Central

    Kuwano, Hiroyuki

    2016-01-01

    The local control effect of esophagectomy with three-field lymph node dissection (3FLD) is reaching its limit pending technical advancement. Minimally invasive esophagectomy (MIE) by thoracotomy is slowly gaining acceptance due to advantages in short-term outcomes. Although the evidence is slowly increasing, MIE is still controversial. Also, the results of treatment by surgery alone are limiting, and multimodality therapy, which includes surgical and non-surgical treatment options including chemotherapy, radiotherapy, and endoscopic treatment, has become the mainstream therapy. Esophagectomy after neoadjuvant chemotherapy (NAC) is the standard treatment for clinical stages II/III (except for T4) esophageal cancer, whereas chemoradiotherapy (CRT) is regarded as the standard treatment for patients who wish to preserve their esophagus, those who refuse surgery, and those with inoperable disease. CRT is also usually selected for clinical stage IV esophageal cancer. On the other hand, with the spread of CRT, salvage esophagectomy has traditionally been recognized as a feasible option; however, many clinicians oppose the use of surgery due to the associated unfavorable morbidity and mortality profile. In the future, the improvement of each treatment result and the establishment of individual strategies are important although esophageal cancer has many treatment options. PMID:28003586

  10. Health care transition in Germany – standardization of procedures and improvement actions

    PubMed Central

    Pieper, Claudia; Kolankowska, Izabela

    2011-01-01

    Previous studies have assessed an increase in the number of people in need and emphasized the advantages of structured discharge management and health care transition. Therefore, our study evaluated the status quo of transition in a major German city after standardization of procedures and implementation of standard forms. Satisfaction with handling of standard forms and improvement of procedures was evaluated. Additionally, patients who had recently been hospitalized were asked about the hospital discharge process. The results show that the recent efforts of standardization helped to improve interface management for health care workers and patients and showed further improvement options. PMID:21811388

  11. The Debate over Literary Tamil versus Standard Spoken Tamil: What Do Teachers Say?

    ERIC Educational Resources Information Center

    Saravanan, Vanithamani; Lakshmi, Seetha; Caleon, Imelda S.

    2009-01-01

    This study aims to determine the attitudes toward Standard Spoken Tamil (SST) and Literary Tamil (LT) of 46 Tamil teachers in Singapore. The teachers' attitudes were used as an indicator of the acceptance or nonacceptance of SST as a viable option in the teaching of Tamil in the classroom, in which the focus has been largely on LT. The…

  12. 40 CFR 63.1505 - Emission standards for affected sources and emission units.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... excess of 0.023 grams (g) of PM per dry standard cubic meter (dscm) (0.010 grain (gr) of PM per dry... device if a COM is chosen as the monitoring option. (h) Rotary dross cooler. On and after the compliance date established by § 63.1501, the owner or operator of a rotary dross cooler at a secondary aluminum...

  13. 78 FR 67881 - Nondiscrimination on the Basis of Disability in Air Travel: Accessibility of Web Sites and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... corresponding accessible pages on a mobile Web site by one year after the final rule's effective date; and (3... Mobile Web site conformant with any of the following standards: WCAG 1.0, WCAG 2.0 at Level A, existing Section 508 standards, or Mobile Web Best Practices (MWBP) 1.0 (if applicable). Two of the options they...

  14. States' Participation Guidelines for Alternate Assessments Based on Modified Academic Achievement Standards (AA-MAS) in 2008. Synthesis Report 71

    ERIC Educational Resources Information Center

    Lazarus, Sheryl S.; Rogers, Christopher; Cormier, Damien; Thurlow, Martha L.

    2008-01-01

    Federal regulations (U.S. Department of Education, 2007a) provide states with the flexibility to offer an alternate assessment based on modified academic achievement standards (AA-MAS). This assessment option is for a small group of students with disabilities who can make significant progress, but may not reach grade-level achievement within the…

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

    Reidy, M.

    While no final legislative schedule has been set for the new Congress, two issues with strong environmental ramifications which are likely to affect the coal industry seem to top the list of closely watched debates in Washington -- the Environmental Protection Agency`s proposed new ozone and particulate matter standards and utility restructuring. The paper discusses the background of the proposed standards, public comment, the Congressional review of regulations, other legislative options, and utility restructuring.

  16. User's guide to FBASE: Relational database software for managing R1/R4 (Northern/Intermountain Regions) fish habitat inventory data

    Treesearch

    Sherry P. Wollrab

    1999-01-01

    FBASE is a microcomputer relational database package that handles data collected using the R1/R4 Fish and Fish Habitat Standard Inventory Procedures (Overton and others 1997). FBASE contains standard data entry screens, data validations for quality control, data maintenance features, and summary report options. This program also prepares data for importation into an...

  17. A novel imaging approach for prostate cancer is tested in new clinical trial | Center for Cancer Research

    Cancer.gov

    Prostate cancer patients who have failed standard radiation therapy have the options of surgery, radioactive seed implantation or cryoablation. Deborah Citrin, M.D., of the Radiation Oncology Branch is leading a study of stereotactic body radiation therapy (SBRT) to treat prostate cancer that has recurred locally after standard radiation therapy. The goal of this study is to

  18. Standard spacecraft economic analysis. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    Harris, E. D.; Large, J. P.

    1976-01-01

    A study of the comparative program costs associated with use of various standardized spacecraft for Air Force space test program missions to be flown on the space shuttle during the 1980-1990 time period is reviewed. The first phase of the study considered a variety of procurement mixes composed of existing or programmed NASA standard spacecraft designs and a Air Force standard spacecraft design. The results were briefed to a joint NASA/Air Force audience on July 11, 1976. The second phase considered additional procurement options using an upgraded version of an existing NASA design. The results of both phases are summarized.

  19. 26 CFR 1.3-1 - Application of optional tax.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... Tables XVI through XXX apply for taxable years beginning after December 31, 1970. The standard deduction... deduction for Tables XVI through XXX, applicable to taxable years beginning in 1971, is 13 percent. For an...

