Longitudinal Processing Speed Impairments in Males with Autism and the Effects of White Matter Microstructure

PubMed Central

Travers, Brittany G.; Bigler, Erin D.; Tromp, Do P. M.; Adluru, Nagesh; Froehlich, Alyson L.; Ennis, Chad; Lange, Nicholas; Nielsen, Jared A.; Prigge, Molly B. D.; Alexander, Andrew L.; Lainhart, Janet E.

2014-01-01

The present study used an accelerated longitudinal design to examine group differences and age-related changes in processing speed in 81 individuals with Autism Spectrum Disorder (ASD) compared to 56 age-matched individuals with typical development (ages 6–39 years). Processing speed was assessed using the Wechsler Intelligence Scale for Children-3rd edition (WISC-III) and the Wechsler Adult Intelligence Scale-3rd edition (WAIS-III). Follow-up analyses examined processing speed subtest performance and relations between processing speed and white matter microstructure (as measured with diffusion tensor imaging [DTI] in a subset of these participants). After controlling for full scale IQ, the present results show that processing speed index standard scores were on average 12 points lower in the group with ASD compared to the group with typical development. There were, however, no significant group differences in standard score age-related changes within this age range. For subtest raw scores, the group with ASD demonstrated robustly slower processing speeds in the adult versions of the IQ test (i.e., WAIS-III) but not in the child versions (WISC-III), even though age-related changes were similar in both the ASD and typically developing groups. This pattern of results may reflect difficulties that become increasingly evident in ASD on more complex measures of processing speed. Finally, DTI measures of whole-brain white matter microstructure suggested that fractional anisotropy (but not mean diffusivity, radial diffusivity, or axial diffusivity) made significant but small-sized contributions to processing speed standard scores across our entire sample. Taken together, the present findings suggest that robust decreases in processing speed may be present in ASD, more pronounced in adulthood, and partially attributable to white matter microstructural integrity. PMID:24269298

[Analysis of the influence of the process of care in primary health care on avoidable hospitalizations for heart failure].

PubMed

del Saz Moreno, Vicente; Alberquilla Menéndez-Asenjo, Ángel; Camacho Hernández, Ana M; Lora Pablos, David; Enríquez de Salamanca Lorente, Rafael; Magán Tapia, Purificación

2016-02-01

To determine if the process of care in primary health, affects the risk of avoidable hospitalizations for ambulatory care sensitive conditions (ACSH) for heart failure (HF). Case-control study analyzing the risk of hospitalization for HF. The exposure factor was the process of care for HF in primary health. Health area of the region of Madrid (n=466.901). There were included all adult patients (14 years or older) with a documented diagnosis of HF in the electronic medical record of primary health (n=3.277). The cases were patients who were hospitalized for HF while the controls did not require admission, during 2007. risk of ACSH for HF related to the process of care considered both overall and for each separate standard of appropiate care. Differences in clinical complexity of the groups were measured using the Adjusted Clinical Group (ACG) classification system. 227 cases and 3.050 controls. Clinical complexity was greater in cases. The standards of appropriate care were met to a greater degree in the control group, but none of the two groups met all the standards that would define a process of care as fully appropriate. A significantly lower risk of ACSH was seen for only two standards of appropriate care. For each additional standard of appropriate care not met, the probability of admission was significantly greater (OR: 1,33, 95% CI: 1,19-1,49). Higher quality in the process of care in primary health was associated with a lower risk of hospitalization for HF. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Review of the transportation planning process in the Denver metropolitan area

DOT National Transportation Integrated Search

2012-11-01

Harmonization Task Groups 1 and 3 (HTG1 and 3) were established by the EU-US International Standards Harmonization Working Group to attempt to harmonize standards (including ISO, CEN, ETSI, IEEE) on security (HTG1) and communications protocols (HTG3)...

Review of the transportation planning process in the Pittsburgh metropolitan area

DOT National Transportation Integrated Search

2012-11-12

Harmonization Task Groups 1 and 3 (HTG1 and 3) were established by the EU-US International Standards Harmonization Working Group to attempt to harmonize standards (including ISO, CEN, ETSI, IEEE) on security (HTG1) and communications protocols (HTG3)...

Understanding the Perception of Very Small Software Companies towards the Adoption of Process Standards

NASA Astrophysics Data System (ADS)

Basri, Shuib; O'Connor, Rory V.

This paper is concerned with understanding the issues that affect the adoption of software process standards by Very Small Entities (VSEs), their needs from process standards and their willingness to engage with the new ISO/IEC 29110 standard in particular. In order to achieve this goal, a series of industry data collection studies were undertaken with a collection of VSEs. A twin track approach of a qualitative data collection (interviews and focus groups) and quantitative data collection (questionnaire) were undertaken. Data analysis was being completed separately and the final results were merged, using the coding mechanisms of grounded theory. This paper serves as a roadmap for both researchers wishing to understand the issues of process standards adoption by very small companies and also for the software process standards community.

The standards process: Technical committee X3B5 digital magnetic tape

NASA Technical Reports Server (NTRS)

Cheatham, Sam

1993-01-01

The definition of X3B5, where it fits in the national and international standards development process, and how it interfaces and influences the world community of standards developers are provided. Details concerning the focus of the committee, how it operates, and what the group sees as the future trends in the area of interchange standards utilizing the multifaceted, ubiquitous magnetic tape are presented.

Standardization efforts of digital pathology in Europe.

PubMed

Rojo, Marcial García; Daniel, Christel; Schrader, Thomas

2012-01-01

EURO-TELEPATH is a European COST Action IC0604. It started in 2007 and will end in November 2011. Its main objectives are evaluating and validating the common technological framework and communication standards required to access, transmit, and manage digital medical records by pathologists and other medical specialties in a networked environment. Working Group 1, "Business Modelling in Pathology," has designed main pathology processes - Frozen Study, Formalin Fixed Specimen Study, Telepathology, Cytology, and Autopsy - using Business Process Modelling Notation (BPMN). Working Group 2 has been dedicated to promoting the application of informatics standards in pathology, collaborating with Integrating Healthcare Enterprise (IHE), Digital Imaging and Communications in Medicine (DICOM), Health Level Seven (HL7), and other standardization bodies. Health terminology standardization research has become a topic of great interest. Future research work should focus on standardizing automatic image analysis and tissue microarrays imaging.

Review of the transportation planning process in the Portland, Orgeon, metropolitan area

DOT National Transportation Integrated Search

2012-11-01

Harmonization Task Groups 1 and 3 (HTG1 and 3) were established by the EU-US International Standards Harmonization Working Group to attempt to harmonize standards (including ISO, CEN, ETSI, IEEE) on security (HTG1) and communications protocols (HTG3)...

Review of the transportation planning process in the southern California metropolitan area

DOT National Transportation Integrated Search

2012-11-01

Harmonization Task Groups 1 and 3 (HTG1 and 3) were established by the EU-US International Standards Harmonization Working Group to attempt to harmonize standards (including ISO, CEN, ETSI, IEEE) on security (HTG1) and communications protocols (HTG3)...

Review of the transportation planning process in the Minneapolis-St. Paul metropolitan area

DOT National Transportation Integrated Search

2012-11-01

Harmonization Task Groups 1 and 3 (HTG1 and 3) were established by the EU-US International Standards Harmonization Working Group to attempt to harmonize standards (including ISO, CEN, ETSI, IEEE) on security (HTG1) and communications protocols (HTG3)...

7 CFR 29.6131 - Scrap (S Group).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Scrap (S Group). 29.6131 Section 29.6131 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., or the web portion of tobacco leaves reduced to scrap by any process. Summary of Standard Grades ...

7 CFR 29.2441 - Scrap (S Group).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Scrap (S Group). 29.2441 Section 29.2441 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... the web portions of tobacco leaves reduced to scrap by any process. summary of standard grades ...

The Use of Nominal Group Technique to Determine Additional Support Needs for a Group of Victorian TAFE Managers and Senior Educators

ERIC Educational Resources Information Center

Bailey, Anthony

2013-01-01

The nominal group technique (NGT) is a structured process to gather information from a group. The technique was first described in 1975 and has since become a widely-used standard to facilitate working groups. The NGT is effective for generating large numbers of creative new ideas and for group priority setting. This paper describes the process of…

Altered standards of care during an influenza pandemic: identifying ethical, legal, and practical principles to guide decision making.

PubMed

Levin, Donna; Cadigan, Rebecca Orfaly; Biddinger, Paul D; Condon, Suzanne; Koh, Howard K

2009-12-01

Although widespread support favors prospective planning for altered standards of care during mass casualty events, the literature includes few, if any, accounts of groups that have formally addressed the overarching policy considerations at the state level. We describe the planning process undertaken by public health officials in the Commonwealth of Massachusetts, along with community and academic partners, to explore the issues surrounding altered standards of care in the event of pandemic influenza. Throughout 2006, the Massachusetts Department of Public Health and the Harvard School of Public Health Center for Public Health Preparedness jointly convened a working group comprising ethicists, lawyers, clinicians, and local and state public health officials to consider issues such as allocation of antiviral medications, prioritization of critical care, and state seizure of private assets. Community stakeholders were also engaged in the process through facilitated discussion of case scenarios focused on these and other issues. The objective of this initiative was to establish a framework and some fundamental principles that would subsequently guide the process of establishing specific altered standards of care protocols. The group collectively identified 4 goals and 7 principles to guide the equitable allocation of limited resources and establishment of altered standards of care protocols. Reviewing and analyzing this process to date may serve as a resource for other states.

A Guide for Developing Standard Operating Job Procedures for the Activated Sludge - Aeration & Sedimentation Process Wastewater Treatment Facility. SOJP No. 5.

ERIC Educational Resources Information Center

Mason, George J.

This guide for developing standard operating job procedures for wastewater treatment facilities is devoted to the activated sludge aeration and sedimentation process. This process is for conversion of nonsettleable and nonfloatable materials in wastewater to settleable, floculated biological groups and separation of the settleable solids from the…

40 CFR 63.112 - Emission standard.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Process Vents, Storage Vessels, Transfer Operations, and Wastewater § 63.112 Emission standard. (a) The... emissions from all Group 1 wastewater streams, as defined in § 63.111 of this subpart. This term is.... Σ EWW2 = Sum of emissions from all Group 2 wastewater streams, as defined in § 63.111 of this...

40 CFR 63.112 - Emission standard.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Process Vents, Storage Vessels, Transfer Operations, and Wastewater § 63.112 Emission standard. (a) The... emissions from all Group 1 wastewater streams, as defined in § 63.111 of this subpart. This term is.... Σ EWW2 = Sum of emissions from all Group 2 wastewater streams, as defined in § 63.111 of this...

40 CFR 63.112 - Emission standard.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Process Vents, Storage Vessels, Transfer Operations, and Wastewater § 63.112 Emission standard. (a) The... emissions from all Group 1 wastewater streams, as defined in § 63.111 of this subpart. This term is.... Σ EWW2 = Sum of emissions from all Group 2 wastewater streams, as defined in § 63.111 of this...

Standard operating procedures for serum and plasma collection: early detection research network consensus statement standard operating procedure integration working group.

PubMed

Tuck, Melissa K; Chan, Daniel W; Chia, David; Godwin, Andrew K; Grizzle, William E; Krueger, Karl E; Rom, William; Sanda, Martin; Sorbara, Lynn; Stass, Sanford; Wang, Wendy; Brenner, Dean E

2009-01-01

Specimen collection is an integral component of clinical research. Specimens from subjects with various stages of cancers or other conditions, as well as those without disease, are critical tools in the hunt for biomarkers, predictors, or tests that will detect serious diseases earlier or more readily than currently possible. Analytic methodologies evolve quickly. Access to high-quality specimens, collected and handled in standardized ways that minimize potential bias or confounding factors, is key to the "bench to bedside" aim of translational research. It is essential that standard operating procedures, "the how" of creating the repositories, be defined prospectively when designing clinical trials. Small differences in the processing or handling of a specimen can have dramatic effects in analytical reliability and reproducibility, especially when multiplex methods are used. A representative working group, Standard Operating Procedures Internal Working Group (SOPIWG), comprised of members from across Early Detection Research Network (EDRN) was formed to develop standard operating procedures (SOPs) for various types of specimens collected and managed for our biomarker discovery and validation work. This report presents our consensus on SOPs for the collection, processing, handling, and storage of serum and plasma for biomarker discovery and validation.

Consensus standards for introductory e-learning courses in human participants research ethics.

PubMed

Williams, John R; Sprumont, Dominique; Hirtle, Marie; Adebamowo, Clement; Braunschweiger, Paul; Bull, Susan; Burri, Christian; Czarkowski, Marek; Fan, Chien Te; Franck, Caroline; Gefenas, Eugenjius; Geissbuhler, Antoine; Klingmann, Ingrid; Kouyaté, Bocar; Kraehenbhul, Jean-Pierre; Kruger, Mariana; Moodley, Keymanthri; Ntoumi, Francine; Nyirenda, Thomas; Pym, Alexander; Silverman, Henry; Tenorio, Sara

2014-06-01

This paper reports the results of a workshop held in January 2013 to begin the process of establishing standards for e-learning programmes in the ethics of research involving human participants that could serve as the basis of their evaluation by individuals and groups who want to use, recommend or accredit such programmes. The standards that were drafted at the workshop cover the following topics: designer/provider qualifications, learning goals, learning objectives, content, methods, assessment of participants and assessment of the course. The authors invite comments on the draft standards and eventual endorsement of a final version by all stakeholders. 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.

Development of a standardized, citywide process for managing smart-pump drug libraries.

PubMed

Walroth, Todd A; Smallwood, Shannon; Arthur, Karen; Vance, Betsy; Washington, Alana; Staublin, Therese; Haslar, Tammy; Reddan, Jennifer G; Fuller, James

2018-06-15

Development and implementation of an interprofessional consensus-driven process for review and optimization of smart-pump drug libraries and dosing limits are described. The Indianapolis Coalition for Patient Safety (ICPS), which represents 6 Indianapolis-area health systems, identified an opportunity to reduce clinically insignificant alerts that smart infusion pumps present to end users. Through a consensus-driven process, ICPS aimed to identify best practices to implement at individual hospitals in order to establish specific action items for smart-pump drug library optimization. A work group of pharmacists, nurses, and industrial engineers met to evaluate variability within and lack of scrutiny of smart-pump drug libraries. The work group used Lean Six Sigma methodologies to generate a list of key needs and barriers to be addressed in process standardization. The group reviewed targets for smart-pump drug library optimization, including dosing limits, types of alerts reviewed, policies, and safety best practices. The work group also analyzed existing processes at each site to develop a final consensus statement outlining a model process for reviewing alerts and managing smart-pump data. Analysis of the total number of alerts per device across ICPS-affiliated health systems over a 4-year period indicated a 50% decrease (from 7.2 to 3.6 alerts per device per month) after implementation of the model by ICPS member organizations. Through implementation of a standardized, consensus-driven process for smart-pump drug library optimization, ICPS member health systems reduced clinically insignificant smart-pump alerts. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

21 CFR 660.21 - Processing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Blood Grouping Reagent § 660.21 Processing. (a... representative samples of each group of products manufactured in the same fashion. (2) Only that material that... specifications to verify that each sublot is identical to other sublots of the lot. (4) Each lot of Blood...

Proficiency Standards and Cut-Scores for Language Proficiency Tests.

ERIC Educational Resources Information Center

Moy, Raymond H.

The problem of standard setting on language proficiency tests is often approached by the use of norms derived from the group being tested, a process commonly known as "grading on the curve." One particular problem with this ad hoc method of standard setting is that it will usually result in a fluctuating standard dependent on the particular group…

IEEE Std 730 Software Quality Assurance: Supporting CMMI-DEV v1.3, Product and Process Quality Assurance

DTIC Science & Technology

2011-05-27

frameworks 4 CMMI-DEV IEEE / ISO / IEC 15288 / 12207 Quality Assurance ©2011 Walz IEEE Life Cycle Processes & Artifacts • Systems Life Cycle Processes...TAG to ISO TC 176 Quality Management • Quality: ASQ, work experience • Software: three books, consulting, work experience • Systems: Telecom & DoD...and IEEE 730 SQA need to align. The P730 IEEE standards working group has expanded the scope of the SQA process standard to align with IS 12207

The Effect of Various Factors on Standard Setting.

ERIC Educational Resources Information Center

Norcini, John J.; And Others

1988-01-01

Two studies of medical certification examinations were undertaken to assess standard setting using Angoff's Method. Results indicate that (1) specialization within broad content areas does not affect an expert's estimates of the performance of the borderline group; and (2) performance data should be provided during the standard-setting process.…

Collaborative business process support in eHealth: integrating IHE profiles through ebXML business process specification language.

PubMed

Dogac, Asuman; Kabak, Yildiray; Namli, Tuncay; Okcan, Alper

2008-11-01

Integrating healthcare enterprise (IHE) specifies integration profiles describing selected real world use cases to facilitate the interoperability of healthcare information resources. While realizing a complex real-world scenario, IHE profiles are combined by grouping the related IHE actors. Grouping IHE actors implies that the associated business processes (IHE profiles) that the actors are involved must be combined, that is, the choreography of the resulting collaborative business process must be determined by deciding on the execution sequence of transactions coming from different profiles. There are many IHE profiles and each user or vendor may support a different set of IHE profiles that fits to its business need. However, determining the precedence of all the involved transactions manually for each possible combination of the profiles is a very tedious task. In this paper, we describe how to obtain the overall business process automatically when IHE actors are grouped. For this purpose, we represent the IHE profiles through a standard, machine-processable language, namely, Organization for the Advancement of Structured Information Standards (OASIS) ebusiness eXtensible Markup Language (ebXML) Business Process Specification (ebBP) Language. We define the precedence rules among the transactions of the IHE profiles, again, in a machine-processable way. Then, through a graphical tool, we allow users to select the actors to be grouped and automatically produce the overall business process in a machine-processable format.

Planning Model of Physics Learning In Senior High School To Develop Problem Solving Creativity Based On National Standard Of Education

NASA Astrophysics Data System (ADS)

Putra, A.; Masril, M.; Yurnetti, Y.

2018-04-01

One of the causes of low achievement of student’s competence in physics learning in high school is the process which they have not been able to develop student’s creativity in problem solving. This is shown that the teacher’s learning plan is not accordance with the National Eduction Standard. This study aims to produce a reconstruction model of physics learning that fullfil the competency standards, content standards, and assessment standards in accordance with applicable curriculum standards. The development process follows: Needs analysis, product design, product development, implementation, and product evaluation. The research process involves 2 peers judgment, 4 experts judgment and two study groups of high school students in Padang. The data obtained, in the form of qualitative and quantitative data that collected through documentation, observation, questionnaires, and tests. The result of this research up to the product development stage that obtained the physics learning plan model that meets the validity of the content and the validity of the construction in terms of the fulfillment of Basic Competence, Content Standards, Process Standards and Assessment Standards.

Biomechanical comparison of cemented versus non-cemented anterior screw fixation in type II odontoid fractures in the elderly: a cadaveric study.

PubMed

Rehousek, Petr; Jenner, Edward; Holton, James; Czyz, Marcin; Capek, Lukas; Henys, Petr; Kulvajtova, Marketa; Krbec, Martin; Skala-Rosenbaum, Jiri

2018-05-18

Odontoid process fractures are the most common injuries of the cervical spine in the elderly. Anterior screw stabilization of type II odontoid process fractures improves survival and function in these patients but may be complicated by failure of fixation. The present study aimed to determine whether cement augmentation of a standard anterior screw provides biomechanically superior fixation of type II odontoid fractures in comparison with a non-cemented standard screw. Twenty human cadaveric C2 vertebrae from elderly donors (mean age 83 years) were obtained. Anderson and D'Alonzo type IIa odontoid fracture was created by transverse osteotomy, and fluoroscopy-guided anterior screw fixation was performed. The specimens were divided into two matched groups. The cemented group (n=10) had radiopaque high viscosity polymethylmethacrylate cement injected via Jamshidi needle into the base of the odontoid process. The other group was not augmented. A V-shaped punch was used for loading the odontoid in an anteroposterior direction until failure. The failure state was defined as screw cutout or 5% force decrease. Mean failure load and bending stiffness were calculated. The mean failure load for the cemented group was 352±12 N compared with 168±23 N for the non-cemented group (p<.001). The mean initial stiffness of the non-cemented group was 153±19 N/mm compared with 195±29 N/mm for the cemented group (p<.001) CONCLUSIONS: Cement augmentation of an anterior standard screw fixation of type II odontoid process fractures in elderly patients significantly increased load to failure under anteroposterior load in comparison with non-augmented fixation. This may be a valuable technique to reduce failure of fixation. Copyright © 2018 Elsevier Inc. All rights reserved.

Safety of clinical and non-clinical decision makers in telephone triage: a narrative review.

PubMed

Wheeler, Sheila Q; Greenberg, Mary E; Mahlmeister, Laura; Wolfe, Nicole

2015-09-01

Patient safety is a persistent problem in telephone triage research; however, studies have not differentiated between clinicians' and non-clinicians' respective safety. Currently, four groups of decision makers perform aspects of telephone triage: clinicians (physicians, nurses), and non-clinicians (emergency medical dispatchers (EMD) and clerical staff). Using studies published between 2002-2012, we applied Donabedian's structure-process-outcome model to examine groups' systems for evidence of system completeness (a minimum measure of structure and quality). We defined system completeness as the presence of a decision maker and four additional components: guidelines, documentation, training, and standards. Defining safety as appropriate referrals (AR) - (right time, right place with the right person), we measured each groups' corresponding AR rate percentages (outcomes). We analyzed each group's respective decision-making process as a safe match to the telephone triage task, based on each group's system structure completeness, process and AR rates (outcome). Studies uniformly noted system component presence: nurses (2-4), physicians (1), EMDs (2), clerical staff (1). Nurses had the highest average appropriate referral (AR) rates (91%), physicians' AR (82% average). Clerical staff had no system and did not perform telephone triage by standard definitions; EMDs may represent the use of the wrong system. Telephone triage appears least safe after hours when decision makers with the least complete systems (physicians, clerical staff) typically manage calls. At minimum, telephone triage decision makers should be clinicians; however, clinicians' safety calls for improvement. With improved training, standards and CDSS quality, the 24/7 clinical call center has potential to represent the national standard. © The Author(s) 2015.