  20. 26 CFR 1.3-1 - Application of optional tax.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... Tables XVI through XXX apply for taxable years beginning after December 31, 1970. The standard deduction... deduction for Tables XVI through XXX, applicable to taxable years beginning in 1971, is 13 percent. For an...

  1. 26 CFR 1.3-1 - Application of optional tax.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... Tables XVI through XXX apply for taxable years beginning after December 31, 1970. The standard deduction... deduction for Tables XVI through XXX, applicable to taxable years beginning in 1971, is 13 percent. For an...

  2. 26 CFR 1.3-1 - Application of optional tax.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... Tables XVI through XXX apply for taxable years beginning after December 31, 1970. The standard deduction... deduction for Tables XVI through XXX, applicable to taxable years beginning in 1971, is 13 percent. For an...

  3. EPA Finalizes Voluntary Quality Assurance Plan for Renewable Fuel Standard Program

    EPA Pesticide Factsheets

    The rule finalizes a voluntary third-party quality assurance program option for RINs that regulated parties may exercise as a supplement to the “buyer beware” liability as prescribed under existing regulations.

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

    Not Available

    This guidebook addresses the primary requirements of the Alternative Fuel Transportation Program to help state and alternative fuel provider fleets comply with the Energy Policy Act via the Standard Compliance option. It also addresses the topics that covered fleets ask about most frequently.

  5. 40 CFR 63.3493 - What work practice standards must I meet?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or the control efficiency/outlet concentration option to comply with the emission limitations, you... materials, and waste materials must be conveyed from one location to another in closed containers or pipes...

  6. 48 CFR 1913.505-2 - Board order forms in lieu of Optional and Standard Forms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... BROADCASTING BOARD OF GOVERNORS CONTRACTING METHODS AND CONTRACT TYPES SMALL PURCHASES AND OTHER SIMPLIFIED...-case basis, in order to accommodate computer-generated purchase order forms. Exception approval for...

  7. 48 CFR 1913.505-2 - Board order forms in lieu of Optional and Standard Forms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... BROADCASTING BOARD OF GOVERNORS CONTRACTING METHODS AND CONTRACT TYPES SMALL PURCHASES AND OTHER SIMPLIFIED...-case basis, in order to accommodate computer-generated purchase order forms. Exception approval for...

  8. [Delayed reconstructions of soft tissue defects of the face].

    PubMed

    Mest'ák, J

    2007-06-01

    The author describes a non-standard approach to the management of facial soft tissue defects. Significance of delayed reconstructions in defect face injuries and options for their employment in indicated cases are highlighted.

  9. 26 CFR 1.3-1 - Application of optional tax.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... Tables XVI through XXX apply for taxable years beginning after December 31, 1970. The standard deduction... deduction for Tables XVI through XXX, applicable to taxable years beginning in 1971, is 13 percent. For an...

  10. A data-centric approach to understanding the pricing of financial options

    NASA Astrophysics Data System (ADS)

    Healy, J.; Dixon, M.; Read, B.; Cai, F. F.

    2002-05-01

    We investigate what can be learned from a purely phenomenological study of options prices without modelling assumptions. We fitted neural net (NN) models to LIFFE ``ESX'' European style FTSE 100 index options using daily data from 1992 to 1997. These non-parametric models reproduce the Black-Scholes (BS) analytic model in terms of fit and performance measures using just the usual five inputs (S, X, t, r, IV). We found that adding transaction costs (bid-ask spread) to these standard five parameters gives a comparable fit and performance. Tests show that the bid-ask spread can be a statistically significant explanatory variable for option prices. The difference in option prices between the models with transaction costs and those without ranges from about -3.0 to +1.5 index points, varying with maturity date. However, the difference depends on the moneyness (S/X), being greatest in-the-money. This suggests that use of a five-factor model can result in a pricing difference of up to #10 to #30 per call option contract compared with modelling under transaction costs. We found that the influence of transaction costs varied between different yearly subsets of the data. Open interest is also a significant explanatory variable, but volume is not.

  11. Application of selection techniques to electric-propulsion options on an advanced synchronous satellite

    NASA Technical Reports Server (NTRS)

    Holcomb, L. B.; Degrey, S. P.

    1973-01-01

    This paper addresses the comparison of several candidate auxiliary-propulsion systems and system combinations for an advanced synchronous satellite. Economic selection techniques, evolved at the Jet Propulsion Laboratory, are used as a basis for system option comparisons. Electric auxiliary-propulsion types considered include pulsed plasma and ion bombardment, with hydrazine systems used as a state-of-the-art reference. Current as well as projected electric-propulsion system performance data are used, as well as projected hydrazine system costs resulting from NASA standardization program projections.

  12. Preliminary engineering analysis for clothes washers

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

    Biermayer, Peter J.

    1996-10-01

    The Engineering Analysis provides information on efficiencies, manufacturer costs, and other characteristics of the appliance class being analyzed. For clothes washers, there are two classes: standard and compact. Since data were not available to analyze the compact class, only clothes washers were analyzed in this report. For this analysis, individual design options were combined and ordered in a manner that resulted in the lowest cumulative cost/savings ratio. The cost/savings ratio is the increase in manufacturer cost for a design option divided by the reduction in operating costs due to fuel and water savings.

  13. End-preparation assessments and tests for compounded sterile preparations.

    PubMed

    McElhiney, Linda F

    2013-01-01

    Outsourcing has become a necessity to obtain sterile products that are currently on backorder. Because of the expense of outsourcing sterile compounding, pharmacy leadership in health systems are now considering the option of insourcing and batch preparing compounded sterile preparations, which can be a viable option for a health system. It can significantly decrease drug-spending costs, and the pharmacy has a complete record of the compounding process. The key to preparing high-quality, safe, sterile preparations and meeting United States Pharmacopeia standards is end-preparation assessments and tests.

  14. An EHR Prototype Using Structured ISO/EN 13606 Documents to Respond to Identified Clinical Information Needs of Diabetes Specialists: A Controlled Study on Feasibility and Impact

    PubMed Central

    Huebner-Bloder, Gudrun; Duftschmid, Georg; Kohler, Michael; Rinner, Christoph; Saboor, Samrend; Ammenwerth, Elske

    2012-01-01

    Cross-institutional longitudinal Electronic Health Records (EHR), as introduced in Austria at the moment, increase the challenge of information overload of healthcare professionals. We developed an innovative cross-institutional EHR query prototype that offers extended query options, including searching for specific information items or sets of information items. The available query options were derived from a systematic analysis of information needs of diabetes specialists during patient encounters. The prototype operates in an IHE-XDS-based environment where ISO/EN 13606-structured documents are available. We conducted a controlled study with seven diabetes specialists to assess the feasibility and impact of this EHR query prototype on efficient retrieving of patient information to answer typical clinical questions. The controlled study showed that the specialists were quicker and more successful (measured in percentage of expected information items found) in finding patient information compared to the standard full-document search options. The participants also appreciated the extended query options. PMID:23304308

  15. Adaptive [theta]-methods for pricing American options

    NASA Astrophysics Data System (ADS)

    Khaliq, Abdul Q. M.; Voss, David A.; Kazmi, Kamran

    2008-12-01

    We develop adaptive [theta]-methods for solving the Black-Scholes PDE for American options. By adding a small, continuous term, the Black-Scholes PDE becomes an advection-diffusion-reaction equation on a fixed spatial domain. Standard implementation of [theta]-methods would require a Newton-type iterative procedure at each time step thereby increasing the computational complexity of the methods. Our linearly implicit approach avoids such complications. We establish a general framework under which [theta]-methods satisfy a discrete version of the positivity constraint characteristic of American options, and numerically demonstrate the sensitivity of the constraint. The positivity results are established for the single-asset and independent two-asset models. In addition, we have incorporated and analyzed an adaptive time-step control strategy to increase the computational efficiency. Numerical experiments are presented for one- and two-asset American options, using adaptive exponential splitting for two-asset problems. The approach is compared with an iterative solution of the two-asset problem in terms of computational efficiency.

  16. Design Considerations | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  17. Gas Fills | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  18. Understanding Windows | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  19. Books & Publications | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  20. Efficient Windows Collaborative | Home

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  1. 78 FR 11257 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... facility for executing and routing standardized equity and index options. The Exchange also proposes a... using the Financial Information Exchange (``FIX'') protocol. The Exchange also proposes to define the...

  2. Resources | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  3. Provide Views | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  4. Links | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  5. Reducing Condensation | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  6. Reduced Fading | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  7. EWC Membership | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  8. Visible Transmittance | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  9. EWC Members | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  10. Financing & Incentives | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  11. Production of renewable diesel fuel from biologically based feedstocks.

    DOT National Transportation Integrated Search

    2014-09-01

    Renewable diesel is an emerging option to achieve the goal set by the Federal Renewable Fuel Standard of displacing 20% of our nations petroleum consumption with : renewable alternatives by 2022. It involves converting readily available vegetable ...

  12. 40 CFR 63.4491 - What are my options for meeting the emission limits?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CATEGORIES National Emission Standards for Hazardous Air Pollutants for Surface Coating of Plastic Parts and... reductions achieved by emission capture systems and add-on controls, the organic HAP emission rate for the...

  13. Modelling determinants of child mortality and poverty in the Comoros.

    PubMed

    Lachaud, Jean-Pierre

    2004-03-01

    Based on the Demographic and Health Survey of the Comoros of 1996, the analysis of the determinants of child mortality reaches three conclusions. Firstly, differentiated analytical options generate partially convergent results and provide different dimensions of child mortality. Secondly, the study shows that the low standard of living of households in terms of assets is associated with high child mortality. Thirdly, the determinants of infant and infanto-juvenile mortality are relatively comparable. On the one hand, some common factors to both analytical options affect negatively child health: (i) geographical location in rural zones and/or on the islands of Anjouan and Mohéli; (ii) the low standard of living of households in terms of assets; (iii) some community elements, in particular morbidity, the insufficiency of vaccination and the absence of childbirth assisted by qualified persons. On the other hand, characteristics of mothers and births have an impact on infant and infanto-juvenile survival.

  14. Current Standard and Investigational Approaches to the Management of Hormone-Refractory Prostate Cancer

    PubMed Central

    Mendiratta, Prateek; Armstrong, Andrew J; George, Daniel J

    2007-01-01

    Prostate cancer is a common cause of death in men and remains incurable in the metastatic setting. In 2004, 2 landmark trials using docetaxel-based chemotherapy, TAX 327 and SWOG 99-16, showed a survival benefit for the first time in metastatic, hormone-refractory prostate cancer. Current research suggests that several distinct mechanisms of androgen-refractory disease may converge in patients with disease progression on androgen deprivation therapy. These findings have identified several potential targets for therapeutic intervention. Current standard and investigational treatment options for this disease are discussed, including chemotherapy and rapidly evolving therapies in phase II/III trials involving antiangiogenic therapies, signal transduction inhibitors, immunomodulatory agents, and nuclear receptor targets. In light of a growing array of treatment options and an increasingly chronic natural history, this review supports a multidisciplinary care approach to these patients, including medical oncologists, urologists, and radiation oncologists, to optimize survival and quality of life. PMID:17387372

  15. [Treatment of asymptomatic carotid artery stenosis: improvement of evidence with new SPACE-2 design necessary].

    PubMed

    Reiff, T; Amiri, H; Ringleb, P A; Jansen, O; Hacke, W; Eckstein, H H; Fraedrich, G; Mudra, H; Mansmann, U

    2013-12-01

    Asymptomatic carotid artery stenosis may be treated with carotid endarterectomy (CEA), carotid artery stenting (CAS) or with best medical treatment (BMT) only. Definitive and evidence-based treatment recommendations for one of these options are currently not possible. Studies showing an advantage of CEA over BMT alone do not meet current standards from a pharmacological point of view. On the other hand, more recent data point to a further stroke risk reduction using BMT according to current standards. Studies on carotid artery stenting as a third alternative treatment are partially insufficient, especially when comparing CAS with BMT. Initiated in 2009, the randomized, controlled, multicenter SPACE-2 trial is intended to answer the question about the best treatment option of asymptomatic carotid artery stenosis; however, to increase recruitment rates as a condition for the successful completion of this important study, the trial design had to be modified.