REAL-PANLAR Project for the Implementation and Accreditation of Centers of Excellence in Rheumatoid Arthritis Throughout Latin America: A Consensus Position Paper From REAL-PANLAR Group on Improvement of Rheumatoid Arthritis Care in Latin America Establishing Centers of Excellence.

PubMed

Santos-Moreno, Pedro; Galarza-Maldonado, Claudio; Caballero-Uribe, Carlo V; Cardiel, Mario H; Massardo, Loreto; Soriano, Enrique R; Olano, José Aguilar; Díaz Coto, José F; Durán Pozo, Gabriel R; da Silveira, Inês Guimarães; de Castrejón, Vianna J Khoury; Pérez, Leticia Lino; Méndez Justo, Carlos A; Montufar Guardado, Rubén A; Muños, Rafael; Elvir, Sergio Murillo; Paredes Domínguez, Ernesto R; Pons-Estel, Bernardo; Ríos Acosta, Carlos R; Sandino, Sayonara; Toro Gutiérrez, Carlos E; Villegas de Morales, Sol María; Pineda, Carlos

2015-06-01

A consensus meeting of representatives of 16 Latin American and Caribbean countries and the REAL-PANLAR group met in the city of Bogota to provide recommendations for improving quality of care of patients with rheumatoid arthritis (RA) in Latin America, defining a minimum standards of care and the concept of center of excellence in RA. Twenty-two rheumatologists from 16 Latin American countries with a special interest in quality of care in RA participated in the consensus meeting. Two RA Colombian patients and 2 health care excellence advisors were also invited to the meeting. A RAND-modified Delphi procedure of 5 steps was applied to define categories of centers of excellence. During a 1-day meeting, working groups were created in order to discuss and validate the minimum quality-of-care standards for the 3 proposed types of centers of excellence in RA. Positive votes from at least 60% of the attending leaders were required for the approval of each standard. Twenty-two opinion leaders from the PANLAR countries and the REAL-PANLAR group participated in the discussion and definition of the standards. One hundred percent of the participants agreed with setting up centers of excellence in RA throughout Latin America. Three types of centers of excellence and its criteria were defined, according to indicators of structure, processes, and outcomes: standard, optimal, and model. The standard level should have basic structure and process indicators, the intermediate or optimal level should accomplish more structure and process indicators, and model level should also fulfill outcome indicators and patient experience. This is the first Latin American effort to standardize and harmonize the treatment provided to RA patients and to establish centers of excellence that would offer to RA patients acceptable clinical results and high levels of safety.

National board certification as professional development: What are teachers learning?

NASA Astrophysics Data System (ADS)

Lustick, David Scott

This study investigated the National Board for Professional Teaching Standards' (NBPTS) assessment process in order to identify, quantify, and substantiate possible learning outcomes from the participants. One hundred and twenty candidates for the Adolescent and Young Adult Science (AYA Science) Certificate were studied over a 2-year period using the recurrent institutional cycle research design. This quasi-experimental methodology allowed for the collection of both cross-sectional and longitudinal data insuring a good measure of internal validity regarding observed changes both between and within group means. Multiple assessors scored transcripts of structured interviews with each teacher using the NBPTS' assessment framework according to the 13 standards accomplished science teaching. The scores (aggregated to the group level) provided the quantitative evidence of teacher learning in this study. Significant changes in mean scores from pre to post are reported at the overall, standard group, and individual standard levels. Findings suggest that the intervention had an overall effect size of .475 upon candidates' understanding of science teaching related knowledge. More specifically, most learning was associated with the standards of Scientific Inquiry and Assessment. The results support the hypothesis that the certification process is an effective standards based professional learning opportunity. The learning outcomes discussed in this report (including the identification of Dynamic, Technical, and Deferred Learning categories) should inform debate between educational stakeholders regarding the financial and ideological support of National Board certification as a means of improving teacher quality, provide suggestions for the improvement of the assessment process, and contribute insight into the current divisive state of science education in public education.

Exploring the New Standards

ERIC Educational Resources Information Center

Willard, Ted; Pratt, Harold; Workosky, Cindy

2012-01-01

This is an exciting time to be in science education. New science standards are being developed by a group of science educators from across the country, working with 26 states in a process managed by Achieve, Inc., a non-profit education reform organization. The development of the "Next Generation Science Standards" (NGSS) promises to be the most…

Identifying the Best Foreign Language Teachers: Teacher Standards and Professional Portfolios

ERIC Educational Resources Information Center

Sullivan, Joann Hammadou

2004-01-01

This study explored the differing perspectives of principals and foreign language department chairs on one state's teaching standards and the use of professional teaching portfolios as part of the hiring process. A 17-item questionnaire completed by 61 participants revealed that both groups strongly agreed with state teacher standards as accurate…

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

Code of Federal Regulations, 2010 CFR

2010-07-01

.../or Table 9 compounds are similar and often identical. (3) Biological treatment processes. Biological treatment processes in compliance with this section may be either open or closed biological treatment processes as defined in § 63.111. An open biological treatment process in compliance with this section need...

Effects of sol-gel processed silica coating on bond strength of resin cements to glass-infiltrated alumina ceramic.

PubMed

Xie, Haifeng; Wang, Xiaozu; Wang, Yu; Zhang, Feimin; Chen, Chen; Xia, Yang

2009-02-01

The aim of this study was to verify the effects of sol-gel processed silica coating on the bond strength between resin cement and glass-infiltrated aluminum oxide ceramic. Silica coatings were prepared on glass-infiltrated aluminum oxide ceramic surface via the sol-gel process. Atomic Force Microscope (AFM), Fourier Transmission Infrared spectrum (FTIR), and Energy Dispersive X-ray Spectroscopy (EDS) were used for coating characterization. Forty-eight blocks of glass-infiltrated aluminum oxide ceramic were fabricated. The ceramic surfaces were polished following sandblasting. Three groups of specimens (16 for each group) with different surface treatment were prepared. Group P: no treatment; group PO: treated with silane solution; group PTO: silica coating via sol-gel process, followed by silane application. Composite cylinders were luted with resin cement to the test specimens. Half of the specimens in each group were stored in distilled water for 24 h and the other half were stored in distilled water for 30 days before shear loading in a universal testing machine until failure. Selected ceramic surfaces were analyzed to identify the failure mode using a scanning electron microscopy (SEM). Nanostructured silica coatings were prepared on glass-infiltrated aluminum oxide ceramic surfaces by the sol-gel process. The silicon element on the ceramic surface increased significantly after the coating process. The mean shear bond strength values (standard deviation) before artificial aging were: group P: 1.882 +/- 0.156 MPa; group PO: 2.177 +/- 0.226 MPa; group PTO: 3.574 +/- 0.671 MPa. Statistically significant differences existed between group PTO and group P, and group PTO and groups PO. The failure mode for group P and group PO was adhesive, while group PTO was mixed. The mean shear bond strength values (standard deviation) after artificial aging were: group P: 1.594 +/- 0.111 MPa; group PO: 2.120 +/- 0.339 MPa; group PTO: 2.955 +/- 0.113 MPa. Statistically significant differences existed between each two groups after artificial aging, group P had the lowest bond durability, and group PTO had the highest bond durability. The sol-gel process is an effective way to prepare silica coating on dental glass-infiltrated alumina ceramic. Sol-gel processed silica coating can improve the resin bond strength of glass-infiltrated alumina ceramic.

Spatio-temporal source cluster analysis reveals fronto-temporal auditory change processing differences within a shared autistic and schizotypal trait phenotype.

PubMed

Ford, Talitha C; Woods, Will; Crewther, David P

2017-01-01

Social Disorganisation (SD) is a shared autistic and schizotypal phenotype that is present in the subclinical population. Auditory processing deficits, particularly in mismatch negativity/field (MMN/F) have been reported across both spectrum disorders. This study investigates differences in MMN/F cortical spatio-temporal source activity between higher and lower quintiles of the SD spectrum. Sixteen low (9 female) and 19 high (9 female) SD subclinical adults (18-40years) underwent magnetoencephalography (MEG) during an MMF paradigm where standard tones (50ms) were interrupted by infrequent duration deviants (100ms). Spatio-temporal source cluster analysis with permutation testing revealed no difference between the groups in source activation to the standard tone. To the deviant tone however, there was significantly reduced right hemisphere fronto-temporal and insular cortex activation for the high SD group ( p = 0.038). The MMF, as a product of the cortical response to the deviant minus that to the standard, did not differ significantly between the high and low Social Disorganisation groups. These data demonstrate a deficit in right fronto-temporal processing of an auditory change for those with more of the shared SD phenotype, indicating that right fronto-temporal auditory processing may be associated with psychosocial functioning.

NDT standards from the perspective of the Department of Defense

NASA Astrophysics Data System (ADS)

Strauss, Bernard

1992-09-01

The interaction of the DoD non-Government Society (NGS) bodies in the area of nondestructive testing (NDT) are illustrated. The adoption process for NGS is outlined including the criteria for adoption, what adoption means, and the advantages of DoD/NGS interaction. The tasks of the DoD's Standardization Program Plan for NDT are described along with DoD's efforts on a Joint Army, Navy, Air Force (JANNAF) NDE Subcommittee and on an international standardization group (America, Britain, Canada, and Australia) called the Quadripartite Working Group on Proofing, Inspection, and Quality Assurance.

The relationship between standards-based reporting systems and third-grade mathematics and science achievement

NASA Astrophysics Data System (ADS)

Prejean-Harris, Rose M.

Over the last decade, accountability has been the driving force for many changes in education in the United States. One major educational reform effort is the standards-based movement with a focus of combining a number of processes that involve aligning curriculum, instruction, assessment and feedback to specific standards that are measureable and indicative of student achievement. The purpose of this study is to determine if the type of report card is a possible predictor of third grade student achievement on standardized tests in mathematics and science for the 2012 Criterion-Referenced Competency Test (CRCT). The results of this study concluded that the difference in test scores in mathematics and science for students in the traditional report card group was not statistically significant when compared to the scores of students in the standards-based report card group when controlling for poverty level, school locale, and school district. However, students in the traditional report card group scored an average of 1.01 point higher in mathematics and 2.27 points higher in science than students in the standards-based report card group.

40 CFR 63.493 - Back-end process provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins § 63.493 Back-end process provisions. Owners and operators of new and existing affected sources shall comply with the requirements in...

40 CFR 63.1322 - Batch process vents-reference control technology.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 12 2013-07-01 2013-07-01 false Batch process vents-reference control... (CONTINUED) National Emission Standards for Hazardous Air Pollutant Emissions: Group IV Polymers and Resins § 63.1322 Batch process vents—reference control technology. (a) Batch process vents. The owner or...

A clinical investigation of motivation to change standards and cognitions about failure in perfectionism.

PubMed

Egan, Sarah J; Piek, Jan P; Dyck, Murray J; Rees, Clare S; Hagger, Martin S

2013-10-01

Clinical perfectionism is a transdiagnostic process that has been found to maintain eating disorders, anxiety disorders and depression. Cognitive behavioural models explaining the maintenance of clinical perfectionism emphasize the contribution of dichotomous thinking and resetting standards higher following both success and failure in meeting their goals. There has been a paucity of research examining the predictions of the models and motivation to change perfectionism. Motivation to change is important as individuals with clinical perfectionism often report many perceived benefits of their perfectionism; they are, therefore, likely to be ambivalent regarding changing perfectionism. The aim was to compare qualitative responses regarding questions about motivation to change standards and cognitions regarding failure to meet a personal standard in two contrasting groups with high and low negative perfectionism. Negative perfectionism refers to concern over not meeting personal standards. A clinical group with a range of axis 1 diagnoses who were elevated on negative perfectionism were compared to a group of athletes who were low on negative perfectionism. Results indicated that the clinical group perceived many negative consequences of their perfectionism. They also, however, reported numerous benefits and the majority stated that they would prefer not to change their perfectionism. The clinical group also reported dichotomous thinking and preferring to either keep standards the same or reset standards higher following failure, whilst the athlete group reported they would keep standards the same or set them lower. The findings support predictions of the cognitive behavioural model of clinical perfectionism.

An Integrated Social, Economic, and Ecologic Conceptual (ISEEC) framework for considering rangeland sustainability

USGS Publications Warehouse

Fox, W.E.; McCollum, D.W.; Mitchell, J.E.; Swanson, L.E.; Kreuter, U.P.; Tanaka, J.A.; Evans, G.R.; Theodore, Heintz H.; Breckenridge, R.P.; Geissler, P.H.

2009-01-01

Currently, there is no standard method to assess the complex systems in rangeland ecosystems. Decision makers need baselines to create a common language of current rangeland conditions and standards for continued rangeland assessment. The Sustainable Rangeland Roundtable (SRR), a group of private and public organizations and agencies, has created a forum to discuss rangeland sustainability and assessment. The SRR has worked to integrate social, economic, and ecological disciplines related to rangelands and has identified a standard set of indicators that can be used to assess rangeland sustainability. As part of this process, SRR has developed a two-tiered conceptual framework from a systems perspective to study the validity of indicators and the relationships among them. The first tier categorizes rangeland characteristics into four states. The second tier defines processes affecting these states through time and space. The framework clearly shows that the processes affect and are affected by each other. ?? 2009 Taylor & Francis Group, LLC.

77 FR 65769 - Petition for Exemption From the Vehicle Theft Prevention Standard; Volkswagen Group of America, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... process. Key components of the antitheft device will include a passive immobilizer, a warning message... feature as standard equipment. When the system is activated, the alarm will trigger if one of the doors...

7 CFR 29.3157 - Scrap (S Group).

Code of Federal Regulations, 2010 CFR

2010-01-01

... INSPECTION Standards Grades § 29.3157 Scrap (S Group). A by-product of unstemmed and stemmed tobacco. Scrap..., or web portions of tobacco leaves reduced to scrap by any process. [24 FR 8771, Oct. 29, 1959, as...

[Global immunization policies and recommendations: objectives and process].

PubMed

Duclos, Philippe; Okwo-Bele, Jean-Marie

2007-04-01

The World Health Organization (WHO) has a dual mandate of providing global policies, standards and norms as well as support for member countries in applying such policies and standards to national programmes with the aim to improve health. The vaccine world is changing and with it the demands and expectations of the global and national policy makers, donors, and other interested parties. Changes pertain to : new vaccines and technologies developments, vaccine safety issues, regulation and approval of vaccines, and increased funding flowing through new financing mechanisms. This places a special responsibility on WHO to respond effectively. WHO has recently reviewed and optimized its policy making structure for vaccines and immunization and adjusted it to the new Global Immunization Vision and Strategy, which broadens the scope of immunization efforts to all age groups and vaccines with emphasis on integration of immunization delivery with other health interventions. This includes an extended consultation process to promptly generate evidence base recommendations, ensuring transparency of the decision making process and added communication efforts. This article presents the objectives and impact of the process set to develop global immunization policies, norms, standards and recommendations. The key advisory committees landscape contributing to this process is described. This includes the Strategic Advisory Group of Experts, the Global Advisory Committee on Vaccine Safety and the Expert Committee on Biological Standardization. The elaboration of WHO vaccine position papers is also described.

To recognize the use of international standards for making harmonized regulation of medical devices in Asia-pacific.

PubMed

Anand, K; Saini, Ks; Chopra, Y; Binod, Sk

2010-07-01

'Medical Devices' include everything from highly sophisticated, computerized, medical equipment, right down to simple wooden tongue depressors. Regulations embody the public expectations for how buildings and facilities are expected to perform and as such represent public policy. Regulators, who develop and enforce regulations, are empowered to act in the public's interest to set this policy and are ultimately responsible to the public in this regard. Standardization contributes to the basic infrastructure that underpins society including health and environment, while promoting sustainability and good regulatory practice. The international organizations that produce International Standards are the International Electrotechnical Commission (IEC), the International Organization for Standardization (ISO), and the International Telecommunication Union (ITU). With the increasing globalization of markets, International Standards (as opposed to regional or national standards) have become critical to the trading process, ensuring a level playing field for exports, and ensuring that imports meet the internationally recognized levels of performance and safety. The development of standards is done in response to sectors and stakeholders that express a clearly established need for them. An industry sector or other stakeholder group typically communicates its requirement for standards to one of the national members. To be accepted for development, a proposed work item must receive a majority support of the participating members, who verify the global relevance of the proposed item. The regulatory authority (RA) should provide a method for the recognition of international voluntary standards and for public notification of such recognition. The process of recognition may vary from country to country. Recognition may occur by periodic publication of lists of standards that a regulatory authority has found will meet the Essential Principles. In conclusion, International standards, such as, basic standards, group standards, and product standards, are a tool for harmonizing regulatory processes, to assure the safety, quality, and performance of medical devices. Standards represent the opinion of experts from all interested parties, including industry, regulators, users, and others.

A Framework for Comprehensive Health Terminology Systems in the United States

PubMed Central

Chute, Christopher G.; Cohn, Simon P.; Campbell, James R.

1998-01-01

Health care in the United States has become an information-intensive industry, yet electronic health records represent patient data inconsistently for lack of clinical data standards. Classifications that have achieved common acceptance, such as the ICD-9-CM or ICD, aggregate heterogeneous patients into broad categories, which preclude their practical use in decision support, development of refined guidelines, or detailed comparison of patient outcomes or benchmarks. This document proposes a framework for the integration and maturation of clinical terminologies that would have practical applications in patient care, process management, outcome analysis, and decision support. Arising from the two working groups within the standards community—the ANSI (American National Standards Institute) Healthcare Informatics Standards Board Working Group and the Computer-based Patient Records Institute Working Group on Codes and Structures—it outlines policies regarding 1) functional characteristics of practical terminologies, 2) terminology models that can broaden their applications and contribute to their sustainability, 3) maintenance attributes that will enable terminologies to keep pace with rapidly changing health care knowledge and process, and 4) administrative issues that would facilitate their accessibility, adoption, and application to improve the quality and efficiency of American health care. PMID:9824798

Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain.

PubMed

Gratacós, Jordi; Luelmo, Jesús; Rodríguez, Jesús; Notario, Jaume; Marco, Teresa Navío; de la Cueva, Pablo; Busquets, Manel Pujol; Font, Mercè García; Joven, Beatriz; Rivera, Raquel; Vega, Jose Luis Alvarez; Álvarez, Antonio Javier Chaves; Parera, Ricardo Sánchez; Carrascosa, Jose Carlos Ruiz; Martínez, Fernando José Rodríguez; Sánchez, José Pardo; Olmos, Carlos Feced; Pujol, Conrad; Galindez, Eva; Barrio, Silvia Pérez; Arana, Ana Urruticoechea; Hergueta, Mercedes; Coto, Pablo; Queiro, Rubén

2018-06-01

To define and give priority to standards of care and quality indicators of multidisciplinary care for patients with psoriatic arthritis (PsA). A systematic literature review on PsA standards of care and quality indicators was performed. An expert panel of rheumatologists and dermatologists who provide multidisciplinary care was established. In a consensus meeting group, the experts discussed and developed the standards of care and quality indicators and graded their priority, agreement and also the feasibility (only for quality indicators) following qualitative methodology and a Delphi process. Afterwards, these results were discussed with 2 focus groups, 1 with patients, another with health managers. A descriptive analysis is presented. We obtained 25 standards of care (9 of structure, 9 of process, 7 of results) and 24 quality indicators (2 of structure, 5 of process, 17 of results). Standards of care include relevant aspects in the multidisciplinary care of PsA patients like an appropriate physical infrastructure and technical equipment, the access to nursing care, labs and imaging techniques, other health professionals and treatments, or the development of care plans. Regarding quality indicators, the definition of multidisciplinary care model objectives and referral criteria, the establishment of responsibilities and coordination among professionals and the active evaluation of patients and data collection were given a high priority. Patients considered all of them as important. This set of standards of care and quality indicators for the multidisciplinary care of patients with PsA should help improve quality of care in these patients.

Ethical Issues in the Research of Group Work

ERIC Educational Resources Information Center

Goodrich, Kristopher M.; Luke, Melissa

2017-01-01

This article provides a primer for researchers exploring ethical issues in the research of group work. The article begins with an exploration of relevant ethical issues through the research process and current standards guiding its practice. Next, the authors identify resources that group work researchers can consult prior to constructing their…

40 CFR 63.1332 - Emissions averaging provisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... other controls for a Group 1 storage vessel, batch process vent, aggregate batch vent stream, continuous... in control after November 15, 1990. (2) Group 1 emission points, identified in paragraph (c)(3) of... applicable reference control technology or standard and the emissions allowed for the Group 1 emission point...

40 CFR 63.1332 - Emissions averaging provisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... other controls for a Group 1 storage vessel, batch process vent, aggregate batch vent stream, continuous... in control after November 15, 1990. (2) Group 1 emission points, identified in paragraph (c)(3) of... reference control technology or standard and the emissions allowed for the Group 1 emission point. Said...

The Use of Nominal Group Technique: Case Study in Vietnam

ERIC Educational Resources Information Center

Dang, Vi Hoang

2015-01-01

The Nominal Group Technique (NGT) is a structured process to gather information from a group. The technique was first described in early 1970s and has since become a widely-used standard to facilitate working groups. The NGT is effective for generating large numbers of creative new ideas and for group priority setting. This article reports on a…

Chronic insomnia cases detection with the help of Athens Insomnia Scale and SF-36 health survey

NASA Astrophysics Data System (ADS)

Wasiewicz, P.; Skalski, M.; Fornal-Pawlowska, Malgorzata

2011-10-01

Standardization of the diagnostic process of insomnia is a highly important task in clinical practice, epidemiological considerations and treatment outcomes assessment. In this paper we describe standard surveys relationships within cluster groups with the same insomnia degrees.

Teaching Group Processes through Multiple Group Leadership Opportunities in a Masters Level Counselor Education Program

ERIC Educational Resources Information Center

Bourgeois, Marc B.; Winters, Ryan C.; Esters, Irvin E.

2016-01-01

Utilizing an experiential component in group work training is a prominent feature in Counselor Education programs. Although numerous models have been proposed, the vast majority offer limited explanations of incorporating the number of hours of group participation and observation recommended by the Professional Standards for the Training of Group…

Standardization of XML Database Exchanges and the James Webb Space Telescope Experience

NASA Technical Reports Server (NTRS)

Gal-Edd, Jonathan; Detter, Ryan; Jones, Ron; Fatig, Curtis C.

2007-01-01

Personnel from the National Aeronautics and Space Administration (NASA) James Webb Space Telescope (JWST) Project have been working with various standard communities such the Object Management Group (OMG) and the Consultative Committee for Space Data Systems (CCSDS) to assist in the definition of a common extensible Markup Language (XML) for database exchange format. The CCSDS and OMG standards are intended for the exchange of core command and telemetry information, not for all database information needed to exercise a NASA space mission. The mission-specific database, containing all the information needed for a space mission, is translated from/to the standard using a translator. The standard is meant to provide a system that encompasses 90% of the information needed for command and telemetry processing. This paper will discuss standardization of the XML database exchange format, tools used, and the JWST experience, as well as future work with XML standard groups both commercial and government.

[Output standard in the mental health services of Reggio Emilia, Italy. Methodological issues].

PubMed

Grassi, G

2000-01-01

The project Output Standards of the Mental Health Department (MHD) of Reggio Emilia is set out to define outputs and quality standards and to guarantee transparency and to facilitate organizational improvement. The MHD started an interprofessional working group that defined the MHD outputs as long as process, quality peculiarities, indicators and standards for each output. The MHD Director validated the group results. The MHD defined 9 outputs and its indicators and standards and consequently modified its data registration system, the way to supply free and partially charged services and budget indicators. As a result, a new instrument for management and quality control has been provided. The A. maintains that to define outputs, indicators and standards will allow to compare several services of the Department, get them omogeneous and guarantee and improve quality.

GNAP (Graphic Normative Analysis Program)

USGS Publications Warehouse

Bowen, Roger W.; Odell, John

1979-01-01

A user-oriented command language is developed to provide direct control over the computation and output of the standard CIPW norm. A user-supplied input format for the oxide values may be given or a standard CIPW Rock Analysis format may be used. Once the oxide values have been read by the computer, these values may be manipulated by the user and the 'norm' recalculated on the basis of the manipulated or 'adjusted' values. Additional output capabilities include tabular listing of computed values, summary listings suitable for publication, x-y plots, and ternary diagrams. As many as 20 rock analysis cards may be processed as a group. Any number of such groups may be processed in any one computer run.

40 CFR 63.1321 - Batch process vents provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Standards for Hazardous Air Pollutant Emissions: Group IV Polymers and Resins § 63.1321 Batch process vents..., owners and operators of new and existing affected sources with batch process vents shall comply with the... applicable reporting requirements in § 63.1327. (b) New SAN batch affected sources. Owners and operators of...

40 CFR 63.487 - Batch front-end process vents-reference control technology.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-reference control technology. 63.487 Section 63.487 Protection of Environment ENVIRONMENTAL PROTECTION... SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins § 63.487 Batch front-end process vents—reference control technology. (a) Batch front-end process...

40 CFR 63.487 - Batch front-end process vents-reference control technology.

Code of Federal Regulations, 2011 CFR

2011-07-01

... control technology. 63.487 Section 63.487 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... CATEGORIES National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins § 63.487 Batch front-end process vents—reference control technology. (a) Batch front-end process vents...

40 CFR 63.487 - Batch front-end process vents-reference control technology.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-reference control technology. 63.487 Section 63.487 Protection of Environment ENVIRONMENTAL PROTECTION... SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins § 63.487 Batch front-end process vents—reference control technology. (a) Batch front-end process...

40 CFR 63.487 - Batch front-end process vents-reference control technology.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-reference control technology. 63.487 Section 63.487 Protection of Environment ENVIRONMENTAL PROTECTION... SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins § 63.487 Batch front-end process vents—reference control technology. (a) Batch front-end process...

Designing Class Activities to Meet Specific Core Training Competencies: A Developmental Approach

ERIC Educational Resources Information Center

Guth, Lorraine J.; McDonnell, Kelly A.

2004-01-01

This article presents a developmental model for designing and utilizing class activities to meet specific Association for Specialists in Group Work (ASGW) core training competencies for group workers. A review of the relevant literature about teaching group work and meeting core training standards is provided. The authors suggest a process by…

REAL-PANLAR Project for the Implementation and Accreditation of Centers of Excellence in Rheumatoid Arthritis Throughout Latin America

PubMed Central

Santos-Moreno, Pedro; Galarza-Maldonado, Claudio; Caballero-Uribe, Carlo V.; Cardiel, Mario H.; Massardo, Loreto; Soriano, Enrique R.; Olano, José Aguilar; Díaz Coto, José F.; Durán Pozo, Gabriel R.; da Silveira, Inês Guimarães; de Castrejón, Vianna J. Khoury; Pérez, Leticia Lino; Méndez Justo, Carlos A.; Montufar Guardado, Rubén A.; Muños, Rafael; Elvir, Sergio Murillo; Paredes Domínguez, Ernesto R.; Pons-Estel, Bernardo; Ríos Acosta, Carlos R.; Sandino, Sayonara; Toro Gutiérrez, Carlos E.; Villegas de Morales, Sol María; Pineda, Carlos

2015-01-01

Objective A consensus meeting of representatives of 16 Latin American and Caribbean countries and the REAL-PANLAR group met in the city of Bogota to provide recommendations for improving quality of care of patients with rheumatoid arthritis (RA) in Latin America, defining a minimum standards of care and the concept of center of excellence in RA. Methods Twenty-two rheumatologists from 16 Latin American countries with a special interest in quality of care in RA participated in the consensus meeting. Two RA Colombian patients and 2 health care excellence advisors were also invited to the meeting. A RAND-modified Delphi procedure of 5 steps was applied to define categories of centers of excellence. During a 1-day meeting, working groups were created in order to discuss and validate the minimum quality-of-care standards for the 3 proposed types of centers of excellence in RA. Positive votes from at least 60% of the attending leaders were required for the approval of each standard. Results Twenty-two opinion leaders from the PANLAR countries and the REAL-PANLAR group participated in the discussion and definition of the standards. One hundred percent of the participants agreed with setting up centers of excellence in RA throughout Latin America. Three types of centers of excellence and its criteria were defined, according to indicators of structure, processes, and outcomes: standard, optimal, and model. The standard level should have basic structure and process indicators, the intermediate or optimal level should accomplish more structure and process indicators, and model level should also fulfill outcome indicators and patient experience. Conclusions This is the first Latin American effort to standardize and harmonize the treatment provided to RA patients and to establish centers of excellence that would offer to RA patients acceptable clinical results and high levels of safety. PMID:26010179

Software handlers for process interfaces

NASA Technical Reports Server (NTRS)

Bercaw, R. W.

1976-01-01

The principles involved in the development of software handlers for custom interfacing problems are discussed. Handlers for the CAMAC standard are examined in detail. The types of transactions that must be supported have been established by standards groups, eliminating conflicting requirements arising out of different design philosophies and applications. Implementation of the standard handlers has been facilititated by standardization of hardware. The necessary local processors can be placed in the handler when it is written or at run time by means of input/output directives, or they can be built into a high-performance input/output processor. The full benefits of these process interfaces will only be realized when software requirements are incorporated uniformly into the hardware.

Proposal for establishing structure and process in the development of implicit chiropractic standards of care and practice guidelines.

PubMed

Hansen, D T; Adams, A H; Meeker, W C; Phillips, R B

1992-09-01

With the advent of health care's "era of accountability", the chiropractic profession is now faced with generating implicit standards and guidelines for care or having it done for us by outside agencies. Already we see chiropractic groups in individual states and provinces being pressured into naive efforts of guideline development. Current knowledge and experience are available through recent health care literature that clearly defines the structure and process of guideline development and offers suggestions on how to measure outcomes of those processes. In addition, the United States Congress has directed a new federal agency to oversee this activity and monitor outcomes of quality improvement programs. The time has come for the chiropractic profession to define its exact role in health care delivery and develop implicit standards of care and practice guidelines. This sentinel effort should be managed by a commissioned body of empaneled experts that generally represent the academic and clinical chiropractic profession. A protocol for selection of these panelists and the panel chairperson needs to be developed and memorialized. Appropriate methodology (with definitions) needs to be developed for the process of standards/guideline development. Adherence to the accepted structure and process of guideline development will ensure the continuity of this dynamic process in the coming generations. This proposal offers a preliminary definition of the structure and process, including a "seed" policy statement and decision flow chart, specific to guideline development. Once the structure and process of guideline development for chiropractic are defined, the profession can then present this product to federal and state agencies, private sector health care purchasers, patient advocacy groups and other stakeholders of chiropractic care.(ABSTRACT TRUNCATED AT 250 WORDS)

Hydroetching of high surface area ceramics using moist supercritical fluids

DOEpatents

Fryxell, Glen; Zemanian, Thomas S.

2004-11-02

Aerogels having a high density of hydroxyl groups and a more uniform pore size with fewer bottlenecks are described. The aerogel is exposed to a mixture of a supercritical fluid and water, whereupon the aerogel forms a high density of hydroxyl groups. The process also relaxes the aerogel into a more open uniform internal structure, in a process referred to as hydroetching. The hydroetching process removes bottlenecks from the aerogels, and forms the hydrogels into more standard pore sizes while preserving their high surface area.

A Comparison of Approaches for Setting Proficiency Standards.

ERIC Educational Resources Information Center

Koffler, Stephen L.

This research compared the cut-off scores estimated from an empirical procedure (Contrasting group method) to those determined from a more theoretical process (Nedelsky method). A methodological and statistical framework was also provided for analysis of the data to obtain the most appropriate standard using the empirical procedure. Data were…

40 CFR 63.867 - Reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Emission Standards for Hazardous Air Pollutants for Chemical Recovery Combustion Sources at Kraft, Soda...) Additional reporting requirements for HAP metals standards. (1) Any owner or operator of a group of process units in a chemical recovery system at a mill complying with the PM emissions limits in § 63.862(a)(1...

40 CFR 63.867 - Reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Emission Standards for Hazardous Air Pollutants for Chemical Recovery Combustion Sources at Kraft, Soda...) Additional reporting requirements for HAP metals standards. (1) Any owner or operator of a group of process units in a chemical recovery system at a mill complying with the PM emissions limits in § 63.862(a)(1...

40 CFR 63.867 - Reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Emission Standards for Hazardous Air Pollutants for Chemical Recovery Combustion Sources at Kraft, Soda...) Additional reporting requirements for HAP metals standards. (1) Any owner or operator of a group of process units in a chemical recovery system at a mill complying with the PM emissions limits in § 63.862(a)(1...

A Survey of Pennsylvania School Principals' Perceptions of the National Board for Professional Teaching Standards Certification Process and the Leadership Roles of National Board Certified Teachers

ERIC Educational Resources Information Center

Balbach, Amy Beth Mackie

2012-01-01

Throughout the 1980's, the notion of standards came to the forefront throughout the education world. Groups questioned how to define quality teaching. The National Board for Professional Teaching Standards was developed to meet this need providing a voluntary national certification to identify accomplished teachers. Since its inception,…

78 FR 23289 - Public Review of Draft National Shoreline Data Content Standard

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-18

...The Federal Geographic Data Committee (FGDC) is conducting a public review of the draft National Shoreline Data Content Standard. The FGDC has developed a draft National Shoreline Data Content Standard that provides a framework for shoreline data development, sharing of data, and shoreline data transformation and fusion. The FGDC Coastal and Marine Spatial Data Subcommittee, chaired by the National Oceanic and Atmospheric Administration (NOAA), sponsored development of the draft standard. The FGDC Coordination Group, comprised of representatives of Federal agencies, has approved releasing this draft standard for public review and comment. The draft National Shoreline Data Content Standard defines attributes or elements that are common for shoreline data development and provides suggested domains for the elements. The functional scope includes definition of data models, schemas, entities, relationships, definitions, and crosswalks to related standards. The draft National Shoreline Data Content Standard is intended to enhance the shoreline framework by providing technical guidance on shoreline semantics, data structures and their relationships to builders and users of shoreline data. The geographical scope of the draft standard comprises all shorelines of navigable waters within the United States and its territories. The primary intended users of the National Shoreline Data Content Standard are the mapping, shoreline engineering, coastal zone management, flood insurance, and natural resource management communities. The FGDC invites all stakeholders to comment on this draft standard to ensure that it meets their needs. The draft National Shoreline Data Content Standard may be downloaded from https://www.fgdc.gov/standards/projects/FGDC-standards- projects/shoreline-data-content/ revisedDraftNationalShorelineDataContentStandard. Comments shall be submitted using the content template at http://www.fgdc.gov/standards/ process/standards-directives/template.doc. Instructions for completing the comment template are found in FGDC Standards Directive 2d, Standards Working Group Review Guidelines: Review Comment Template, http://www.fgdc.gov/standards/process/standards-directives/directive- 2d-standards-working-group-review-guidelines-review-comment-template. Comments that concern specific issues/changes/additions may result in revisions to the National Shoreline Data Content Standard. Reviewers may obtain information about how comments were addressed upon request. After formal endorsement of the standard by the FGDC, the National Shoreline Data Content Standard and a summary analysis of the changes will be made available to the public on the FGDC Web site, www.fgdc.gov.

Quality standards in a rheumatology Day-Care Hospital Unit. The proposal of the Spanish Society of Rheumatology Day Hospitals' Working Group.

PubMed

García-Vicuña, Rosario; Montoro, María; Egües Dubuc, César Antonio; Bustabad Reyes, Sagrario; Gómez-Centeno, Antonio; Muñoz-Fernández, Santiago; Pérez Pampín, Eva; Román Ivorra, Jose Andrés; Balsa, Alejandro; Loza, Estíbaliz

2014-01-01

In recent years, the Rheumatology Day-Care Hospital Units (DHU have undergone extensive development. However, the quality standards are poorly documented and mainly limited to structure items rather than including broad and specific areas of this specialty. To develop specific quality standards for Rheumatology DHU. After a systematic review of the literature and related documents, a working group (WG) involving 8 DHU-experienced rheumatologists developed an initial proposal of the quality standards, under the supervision of an expert methodologist. A second round was held by the WG group to review the initial proposal and to consider further suggestions. Once the content was agreed upon by consensus, a final report was prepared. 17 structure standards, 25 process standards and 10 results standards were defined, with special emphasis on specific aspects of the Rheumatology DHU. The proposal includes: 1) essential standards to 2) excellent standards, 3) a Rheumatology DHU services portfolio and 4) performance criteria. The proposed quality standards are the basis for developing the indicators and other management tools for Rheumatology DHU, thereby ensuring a patient-oriented practice based on both the evidence and the experience. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

The Effect of Standardized Interviews on Organ Donation.

PubMed

Corman Dincer, Pelin; Birtan, Deniz; Arslantas, Mustafa Kemal; Tore Altun, Gulbin; Ayanoglu, Hilmi Omer

2018-03-01

Organ donation is the most important stage for organ transplant. Studies reveal that attitudes of families of brain-dead patients toward donation play a significant role in their decision. We hypothesized that supporting family awareness about the meaning of organ donation, including saving lives while losing a loved one, combined with being informed about brain death and the donation process must be maintained by intensive care unit physicians through standardized interviews and questionnaires to increase the donation rate. We retrospectively evaluated the final decisions of families of 52 brain-dead donors treated at our institution between 2014 and 2017. Data underwent descriptive analyses. The standard interview content was generated after literature search results were reviewed by the authors. Previously, we examined the impact of standardized interviews done by intensive care unit physicians with relatives of potential brain-dead donors regarding decisions to donate or reasons for refusing organ donation. After termination of that study, interviews were done according to the intensivist's orientation, resulting in significantly decreased donation rates. Standardized interviews were then started again, resulting in increased donation rates. Of 17 families who participated in standardized interviews, 5 families (29.4%) agreed to donate organs of their brain-dead relatives. In the other group of families, intensivists governed informing the families of donation without standardized interviews. In this group of 35 families, 5 families (14.3%) approved organ donation. The decision regarding whether to agree to organ donation was statistically different between the 2 family groups (P < .05). Conducting a standard interview between relatives of brain-dead donors and the intensivists, facilitating visits between relatives and the brain-dead patients, and informing relatives about the donation process resulted in an increased rate of organ donation compared with routine protocols.

Are clinical diagnoses of Alzheimer's disease and other dementias affected by education and self-reported race?

PubMed

Teresi, Jeanne A; Grober, Ellen; Eimicke, Joseph P; Ehrlich, Amy R

2012-09-01

A randomized controlled trial examined whether the diagnostic process for Alzheimer's disease and other dementias may be influenced by knowledge of the patient's education and/or self-reported race. Four conditions were implemented: diagnostic team knows (a) race and education, (b) education only, (c) race only, or (d) neither. Diagnosis and clinical staging was established at baseline, at Wave 2, and for a random sample of Wave 3 respondents by a consensus panel. At study end, a longitudinal, "gold standard" diagnosis was made for patients with follow-up data (71%). Group differences in Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis were estimated using logistic regression and generalized estimating equations. Sensitivity and specificity were examined for baseline diagnosis in relation to the gold standard, longitudinal diagnosis. Despite equivalent status on all measured variables across waves, members of the "knows race only" group were less likely than those of other groups to receive a diagnosis of dementia. At final diagnosis, 19% of the "knows race only" group was diagnosed with dementia versus 38% to 40% in the other 3 conditions (p = .038). Examination of sensitivities and specificities of baseline diagnosis in relation to the gold standard diagnosis showed a nonsignificant trend for lower sensitivities in the knowing race conditions (0.3846), as contrasted with knowing education only (0.480) or neither (0.600). The finding that knowledge of race may influence the diagnostic process in some unknown way is timely, given the recent State-of-the-Science conference on Alzheimer's disease prevention, the authors of which called for information about and standardization of the diagnostic process. PsycINFO Database Record (c) 2012 APA, all rights reserved.

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

Harmonisation of standards for permissible radionuclide activity concentrations in foodstuffs in the long term after the Chernobyl accident.

PubMed

Balonov, M; Kashparov, V; Nikolaenko, A; Berkovskyy, V; Fesenko, S

2018-06-01

The article critically examines the practice of post-Chernobyl standardisation of radionuclide concentrations (mainly 137 Cs and 90 Sr) in food products (FPs) in the USSR and the successor countries of Belarus, Russia and Ukraine. Recommendations are given on potential harmonisation of these standards of radionuclide concentrations in FPs among the three countries, taking into account substantial international experience. We propose to reduce the number of product groups for standardisation purposes from the current amount of several dozens to three to five groups to optimise radiation control and increase the transparency of the process. We recommend five product groups for the standardisation of 137 Cs and three groups for 90 Sr in food in radiocontaminated areas. The values of standards for individual product groups are recommended to be set proportionally to the measured specific activity in each of these groups, which will reduce unreasonable food rejection. The standards might be set for the entire country, and could be also used to control imports from other countries as well as exports to other countries. The developed recommendations were transferred in 2015-2016 to the regulatory authorities of the three countries.

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

Carr, S.J.

The development of nuclear standards is an active and necessary endeavor that is concerned with the safe, orderly, and economic development of nuclear potential. There are almost 4100 people from the teachnical community who are presently involved either in writing nuclear standards, including codes, or in the management and processing roles necessary for their approval and promulgation. This document identifies the current participation of each individual as member, chairman, cochairman (vice-chairman), or secretary of about 700 standards development committees and groups. The standards committees and groups are identified with the organizations that are responsible for the preparation, review, and maintenancemore » of the standards and that provide support through supervisory committees and headquarters staff. This directory includes four major sections: personnel, employers, committees, and a Key-Word-in-Context (KWIC) Index of committee titles. It can also be used to identify the participation of employers as well as to recognize the contributions of individuals to the often interdisciplinary activity of standards development.« less

Global standard for the composition of infant formula: recommendations of an ESPGHAN coordinated international expert group.

PubMed

Koletzko, Berthold; Baker, Susan; Cleghorn, Geoff; Neto, Ulysses Fagundes; Gopalan, Sarath; Hernell, Olle; Hock, Quak Seng; Jirapinyo, Pipop; Lonnerdal, Bo; Pencharz, Paul; Pzyrembel, Hildegard; Ramirez-Mayans, Jaime; Shamir, Raanan; Turck, Dominique; Yamashiro, Yuichiro; Zong-Yi, Ding

2005-11-01

The Codex Alimentarius Commission of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) develops food standards, guidelines and related texts for protecting consumer health and ensuring fair trade practices globally. The major part of the world's population lives in more than 160 countries that are members of the Codex Alimentarius. The Codex Standard on Infant Formula was adopted in 1981 based on scientific knowledge available in the 1970s and is currently being revised. As part of this process, the Codex Committee on Nutrition and Foods for Special Dietary Uses asked the ESPGHAN Committee on Nutrition to initiate a consultation process with the international scientific community to provide a proposal on nutrient levels in infant formulae, based on scientific analysis and taking into account existing scientific reports on the subject. ESPGHAN accepted the request and, in collaboration with its sister societies in the Federation of International Societies on Pediatric Gastroenterology, Hepatology and Nutrition, invited highly qualified experts in the area of infant nutrition to form an International Expert Group (IEG) to review the issues raised. The group arrived at recommendations on the compositional requirements for a global infant formula standard which are reported here.