  16. Impact of the hard-coded parameters on the hydrologic fluxes of the land surface model Noah-MP

    NASA Astrophysics Data System (ADS)

    Cuntz, Matthias; Mai, Juliane; Samaniego, Luis; Clark, Martyn; Wulfmeyer, Volker; Attinger, Sabine; Thober, Stephan

    2016-04-01

    Land surface models incorporate a large number of processes, described by physical, chemical and empirical equations. The process descriptions contain a number of parameters that can be soil or plant type dependent and are typically read from tabulated input files. Land surface models may have, however, process descriptions that contain fixed, hard-coded numbers in the computer code, which are not identified as model parameters. Here we searched for hard-coded parameters in the computer code of the land surface model Noah with multiple process options (Noah-MP) to assess the importance of the fixed values on restricting the model's agility during parameter estimation. We found 139 hard-coded values in all Noah-MP process options, which are mostly spatially constant values. This is in addition to the 71 standard parameters of Noah-MP, which mostly get distributed spatially by given vegetation and soil input maps. We performed a Sobol' global sensitivity analysis of Noah-MP to variations of the standard and hard-coded parameters for a specific set of process options. 42 standard parameters and 75 hard-coded parameters were active with the chosen process options. The sensitivities of the hydrologic output fluxes latent heat and total runoff as well as their component fluxes were evaluated. These sensitivities were evaluated at twelve catchments of the Eastern United States with very different hydro-meteorological regimes. Noah-MP's hydrologic output fluxes are sensitive to two thirds of its standard parameters. The most sensitive parameter is, however, a hard-coded value in the formulation of soil surface resistance for evaporation, which proved to be oversensitive in other land surface models as well. Surface runoff is sensitive to almost all hard-coded parameters of the snow processes and the meteorological inputs. These parameter sensitivities diminish in total runoff. Assessing these parameters in model calibration would require detailed snow observations or the calculation of hydrologic signatures of the runoff data. Latent heat and total runoff exhibit very similar sensitivities towards standard and hard-coded parameters in Noah-MP because of their tight coupling via the water balance. It should therefore be comparable to calibrate Noah-MP either against latent heat observations or against river runoff data. Latent heat and total runoff are sensitive to both, plant and soil parameters. Calibrating only a parameter sub-set of only soil parameters, for example, thus limits the ability to derive realistic model parameters. It is thus recommended to include the most sensitive hard-coded model parameters that were exposed in this study when calibrating Noah-MP.

  17. Who Are the Students Who May Qualify for an Alternate Assessment Based on Modified Academic Achievement Standards (AA-MAS)?: Focus Group Results. Synthesis Report 79

    ERIC Educational Resources Information Center

    Berndt, Sandra; Ebben, Barbara; Kubinski, Eva; Sim, Grant; Liu, Kristin; Lazarus, Sheryl; Thurlow, Martha; Christian, Elizabeth

    2011-01-01

    Beginning in 2007, federal regulations to two major education laws gave state departments of education the option to develop an alternate assessment based on modified achievement standards (AA-MAS) for some students with disabilities. The regulations stated that the AA-MAS was intended for students who were being instructed in the grade-level…

  18. Electron microprobe analysis program for biological specimens: BIOMAP

    NASA Technical Reports Server (NTRS)

    Edwards, B. F.

    1972-01-01

    BIOMAP is a Univac 1108 compatible program which facilitates the electron probe microanalysis of biological specimens. Input data are X-ray intensity data from biological samples, the X-ray intensity and composition data from a standard sample and the electron probe operating parameters. Outputs are estimates of the weight percentages of the analyzed elements, the distribution of these estimates for sets of red blood cells and the probabilities for correlation between elemental concentrations. An optional feature statistically estimates the X-ray intensity and residual background of a principal standard relative to a series of standards.

  19. A novel imaging approach for prostate cancer is tested in new clinical trial | Center for Cancer Research

    Cancer.gov

    Prostate cancer patients who have failed standard radiation therapy have the options of surgery, radioactive seed implantation or cryoablation. Deborah Citrin, M.D., of the Radiation Oncology Branch is leading a study of stereotactic body radiation therapy (SBRT) to treat prostate cancer that has recurred locally after standard radiation therapy. The goal of this study is to use a novel imaging approach to guide treatment and to define the best dose of SBRT for patients whose prostate cancer has recurred after standard radiotherapy. Read more...

  20. Les inconvénients de perdre du poids

    PubMed Central

    Bosomworth, N. John

    2012-01-01

    Résumé Objectif Explorer les raisons pour lesquelles la perte de poids à long terme échoue la plupart du temps et évaluer les conséquences de diverses trajectoires pondérales, y compris la stabilité, la perte et le gain. Source des données Les études qui évaluent les paramètres pondéraux dans la population sont en majorité observationnelles. Des données probantes de niveau I ont été publiées pour évaluer l’influence des interventions relatives au poids sur la mortalité et la qualité de vie. Message principal Seulement un petit pourcentage des personnes qui désirent perdre du poids réussissent à le faire de manière durable. La mortalité est la plus faible chez les personnes se situant dans la catégorie de poids élevé-normal et surpoids. La trajectoire pondérale la plus sécuritaire est la stabilité du poids avec une optimisation de la condition physique et métabolique. Il est démontré que la mortalité est plus faible chez les personnes ayant des comorbidités reliées à l’obésité si elles perdent du poids. Il est aussi établi que la qualité de vie sur le plan de la santé est meilleure chez les personnes obèses qui perdent du poids. Par contre, la perte de poids chez une personne obèse autrement en santé est associée à une mortalité accrue. Conclusion La perte de poids est recommandable seulement chez les personnes qui ont des comorbidités reliées à l’obésité. Les personnes obèses en santé qui veulent perdre du poids devraient être informées qu’il peut y avoir des risques à le faire. Une stratégie qui se traduit par un indice de masse corporelle stable avec une condition physique et métabolique optimisée, peu importe le poids, est l’option d’intervention la plus sécuritaire en ce qui concerne le poids.