40 CFR 63.2455 - What requirements must I meet for continuous process vents?

Code of Federal Regulations, 2011 CFR

2011-07-01

... CATEGORIES National Emission Standards for Hazardous Air Pollutants: Miscellaneous Organic Chemical... any continuous process vent that is combined with Group 1 batch process vents before a control device or recovery device because the requirements of § 63.2450(c)(2)(i) apply to the combined stream. (2...

40 CFR 63.166 - Standards: Sampling connection systems.

Code of Federal Regulations, 2012 CFR

2012-07-01

... fluid to a process; or (3) Be designed and operated to capture and transport the purged process fluid to a control device that complies with the requirements of § 63.172 of this subpart; or (4) Collect... of subpart G of this part applicable to group 1 wastewater streams. If the purged process fluid does...

40 CFR 63.166 - Standards: Sampling connection systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

... fluid to a process; or (3) Be designed and operated to capture and transport the purged process fluid to a control device that complies with the requirements of § 63.172 of this subpart; or (4) Collect... of subpart G of this part applicable to group 1 wastewater streams. If the purged process fluid does...

An International Collaborative Standardizing a Comprehensive Patient-Centered Outcomes Measurement Set for Colorectal Cancer.

PubMed

Zerillo, Jessica A; Schouwenburg, Maartje G; van Bommel, Annelotte C M; Stowell, Caleb; Lippa, Jacob; Bauer, Donna; Berger, Ann M; Boland, Gilles; Borras, Josep M; Buss, Mary K; Cima, Robert; Van Cutsem, Eric; van Duyn, Eino B; Finlayson, Samuel R G; Hung-Chun Cheng, Skye; Langelotz, Corinna; Lloyd, John; Lynch, Andrew C; Mamon, Harvey J; McAllister, Pamela K; Minsky, Bruce D; Ngeow, Joanne; Abu Hassan, Muhammad R; Ryan, Kim; Shankaran, Veena; Upton, Melissa P; Zalcberg, John; van de Velde, Cornelis J; Tollenaar, Rob

2017-05-01

Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients. The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer. The working group was composed of multidisciplinary oncology specialists in medicine, surgery, radiation therapy, palliative care, nursing, and pathology, along with patient representatives. Through a modified Delphi process during 8 months (July 8, 2015 to February 29, 2016), ICHOM led the working group to a consensus on a final recommended standard set. The process was supported by a systematic PubMed literature review (1042 randomized clinical trials and guidelines from June 3, 2005, to June 3, 2015), a patient focus group (11 patients with early and metastatic colorectal cancer convened during a teleconference in August 2015), and a patient validation survey (among 276 patients with and survivors of colorectal cancer between October 15, 2015, and November 4, 2015). After consolidating findings of the literature review and focus group meeting, a list of 40 outcomes was presented to the WG and underwent voting. The final recommendation includes outcomes in the following categories: survival and disease control, disutility of care, degree of health, and quality of death. Selected case-mix factors were recommended to be collected at baseline to facilitate comparison of results across treatments and health care professionals. A standardized set of patient-centered outcome measures to inform value-based health care in colorectal cancer was developed. Pilot efforts are under way to measure the standard set among members of the working group.

High efficiency endocrine operation protocol: From design to implementation.

PubMed

Mascarella, Marco A; Lahrichi, Nadia; Cloutier, Fabienne; Kleiman, Simcha; Payne, Richard J; Rosenberg, Lawrence

2016-10-01

We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. Using this protocol, a case-control study of 72 patients undergoing endocrine operation during high efficiency days were age, sex, and procedure-matched to 72 patients undergoing operation during standard days. The demographic profile, operative times, and perioperative complications were noted. The average number of cases per 8-hour workday in the high efficiency and standard operating rooms were 7 and 5, respectively. Mean procedure times in both groups were similar. The turnaround time (mean ± standard deviation) in the high efficiency group was 8.5 (±2.7) minutes as compared with 15.4 (±4.9) minutes in the standard group (P < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively (P = .99). In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program. Copyright © 2016 Elsevier Inc. All rights reserved.

Final Report. An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group

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

Rosenthal, Andrew

The DOE grant, “An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group,” to New Mexico State University created the Solar America Board for Codes and Standards (Solar ABCs). From 2007 – 2013 with funding from this grant, Solar ABCs identified current issues, established a dialogue among key stakeholders, and catalyzed appropriate activities to support the development of codes and standards that facilitated the installation of high quality, safe photovoltaic systems. Solar ABCs brought the following resources to the PV stakeholder community; Formal coordination in the planning or revision of interrelated codes and standards removing “stovemore » pipes” that have only roofing experts working on roofing codes, PV experts on PV codes, fire enforcement experts working on fire codes, etc.; A conduit through which all interested stakeholders were able to see the steps being taken in the development or modification of codes and standards and participate directly in the processes; A central clearing house for new documents, standards, proposed standards, analytical studies, and recommendations of best practices available to the PV community; A forum of experts that invites and welcomes all interested parties into the process of performing studies, evaluating results, and building consensus on standards and code-related topics that affect all aspects of the market; and A biennial gap analysis to formally survey the PV community to identify needs that are unmet and inhibiting the market and necessary technical developments.« less

Does habituation really happen? Investigation of psycho-biological responses to body exposure in bulimia nervosa.

PubMed

Trentowska, Monika; Svaldi, Jennifer; Blechert, Jens; Tuschen-Caffier, Brunna

2017-03-01

Body exposure is a common and effective treatment for body image disturbance in bulimia nervosa (BN). However, little is known about treatment mechanisms. Based on models of emotional processing and neurovisceral integration, we expected to observe a) initial activation and b) habituation of cognitive-affective and autonomic responding within one and between two standardized body exposure sessions. A group of 13 women with BN and 13 healthy controls (HC) were repeatedly exposed to their bodies. Prior to and after treatment with three individualized mirror exposure sessions participants received a session of standardized exposure to videographic recordings of their body. Subjective ratings of body-related emotions and thoughts were assessed repeatedly throughout the standardized exposure sessions and autonomic responses were recorded continuously. Subjective and sympathetic responses were activated initially in both groups. Cognitive-affective responses habituated within the standardized sessions in both groups, whereas between the standardized sessions habituation was only found in women with BN. Increasing sympathetic responses were found within the sessions in both groups. The results support cognitive-affective habituation during body exposure in BN and to a lesser extent in HC. Autonomic responses however did not show a corresponding pattern and did not distinguish between groups. Implications for body exposure research and practice are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Conflict of Interest Arises as Concern in Standards Push

ERIC Educational Resources Information Center

Zehr, Mary Ann

2009-01-01

A respected literacy-research organization is asking that a process be put in place to make more transparent potential conflicts of interest that writers of the common national academic standards might have, and to address them. The Literacy Research Association sent a letter Oct. 21 to the groups overseeing the development of common standards…

Methodological considerations on descriptive studies of induced periodontal diseases in rats.

PubMed

Galvão, Mariane Ponzio; Chapper, Ana; Rösing, Cassiano Kuchenbecker; Ferreira, Maria Beatriz; de Souza, Maria Antonieta

2003-01-01

The aim of this study was to show the technique and the methodological approach used in describing histological characteristics of induced periodontal disease in rats. To reach that inflammatory process, periodontal disease was induced by ligature, with or without sucrose-rich diet. Twenty-four female adult (60 days old) Wistar rats were divided in four groups: Group 1, or control (which received standard diet), Group 2 (which received ligature around the upper second molars and a standard diet), Group 3 (which received a sucrose-rich diet), and Group 4 (which received ligature around the upper second molars and a sucrose-rich diet). The animals were followed for a period of 30 days, after which they were sacrificed. The upper second molars were removed, processed, and the histological characteristics were analyzed by a descriptive dichotomous method. The results were analyzed by the Fisher's exact test (significance level of 95%) and by a residual test, which showed the relation between groups and histological characteristics. The animals which received ligature (Groups 2 and 4) showed histological characteristics related with periodontitis, whilst the animals without ligatures showed no periodontal destruction. This was shown by a distribution of these groups in extremes of a graphic representation. The use of a ligature, as done in this study, was able to promote a chronic inflammatory process in the periodontium of rats, regardless of the adopted diet. The correspondence factorial analysis was capable of showing these characteristics, being one more tool to be used in histological research.

Brain dynamics in spider-phobic individuals exposed to phobia-relevant and other emotional stimuli.

PubMed

Michalowski, Jaroslaw M; Melzig, Christiane A; Weike, Almut I; Stockburger, Jessica; Schupp, Harald T; Hamm, Alfons O

2009-06-01

Dense sensor event-related brain potentials were measured in participants with spider phobia and nonfearful controls during viewing of phobia-relevant spider and standard emotional (pleasant, unpleasant, neutral) pictures. Irrespective of the picture content, spider phobia participants responded with larger P1 amplitudes than controls, suggesting increased vigilance in this group. Furthermore, spider phobia participants showed a significantly enlarged early posterior negativity (EPN) and late positive potential (LPP) during the encoding of phobia-relevant pictures compared to nonfearful controls. No group differences were observed for standard emotional materials indicating that these effects were specific to phobia-relevant material. Within group comparisons of the spider phobia group, though, revealed comparable EPN and LPP evoked by spider pictures and emotional (unpleasant and pleasant) picture contents. These results demonstrate a temporal unfolding in perceptual processing from unspecific vigilance (P1) to preferential responding (EPN and LPP) to phobia-relevant materials in the spider phobia group. However, at the level of early stimulus processing, these effects of increased attention seem to be related to emotional relevance of the stimulus cues rather than reflecting a fear-specific response.

The Internal Medicine of the 21st century: Organizational and operational standards.

PubMed

Casariego-Vales, E; Zapatero-Gaviria, A; Elola-Somoza, F J

2017-12-01

The Spanish Society of Internal Medicine has developed a consensus document on the standards and recommendations that they consider essential to the organisation of internal medicine units for conducting their activities efficiently and with high quality. We defined 3 groups of key processes: the care of acutely ill adult patients, the comprehensive care of complex chronic patients and the examination of a patient with a difficult diagnosis and no organ-specific disease. As support processes, we identified the structure and operation of the Internal Medicine units. As strategic processes, we identified training and research. The main subprocesses are structured below, and we established the standards and recommendations for each of them. Lastly, we proposed resulting workloads. The prepared standards must be reviewed within a maximum of 4 years. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Cognitive models of medical decision-making capacity in patients with mild cognitive impairment.

PubMed

Okonkwo, O C; Griffith, H R; Belue, K; Lanza, S; Zamrini, E Y; Harrell, L E; Brockington, J C; Clark, D; Raman, R; Marson, D C

2008-03-01

This study investigated cognitive predictors of medical decision-making capacity (MDC) in patients with amnestic mild cognitive impairment (MCI). A total of 56 healthy controls, 60 patients with MCI, and 31 patients with mild Alzheimer's disease (AD) were administered the Capacity to Consent to Treatment Instrument (CCTI) and a neuropsychological test battery. The CCTI assesses MDC across four established treatment consent standards--S1 (expressing choice), S3 (appreciation), S4 (reasoning), and S5 (understanding)--and one experimental standard [S2] (reasonable choice). Scores on neuropsychological measures were correlated with scores on each CCTI standard. Significant bivariate correlates were subsequently entered into stepwise regression analyses to identity group-specific multivariable predictors of MDC across CCTI standards. Different multivariable cognitive models emerged across groups and consent standards. For the MCI group, measures of short-term verbal memory were key predictors of MDC for each of the three clinically relevant standards (S3, S4, and S5). Secondary predictors were measures of executive function. In contrast, in the mild AD group, measures tapping executive function and processing speed were primary predictors of S3, S4, and S5. MDC in patients with MCI is supported primarily by short-term verbal memory. The findings demonstrate the impact of amnestic deficits on MDC in patients with MCI.

[Indicators monitoring the process of specialized nutritional support. Grupo de Nutrición de la SEFH].

PubMed

Sirvent, Mariola; Victoria Calvo, María; Sagalés, María; Rodríguez-Penin, Isaura; Cervera, Mercedes; Piñeiro, Guadalupe; García-Rodicio, Sonsoles; Gomis, Pilar; Caba, Isabel; Vazquez, Amparo; Gomez, María E; Pedraza, Luis

2013-01-01

To identify and develop monitoring indicators of the process of specialized nutritional support that will allow measuring the level of adherence to the established practice standards. Those practice standards considered to be key elements of the process were selected to develop performance indicators. The construction of these indicators combined the scientific evidence with expert opinion. Key goals were identified within each standard provided that its consecution would allow increasing the achievement of the standard. Particular improvement initiatives associated to each key goal were generated. Lastly, monitoring indicators were defined allowing undertaking a follow-up of the implementation of the improvement initiatives or either to assess the level of achievement of the key goals identified. Nineteen practice standards were selected representative of the critical points of the process. The strategic map for each standard has been defined, with the identification of 43 key goals. In order to achieve these key goals, a portfolio of improvements has been generated comprising 56 actions. Finally, 44 monitoring indicators have been defined grouped into three categories: 1. Numeric: they assess the level of goal achievement; 2. Dichotomic (yes/no): they inform on the execution of the improvement actions; 3. Results of the practice audits. We have made available monitoring indicators that allow assessing the level of adherence to the practice standards of the process of specialized nutritional support and the impact of the implementation of improvement actions within this process. Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.

Standard setting processes and regulations for environmental contaminants in drinking water: State versus federal needs and viewpoints

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

Sidhu, K.S.

1991-06-01

The primary objective of a standard setting process is to arrive at a drinking water concentration at which exposure to a contaminant would result in no known or potential adverse health effect on human health. The drinking water standards also serve as guidelines to prevent pollution of water sources and may be applicable in some cases as regulatory remediation levels. The risk assessment methods along with various decision making parameters are used to establish drinking water standards. For carcinogens classified in Groups A and B by the United States Environmental Protection Agency (USEPA) the standards are set by using nonthresholdmore » cancer risk models. The linearized multistage model is commonly used for computation of potency factors for carcinogenic contaminants. The acceptable excess risk level may vary from 10(-6) to 10(-4). For noncarcinogens, a threshold model approach based on application of an uncertainty factor is used to arrive at a reference dose (RfD). The RfD approach may also be used for carcinogens classified in Group C by the USEPA. The RfD approach with an additional uncertainty factory of 10 for carcinogenicity has been applied in the formulation of risk assessment for Group C carcinogens. The assumptions commonly used in arriving at drinking water standards are human life expectancy, 70 years; average human body weight, 70 kg; human daily drinking water consumption, 2 liters; and contribution of exposure to the contaminant from drinking water (expressed as a part of the total environmental exposure), 20%. Currently, there are over 80 USEPA existing or proposed primary standards for organic and inorganic contaminants in drinking water. Some of the state versus federal needs and viewpoints are discussed.« less

American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology.

PubMed

Mayo, Charles S; Moran, Jean M; Bosch, Walter; Xiao, Ying; McNutt, Todd; Popple, Richard; Michalski, Jeff; Feng, Mary; Marks, Lawrence B; Fuller, Clifton D; Yorke, Ellen; Palta, Jatinder; Gabriel, Peter E; Molineu, Andrea; Matuszak, Martha M; Covington, Elizabeth; Masi, Kathryn; Richardson, Susan L; Ritter, Timothy; Morgas, Tomasz; Flampouri, Stella; Santanam, Lakshmi; Moore, Joseph A; Purdie, Thomas G; Miller, Robert C; Hurkmans, Coen; Adams, Judy; Jackie Wu, Qing-Rong; Fox, Colleen J; Siochi, Ramon Alfredo; Brown, Norman L; Verbakel, Wilko; Archambault, Yves; Chmura, Steven J; Dekker, Andre L; Eagle, Don G; Fitzgerald, Thomas J; Hong, Theodore; Kapoor, Rishabh; Lansing, Beth; Jolly, Shruti; Napolitano, Mary E; Percy, James; Rose, Mark S; Siddiqui, Salim; Schadt, Christof; Simon, William E; Straube, William L; St James, Sara T; Ulin, Kenneth; Yom, Sue S; Yock, Torunn I

2018-03-15

A substantial barrier to the single- and multi-institutional aggregation of data to supporting clinical trials, practice quality improvement efforts, and development of big data analytics resource systems is the lack of standardized nomenclatures for expressing dosimetric data. To address this issue, the American Association of Physicists in Medicine (AAPM) Task Group 263 was charged with providing nomenclature guidelines and values in radiation oncology for use in clinical trials, data-pooling initiatives, population-based studies, and routine clinical care by standardizing: (1) structure names across image processing and treatment planning system platforms; (2) nomenclature for dosimetric data (eg, dose-volume histogram [DVH]-based metrics); (3) templates for clinical trial groups and users of an initial subset of software platforms to facilitate adoption of the standards; (4) formalism for nomenclature schema, which can accommodate the addition of other structures defined in the future. A multisociety, multidisciplinary, multinational group of 57 members representing stake holders ranging from large academic centers to community clinics and vendors was assembled, including physicists, physicians, dosimetrists, and vendors. The stakeholder groups represented in the membership included the AAPM, American Society for Radiation Oncology (ASTRO), NRG Oncology, European Society for Radiation Oncology (ESTRO), Radiation Therapy Oncology Group (RTOG), Children's Oncology Group (COG), Integrating Healthcare Enterprise in Radiation Oncology (IHE-RO), and Digital Imaging and Communications in Medicine working group (DICOM WG); A nomenclature system for target and organ at risk volumes and DVH nomenclature was developed and piloted to demonstrate viability across a range of clinics and within the framework of clinical trials. The final report was approved by AAPM in October 2017. The approval process included review by 8 AAPM committees, with additional review by ASTRO, European Society for Radiation Oncology (ESTRO), and American Association of Medical Dosimetrists (AAMD). This Executive Summary of the report highlights the key recommendations for clinical practice, research, and trials. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The Calibration of dc Voltage Standards at NIST

PubMed Central

Field, Bruce F.

1990-01-01

This document describes the procedures used at NIST to calibrate dc voltage standards in terms of the NIST volt. Three calibration services are offered by the Electricity Division: Regular Calibration Service (RCS) of client standard cells at NIST; the Volt Transfer Program (VTP) a process to determine the difference between the NIST volt and the volt as maintained by a group of standard cells in a client laboratory; and the calibration of client solid-state dc voltage standards at NIST. The operational procedures used to compare these voltage standards to NIST voltage standards and to maintain the NIST volt via the ac Josephson effect are discussed. PMID:28179777

Computerized Orders with Standardized Concentrations Decrease Dispensing Errors of Continuous Infusion Medications for Pediatrics

PubMed Central

Sowan, Azizeh K.; Vaidya, Vinay U.; Soeken, Karen L.; Hilmas, Elora

2010-01-01

OBJECTIVES The use of continuous infusion medications with individualized concentrations may increase the risk for errors in pediatric patients. The objective of this study was to evaluate the effect of computerized prescriber order entry (CPOE) for continuous infusions with standardized concentrations on frequency of pharmacy processing errors. In addition, time to process handwritten versus computerized infusion orders was evaluated and user satisfaction with CPOE as compared to handwritten orders was measured. METHODS Using a crossover design, 10 pharmacists in the pediatric satellite within a university teaching hospital were given test scenarios of handwritten and CPOE order sheets and asked to process infusion orders using the pharmacy system in order to generate infusion labels. Participants were given three groups of orders: five correct handwritten orders, four handwritten orders written with deliberate errors, and five correct CPOE orders. Label errors were analyzed and time to complete the task was recorded. RESULTS Using CPOE orders, participants required less processing time per infusion order (2 min, 5 sec ± 58 sec) compared with time per infusion order in the first handwritten order sheet group (3 min, 7 sec ± 1 min, 20 sec) and the second handwritten order sheet group (3 min, 26 sec ± 1 min, 8 sec), (p<0.01). CPOE eliminated all error types except wrong concentration. With CPOE, 4% of infusions processed contained errors, compared with 26% of the first group of handwritten orders and 45% of the second group of handwritten orders (p<0.03). Pharmacists were more satisfied with CPOE orders when compared with the handwritten method (p=0.0001). CONCLUSIONS CPOE orders saved pharmacists' time and greatly improved the safety of processing continuous infusions, although not all errors were eliminated. pharmacists were overwhelmingly satisfied with the CPOE orders PMID:22477811

Scalability, Complexity and Reliability in Quantum Information Processing

DTIC Science & Technology

2007-03-01

hidden subgroup framework to abelian groups which are not finitely generated. An extension of the basic algorithm breaks the Buchmann-Williams...finding short lattice vectors . In [2], we showed that the generalization of the standard method --- random coset state preparation followed by fourier...sampling --- required exponential time for sufficiently non-abelian groups including the symmetric group , at least when the fourier transforms are

Permissible Inferences from the Outcome of Training Studies in Cognitive Development Research. Technical Report No. 127.

ERIC Educational Resources Information Center

Brown, Ann L.; Campione, Joseph C.

In modal training studies, the comparative groups differ in the use of a particular cognitive process; training to overcome the deficiency is provided for the deficient group only, and their performance is then compared to the standard set by the untrained group. Improvements are necessary in the design of training studies, as are a…

Predicting Student Performance in a Collaborative Learning Environment

ERIC Educational Resources Information Center

Olsen, Jennifer K.; Aleven, Vincent; Rummel, Nikol

2015-01-01

Student models for adaptive systems may not model collaborative learning optimally. Past research has either focused on modeling individual learning or for collaboration, has focused on group dynamics or group processes without predicting learning. In the current paper, we adjust the Additive Factors Model (AFM), a standard logistic regression…

Standard Systems Group (SSG) Technology Adoption Planning Workshop

DTIC Science & Technology

2004-04-01

11 Figure 2: Map of SEI Technologies Against SSG (Cluster Focused on Customer Issues...them could be consolidated. The objectives were grouped into three categories ( customer focused, internal operations, and innovation & learning... customers ! • Streamlined organization with agile processes • Recognized expertise in exploring and exploiting leading IT technologies • Enterprise

21 CFR 660.34 - Processing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Reagent Red Blood Cells § 660.34 Processing. (a... required blood group antigens specified in the labeling as present. (b) Products prepared from pooled red blood cells. If the product is recommended for the detection of unexpected antibodies, the pool shall be...

21 CFR 660.34 - Processing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Reagent Red Blood Cells § 660.34 Processing. (a... required blood group antigens specified in the labeling as present. (b) Products prepared from pooled red blood cells. If the product is recommended for the detection of unexpected antibodies, the pool shall be...

21 CFR 660.34 - Processing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Reagent Red Blood Cells § 660.34 Processing. (a... required blood group antigens specified in the labeling as present. (b) Products prepared from pooled red blood cells. If the product is recommended for the detection of unexpected antibodies, the pool shall be...

21 CFR 660.34 - Processing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Reagent Red Blood Cells § 660.34 Processing. (a... required blood group antigens specified in the labeling as present. (b) Products prepared from pooled red blood cells. If the product is recommended for the detection of unexpected antibodies, the pool shall be...

Recommendations for improved and coherent acquisition and processing of backscatter data from seafloor-mapping sonars

NASA Astrophysics Data System (ADS)

Lamarche, Geoffroy; Lurton, Xavier

2018-06-01

Multibeam echosounders are becoming widespread for the purposes of seafloor bathymetry mapping, but the acquisition and the use of seafloor backscatter measurements, acquired simultaneously with the bathymetric data, are still insufficiently understood, controlled and standardized. This presents an obstacle to well-accepted, standardized analysis and application by end users. The Marine Geological and Biological Habitat Mapping group (Geohab.org) has long recognized the need for better coherence and common agreement on acquisition, processing and interpretation of seafloor backscatter data, and established the Backscatter Working Group (BSWG) in May 2013. This paper presents an overview of this initiative, the mandate, structure and program of the working group, and a synopsis of the BSWG Guidelines and Recommendations to date. The paper includes (1) an overview of the current status in sensors and techniques available in seafloor backscatter data from multibeam sonars; (2) the presentation of the BSWG structure and results; (3) recommendations to operators, end-users, sonar manufacturers, and software developers using sonar backscatter for seafloor-mapping applications, for best practice methods and approaches for data acquisition and processing; and (4) a discussion on the development needs for future systems and data processing. We propose for the first time a nomenclature of backscatter processing levels that affords a means to accurately and efficiently describe the data processing status, and to facilitate comparisons of final products from various origins.

Effective Change: A Case Study of Implementation of A Standards Based Grading Initiative

ERIC Educational Resources Information Center

MacCrindle, Amy N.

2017-01-01

This study followed mindset changes in elementary teachers as they transitioned from traditional grading to standards based grading during the earliest stages of the change process. A pre- and post-survey of mindsets of participants, individual interviews, and a focus group interview were conducted. While the results of the pre- and post-survey…

Architecture for Survivable System Processing (ASSP)

NASA Astrophysics Data System (ADS)

Wood, Richard J.

1991-11-01

The Architecture for Survivable System Processing (ASSP) Program is a multi-phase effort to implement Department of Defense (DOD) and commercially developed high-tech hardware, software, and architectures for reliable space avionics and ground based systems. System configuration options provide processing capabilities to address Time Dependent Processing (TDP), Object Dependent Processing (ODP), and Mission Dependent Processing (MDP) requirements through Open System Architecture (OSA) alternatives that allow for the enhancement, incorporation, and capitalization of a broad range of development assets. High technology developments in hardware, software, and networking models, address technology challenges of long processor life times, fault tolerance, reliability, throughput, memories, radiation hardening, size, weight, power (SWAP) and security. Hardware and software design, development, and implementation focus on the interconnectivity/interoperability of an open system architecture and is being developed to apply new technology into practical OSA components. To insure for widely acceptable architecture capable of interfacing with various commercial and military components, this program provides for regular interactions with standardization working groups (e.g.) the International Standards Organization (ISO), American National Standards Institute (ANSI), Society of Automotive Engineers (SAE), and Institute of Electrical and Electronic Engineers (IEEE). Selection of a viable open architecture is based on the widely accepted standards that implement the ISO/OSI Reference Model.

Architecture for Survivable System Processing (ASSP)

NASA Technical Reports Server (NTRS)

Wood, Richard J.

1991-01-01

The Architecture for Survivable System Processing (ASSP) Program is a multi-phase effort to implement Department of Defense (DOD) and commercially developed high-tech hardware, software, and architectures for reliable space avionics and ground based systems. System configuration options provide processing capabilities to address Time Dependent Processing (TDP), Object Dependent Processing (ODP), and Mission Dependent Processing (MDP) requirements through Open System Architecture (OSA) alternatives that allow for the enhancement, incorporation, and capitalization of a broad range of development assets. High technology developments in hardware, software, and networking models, address technology challenges of long processor life times, fault tolerance, reliability, throughput, memories, radiation hardening, size, weight, power (SWAP) and security. Hardware and software design, development, and implementation focus on the interconnectivity/interoperability of an open system architecture and is being developed to apply new technology into practical OSA components. To insure for widely acceptable architecture capable of interfacing with various commercial and military components, this program provides for regular interactions with standardization working groups (e.g.) the International Standards Organization (ISO), American National Standards Institute (ANSI), Society of Automotive Engineers (SAE), and Institute of Electrical and Electronic Engineers (IEEE). Selection of a viable open architecture is based on the widely accepted standards that implement the ISO/OSI Reference Model.

Use of a multimedia module to aid the informed consent process in patients undergoing gynecologic laparoscopy for pelvic pain: randomized controlled trial.

PubMed

Ellett, Lenore; Villegas, Rocio; Beischer, Andrew; Ong, Nicole; Maher, Peter

2014-01-01

To determine whether providing additional information to the standard consent process, in the form of a multimedia module (MM), improves patient knowledge about operative laparoscopy without increasing anxiety. Randomized controlled trial (Canadian Task Force classification I). Two outpatient gynecologic clinics, one in a private hospital and the other in a public teaching hospital. Forty-one women aged 19 to 51 years (median, 35.6 years) requiring operative laparoscopy for investigation and treatment of pelvic pain. Following the standard informed consent process, patients were randomized to watch the MM (intervention group, n = 21) or not (control group, n = 20). The surgeon was blinded to the group assignments. All patients completed a knowledge questionnaire and the Spielberger short-form State-Trait Anxiety Inventory. Six weeks after recruitment, patients completed the knowledge questionnaire and the State-Trait Anxiety Inventory a second time to assess knowledge retention and anxiety scores. Patient knowledge of operative laparoscopy, anxiety level, and acceptance of the MM were recorded. The MM intervention group demonstrated superior knowledge scores. Mean (SE) score in the MM group was 11.3 (0.49), and in the control group was 7.9 (0.50) (p <.001) (maximum score, 14). This did not translate into improved knowledge scores 6 weeks later; the score in the MM group was 8.4 (0.53) vs. 7.8 (0.50) in the control group (p = .44). There was no difference in anxiety levels between the groups at intervention or after 6 weeks. Overall, patients found the MM acceptable, and 18 women (86%) in the intervention group and 12 (60%) in the control group stated they would prefer this style of informed consent in the future. Use of an MM enhances the informed consent process by improving patient knowledge, in the short term, without increasing anxiety. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Using visual processing training to enhance standard cognitive remediation outcomes in schizophrenia: A pilot study.

PubMed

Contreras, Natalia A; Tan, Eric J; Lee, Stuart J; Castle, David J; Rossell, Susan L

2018-04-01

Approaches to cognitive remediation (CR) that address sensory perceptual skills before higher cognitive skills, have been found to be effective in enhancing cognitive performance in schizophrenia. To date, however, most of the conducted trials have concentrated on auditory processing. The aim of this study was to explore whether the addition of visual processing training could enhance standard cognitive remediation outcomes in a schizophrenia population. Twenty participants were randomised to either receive 20h of computer-assisted cognitive remediation alone or 20h of visual processing training modules and cognitive remediation training. All participants were assessed at baseline and at the end of cognitive remediation training on cognitive and psychosocial (i.e. self-esteem, quality of life) measures. At the end of the study participants across both groups improved significantly in overall cognition and psychosocial functioning. No significant differences were observed between groups on any of the measures. Of potential interest, however, was that the Cohen's d assessing the between group difference in the rates of change were moderate/large for a greater improvement in Visual Learning, Working Memory and Social Cognition for the visual training plus cognitive remediation group. On the basis of our effect sizes on three domains of cognition, we recommend replicating this intervention with a larger sample. Copyright © 2017 Elsevier B.V. All rights reserved.

The Role of Lobbyists in the Defense Budget and Procurement Process.

DTIC Science & Technology

1986-05-15

selfish or misguided methods used by pressure groups led to legislation that lined the pockets of the pressure group or imposed the group’s 2 standards on...corporations, unions, and other strong pressure group organizations. 3 It must also be remembered that this legislation primarily affects the Executive...purposes in mind. Common Cause, the most active pressure group advocating reform on this issue, argued that companies spend large sums of money to

Differences in Activities of Daily Living Performance Between Long-Term Pediatric Sarcoma Survivors and a Matched Comparison Group on Standardized Testing

PubMed Central

Parks, Rebecca; Rasch, Elizabeth K.; Mansky, Patrick J.; Oakley, Frances

2009-01-01

BACKGROUND: In a cross-sectional study examining late effects of pediatric sarcoma therapy, long-term survivors were evaluated on their activities of daily living (ADL) performance. PROCEDURE: Thirty-two persons with Ewing sarcoma family of tumors, rhabdomyosarcoma, and non-rhabdomysarcoma-soft tissue sarcoma enrolled an average of 17 years after treatment. Participants were evaluated using the Assessment of Motor and Process Skills (AMPS) [1], a standardized observational evaluation of ADL task performance. Means and 95% confidence intervals for ADL motor and ADL process ability measures were calculated for four groups: 1) sarcoma survivors, 2) “well” adults matched for age and gender, 3) “well” adults matched for gender that were 10 years older; and 4) “well” adults matched for gender that were 20 years older. RESULTS: ADL motor ability was significantly lower for sarcoma survivors than for the age and gender matched comparison group (p<0.05). There was no significant difference between ADL motor ability of sarcoma survivors and the comparison group 10 years older, but sarcoma survivors had significantly better ADL motor ability (p<0.05) than the oldest comparison group (20 years older). Sarcoma survivors had significantly worse ADL process ability than the age matched group (p<0.05). There was no difference in ADL process ability between the sarcoma survivors and comparison groups that were 10 and 20 years older. CONCLUSIONS: This first report of a clinical evaluation of ADL limitation in pediatric sarcoma survivors treated with intensive multimodal cancer therapy suggests that influences on performance of daily life activities are more common than previously reported. PMID:19533662

The Future of Geospatial Standards

NASA Astrophysics Data System (ADS)

Bermudez, L. E.; Simonis, I.

2016-12-01

The OGC is an international not-for-profit standards development organization (SDO) committed to making quality standards for the geospatial community. A community of more than 500 member organizations with more than 6,000 people registered at the OGC communication platform drives the development of standards that are freely available for anyone to use and to improve sharing of the world's geospatial data. OGC standards are applied in a variety of application domains including Environment, Defense and Intelligence, Smart Cities, Aviation, Disaster Management, Agriculture, Business Development and Decision Support, and Meteorology. Profiles help to apply information models to different communities, thus adapting to particular needs of that community while ensuring interoperability by using common base models and appropriate support services. Other standards address orthogonal aspects such as handling of Big Data, Crowd-sourced information, Geosemantics, or container for offline data usage. Like most SDOs, the OGC develops and maintains standards through a formal consensus process under the OGC Standards Program (OGC-SP) wherein requirements and use cases are discussed in forums generally open to the public (Domain Working Groups, or DWGs), and Standards Working Groups (SWGs) are established to create standards. However, OGC is unique among SDOs in that it also operates the OGC Interoperability Program (OGC-IP) to provide real-world testing of existing and proposed standards. The OGC-IP is considered the experimental playground, where new technologies are researched and developed in a user-driven process. Its goal is to prototype, test, demonstrate, and promote OGC Standards in a structured environment. Results from the OGC-IP often become requirements for new OGC standards or identify deficiencies in existing OGC standards that can be addressed. This presentation will provide an analysis of the work advanced in the OGC consortium including standards and testbeds, where we can extract a trend for the future of geospatial standards. We see a number of key elements in focus, but simultaneously a broadening of standards to address particular communities' needs.

Teaching methotrexate self-injection with a web-based video maintains patient care while reducing healthcare resources: a pilot study.

PubMed

Katz, Steven J; Leung, Sylvia

2015-01-01

The aim of the study was to compare standard nurse-led methotrexate self-injection patient education to a web-based methotrexate self-injection education video in conjunction with standard teaching on patient self-confidence for self-injection, as well as patient satisfaction, patient knowledge and teaching time. Consecutive rheumatology patients seen for methotrexate self-injection education were enrolled. Prior to education, patient self-confidence for self-injection, age, gender and education were recorded. Patients were randomized 1:1 to standard teaching or the intervention: a 12-min methotrexate self-injection education video followed by further in-person nurse education. Patients recorded their post-education confidence for self-injection, satisfaction with the teaching process and answered four specific questions testing knowledge on methotrexate self-injection. The time spent providing direct education to the patient was recorded. Twenty-nine patients participated in this study: 15 had standard (C) teaching and 14 were in the intervention group (I). Average age, gender and education level were similar in both groups. Both groups were satisfied with the quality of teaching. There was no difference in pre-confidence (C = 5.5/10 vs. I = 4.7/10, p = 0.44) or post-confidence (C = 8.8, I = 8.8, p = 0.93) between the groups. There was a trend toward improved patient knowledge in the video group versus the standard group (C = 4.7/6, I = 5.5/6, p = 0.15). Nurse teaching time was less in the video group (C = 60 min, I = 44 min, p = 0.012), with men requiring longer education time than women across all groups. An education video may be a good supplement to standard in-person nurse teaching for methotrexate self-injection. It equals the standard teaching practise with regard to patient satisfaction, confidence and knowledge while decreasing teaching time by 25 %.

Object Management Group object transaction service based on an X/Open and International Organization for Standardization open systems interconnection transaction processing kernel

NASA Astrophysics Data System (ADS)

Liang, J.; Sédillot, S.; Traverson, B.

1997-09-01

This paper addresses federation of a transactional object standard - Object Management Group (OMG) object transaction service (OTS) - with the X/Open distributed transaction processing (DTP) model and International Organization for Standardization (ISO) open systems interconnection (OSI) transaction processing (TP) communication protocol. The two-phase commit propagation rules within a distributed transaction tree are similar in the X/Open, ISO and OMG models. Building an OTS on an OSI TP protocol machine is possible because the two specifications are somewhat complementary. OTS defines a set of external interfaces without specific internal protocol machine, while OSI TP specifies an internal protocol machine without any application programming interface. Given these observations, and having already implemented an X/Open two-phase commit transaction toolkit based on an OSI TP protocol machine, we analyse the feasibility of using this implementation as a transaction service provider for OMG interfaces. Based on the favourable result of this feasibility study, we are implementing an OTS compliant system, which, by initiating the extensibility and openness strengths of OSI TP, is able to provide interoperability between X/Open DTP and OMG OTS models.

[Optimization of blood gas analysis in intensive care units : Reduction of preanalytical errors and improvement of workflow].

PubMed

Kieninger, M; Zech, N; Mulzer, Y; Bele, S; Seemann, M; Künzig, H; Schneiker, A; Gruber, M

2015-05-01

Point of care testing with blood gas analysis (BGA) is an important factor for intensive care medicine. Continuous efforts to optimize workflow, improve safety for the staff and avoid preanalytical mistakes are important and should reflect quality management standards. In a prospective observational study it was investigated whether the implementation of a new system for BGA using labeled syringes and automated processing of the specimens leads to improvements compared to the previously used procedure. In a 4-week test period the time until receiving the final results of the BGA with the standard method used in the clinical routine (control group) was compared to the results in a second 4-week test period using the new labeled syringes and automated processing of the specimens (intervention group). In addition, preanalytical mistakes with both systems were checked during routine daily use. Finally, it was investigated whether a delay of 10 min between taking and analyzing the blood samples alters the results of the BGA. Preanalytical errors were frequently observed in the control group where non-deaerated samples were recorded in 87.3 % but in the intervention group almost all samples (98.9 %) were correctly deaerated. Insufficient homogenization due to omission of manual pivoting was seen in 83.2 % in the control group and in 89.9 % in the intervention group; however, in the intervention group the samples were homogenized automatically during the further analytical process. Although a survey among the staff revealed a high acceptance of the new system and a subjective improvement of workflow, a measurable gain in time after conversion to the new procedure could not be seen. The mean time needed for a complete analysis process until receiving the final results was 244 s in the intervention group and 201 s in the control group. A 10-min delay between taking and analyzing the blood samples led to a significant and clinically relevant elevation of the values for partial pressure of oxygen (pO2) in both groups compared to the results when analyzing the samples immediately (118.4 vs. 148.6 mmHg in the control group and 115.3 vs. 123.7 mmHg in the intervention group). When using standard syringes the partial pressure of carbon dioxide (pCO2) was significantly lower (40.5 vs. 38.3 mmHg) whereas no alterations were seen when using the labeled syringes. The implementation of a new BGA system with labeled syringes and automated processing of the specimens was possible without any difficulties under daily clinical routine conditions in this 10-bed intensive care unit (ICU). A gain of time could not be measured but a reduction in preanalytical errors using the labeled syringes with automated processing was found. Delayed analysis of blood samples can lead to significant changes in pO2 and pCO2 depending on the type of syringe used.

Educating anesthesia residents to obtain and document informed consent for epidural labor analgesia: does simulation play a role?

PubMed

Antoniou, A; Marmai, K; Qasem, F; Cherry, R; Jones, P M; Singh, S

2018-05-01

Informed consent is required before placing an epidural. At our hospital, teaching of residents about this is done informally at the bedside. This study aimed to assess the ability of anesthesia residents to acquire and retain knowledge required when seeking informed consent for epidural labor analgesia. It assessed how well this knowledge was translated to clinical ability, by assessing the verbal consent process during an interaction with a standardized patient. Twenty anesthesia residents were randomized to a 'didactic group' or a 'simulation group'. Each resident was presented with a written scenario and asked to document the informed consent process, as they normally would do (pre-test). The didactic group then had a presentation about informed consent, while the simulation group members interviewed a simulated patient, the scenarios focusing on different aspects of consent. All residents then read a scenario and documented their informed consent process (post-test). Six weeks later all residents interviewed a standardized patient in labor and documented the consent from this interaction (six-week test). There was no significant difference in the baseline performance of the two groups. Both groups showed significant improvement in their written consent documentation at the immediate time point, the improvement in the didactic group being greater. The didactic group performed better at both the immediate time point and the six-week time point. In this small study, a didactic teaching method proved better than simulation-based teaching in helping residents to gain knowledge needed to obtain informed consent for epidural labor analgesia. Copyright © 2017 Elsevier Ltd. All rights reserved.

40 CFR 63.497 - Back-end process provisions-monitoring provisions for control and recovery devices used to comply...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Back-end process provisions-monitoring... Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins § 63.497 Back-end process... limitations. (a) An owner or operator complying with the residual organic HAP limitations in § 63.494(a)(1...

Quality standards for rheumatology outpatient clinic. The EXTRELLA project.

PubMed

Nolla, Joan M; Martínez, Carmen; García-Vicuña, Rosario; Seoane-Mato, Daniel; Rosario Lozano, M Piedad; Alonso, Alberto; Alperi, Mercedes; Barbazán, Ceferino; Calvo, Jaime; Delgado, Concepción; Fernández-Nebro, Antonio; Mateo, Lourdes; Pérez Sandoval, Trinidad; Pérez Venegas, José; Rodríguez Lozano, Carlos; Rosas, José

2016-01-01

In recent years, outpatient clinics have undergone extensive development. At present, patients with rheumatic diseases are mainly assisted in this area. However, the quality standards of care are poorly documented. To develop specific quality criteria and standards for an outpatient rheumatology clinic. The project was based on the two-round Delphi method. The following groups of participants took part: scientific committee (13 rheumatologists), five nominal groups (45 rheumatologists and 12 nurses) and a group of discussion formed by 9 patients. Different drafts were consecutively generated until a final document was obtained that included the standards that received a punctuation equal or over 7 in at least 70% of the participants. 148 standards were developed, grouped into the following 9 dimensions: a) structure (22), b) clinical activity and relationship with the patients (34), c) planning (7), d) levels of priority (5), e) relations with primary care physicians, with Emergency Department and with other clinical departments, f) process (26), g) nursing (13), h) teaching and research (13) and i) activity measures (8). This study established specific quality standards for rheumatology outpatient clinic. It can be a useful tool for organising this area in the Rheumatology Department and as a reference when proposing improvement measures to health administrators. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Group Work during International Disaster Outreach Projects: A Model to Advance Cultural Competence

ERIC Educational Resources Information Center

West-Olatunji, Cirecie; Henesy, Rachel; Varney, Melanie

2015-01-01

Given the rise in disasters worldwide, counselors will increasingly be called upon to respond. Current accreditation standards require that programs train students to become skillful in disaster/crisis interventions. Group processing to enhance self-awareness and improve conceptualization skills is an essential element of such training. This…

Randomized Trial of a Lifestyle Physical Activity Intervention for Breast Cancer Survivors: Effects on Transtheoretical Model Variables.