  1. Some practical universal noiseless coding techniques, part 3, module PSl14,K+

    NASA Technical Reports Server (NTRS)

    Rice, Robert F.

    1991-01-01

    The algorithmic definitions, performance characterizations, and application notes for a high-performance adaptive noiseless coding module are provided. Subsets of these algorithms are currently under development in custom very large scale integration (VLSI) at three NASA centers. The generality of coding algorithms recently reported is extended. The module incorporates a powerful adaptive noiseless coder for Standard Data Sources (i.e., sources whose symbols can be represented by uncorrelated non-negative integers, where smaller integers are more likely than the larger ones). Coders can be specified to provide performance close to the data entropy over any desired dynamic range (of entropy) above 0.75 bit/sample. This is accomplished by adaptively choosing the best of many efficient variable-length coding options to use on each short block of data (e.g., 16 samples) All code options used for entropies above 1.5 bits/sample are 'Huffman Equivalent', but they require no table lookups to implement. The coding can be performed directly on data that have been preprocessed to exhibit the characteristics of a standard source. Alternatively, a built-in predictive preprocessor can be used where applicable. This built-in preprocessor includes the familiar 1-D predictor followed by a function that maps the prediction error sequences into the desired standard form. Additionally, an external prediction can be substituted if desired. A broad range of issues dealing with the interface between the coding module and the data systems it might serve are further addressed. These issues include: multidimensional prediction, archival access, sensor noise, rate control, code rate improvements outside the module, and the optimality of certain internal code options.

  2. Acceptability of electronic cigarettes as an option to replace tobacco smoking for alcoholics admitted to hospital for detoxification.

    PubMed

    Truman, Penelope; Gilmour, Moira; Robinson, Geoffrey

    2018-02-23

    A feasibility/acceptability trial was undertaken at Ward 5, Kenepuru Hospital, Porirua, to ascertain whether electronic cigarettes (e-cigarettes) were a useful option to replace or reduce smoking in the detoxification ward. Two groups of patients were studied. Tobacco use and dependency data were collected for each. The first group was surveyed on the usefulness of standard nicotine replacement therapy (NRT). The second group were offered e-cigarettes with the option of standard NRT as well. All were asked to record their use of cigarettes, e-cigarettes and NRT during their stay on the ward, and to comment on their experiences. Outcomes monitored were self-reported use of NRT and of tobacco. Informal impressions of the nursing staff were also collected, where offered. For the e-cigarette group, a blood sample was taken on day 3 or 4 of their stay in hospital for nicotine/cotinine analysis, to confirm nicotine intake status. E-cigarettes were well tolerated as a form of nicotine replacement, eliciting positive comments, though they were not effective for all. The average reduction in median cigarettes per day was very similar between the group given standard NRT and the e-cigarette group, at 80% and 86% respectively. There were no adverse effects reported. The study showed that e-cigarettes were an acceptable form of nicotine replacement for these alcohol-dependent patients during their time in the ward. For heavily tobacco-dependent smokers, e-cigarettes may provide a useful aid to patient management within a hospital setting.

  3. Options as information: rational reversals of evaluation and preference.

    PubMed

    Sher, Shlomi; McKenzie, Craig R M

    2014-06-01

    This article develops a rational analysis of an important class of apparent preference reversals-joint-separate reversals traditionally explained by the evaluability hypothesis. The "options-as-information" model considers a hypothetical rational actor with limited knowledge about the market distribution of a stimulus attribute. The actor's evaluations are formed via a 2-stage process-an inferential stage in which beliefs are updated on the basis of the sample of options received, followed by an assessment stage in which options are evaluated in light of these updated beliefs. This process generates joint-separate reversals in standard experimental designs. The normative model explains why the evaluability hypothesis works when it does, identifies boundary conditions for the hypothesis, and clarifies some common misconceptions about these effects. In particular, it implies that joint-separate reversals are not irrational; in fact, they are not preference reversals. However, in expanded designs where more than 2 options are jointly evaluated, the model predicts that genuine (and rational) preference reversals will sometimes emerge. Results of 3 experiments suggest an excellent fit between the rational actor model and the judgments of human actors in joint-separate experiments. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  4. Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery

    PubMed Central

    Plummer, Joseph M; Leake, Pierre-Anthony; Albert, Matthew R

    2017-01-01

    Over the last decade, with the acceptance of the need for improvements in the outcome of patients affected with rectal cancer, there has been a significant increase in the literature regarding treatment options available to patients affected by this disease. That treatment related decisions should be made at a high volume multidisciplinary tumor board, after pre-operative rectal magnetic resonance imaging and the importance of total mesorectal excision (TME) are accepted standard of care. More controversial is the emerging role for watchful waiting rather than radical surgery in complete pathologic responders, which may be appropriate in 20% of patients. Patients with early T1 rectal cancers and favorable pathologic features can be cured with local excision only, with transanal minimal invasive surgery (TAMIS) because of its versatility and almost universal availability of the necessary equipment and skillset in the average laparoscopic surgeon, emerging as the leading option. Recent trials have raised concerns about the oncologic outcomes of the standard “top-down” TME hence transanal TME (TaTME “bottom-up”) approach has gained popularity as an alternative. The challenges are many, with a dearth of evidence of the oncologic superiority in the long-term for any given option. However, this review highlights recent advances in the role of chemoradiation only for complete pathologic responders, TAMIS for highly selected early rectal cancer patients and TaTME as options to improve cure rates whilst maintaining quality of life in these patients, while we await the results of further definitive trials being currently conducted. PMID:28690773

  5. Benefits of Efficient Windows | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  6. Increased Light & View | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  7. Windows for New Construction | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  8. Window Selection Tool | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  9. Ozone (O3) Standards - Policy Assessments from Current Review

    EPA Pesticide Factsheets

    The policy assessment (PA) provides a transparent staff analysis of the scientific basis for alternative policy options for consideration by senior EPA management prior to rulemaking. These are the policy assessments used to develop the ozone NAAQS.

  10. Satellite Power System (SPS) international agreements

    NASA Technical Reports Server (NTRS)

    Grove, S.