PubMed

Scruggs, Stacie; Mama, Scherezade K; Carmack, Cindy L; Douglas, Tommy; Diamond, Pamela; Basen-Engquist, Karen

2018-01-01

This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.

[Description of the ISO 9001/2000 certification process in the parenteral nutrition area].

PubMed

Miana Mena, M T; Fontanals Martínez, S; López Púa, Y; López Suñé, E; Codina Jané, C; Ribas Sala, J

2007-01-01

In order to guarantee quality and safety and to increase user satisfaction, healthcare organisations have integrated quality management systems into their structures. This study describes the process for introducing the UNE-EN-ISO-9001/2000 standard in the parenteral nutrition area. A multidisciplinary group established the scope of the standard, focusing on transcription, preparation, dispensation and microbiological control. A detailed procedure describing the sequences of circuits and associated activities, the responsible staff and the action guidelines to be followed was established. Quality and activity markers were also established. This process has enabled a standard system to be implemented, with its operation perfectly described and documented, allowing its stages to be traceable and supervised. As there is no record of the data obtained beforehand, no direct comparison can be made; its evolution must therefore be analysed in the future.

Development of the Joint Committee Standards for Evaluations of Educational Programs, Projects, and Materials.

ERIC Educational Resources Information Center

Diamond, Esther E.

The growing demand for program evaluation in the 1970s gave rise to a need for a comprehensive, carefully developed, objective set of guiding principles for the evaluation process, from initial planning to final report. The Joint Committee on Standards for Education Evaluation was established to meet this need. This broad-based group, representing…

[Development of integrated support software for clinical nutrition].

PubMed

Siquier Homar, Pedro; Pinteño Blanco, Manel; Calleja Hernández, Miguel Ángel; Fernández Cortés, Francisco; Martínez Sotelo, Jesús

2015-09-01

to develop an integrated computer software application for specialized nutritional support, integrated in the electronic clinical record, which detects automatically and early those undernourished patients or at risk of developing undernourishment, determining points of opportunity for improvement and evaluation of the results. the quality standards published by the Nutrition Work Group of the Spanish Society of Hospital Pharmacy (SEFH) and the recommendations by the Pharmacy Group of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) have been taken into account. According to these quality standards, the nutritional support has to include the following healthcare stages or sub-processes: nutritional screening, nutritional assessment, plan for nutritional care, prescription, preparation and administration. this software allows to conduct, in an automated way, a specific nutritional assessment for those patients with nutritional risk, implementing, if necessary, a nutritional treatment plan, conducting follow-up and traceability of outcomes derived from the implementation of improvement actions, and quantifying to what extent our practice is close to the established standard. this software allows to standardize the specialized nutritional support from a multidisciplinary point of view, introducing the concept of quality control per processes, and including patient as the main customer. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

An intraorganizational model for developing and spreading quality improvement innovations.

PubMed

Kellogg, Katherine C; Gainer, Lindsay A; Allen, Adrienne S; OʼSullivan, Tatum; Singer, Sara J

Recent policy reforms encourage quality improvement (QI) innovations in primary care, but practitioners lack clear guidance regarding spread inside organizations. We designed this study to identify how large organizations can facilitate intraorganizational spread of QI innovations. We conducted ethnographic observation and interviews in a large, multispecialty, community-based medical group that implemented three QI innovations across 10 primary care sites using a new method for intraorganizational process development and spread. We compared quantitative outcomes achieved through the group's traditional versus new method, created a process model describing the steps in the new method, and identified barriers and facilitators at each step. The medical group achieved substantial improvement using its new method of intraorganizational process development and spread of QI innovations: standard work for rooming and depression screening, vaccine error rates and order compliance, and Pap smear error rates. Our model details nine critical steps for successful intraorganizational process development (set priorities, assess the current state, develop the new process, and measure and refine) and spread (develop support, disseminate information, facilitate peer-to-peer training, reinforce, and learn and adapt). Our results highlight the importance of utilizing preexisting organizational structures such as established communication channels, standardized roles, common workflows, formal authority, and performance measurement and feedback systems when developing and spreading QI processes inside an organization. In particular, we detail how formal process advocate positions in each site for each role can facilitate the spread of new processes. Successful intraorganizational spread is possible and sustainable. Developing and spreading new QI processes across sites inside an organization requires creating a shared understanding of the necessary process steps, considering the barriers that may arise at each step, and leveraging preexisting organizational structures to facilitate intraorganizational process development and spread.

Status of emerging standards for data definitions and transfer in the petroleum industry

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

Winczewski, L.M.

1991-03-01

Leading-edge hardware and software to store, retrieve, process, analyze, visualize, and interpret geoscience and petroleum data are improving continuously. A babel of definitions and formats for common industry data items limits the overall effectiveness of these computer-aided exploration and production tools. Custom data conversion required to load applications causes delays and exposes data content to error and degradation. Emerging industry-wide standards for management of geoscience and petroleum-related data are poised to overcome long-standing internal barriers to the full exploitation of these high-tech hardware/software systems. Industry technical organizations, such as AAPG, SEG, and API, have been actively pursuing industry-wide standards formore » data transfer, data definitions, and data models. These standard-defining groups are non-fee and solicit active participation from the entire petroleum community. The status of the most active of these groups is presented here. Data transfer standards are being pursued within AAPG (AAPG-B Data Transfer Standard), API (DLIS, for log data) and SEG (SEG-DEF, for seismic data). Converging data definitions, models, and glossaries are coming from the Petroleum Industry Data Dictionary Group (PIDD) and from subcommittees of the AAPG Computer Applications Committee. The National Computer Graphics Association is promoting development of standards for transfer of geographically oriented data. The API Well-Number standard is undergoing revision.« less

A Study on Signal Group Processing of AUTOSAR COM Module

NASA Astrophysics Data System (ADS)

Lee, Jeong-Hwan; Hwang, Hyun Yong; Han, Tae Man; Ahn, Yong Hak

2013-06-01

In vehicle, there are many ECU(Electronic Control Unit)s, and ECUs are connected to networks such as CAN, LIN, FlexRay, and so on. AUTOSAR COM(Communication) which is a software platform of AUTOSAR(AUTomotive Open System ARchitecture) in the international industry standards of automotive electronic software processes signals and signal groups for data communications between ECUs. Real-time and reliability are very important for data communications in the vehicle. Therefore, in this paper, we analyze functions of signals and signal groups used in COM, and represent that functions of signal group are more efficient than signals in real-time data synchronization and network resource usage between the sender and receiver.

Rehearsal Processes in Children's Memory.

ERIC Educational Resources Information Center

Ornstein, Peter A.; Liberty, Charles

This study investigates developmental trends in free recall, with emphasis on rehearsal processes. An overt rehearsal technique was used in which 28 children in grades 3, 6, and 8 were instructed to rehearse out loud while trying to memorize a list of unrelated nouns. Control groups at each age level received standard free recall instructions,…

Differences in age-dependent neural correlates of semantic processing between youths with autism spectrum disorder and typically developing youths.

PubMed

Chen, Pin-Jane; Gau, Susan Shur-Fen; Lee, Shu-Hui; Chou, Tai-Li

2016-12-01

Individuals with autism spectrum disorders (ASD) have aberrant neural activity during semantic judgments. We aimed to examine age-dependent neural correlates of semantic processing in boys with ASD as compared to typically developing boys (TD). We used functional MRI to investigate 37 boys with ASD (mean age = 13.3 years, standard deviation = 2.4) and 35 age-, sex-, Intelligence quotient (IQ)- and handedness-matched TD boys (mean age = 13.3 years, standard deviation = 2.7) from age 8 to 18 years. Participants had to indicate whether pairs of Chinese characters presented visually were related in meaning. Group (ASD, TD) × Age (Old, Young) ANOVA was used to examine the difference of age-related changes. Direct comparisons between the adolescent group and the child group were also performed. The behavioral results showed that the ASD group had lower accuracy in the related condition relative to the TD group. The neuroimaging results showed greater activation in the cuneus and less activation in the left inferior frontal gyrus in boys with ASD than TD boys. Children with ASD produced greater activation in the cuneus than TD children. Adolescents with ASD showed reduced left IFG activation as compared to TD adolescents. Our findings suggest that TD boys may engage more in higher-level processing of retrieving or selecting semantic features while boys with ASD may rely more on lower-level visual processing during semantic judgments. The findings imply different functional organizations of the semantic system between the two groups. Autism Res 2016, 9: 1263-1273. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Process Improvement in a Radically Changing Organization

NASA Technical Reports Server (NTRS)

Varga, Denise M.; Wilson, Barbara M.

2007-01-01

This presentation describes how the NASA Glenn Research Center planned and implemented a process improvement effort in response to a radically changing environment. As a result of a presidential decision to redefine the Agency's mission, many ongoing projects were canceled and future workload would be awarded based on relevance to the Exploration Initiative. NASA imposed a new Procedural Requirements standard on all future software development, and the Center needed to redesign its processes from CMM Level 2 objectives to meet the new standard and position itself for CMMI. The intended audience for this presentation is systems/software developers and managers in a large, research-oriented organization that may need to respond to imposed standards while also pursuing CMMI Maturity Level goals. A set of internally developed tools will be presented, including an overall Process Improvement Action Item database, a formal inspection/peer review tool, metrics collection spreadsheet, and other related technologies. The Center also found a need to charter Technical Working Groups (TWGs) to address particular Process Areas. In addition, a Marketing TWG was needed to communicate the process changes to the development community, including an innovative web site portal.

Assessing the Relative Influence and Efficacy of Public and Private Food Safety Regulation Regimes: Comparing Codex and Global G.A.P. Standards.

PubMed

Halabi, Sam F; Lin, Ching-Fu

An extensive global system of private food regulation is under construction, one that exceeds conventional regulation thought of as being driven by public authorities like FDA and USDA in the U.S. or the Food Standards Agency in the UK. Agrifood and grocer organizations, in concert with some farming groups, have been the primary designers of this new food regulatory regime. These groups have established alliances that compete with national regulators in complex ways. This article analyzes the relationship between public and private sources of food safety regulation by examining standards adopted by the Codex Alimentarius Commission, a food safety organization jointly run by the Food and Agricultural Organization and the World Health Organization and GlobalG.A.P., a farm assurance program created in the late 1990s by supermarket chains and their major suppliers which has now expanded into a global certifying coalition. While Codex standards are adopted, often as written, by national food safety regulators who are principal drivers of the standard setting process, customers for agricultural products in many countries now demand evidence of GlobalG.A.P. certification as a prerequisite for doing business This article tests not only the durability and strength of private sector standard setting in the food safety system, but also the desirability of that system as an alternative to formal, governmental processes embodied, for our purposes, in the standards adopted by Codex. In many cases, official standards and GlobalG.A.P. standards clash in ways that implicate not only food safety but the flow of agricultural products in the global trading system. The article analyzes current weaknesses in both regimes and possibilities for change that will better reconcile the two competing systems.

The need for GPS standardization

NASA Technical Reports Server (NTRS)

Lewandowski, Wlodzimierz W.; Petit, Gerard; Thomas, Claudine

1992-01-01

A desirable and necessary step for improvement of the accuracy of Global Positioning System (GPS) time comparisons is the establishment of common GPS standards. For this reason, the CCDS proposed the creation of a special group of experts with the objective of recommending procedures and models for operational time transfer by GPS common-view method. Since the announcement of the implementation of Selective Availability at the end of last spring, action has become much more urgent and this CCDS Group on GPS Time Transfer Standards has now been set up. It operates under the auspices of the permanent CCDS Working Group on TAI and works in close cooperation with the Sub-Committee on Time of the Civil GPS Service Interface Committee (CGSIC). Taking as an example the implementation of SA during the first week of July 1991, this paper illustrates the need to develop urgently at least two standardized procedures in GPS receiver software: monitoring GPS tracks with a common time scale and retaining broadcast ephemeris parameters throughout the duration of a track. Other matters requiring action are the adoption of common models for atmospheric delay, a common approach to hardware design and agreement about short-term data processing. Several examples of such deficiencies in standardization are presented.

40 CFR 65.3 - Compliance with standards and operation and maintenance requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...)(4)(i) and (ii) do not apply to Group 2A or Group 2B process vents. Compliance with design, equipment... include, but are not limited to, air pollution control technologies, recovery technologies, work practices... control devices are not required but may be used if available. This paragraph (a)(3) does not apply to...

40 CFR 65.3 - Compliance with standards and operation and maintenance requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

...)(4)(i) and (ii) do not apply to Group 2A or Group 2B process vents. Compliance with design, equipment... include, but are not limited to, air pollution control technologies, recovery technologies, work practices... control devices are not required but may be used if available. This paragraph (a)(3) does not apply to...

Reading Comprehension Assessment through Retelling: Performance Profiles of Children with Dyslexia and Language-Based Learning Disability

PubMed Central

Kida, Adriana de S. B.; de Ávila, Clara R. B.; Capellini, Simone A.

2016-01-01

Purpose: To study reading comprehension performance profiles of children with dyslexia as well as language-based learning disability (LBLD) by means of retelling tasks. Method: One hundred and five children from 2nd to 5th grades of elementary school were gathered into six groups: Dyslexia group (D; n = 19), language-based learning disability group (LBLD; n = 16); their respective control groups paired according to different variables – age, gender, grade and school system (public or private; D-control and LBLD-control); and other control groups paired according to different reading accuracy (D-accuracy; LBLD-accuracy). All of the children read an expository text and orally retold the story as they understood it. The analysis quantified propositions (main ideas and details) and retold links. A retelling reference standard (3–0) was also established from the best to the worst performance. We compared both clinical groups (D and LBLD) with their respective control groups by means of Mann–Whitney tests. Results: D showed the same total of propositions, links and reference standards as D-control, but performed better than D-accuracy in macro structural (total of links) and super structural (retelling reference standard) measures. Results suggest that dyslexic children are able to use their linguistic competence and their own background knowledge to minimize the effects of their decoding deficit, especially at the highest text processing levels. LBLD performed worse than LBLD-control in all of the retelling measures and LBLD showed worse performance than LBLD-accuracy in the total retold links and retelling reference standard. Those results suggest that both decoding and linguistic difficulties affect reading comprehension. Moreover, the linguistic deficits presented by LBLD students do not allow these pupils to perform as competently in terms of text comprehension as the children with dyslexia do. Thus, failure in the macro and super-structural information processing of the expository text were evidenced. Conclusion: Each clinical group showed a different retelling profile. Such findings support the view that there are differences between these two clinical populations in the non-phonological dimensions of language. PMID:27313551

International standards for programmes of training in intensive care medicine in Europe.

PubMed

2011-03-01

To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.

Are Clinical Diagnoses of Alzheimer’s Disease and Other Dementias Affected by Education and Self-Reported Race?

PubMed Central

Teresi, Jeanne A.; Grober, Ellen; Eimicke, Joseph P.; Ehrlich, Amy R.

2012-01-01

A randomized controlled trial examined whether the diagnostic process for Alzheimer’s disease and other dementias may be influenced by knowledge of the patient’s education and/or self-reported race. Four conditions were implemented: diagnostic team knows (a) race and education, (b) education only, (c) race only, or (d) neither. Diagnosis and clinical staging was established at baseline, at Wave 2, and for a random sample of Wave 3 respondents by a consensus panel. At study end, a longitudinal, “gold standard” diagnosis was made for patients with follow-up data (71%). Group differences in Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis were estimated using logistic regression and generalized estimating equations. Sensitivity and specificity were examined for baseline diagnosis in relation to the gold standard, longitudinal diagnosis. Despite equivalent status on all measured variables across waves, members of the “knows race only” group were less likely than those of other groups to receive a diagnosis of dementia. At final diagnosis, 19% of the “knows race only” group was diagnosed with dementia versus 38% to 40% in the other 3 conditions (p = .038). Examination of sensitivities and specificities of baseline diagnosis in relation to the gold standard diagnosis showed a nonsignificant trend for lower sensitivities in the knowing race conditions (0.3846), as contrasted with knowing education only (0.480) or neither (0.600). The finding that knowledge of race may influence the diagnostic process in some unknown way is timely, given the recent State-of-the-Science conference on Alzheimer’s disease prevention, the authors of which called for information about and standardization of the diagnostic process. PMID:22309001

First Workshop on Convergence and Consolidation towards Standard AAL Platform Services

NASA Astrophysics Data System (ADS)

Lázaro, Juan-Pablo; Guillén, Sergio; Farshchian, Babak; Mikalsen, Marius

The following document describes the call for papers for a workshop based on identifying which are the potential commonalities that are important for an AAL system, so they can be discussed and proposed for opening an standardization process. Groups of components like context-management, user interaction management or semantic description of services are frequent components and technologies that are part of an AAL system.

Standard terminology in the laboratory and classroom

NASA Technical Reports Server (NTRS)

Strehlow, Richard A.

1992-01-01

Each of the materials produced by modern technologists is associated with a family of immaterials--all the concepts of substance, process, and purpose. It is concepts that are essential to transfer knowledge. It is concepts that are the stuff of terminology. Terminology is standardized today by companies, standards organizations, governments, and other groups. Simply described, it is the pre-negotiation of the meanings of terms. Terminology has become a key issue in businesses, and terminology knowledge is essential in understanding the modern world. The following is a introductory workshop discussing the concepts of terminology and methods of its standardization.

Effect of shot peening on surface fatigue life of carburized and hardened AISI 9310 spur gears

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Zaretsky, E. V.

1982-01-01

Surface fatigue tests were conducted on two groups of AISI 9310 spur gears. Both groups were manufactured with standard ground tooth surfaces, with the second group subjected to an additional shot peening process on the gear tooth flanks. The gear pitch diameter was 8.89 cm (3.5 in.). Test conditions were a gear temperature of 350 K (170 F), a maximum Hertz stress of 1.71 billion N/sq m (248,000 psi), and a speed of 10,000 rpm. The shot peened gears exhibited pitting fatigue lives 1.6 times the life of standard gears without shot peening. Residual stress measurements and analysis indicate that the longer fatigue life is the result of the higher compressive stress produced by the shot peening. The life for the shot peened gear was calculated to be 1.5 times that for the plain gear by using the measured residual stress difference for the standard and shot peened gears. The measured residual stress for the shot peened gears was much higher than that for the standard gears.

40 CFR 63.486 - Batch front-end process vent provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins § 63.486... paragraph (b) of this section, owners and operators of new and existing affected sources with batch front...

Using an electronic prescribing system to ensure accurate medication lists in a large multidisciplinary medical group.

PubMed

Stock, Ron; Scott, Jim; Gurtel, Sharon

2009-05-01

Although medication safety has largely focused on reducing medication errors in hospitals, the scope of adverse drug events in the outpatient setting is immense. A fundamental problem occurs when a clinician lacks immediate access to an accurate list of the medications that a patient is taking. Since 2001, PeaceHealth Medical Group (PHMG), a multispecialty physician group, has been using an electronic prescribing system that includes medication-interaction warnings and allergy checks. Yet, most practitioners recognized the remaining potential for error, especially because there was no assurance regarding the accuracy of information on the electronic medical record (EMR)-generated medication list. PeaceHealth developed and implemented a standardized approach to (1) review and reconcile the medication list for every patient at each office visit and (2) report on the results obtained within the PHMG clinics. In 2005, PeaceHealth established the ambulatory medication reconciliation project to develop a reliable, efficient process for maintaining accurate patient medication lists. Each of PeaceHealth's five regions created a medication reconciliation task force to redesign its clinical practice, incorporating the systemwide aims and agreed-on key process components for every ambulatory visit. Implementation of the medication reconciliation process at the PHMG clinics resulted in a substantial increase in the number of accurate medication lists, with fewer discrepancies between what the patient is actually taking and what is recorded in the EMR. The PeaceHealth focus on patient safety, and particularly the reduction of medication errors, has involved a standardized approach for reviewing and reconciling medication lists for every patient visiting a physician office. The standardized processes can be replicated at other ambulatory clinics-whether or not electronic tools are available.

Proposed minimum reporting standards for chemical analysis Chemical Analysis Working Group (CAWG) Metabolomics Standards Initiative (MSI)

PubMed Central

Amberg, Alexander; Barrett, Dave; Beale, Michael H.; Beger, Richard; Daykin, Clare A.; Fan, Teresa W.-M.; Fiehn, Oliver; Goodacre, Royston; Griffin, Julian L.; Hankemeier, Thomas; Hardy, Nigel; Harnly, James; Higashi, Richard; Kopka, Joachim; Lane, Andrew N.; Lindon, John C.; Marriott, Philip; Nicholls, Andrew W.; Reily, Michael D.; Thaden, John J.; Viant, Mark R.

2013-01-01

There is a general consensus that supports the need for standardized reporting of metadata or information describing large-scale metabolomics and other functional genomics data sets. Reporting of standard metadata provides a biological and empirical context for the data, facilitates experimental replication, and enables the re-interrogation and comparison of data by others. Accordingly, the Metabolomics Standards Initiative is building a general consensus concerning the minimum reporting standards for metabolomics experiments of which the Chemical Analysis Working Group (CAWG) is a member of this community effort. This article proposes the minimum reporting standards related to the chemical analysis aspects of metabolomics experiments including: sample preparation, experimental analysis, quality control, metabolite identification, and data pre-processing. These minimum standards currently focus mostly upon mass spectrometry and nuclear magnetic resonance spectroscopy due to the popularity of these techniques in metabolomics. However, additional input concerning other techniques is welcomed and can be provided via the CAWG on-line discussion forum at http://msi-workgroups.sourceforge.net/ or http://Msi-workgroups-feedback@lists.sourceforge.net. Further, community input related to this document can also be provided via this electronic forum. PMID:24039616

Metal-organic complexes in geochemical processes: Estimation of standard partial molal thermodynamic properties of aqueous complexes between metal cations and monovalent organic acid ligands at high pressures and temperatures

NASA Astrophysics Data System (ADS)

Shock, Everetr L.; Koretsky, Carla M.