    1978-01-01

    The problems in obtaining international agreements on geostationary orbit availability, microwave frequency allocations and microwave frequency standards for satellites transmitting solar power are considered. The various U.S. policy options, strategies and time frames with respect to key issues are analyzed.

  11. What's New in Aquatics Training.

    ERIC Educational Resources Information Center

    Ensign, Jim

    1992-01-01

    There are many options for aquatic professionals requiring retraining to stay current and certified. The article describes six aquatics training programs, noting their strong points, common concerns, basic features, standard fees, course lengths, and how other professionals view their services. (SM)

  12. Air Leakage (AL) | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  13. State Fact Sheets | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  14. Fact Sheets & Publications | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  15. Condensation Resistance (CR) | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  16. Low Conductance Spacers | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  17. Energy & Cost Savings | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  18. U-Factor (U-value) | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  19. 42 CFR 413.20 - Financial data and reports.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... costs payable under the program. Standardized definitions, accounting, statistics, and reporting...; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Accounting Records and... providers on an annual basis with reporting periods based on the provider's accounting year. In the...

  20. Environmental Assessment of Biofuel Options

    EPA Science Inventory

    The EPA Office of Transportation and Air Quality is responsible for administering the Second Renewable Fuels Standard under the Energy Independence and Security Act of 2007. The progress of these efforts and the associated environmental impacts are assessed in the Triennial Biof...

  1. Practice Parameters for the Surgical Modifications of the Upper Airway for Obstructive Sleep Apnea in Adults

    PubMed Central

    Aurora, R. Nisha; Casey, Kenneth R.; Kristo, David; Auerbach, Sanford; Bista, Sabin R.; Chowdhuri, Susmita; Karippot, Anoop; Lamm, Carin; Ramar, Kannan; Zak, Rochelle; Morgenthaler, Timothy I.

    2010-01-01

    Background: Practice parameters for the treatment of obstructive sleep apnea syndrome (OSAS) in adults by surgical modification of the upper airway were first published in 1996 by the American Academy of Sleep Medicine (formerly ASDA). The following practice parameters update the previous practice parameters. These recommendations were reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. Methods: A systematic review of the literature was performed, and the GRADE system was used to assess the quality of evidence. The findings from this evaluation are provided in the accompanying review paper, and the subsequent recommendations have been developed from this review. The following procedures have been included: tracheostomy, maxillo-mandibular advancement (MMA), laser assisted uvulopalatoplasty (LAUP), uvulopalatopharyngoplasty (UPPP),radiofrequency ablation (RFA), and palatal implants. Recommendations: The presence and severity of obstructive sleep apnea must be determined before initiating surgical therapy (Standard). The patient should be advised about potential surgical success rates and complications, the availability of alternative treatment options such as nasal positive airway pressure and oral appliances, and the levels of effectiveness and success rates of these alternative treatments (Standard). The desired outcomes of treatment include resolution of the clinical signs and symptoms of obstructive sleep apnea and the normalization of sleep quality, the apnea-hypopnea index, and oxyhemoglobin saturation levels (Standard). Tracheostomy has been shown to be an effective single intervention to treat obstructive sleep apnea. This operation should be considered only when other options do not exist, have failed, are refused, or when this operation is deemed necessary by clinical urgency (Option). MMA is indicated for surgical treatment of severe OSA in patients who cannot tolerate or who are unwilling to adhere to positive airway pressure therapy, or in whom oral appliances, which are more often appropriate in mild and moderate OSA patients, have been considered and found ineffective or undesirable (Option). UPPP as a sole procedure, with or without tonsillectomy, does not reliably normalize the AHI when treating moderate to severe obstructive sleep apnea syndrome. Therefore, patients with severe OSA should initially be offered positive airway pressure therapy, while those with moderate OSA should initially be offered either PAP therapy or oral appliances (Option). Use of multi-level or stepwise surgery (MLS), as a combined procedure or as stepwise multiple operations, is acceptable in patients with narrowing of multiple sites in the upper airway, particularly if they have failed UPPP as a sole treatment (Option). LAUP is not routinely recommended as a treatment for obstructive sleep apnea syndrome (Standard). RFA can be considered as a treatment in patients with mild to moderate obstructive sleep apnea who cannot tolerate or who are unwilling to adhere to positive airway pressure therapy, or in whom oral appliances have been considered and found ineffective or undesirable (Option). Palatal implants may be effective in some patients with mild obstructive sleep apnea who cannot tolerate or who are unwilling to adhere to positive airway pressure therapy, or in whom oral appliances have been considered and found ineffective or undesirable (Option). Postoperatively, after an appropriate period of healing, patients should undergo follow-up evaluation including an objective measure of the presence and severity of sleep-disordered breathing and oxygen saturation, as well as clinical assessment for residual symptoms. Additionally, patients should be followed over time to detect the recurrence of disease (Standard). Conclusions: While there has been significant progress made in surgical techniques for the treatment of OSA, there is a lack of rigorous data evaluating surgical modifications of the upper airway. Systematic and methodical investigations are needed to improve the quality of evidence, assess additional outcome measures, determine which populations are most likely to benefit from a particular procedure or procedures, and optimize perioperative care. Citation: Aurora RN; Casey KR; Kristo D; Auerbach S; Bista SR; Chowdhuri S; Karippot A; Lamm C; Ramar K; Zak R; Morgenthaler TI. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. SLEEP 2010;33(10):1408-1413. PMID:21061864

  2. Stakeholder analysis for adopting a personal health record standard in Korea.

    PubMed

    Kang, Min-Jeoung; Jung, Chai Young; Kim, Soyoun; Boo, Yookyung; Lee, Yuri; Kim, Sundo

    Interest in health information exchanges (HIEs) is increasing. Several countries have adopted core health data standards with appropriate strategies. This study was conducted to determine the feasibility of a continuity of care record (CCR) as the standard for an electronic version of the official transfer note and the HIE in Korean healthcare. A technical review of the CCR standard and analysis of stakeholders' views were undertaken. Transfer notes were reviewed and matched with CCR standard categories. The standard for the Korean coding system was selected. Stakeholder analysis included an online survey of members of the Korean Society of Medical Informatics, a public hearing to derive opinions of consumers, doctors, vendors, academic societies and policy makers about the policy process, and a focus group meeting with EMR vendors to determine which HIE objects were technically applicable. Data objects in the official transfer note form matched CCR standards. Korean Classification of Diseases, Korean Standard Terminology of Medicine, Electronic Data Interchange code (EDI code), Logical Observation Identifiers Names and Codes, and Korean drug codes (KD code) were recommended as the Korean coding standard.'Social history', 'payers', and 'encounters' were mostly marked as optional or unnecessary sections, and 'allergies', 'alerts', 'medication list', 'problems/diagnoses', 'results',and 'procedures' as mandatory. Unlike the US, 'social history' was considered optional and 'advance directives' mandatory.At the public hearing there was some objection from the Korean Medical Association to the HIE on legal grounds in termsof intellectual property and patients' personal information. Other groups showed positive or neutral responses. Focus group members divided CCR data objects into three phases based onpredicted adoption time in CCR: (i) immediate adoption; (ii) short-term adoption ('alerts', 'family history'); and (iii) long-term adoption ('results', 'advanced directives', 'functional status', 'medical equipment', 'vital signs', 'plan of care', 'social history'). There were no technical problems in generating the CCR standard document from EMRs. Matters of concern that arose from study results should be resolved with time and consultation.

  3. Does provision of point-of-care CD4 technology and early knowledge of CD4 levels affect early initiation and retention on antiretroviral treatment in HIV-positive pregnant women in the context of Option B+ for PMTCT?

    PubMed

    Mangwiro, Alexio-Zambezi; Makomva, Kudzai; Bhattacharya, Antoinette; Bhattacharya, Gaurav; Gotora, Tendai; Owen, Mila; Mushavi, Angela; Mangwanya, Douglas; Zinyowera, Sekesai; Rusakaniko, Simbarashe; Mugurungi, Owen; Zizhou, Simukai; Busumani, William; Masuka, Nyasha

    2014-11-01

    Evidence for Elimination (E4E) is a collaborative project established in 2012 as part of the INSPIRE (INtegrating and Scaling up PMTCT through Implementation REsearch) initiative. E4E is a cluster-randomized trial with 2 arms; Standard of care and "POC Plus" [in which point-of-care (POC) CD4 devices and related counseling support are provided]; aimed at improving retention-in-care of HIV-infected pregnant women and mothers. In November 2013, Zimbabwe adopted Option B+ for HIV-positive pregnant women under which antiretroviral treatment eligibility is no longer based on CD4 count. However, Ministry of Health and Child Care guidelines still require baseline and 6-monthly CD4 testing for treatment monitoring, until viral load testing becomes widely available. Considering the current limited capacity for viral-load testing, the significant investments in CD4 testing already made and the historical reliance on CD4 by health care workers for determining eligibility for antiretroviral treatment, E4E seeks to compare the impact of the provision of POC CD4 technology and early knowledge of CD4 levels on retention-in-care at 12 months, with the current standard of routine, laboratory-based CD4 testing. The study also compares rates of initiation and time-to-initiation between the 2 arms and according to level of maternal CD4 count, the cost of retaining HIV-positive pregnant women in care and the acceptability and feasibility of POC CD4 in the context of Option B+. Outcome measures are derived from routine health systems data. E4E will provide data on POC CD4 testing and retention-in-care associated with Option B+ and serve as an early learning platform to inform implementation of Option B+ in Zimbabwe.

  4. [Systematic review on conservative treatment options in non-muscle-invasive bladder cancer patients refractory to Bacillus Calmette-Guérin instillation therapy].

    PubMed

    Martini, Thomas; Wezel, Felix; Löbig, Niklas; Mitterberger, Michael J; Colleselli, Daniela

    2017-08-01

    Background Adjuvant Bacillus Calmette-Guérin (BCG) intravesical instillation is the recommended standard treatment in patients with high-risk non-muscle-invasive bladder cancer (NMIBC). However, a significant proportion of patients fail treatment, and radical cystectomy (RC) is the subsequent gold standard. On the other hand, there is an unmet need for conservative alternatives for patients who are unfit or unwilling to undergo surgery. This study aimed to identify conservative treatment options in NMIBC patients after BCG failure. Material and Methods We performed a systematic search in the databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, including all randomised controlled trials (RCTs), quasi-RCTs and single-arm studies, in which patients with NMIBC were treated with second-line intravesical or systemic therapy after BCG failure. A minimum of eight patients were included in each treatment arm. Full papers were restricted to English language. Literature research and data analysis were assessed independently by two reviewers. Data on treatment response, recurrence, time to recurrence, progression and rate of cystectomy were collected and analysed. Results  This systematic review included 42 publications with a total of 3521 patients (2371 BCG failures). Valrubicin, taxanes, gemcitabine, combination chemotherapy, thermochemotherapy, photodynamic therapy, combination of BCG and interferon and immunotherapies or targeted therapies were identified as conservative treatment options. For taxanes, gemcitabine and thermochemotherapy there is the highest evidence for a clinical meaningful response with minor toxicities. Conclusions Despite some promising response rates for taxanes, gemcitabine or thermochemotherapy, an evidence-based recommendation for treatment options superior to RC in patients failing BCG therapy cannot be made. The definition of BCG failure is still inconsistent and heterogeneous outcomes in patients with BCG failure have been reported. In order to identify effective conservative therapy options in patients failing BCG therapy, prospective trials with a standardised trial design are needed. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Reduction of Noise from the J-52 and F-404 Jet Engines During Static Testing Using the Noise Attenuation Device (NAD)

    DTIC Science & Technology

    2009-06-01

    Filters, Order 3, Type 0-C, Optional Range B.2.2 Sound Level Meter Calibration • ISO / IEC 17025 :2005 General requirements for the competence of...noise levels − NCSL -National Conference of Standards Laboratories − ISO - International Standards Organization − IEC - The International...testing and calibration laboratories • ISO 10012:2003 Measurement management systems -- Requirements for measurement processes and measuring

  6. Space station needs, attributes and architectural options study. Volume 4: Architectural options, subsystems, technology and programmatics

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Space station architectural options, habitability considerations and subsystem analyses, technology, and programmatics are reviewed. The methodology employed for conceiving and defining space station concepts is presented. As a result of this approach, architectures were conceived and along with their supporting rationale are described within this portion of the report. Habitability consideration and subsystem analyses describe the human factors associated with space station operations and includes subsections covering (1) data management, (2) communications and tracking, (3) environmental control and life support, (4) manipulator systems, (5) resupply, (6) pointing, (7) thermal management and (8) interface standardization. A consolidated matrix of subsystems technology issues as related to meeting the mission needs for a 1990's era space station is presented. Within the programmatics portion, a brief description of costing and program strategies is outlined.