1995-04-01

Regression of standard state equilibrium constants with the revised Helgeson-Kirkham-Flowers (HKF) equation of state allows evaluation of standard partial molal entropies ( overlineSo) of aqueous metal-organic complexes involving monovalent organic acid ligands. These values of overlineSo provide the basis for correlations that can be used, together with correlation algorithms among standard partial molal properties of aqueous complexes and equation-of-state parameters, to estimate thermodynamic properties including equilibrium constants for complexes between aqueous metals and several monovalent organic acid ligands at the elevated pressures and temperatures of many geochemical processes which involve aqueous solutions. Data, parameters, and estimates are given for 270 formate, propanoate, n-butanoate, n-pentanoate, glycolate, lactate, glycinate, and alanate complexes, and a consistent algorithm is provided for making other estimates. Standard partial molal entropies of association ( Δ -Sro) for metal-monovalent organic acid ligand complexes fall into at least two groups dependent upon the type of functional groups present in the ligand. It is shown that isothermal correlations among equilibrium constants for complex formation are consistent with one another and with similar correlations for inorganic metal-ligand complexes. Additional correlations allow estimates of standard partial molal Gibbs free energies of association at 25°C and 1 bar which can be used in cases where no experimentally derived values are available.

Refined scenario of standard Big Bang nucleosynthesis allowing for nonthermal nuclear reactions in the primordial plasma

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

Voronchev, Victor T.; Nakao, Yasuyuki; Nakamura, Makoto

The standard scenario of big bang nucleosynthesis (BBN) is generalized to take into account nonthermal nuclear reactions in the primordial plasma. These reactions are naturally triggered in the BBN epoch by fast particles generated in various exoergic processes. It is found that, although such particles can appreciably enhance the rates of some individual reactions, their influence on the whole process of element production is not significant. The nonthermal corrections to element abundances are obtained to be 0.1% ({sup 3}H), -0.03% ({sup 7}Li), and 0.34 %-0.63% (CNO group).

Aeromedical Disposition and Waiver Consideration for ISS Crewmembers

NASA Technical Reports Server (NTRS)

Taddeo, Terrance

2012-01-01

Aeromedical certification of astronauts and cosmonauts traveling to the International Space Station is a multi?-tiered process that involv es standards agreed to by the partner agencies, and participation by the individual agency aeromedical boards and a multilateral space medi cine board. Medical standards are updated continually by a multilater al working group. The boards operate by consensus and strive to achie ve effective decision making through experience, medical judgment, medical evidence and risk modeling. The aim of the certification process is to minimize the risk to the ISS program of loss of mission object ives due to human health issues.

The Western Aeronautical Test Range. Chapter 10 Tools

NASA Technical Reports Server (NTRS)

Knudtson, Kevin; Park, Alice; Downing, Robert; Sheldon, Jack; Harvey, Robert; Norcross, April

2011-01-01

The Western Aeronautical Test Range (WATR) staff at the NASA Dryden Flight Research Center is developing a translation software called Chapter 10 Tools in response to challenges posed by post-flight processing data files originating from various on-board digital recorders that follow the Range Commanders Council Inter-Range Instrumentation Group (IRIG) 106 Chapter 10 Digital Recording Standard but use differing interpretations of the Standard. The software will read the date files regardless of the vendor implementation of the source recorder, displaying data, identifying and correcting errors, and producing a data file that can be successfully processed post-flight

JPEG XS call for proposals subjective evaluations

NASA Astrophysics Data System (ADS)

McNally, David; Bruylants, Tim; Willème, Alexandre; Ebrahimi, Touradj; Schelkens, Peter; Macq, Benoit

2017-09-01

In March 2016 the Joint Photographic Experts Group (JPEG), formally known as ISO/IEC SC29 WG1, issued a call for proposals soliciting compression technologies for a low-latency, lightweight and visually transparent video compression scheme. Within the JPEG family of standards, this scheme was denominated JPEG XS. The subjective evaluation of visually lossless compressed video sequences at high resolutions and bit depths poses particular challenges. This paper describes the adopted procedures, the subjective evaluation setup, the evaluation process and summarizes the obtained results which were achieved in the context of the JPEG XS standardization process.

Can an evidence-based book club intervention delivered via a tablet computer improve physical activity in middle-aged women?

PubMed

Ehlers, Diane K; Huberty, Jennifer L; de Vreede, Gert-Jan

2015-02-01

Fewer than 50% of middle-aged women participate in regular physical activity (PA). Innovative approaches that engage women who may not otherwise participate in PA programs are warranted. The purpose of this study was to explore the acceptability and feasibility of a 12-week tablet-based book club for improving middle-aged women's PA. Thirty women (35-64 years of age) were randomized to the Fit Minded Tablet (n=15) and the Standard Fit Minded (i.e., face-to-face intervention) (n=15) groups. The Fit Minded Tablet was adapted from the Standard Fit Minded, a previously tested, theory-based book club intervention using books as a platform for discussion and group support to help women adopt regular PA. Both interventions met weekly for 3 months, for a total of 12 sessions. Tablet group participants accessed materials (e.g., e-books, workbook, live/recorded videoconferencing) via a tablet computer; Standard group participants received materials (e.g., printed books, workbook, live face-to-face meetings) in person. Feasibility (i.e., implementation and expansion) was assessed using process evaluation, qualitative interviews, satisfaction surveys, and quantitative outcome assessments. Women in the Tablet group attended fewer meetings (mean, 8.25) than women in the Standard group (mean, 9.9). Videoconferencing, digital literacy, and participant engagement limitations were observed in the Tablet group. Tablet participants enjoyed the e-books but thought technology barriers hindered their engagement during meetings. Women in both groups valued the support they received from other group members. Standard participants cited this support as a key contributor to their PA changes, whereas Tablet participants reported needing in-person contact to feel more connected. Given the popularity of tablet computers and the value that middle-aged women place on group interaction to support their PA behaviors, additional research is warranted to determine best strategies for optimizing social support, mitigating technology barriers, and improving engagement in online and mobile health promotion programs targeting middle-aged women.

Cueing Complex Animations: Does Direction of Attention Foster Learning Processes?

ERIC Educational Resources Information Center

Lowe, Richard; Boucheix, Jean-Michel

2011-01-01

The time course of learners' processing of a complex animation was studied using a dynamic diagram of a piano mechanism. Over successive repetitions of the material, two forms of cueing (standard colour cueing and anti-cueing) were administered either before or during the animated segment of the presentation. An uncued group and two other control…

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

Code of Federal Regulations, 2014 CFR

2014-07-01

... applicable. (4) Performance tests and design evaluations. If design steam stripper option (§ 63.138(d)) or..., neither a design evaluation nor a performance test is required. For any other non-biological treatment... or operator shall conduct either a design evaluation as specified in § 63.138(j), or a performance...

40 CFR Table 2 to Subpart Ffff of... - Emission Limits and Work Practice Standards for Batch Process Vents

Code of Federal Regulations, 2012 CFR

2012-07-01

... Pollutants: Miscellaneous Organic Chemical Manufacturing Pt. 63, Subpt. FFFF, Table 2 Table 2 to Subpart FFFF... Group 1 batch process vents a. Reduce collective uncontrolled organic HAP emissions from the sum of all... a flare); or Not applicable. b. Reduce collective uncontrolled organic HAP emissions from the sum of...

40 CFR 61.242-5 - Standards: Sampling connecting systems.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Collect and recycle the purged process fluid; or (3) Be designed and operated to capture and transport all the purged process fluid to a control device that complies with the requirements of § 61.242-11; or (4... operated in compliance with the provisions of 40 CFR part 63, subpart G, applicable to Group 1 wastewater...

40 CFR 61.242-5 - Standards: Sampling connecting systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Collect and recycle the purged process fluid; or (3) Be designed and operated to capture and transport all the purged process fluid to a control device that complies with the requirements of § 61.242-11; or (4... operated in compliance with the provisions of 40 CFR part 63, subpart G, applicable to Group 1 wastewater...

Improving Students' Expertise and Attitudes during the Postwriting Stage of the Writing Process through Collaborative Revision.

ERIC Educational Resources Information Center

Wells, Mary C.

A practicum addressed the problem of students' lack of fluency in standard English despite the traditional paradigm for formal grammar instruction and the emphasis on process writing in most English classrooms. Nineteen (English 2) high school students participated in peer editing groups in a collaborative learning environment. The solution…

Core Outcome Set-STAndards for Development: The COS-STAD recommendations.

PubMed

Kirkham, Jamie J; Davis, Katherine; Altman, Douglas G; Blazeby, Jane M; Clarke, Mike; Tunis, Sean; Williamson, Paula R

2017-11-01

The use of core outcome sets (COS) ensures that researchers measure and report those outcomes that are most likely to be relevant to users of their research. Several hundred COS projects have been systematically identified to date, but there has been no formal quality assessment of these studies. The Core Outcome Set-STAndards for Development (COS-STAD) project aimed to identify minimum standards for the design of a COS study agreed upon by an international group, while other specific guidance exists for the final reporting of COS development studies (Core Outcome Set-STAndards for Reporting [COS-STAR]). An international group of experienced COS developers, methodologists, journal editors, potential users of COS (clinical trialists, systematic reviewers, and clinical guideline developers), and patient representatives produced the COS-STAD recommendations to help improve the quality of COS development and support the assessment of whether a COS had been developed using a reasonable approach. An open survey of experts generated an initial list of items, which was refined by a 2-round Delphi survey involving nearly 250 participants representing key stakeholder groups. Participants assigned importance ratings for each item using a 1-9 scale. Consensus that an item should be included in the set of minimum standards was defined as at least 70% of the voting participants from each stakeholder group providing a score between 7 and 9. The Delphi survey was followed by a consensus discussion with the study management group representing multiple stakeholder groups. COS-STAD contains 11 minimum standards that are the minimum design recommendations for all COS development projects. The recommendations focus on 3 key domains: the scope, the stakeholders, and the consensus process. The COS-STAD project has established 11 minimum standards to be followed by COS developers when planning their projects and by users when deciding whether a COS has been developed using reasonable methods.

Apollo Quality Program.

PubMed

Sibal, Anupam; Dewan, Shaveta; Uberoi, R S; Kar, Sujoy; Loria, Gaurav; Fernandes, Clive; Yatheesh, G; Sharma, Karan

2012-01-01

Ensuring patient safety is a vital step for any hospital in achieving the best clinical outcomes. The Apollo Quality Program aimed at standardization of processes for clinical handovers, medication safety, surgical safety, patient identification, verbal orders, hand washing compliance and falls prevention across the hospitals in the Group. Thirty-two hospitals across the Group in settings varying from rural to semi urban, urban and metropolitan implemented the program and over a period of one year demonstrated a visible improvement in the compliance to processes for patient safety translating into better patient safety statistics.

A randomized trial comparing concise and standard consent forms in the START trial

PubMed Central

Touloumi, Giota; Walker, A. Sarah; Smolskis, Mary; Sharma, Shweta; Babiker, Abdel G.; Pantazis, Nikos; Tavel, Jorge; Florence, Eric; Sanchez, Adriana; Hudson, Fleur; Papadopoulos, Antonios; Emanuel, Ezekiel; Clewett, Megan; Munroe, David; Denning, Eileen

2017-01-01

Background Improving the effectiveness and efficiency of research informed consent is a high priority. Some express concern about longer, more complex, written consent forms creating barriers to participant understanding. A recent meta-analysis concluded that randomized comparisons were needed. Methods We conducted a cluster-randomized non-inferiority comparison of a standard versus concise consent form within a multinational trial studying the timing of starting antiretroviral therapy in HIV+ adults (START). Interested sites were randomized to standard or concise consent forms for all individuals signing START consent. Participants completed a survey measuring comprehension of study information and satisfaction with the consent process. Site personnel reported usual site consent practices. The primary outcome was comprehension of the purpose of randomization (pre-specified 7.5% non-inferiority margin). Results 77 sites (2429 participants) were randomly allocated to use standard consent and 77 sites (2000 participants) concise consent, for an evaluable cohort of 4229. Site and participant characteristics were similar for the two groups. The concise consent was non-inferior to the standard consent on comprehension of randomization (80.2% versus 82%, site adjusted difference: 0.75% (95% CI -3.8%, +5.2%)); and the two groups did not differ significantly on total comprehension score, satisfaction, or voluntariness (p>0.1). Certain independent factors, such as education, influenced comprehension and satisfaction but not differences between consent groups. Conclusions An easier to read, more concise consent form neither hindered nor improved comprehension of study information nor satisfaction with the consent process among a large number of participants. This supports continued efforts to make consent forms more efficient. Trial registration Informed consent substudy was registered as part of START study in clinicaltrials.gov #NCT00867048, and EudraCT # 2008-006439-12 PMID:28445471

23 CFR 940.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION INTELLIGENT TRANSPORTATION SYSTEMS INTELLIGENT TRANSPORTATION SYSTEM ARCHITECTURE AND STANDARDS § 940.3 Definitions. Intelligent Transportation System (ITS... projects or groups of projects. Systems engineering is a structured process for arriving at a final design...

23 CFR 940.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION INTELLIGENT TRANSPORTATION SYSTEMS INTELLIGENT TRANSPORTATION SYSTEM ARCHITECTURE AND STANDARDS § 940.3 Definitions. Intelligent Transportation System (ITS... projects or groups of projects. Systems engineering is a structured process for arriving at a final design...

23 CFR 940.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION INTELLIGENT TRANSPORTATION SYSTEMS INTELLIGENT TRANSPORTATION SYSTEM ARCHITECTURE AND STANDARDS § 940.3 Definitions. Intelligent Transportation System (ITS... projects or groups of projects. Systems engineering is a structured process for arriving at a final design...

Structured patient handoff on an internal medicine ward: A cluster randomized control trial.

PubMed

Tam, Penny; Nijjar, Aman P; Fok, Mark; Little, Chris; Shingina, Alexandra; Bittman, Jesse; Raghavan, Rashmi; Khan, Nadia A

2018-01-01

The effect of a multi-faceted handoff strategy in a high volume internal medicine inpatient setting on process and patient outcomes has not been clearly established. We set out to determine if a multi-faceted handoff intervention consisting of education, standardized handoff procedures, including fixed time and location for face-to-face handoff would result in improved rates of handoff compared with usual practice. We also evaluated resident satisfaction, health resource utilization and clinical outcomes. This was a cluster randomized controlled trial in a large academic tertiary care center with 18 inpatient internal medicine ward teams from January-April 2013. We randomized nine inpatient teams to an intervention where they received an education session standardizing who and how to handoff patients, with practice and feedback from facilitators. The control group of 9 teams continued usual non-standardized handoffs. The primary process outcome was the rate of patients handed over per 1000 patient nights. Other process outcomes included perceptions of inadequate handoff by overnight physicians, resource utilization overnight and hospital length of stay. Clinical outcomes included medical errors, frequency of patients requiring higher level of care overnight, and in-hospital mortality. The intervention group demonstrated a significant increase in the rate of patients handed over to the overnight physician (62.90/1000 person-nights vs. 46.86/1000 person-nights, p = 0.002). There was no significant difference in other process outcomes except resource utilization was increased in the intervention group (26.35/1000 person-days vs. 17.57/1000 person-days, p-value = 0.01). There was no significant difference between groups in medical errors (4.8% vs. 4.1%), need for higher level of care or in hospital mortality. Limitations include a dependence of accurate record keeping by the overnight physician, the possibility of cross-contamination in the handoff process, analysis at the cluster level and an overall low number of clinical events. Implementation of a multi-faceted resident handoff intervention did not result in a significant improvement in patient safety although did improve number of patients handed off. Novel methods to improve handoff need to be explored. Registered at ClinicalTrials.gov: NCT01796756.

Efficacy of a separate informed consent for anesthesia services: A prospective study from the Caribbean.

PubMed

Rampersad, Kavi; Chen, Deryk; Hariharan, Seetharaman

2016-01-01

This study aimed to determine whether a separate written consent form improved the efficacy of the informed consent process for anesthesia in adult patients undergoing elective surgery at a tertiary care teaching hospital. We randomized patients into two groups prospectively. The first group (Group A) signed the hospital's standard Consent for Operation form only while the second group (Group B) signed a separate Consent for Anesthesia form additionally. Patients were interviewed postoperatively with an eight-item questionnaire with responses in a 5-point Likert scale. A composite adequacy of consent index was generated from the responses and analyzed. Two hundred patients (100 in each group) were studied. All patients indicated that the anesthesiologist(s) had their permission to proceed with their anesthesia care. The mean adequacy of consent index score in Group B was higher than that of Group A (30.6 ± 4.6 [standard deviation (SD)] vs. 27.9 ± 5.2 [SD]) (P < 0.001). The separate written consent had a positive impact on the patients' understanding of the nature and purpose of the intended anesthesia procedures (P = 0.04), satisfaction with the adequacy of information provided about common side effects (P < 0.001) and rare but serious complications (P = 0.008). A separate written consent for anesthesia improved the efficacy of the informed consent process with respect to better information about the nature and purpose of anesthesia, common side effects, and rare but serious complications.

Fostering students' reflection about bias in healthcare: cognitive dissonance and the role of personal and normative standards.

PubMed

Hernandez, Rachael A; Haidet, Paul; Gill, Anne C; Teal, Cayla R

2013-04-01

To reduce cognitive dissonance about one's beliefs or behavior, individuals may compare their behavior to personal and/or normative standards. The details of this reflection process are unclear. We examined how medical students compare their behavior or beliefs to standards in discussions about implicit bias, and explored if and how different reflective pathways (preserving vs. reconciling) are associated with each standard. Third-year students engaged in a small-group discussion about bias. Some students and group facilitators also participated in a debriefing about the experience. Using qualitative methods, the transcripts from these 11 sessions were analyzed for evidence of student comparison to a standard and of reflection pathways. Of 557 text units, 75.8% could be coded with a standard and/or a path of reflection. Students referenced personal and normative standards about equally, and preserved or reconciled existing beliefs about equally. Uses of normative standards were associated with preservation-type reflection, and uses of personal standards with reconciliation-type reflection. Normative expectations of physicians are sometimes used to provoke students' consideration of implicit biases about patients. To encourage critical reflection and reconciliation of biased beliefs or behavior, educators should frame reflective activities as a personal exercise rather than as a requirement.

Enhancing the placebo response: fMRI Evidence of Memory and Semantic Processing in Placebo Analgesia

PubMed Central

Craggs, Jason G.; Price, Donald D.; Robinson, Michael E.

2014-01-01

Two groups of patients with irritable bowel syndrome (IBS) rated pain and underwent fMRI brain scanning during experimentally induced rectal distension (20 sec, 7 stimuli). Group #1 was tested under baseline (natural history) and a verbally induced placebo condition, whereas Group #2 was tested under baseline, and standard placebo (no verbal suggestion for pain reduction) and intrarectal lidocaine conditions. As hypothesized, intrarectal lidocaine reduced evoked pain and pain-related brain activity within Group #2Between-group comparisons showed that adding a verbal suggestion to a placebo condition increased neural activity involved in memory and semantic processing, areas that process the placebo suggestions. These areas, in turn, are likely to influence brain areas involved in emotions and analgesia and consequently the placebo effect. These placebo suggestions also added significant decreases in activity of brain areas that process pain. The test stimulus itself seems to cue these effects and is consistent with previous explanations that somatic focus and sensory feedback reinforce expectations and other factors that mediate placebo analgesic effects. PMID:24412799

Microscopic assessment of the sealing ability of three endodontic filling techniques

PubMed Central

Cueva-Goig, Roger; Llena-Puy, Mª Carmen

2016-01-01

Background Several techniques have been proposed for root canal filling. New rotary files, with non-standardized taper, are appearing, so, points adapted to the taper of the last instrument used to prepare the canal can help in the obturation process. The aim of this study is to assess the sealing ability of different root canal filling techniques. Material and Methods Root canals from 30 teeth were shaped with Mtwo and divided in three groups; A, standard lateral condensation with size 35 and 20 gutta-percha points; B, standard lateral condensation and injected gutta-percha; C, single gutta-percha point (standardized 35 Mtwo), continuous wave technique and injected gutta-percha. Root surfaces were covered with nail varnish, except for the apical 2 mm, and submerged in a NO3Ag2 solution; apical stain penetration was measured in mm. Data were compared using the Kruskal-Wallis test with a 90% confidence interval. Results A and B groups showed stain leakage in the 90% of the cases, whereas it was of 80% for group C. Stain leakage intervals were 1-5 mm for groups A and B and 1-3 mm for group C. There were no statistically significant differences between the three studied groups (p>.05). Conclusions All the analyzed root canal filling techniques showed some apical stain leakage, without significant differences among them. Key words:Gutta-percha filling, microleakage, single cone, injected gutta-percha, warm gutta-percha. PMID:26855702

Fatigue and fluoride corrosion on Streptococcus mutans adherence to titanium-based implant/component surfaces.

PubMed

Correa, Cassia Bellotto; Pires, Juliana Rico; Fernandes-Filho, Romeu Belon; Sartori, Rafael; Vaz, Luis Geraldo

2009-07-01

The influence of fatigue and the fluoride ion corrosion process on Streptococcus mutans adherence to commercially pure Titanium (Cp Ti) implant/component set surfaces were studied. Thirty Nobel implants and 30 Neodent implants were used. Each commercial brand was divided into three groups. Group A: control, Group B: sets submitted to fatigue (10(5) cycles, 15 Hz, 150 N), and Group C: sets submitted to fluoride (1500 ppm, pH 5.5) and fatigue, simulating a mean use of 5 years in the oral medium. Afterward, the sets were contaminated with standard strains of S. mutans (NTCC 1023) and analyzed by scanning electronic microscopy (SEM) and colony-forming unit counts (CFU/mL). By SEM, bacterial adherence was verified only in group C in both brands. By CFU/mL counts, S. mutans was statistically higher in both brands in group C than in groups A and B (p < 0.05, ANOVA). The process of corrosion by fluoride ions on Cp Ti implant/component sets allowed greater S. mutans adherence than in the absence of corrosion and with the fatigue process in isolation.