  7. Management of urinary incontinence in residential care.

    PubMed

    Lim, David S

    2016-07-01

    Urinary incontinence is prevalent in residential care and rates are expected to increase with the ageing population in Australia. It contributes to poor quality of life (QoL), functional impairments in activities of daily living, and deterioration of mental and sexual health. Management depends on the type of incontinence, its aetiology, the severity of symptoms, the effects on QoL, and patient factors. Treatment options include active treatment and passive containment. However, not all active treatment options are feasible in residential care. There is little evidence to advise on standard best practice. The aims of this article are to review treatment options for urinary incontinence in residential care, feasibility of service delivery and challenges associated with this. A greater understanding of the issues surrounding the management of urinary incontinence in residential care is required to deliver satisfactory patient-centred care on a consistent basis.

  8. Fertility patients' views about frozen embryo disposition: Results of a multi-institutional U.S. survey

    PubMed Central

    Lyerly, Anne Drapkin; Steinhauser, Karen; Voils, Corrine; Namey, Emily; Alexander, Carolyn; Bankowski, Brandon; Cook-Deegan, Robert; Dodson, William C.; Gates, Elena; Jungheim, Emily S.; McGovern, Peter G.; Myers, Evan R.; Osborn, Barbara; Schlaff, William; Sugarman, Jeremy; Tulsky, James A.; Walmer, David; Faden, Ruth R.; Wallach, Edward

    2010-01-01

    Objective To describe fertility patients' preferences for disposition of cryopreserved embryos and determine factors important to these preferences Design Cross-sectional survey conducted between June 2006 and July 2007 Setting Nine geographically diverse U.S. fertility clinics Participants 1020 fertility patients with cryopreserved embryos Interventions Self-administered questionnaire Main Outcome Measures Likelihood of selecting each of five conventional embryo disposition options: store for reproduction, thaw and discard, donate to another couple, freeze indefinitely, and donate for research; likelihood of selecting each of two alternative options identified in previous research: placement of embryos in the woman's body at an infertile time, and a disposal ceremony; importance of each of 26 considerations to disposition decisions; and views on the embryo's moral status. Results 54% of respondents with cryopreserved embryos were very likely to use them for reproduction, 21% were very likely to donate for research, 7% or fewer were very likely to choose any other option. Respondents who ascribed high importance to concerns about the health or well-being of the embryo, fetus, or future child were more likely to thaw and discard embryos or freeze them indefinitely. Conclusions Fertility patients frequently prefer disposition options not available to them or find available options unacceptable. Restructuring and standardizing the informed consent process and ensuring availability of all disposition options may benefit patients, facilitate disposition decisions and address problems of long term storage. PMID:19061998

  9. Ozone (O3) Standards - Policy Assessments from Review Completed in 2015

    EPA Pesticide Factsheets

    The policy assessment (PA) provides a transparent staff analysis of the scientific basis for alternative policy options for consideration by senior EPA management prior to rulemaking. These are the policy assessments used to develop the ozone NAAQS.

  10. Selection Process for New Windows | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  11. Design Guidance for New Windows | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  12. Selection Process for Replacement Windows | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  13. Design Guidance for Replacement Windows | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  14. 78 FR 66318 - Securities Investor Protection Corporation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ...] Securities Investor Protection Corporation AGENCY: Securities and Exchange Commission. ACTION: Proposed rule. SUMMARY: The Securities Investor Protection Corporation (``SIPC'') filed a proposed rule change with the... satisfaction of customer claims for standardized options under the Securities Investor Protection Act of 1970...

  15. 78 FR 75657 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-12

    ... facility for executing and routing standardized equity and index options, to amend Routing Fees. While... other persons using any facility or system which NASDAQ operates or controls, and is not designed to...

  16. Breast Cancer: Treatment Options

    MedlinePlus

    ... A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should ...

  17. Solar Heat Gain Coefficient (SHGC) | Efficient Windows Collaborative

    Science.gov Websites

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  18. Care of elderly women with ovarian cancer.

    PubMed

    De Gaetano, Colleen; Lichtman, Stuart M

    2004-01-01

    The goal of this article is to educate nurses about ovarian cancer in older women, its treatment options, and related nursing interventions. This information will enable readers to identify risk factors for ovarian cancer, standard treatment approaches, nursing interventions, and patient care.

  19. Advanced space program studies: Overall executive summary

    NASA Technical Reports Server (NTRS)

    Sitney, L. R.

    1974-01-01

    Studies were conducted to provide NASA with advanced planning analyses which relate integrated space program goals and options to credible technical capabilities, applications potential, and funding resources. The studies concentrated on the following subjects: (1) upper stage options for the space transportation system based on payload considerations, (2) space servicing and standardization of payloads, (3) payload operations, and (4) space transportation system economic analyses related to user charges and new space applications. A systems cost/performance model was developed to synthesize automated, unmanned spacecraft configurations based on the system requirements and a list of equipments at the assembly level.

  20. Cost analysis in support of minimum energy standards for clothes washers and dryers

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

    Not Available

    1979-02-02

    The results of the cost analysis of energy conservation design options for laundry products are presented. The analysis was conducted using two approaches. The first, is directed toward the development of industrial engineering cost estimates of each energy conservation option. This approach results in the estimation of manufacturers costs. The second approach is directed toward determining the market price differential of energy conservation features. The results of this approach are shown. The market cost represents the cost to the consumer. It is the final cost, and therefore includes distribution costs as well as manufacturing costs.

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