Relative air temperature analysis external building on Gowa Campus

NASA Astrophysics Data System (ADS)

Mustamin, Tayeb; Rahim, Ramli; Baharuddin; Jamala, Nurul; Kusno, Asniawaty

2018-03-01

This study aims to data analyze the relative temperature and humidity of the air outside the building. Data retrieval taken from weather monitoring device (monitoring) Vaisala, RTU (Remote Terminal Unit), Which is part of the AWS (Automatic Weather Stations) Then Processing data processed and analyzed by using Microsoft Excel program in the form of graph / picture fluctuation Which shows the average value, standard deviation, maximum value, and minimum value. Results of data processing then grouped in the form: Daily, and monthly, based on time intervals every 30 minutes. The results showed Outside air temperatures in March, April, May and September 2016 Which entered in the thermal comfort zone according to SNI standard (Indonesian National Standard) only at 06.00-10.00. In late March to early April Thermal comfort zone also occurs at 15.30-18.00. The highest maximum air temperature occurred in September 2016 at 11.01-11.30 And the lowest minimum value in September 2016, time 6:00 to 6:30. The result of the next analysis shows the level of data conformity with thermal comfort zone based on SNI (Indonesian National Standard) every month.

Study and validation of tools interoperability in JPSEC

NASA Astrophysics Data System (ADS)

Conan, V.; Sadourny, Y.; Jean-Marie, K.; Chan, C.; Wee, S.; Apostolopoulos, J.

2005-08-01

Digital imagery is important in many applications today, and the security of digital imagery is important today and is likely to gain in importance in the near future. The emerging international standard ISO/IEC JPEG-2000 Security (JPSEC) is designed to provide security for digital imagery, and in particular digital imagery coded with the JPEG-2000 image coding standard. One of the primary goals of a standard is to ensure interoperability between creators and consumers produced by different manufacturers. The JPSEC standard, similar to the popular JPEG and MPEG family of standards, specifies only the bitstream syntax and the receiver's processing, and not how the bitstream is created or the details of how it is consumed. This paper examines the interoperability for the JPSEC standard, and presents an example JPSEC consumption process which can provide insights in the design of JPSEC consumers. Initial interoperability tests between different groups with independently created implementations of JPSEC creators and consumers have been successful in providing the JPSEC security services of confidentiality (via encryption) and authentication (via message authentication codes, or MACs). Further interoperability work is on-going.

Consensus standards for introductory e-learning courses in human participants research ethics

PubMed Central

Williams, John R; Sprumont, Dominique; Hirtle, Marie; Adebamowo, Clement; Braunschweiger, Paul; Bull, Susan; Burri, Christian; Czarkowski, Marek; Te Fan, Chien; Franck, Caroline; Gefenas, Eugenjius; Geissbuhler, Antoine; Klingmann, Ingrid; Kouyaté, Bocar; Kraehenbhul, Jean-Pierre; Kruger, Mariana; Moodley, Keymanthri; Ntoumi, Francine; Nyirenda, Thomas; Pym, Alexander; Silverman, Henry; Tenorio, Sara

2015-01-01

This paper reports the results of a workshop held in January 2013 to begin the process of establishing standards for e-learning programmes in the ethics of research involving human participants that could serve as the basis of their evaluation by individuals and groups who want to use, recommend or accredit such programmes. The standards that were drafted at the workshop cover the following topics: designer/provider qualifications, learning goals, learning objectives, content, methods, assessment of participants and assessment of the course. The authors invite comments on the draft standards and eventual endorsement of a final version by all stakeholders. PMID:23959838

The labor movement's role in gaining federal safety and health standards to protect America's workers.

PubMed

Weinstock, Deborah; Failey, Tara

2014-11-01

In the United States, unions sometimes joined by worker advocacy groups (e.g., Public Citizen and the American Public Health Association) have played a critical role in strengthening worker safety and health protections. They have sought to improve standards that protect workers by participating in the rulemaking process, through written comments and involvement in hearings; lobbying decision-makers; petitioning the Department of Labor; and defending improved standards in court. Their efforts have culminated in more stringent exposure standards, access to information about the presence of potentially hazardous toxic chemicals, and improved access to personal protective equipment-further improving working conditions in the United States.

Quality improvement through implementation of discharge order reconciliation.

PubMed

Lu, Yun; Clifford, Pamela; Bjorneby, Andreas; Thompson, Bruce; VanNorman, Samuel; Won, Katie; Larsen, Kevin

2013-05-01

A coordinated multidisciplinary process to reduce medication errors related to patient discharges to skilled-nursing facilities (SNFs) is described. After determining that medication errors were a frequent cause of readmission among patients discharged to SNFs, a medical center launched a two-phase quality-improvement project focused on cardiac and medical patients. Phase one of the project entailed a three-month failure modes and effects analysis of existing procedures discharge, followed by the development and pilot testing of a multidisciplinary, closed-loop workflow process involving staff and resident physicians, clinical nurse coordinators, and clinical pharmacists. During pilot testing of the new workflow process, the rate of discharge medication errors involving SNF patients was tracked, and data on medication-related readmissions in a designated intervention group (n = 87) and a control group of patients (n = 1893) discharged to SNFs via standard procedures during a nine-month period were collected, with the data stratified using severity of illness (SOI) classification. Analysis of the collected data indicated a cumulative 30-day medication-related readmission rate for study group patients in the minor, moderate, and major SOI categories of 5.4% (4 of 74 patients), compared with a rate of 9.5% (169 of 1780 patients) in the control group. In phase 2 of the project, the revised SNF discharge medication reconciliation procedure was implemented throughout the hospital; since hospitalwide implementation of the new workflow, the readmission rate for SNF patients has been maintained at about 6.7%. Implementing a standardized discharge order reconciliation process that includes pharmacists led to decreased readmission rates and improved care for patients discharged to SNFs.

Software And Systems Engineering Risk Management

DTIC Science & Technology

2010-04-01

RSKM 2004 COSO Enterprise RSKM Framework 2006 ISO/IEC 16085 Risk Management Process 2008 ISO/IEC 12207 Software Lifecycle Processes 2009 ISO/IEC...1 Software And Systems Engineering Risk Management John Walz VP Technical and Conferences Activities, IEEE Computer Society Vice-Chair Planning...Software & Systems Engineering Standards Committee, IEEE Computer Society US TAG to ISO TMB Risk Management Working Group Systems and Software

Setting the Scope of Concept Inventories for Introductory Computing Subjects

ERIC Educational Resources Information Center

Goldman, Ken; Gross, Paul; Heeren, Cinda; Herman, Geoffrey L.; Kaczmarczyk, Lisa; Loui, Michael C.; Zilles, Craig

2010-01-01

A concept inventory is a standardized assessment tool intended to evaluate a student's understanding of the core concepts of a topic. In order to create a concept inventory it is necessary to accurately identify these core concepts. A Delphi process is a structured multi-step process that uses a group of experts to achieve a consensus opinion. We…

Distribution of magnesium in central nervous system tissue, trabecular and cortical bone in rats fed with unbalanced diets of minerals.

PubMed

Yasui, M; Yano, I; Yase, Y; Ota, K

1990-11-01

Recent epidemiological changes in patterns of foci of amyotrophic lateral sclerosis (ALS) in the Western Pacific suggest that environmental factors play a contributory role in the pathogenic process of this disorder. In this experimental study on rats, a similar situation of dietary mineral imbalance was created as is found in the soil and drinking water of these ALS foci with a low content of calcium (Ca) and magnesium (Mg) and a high content of aluminum (Al). In groups of rats fed a low Ca diet, low Ca-Mg diet, and low Ca-Mg plus high Al diet, serum Ca levels were found to be lower than those in a group fed a standard diet. Also, serum Mg levels were lower in the groups fed a low Ca-Mg diet and a low Ca-Mg plus high Al diet than in the groups fed a standard diet and only a low Ca diet. There was no significant difference in Mg content of central nervous system (CNS) tissues of groups fed unbalanced and standard diets, except for a significant decrease in Mg content of the spinal cord of rats fed a low Ca-Mg plus high Al diet. Mg content of the lumbar spine and cortical bone decreased in the unbalanced diet groups compared with that of a group fed a standard diet. These findings suggest that under the disturbed bone mineralization induced by unbalanced mineral diets, Mg may be mobilized from bone to maintain the level necessary for vital activity in soft tissues including CNS tissue.

A comparison of BPMN 2.0 with other notations for manufacturing processes

NASA Astrophysics Data System (ADS)

García-Domínguez, A.; Marcos, Mariano; Medina, I.

2012-04-01

In order to study their current practices and improve on them, manufacturing firms need to view their processes from several viewpoints at various abstraction levels. Several notations have been developed for this purpose, such as Value Stream Mappings or IDEF models. More recently, the BPMN 2.0 standard from the Object Management Group has been proposed for modeling business processes. A process organizes several activities (manual or automatic) into a single higher-level entity, which can be reused elsewhere in the organization. Its potential for standardizing business interactions is well-known, but there is little work on using BPMN 2.0 to model manufacturing processes. In this work some of the previous notations are outlined and BPMN 2.0 is positioned among them after discussing it in more depth. Some guidelines on using BPMN 2.0 for manufacturing are offered, and its advantages and disadvantages in comparison with the other notations are presented.

Evidence for determinism in species diversification and contingency in phenotypic evolution during adaptive radiation.

PubMed

Burbrink, Frank T; Chen, Xin; Myers, Edward A; Brandley, Matthew C; Pyron, R Alexander

2012-12-07

Adaptive radiation (AR) theory predicts that groups sharing the same source of ecological opportunity (EO) will experience deterministic species diversification and morphological evolution. Thus, deterministic ecological and morphological evolution should be correlated with deterministic patterns in the tempo and mode of speciation for groups in similar habitats and time periods. We test this hypothesis using well-sampled phylogenies of four squamate groups that colonized the New World (NW) in the Late Oligocene. We use both standard and coalescent models to assess species diversification, as well as likelihood models to examine morphological evolution. All squamate groups show similar early pulses of speciation, as well as diversity-dependent ecological limits on clade size at a continental scale. In contrast, processes of morphological evolution are not easily predictable and do not show similar pulses of early and rapid change. Patterns of morphological and species diversification thus appear uncoupled across these groups. This indicates that the processes that drive diversification and disparification are not mechanistically linked, even among similar groups of taxa experiencing the same sources of EO. It also suggests that processes of phenotypic diversification cannot be predicted solely from the existence of an AR or knowledge of the process of diversification.

Evidence for determinism in species diversification and contingency in phenotypic evolution during adaptive radiation

PubMed Central

Burbrink, Frank T.; Chen, Xin; Myers, Edward A.; Brandley, Matthew C.; Pyron, R. Alexander

2012-01-01

Adaptive radiation (AR) theory predicts that groups sharing the same source of ecological opportunity (EO) will experience deterministic species diversification and morphological evolution. Thus, deterministic ecological and morphological evolution should be correlated with deterministic patterns in the tempo and mode of speciation for groups in similar habitats and time periods. We test this hypothesis using well-sampled phylogenies of four squamate groups that colonized the New World (NW) in the Late Oligocene. We use both standard and coalescent models to assess species diversification, as well as likelihood models to examine morphological evolution. All squamate groups show similar early pulses of speciation, as well as diversity-dependent ecological limits on clade size at a continental scale. In contrast, processes of morphological evolution are not easily predictable and do not show similar pulses of early and rapid change. Patterns of morphological and species diversification thus appear uncoupled across these groups. This indicates that the processes that drive diversification and disparification are not mechanistically linked, even among similar groups of taxa experiencing the same sources of EO. It also suggests that processes of phenotypic diversification cannot be predicted solely from the existence of an AR or knowledge of the process of diversification. PMID:23034709

A Project Team Analysis Using Tuckman's Model of Small-Group Development.

PubMed

Natvig, Deborah; Stark, Nancy L

2016-12-01

Concerns about equitable workloads for nursing faculty have been well documented, yet a standardized system for workload management does not exist. A project team was challenged to establish an academic workload management system when two dissimilar universities were consolidated. Tuckman's model of small-group development was used as the framework for the analysis of processes and effectiveness of a workload project team. Agendas, notes, and meeting minutes were used as the primary sources of information. Analysis revealed the challenges the team encountered. Utilization of a team charter was an effective tool in guiding the team to become a highly productive group. Lessons learned from the analysis are discussed. Guiding a diverse group into a highly productive team is complex. The use of Tuckman's model of small-group development provided a systematic mechanism to review and understand group processes and tasks. [J Nurs Educ. 2016;55(12):675-681.]. Copyright 2016, SLACK Incorporated.

Developing policy, standard orders, and quality-assurance monitoring for palliative sedation therapy.

PubMed

Ghafoor, Virginia L; Silus, Lauren S

2011-03-15

The development of a policy, evidence-based standard orders, and monitoring for palliative sedation therapy (PST) is described. Concerns regarding PST at the University of Minnesota Medical Center (UMMC) arose and needed to be addressed in a formal process. A multidisciplinary group consisting of palliative care physicians, nurse practitioners, clinical nurse specialists, and clinical pharmacy specialists reached consensus on the practice model and medications to be used for PST. Major elements of the plan included the development and implementation of an institutional policy for palliative sedation; standard orders for patient care, sedation, and monitoring; education for staff, patients, and patients' family members; and quality-assurance monitoring. A literature review was performed to identify research and guidelines defining the practice of PST. Policy content includes the use of a standard order set linking patient care, medication administration, the monitoring of sedation, and symptom management. Approval of the policy involved several UMMC committees. An evaluation matrix was used to determine critical areas for PST monitoring and to guide development of a form to monitor quality. A retrospective chart audit using the quality-assurance monitoring form assessed baseline sedation medication and patient outcomes. Assessment of compliance began in the fall of 2008, after the policy and standard orders were approved by the UMMC medical executive committee. In 2008, two cases of PST were monitored using the standardized form. PST cases will be continually monitored and analyzed. Development of policy, standard orders, and quality-assurance monitoring for PST required a formal multidisciplinary process. A process-improvement process is critical to defining institutional policy, educational goals, and outcome metrics for PST.

A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech.

PubMed

Shriberg, Lawrence D; Strand, Edythe A; Fourakis, Marios; Jakielski, Kathy J; Hall, Sheryl D; Karlsson, Heather B; Mabie, Heather L; McSweeny, Jane L; Tilkens, Christie M; Wilson, David L

2017-04-14

Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS. PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay. Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS-AAS similarities in the age-sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings. Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

CT and MR Protocol Standardization Across a Large Health System: Providing a Consistent Radiologist, Patient, and Referring Provider Experience.

PubMed

Sachs, Peter B; Hunt, Kelly; Mansoubi, Fabien; Borgstede, James

2017-02-01

Building and maintaining a comprehensive yet simple set of standardized protocols for a cross-sectional image can be a daunting task. A single department may have difficulty preventing "protocol creep," which almost inevitably occurs when an organized "playbook" of protocols does not exist and individual radiologists and technologists alter protocols at will and on a case-by-case basis. When multiple departments or groups function in a large health system, the lack of uniformity of protocols can increase exponentially. In 2012, the University of Colorado Hospital formed a large health system (UCHealth) and became a 5-hospital provider network. CT and MR imaging studies are conducted at multiple locations by different radiology groups. To facilitate consistency in ordering, acquisition, and appearance of a given study, regardless of location, we minimized the number of protocols across all scanners and sites of practice with a clinical indication-driven protocol selection and standardization process. Here we review the steps utilized to perform this process improvement task and insure its stability over time. Actions included creation of a standardized protocol template, which allowed for changes in electronic storage and management of protocols, designing a change request form, and formation of a governance structure. We utilized rapid improvement events (1 day for CT, 2 days for MR) and reduced 248 CT protocols into 97 standardized protocols and 168 MR protocols to 66. Additional steps are underway to further standardize output and reporting of imaging interpretation. This will result in an improved, consistent radiologist, patient, and provider experience across the system.

Algorithms for Computation of Fundamental Properties of Seawater. Endorsed by Unesco/SCOR/ICES/IAPSO Joint Panel on Oceanographic Tables and Standards and SCOR Working Group 51. Unesco Technical Papers in Marine Science, No. 44.

ERIC Educational Resources Information Center

Fofonoff, N. P.; Millard, R. C., Jr.

Algorithms for computation of fundamental properties of seawater, based on the practicality salinity scale (PSS-78) and the international equation of state for seawater (EOS-80), are compiled in the present report for implementing and standardizing computer programs for oceanographic data processing. Sample FORTRAN subprograms and tables are given…

Academic Outcome Measures of a Dedicated Education Unit Over Time: Help or Hinder?

PubMed

Smyer, Tish; Gatlin, Tricia; Tan, Rhigel; Tejada, Marianne; Feng, Du

2015-01-01

Critical thinking, nursing process, quality and safety measures, and standardized RN exit examination scores were compared between students (n = 144) placed in a dedicated education unit (DEU) and those in a traditional clinical model. Standardized test scores showed that differences between the clinical groups were not statistically significant. This study shows that the DEU model is 1 approach to clinical education that can enhance students' academic outcomes.

Electrocortical Dynamics in Children with a Language-Learning Impairment Before and After Audiovisual Training.

PubMed

Heim, Sabine; Choudhury, Naseem; Benasich, April A

2016-05-01

Detecting and discriminating subtle and rapid sound changes in the speech environment is a fundamental prerequisite of language processing, and deficits in this ability have frequently been observed in individuals with language-learning impairments (LLI). One approach to studying associations between dysfunctional auditory dynamics and LLI, is to implement a training protocol tapping into this potential while quantifying pre- and post-intervention status. Event-related potentials (ERPs) are highly sensitive to the brain correlates of these dynamic changes and are therefore ideally suited for examining hypotheses regarding dysfunctional auditory processes. In this study, ERP measurements to rapid tone sequences (standard and deviant tone pairs) along with behavioral language testing were performed in 6- to 9-year-old LLI children (n = 21) before and after audiovisual training. A non-treatment group of children with typical language development (n = 12) was also assessed twice at a comparable time interval. The results indicated that the LLI group exhibited considerable gains on standardized measures of language. In terms of ERPs, we found evidence of changes in the LLI group specifically at the level of the P2 component, later than 250 ms after the onset of the second stimulus in the deviant tone pair. These changes suggested enhanced discrimination of deviant from standard tone sequences in widespread cortices, in LLI children after training.

Effectiveness of facilitated introduction of a standard operating procedure into routine processes in the operating theatre: a controlled interrupted time series.

PubMed

Morgan, Lauren; New, Steve; Robertson, Eleanor; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; Pickering, Sharon P; Hadi, Mohammed; Griffin, Damian; McCulloch, Peter

2015-02-01

Standard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. In a controlled interrupted time series, we evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs. Process measures were evaluated by direct observation, using Oxford Non-Technical Skills II for non-technical skills and the 'glitch count' for technical performance. All staff in two orthopaedic operating theatres were trained in the principles of SOPs and then assisted to develop standardised procedures. Staff in a control operating theatre underwent the same observations but received no training. The change in difference between active and control groups was compared before and after the intervention using repeated measures analysis of variance. We observed 50 operations before and 55 after the intervention and analysed clinical data on 1022 and 861 operations, respectively. The staff chose to structure their efforts around revising the 'whiteboard' which documented and prompted tasks, rather than directly addressing specific task problems. Although staff preferred and sustained the new system, we found no significant differences in process or outcome measures before/after intervention in the active versus the control group. There was a secular trend towards worse outcomes in the postintervention period, seen in both active and control theatres. SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change. 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.

Heart Rate and Oxygen Uptake Kinetics in Type 2 Diabetes Patients - A Pilot Study on the Influence of Cardiovascular Medication on Regulatory Processes.

PubMed

Koschate, Jessica; Drescher, Uwe; Baum, Klaus; Brinkmann, Christian; Schiffer, Thorsten; Latsch, Joachim; Brixius, Klara; Hoffmann, Uwe

2017-05-01

The aim of this pilot study was to investigate whether there are differences in heart rate and oxygen uptake kinetics in type 2 diabetes patients, considering their cardiovascular medication. It was hypothesized that cardiovascular medication would affect heart rate and oxygen uptake kinetics and that this could be detected using a standardized exercise test. 18 subjects were tested for maximal oxygen uptake. Kinetics were measured in a single test session with standardized, randomized moderate-intensity work rate changes. Time series analysis was used to estimate kinetics. Greater maxima in cross-correlation functions indicate faster kinetics. 6 patients did not take any cardiovascular medication, 6 subjects took peripherally acting medication and 6 patients were treated with centrally acting medication. Maximum oxygen uptake was not significantly different between groups. Significant main effects were identified regarding differences in muscular oxygen uptake kinetics and heart rate kinetics. Muscular oxygen uptake kinetics were significantly faster than heart rate kinetics in the group with no cardiovascular medication (maximum in cross-correlation function of muscular oxygen uptake vs. heart rate; 0.32±0.08 vs. 0.25±0.06; p=0.001) and in the group taking peripherally acting medication (0.34±0.05 vs. 0.28±0.05; p=0.009) but not in the patients taking centrally acting medication (0.28±0.05 vs. 0.30±0.07; n.s.). It can be concluded that regulatory processes for the achievement of a similar maximal oxygen uptake are different between the groups. The used standardized test provided plausible results for heart rate and oxygen uptake kinetics in a single measurement session in this patient group. © Georg Thieme Verlag KG Stuttgart · New York.

Development of data representation standards by the human proteome organization proteomics standards initiative

PubMed Central

Albar, Juan Pablo; Binz, Pierre-Alain; Eisenacher, Martin; Jones, Andrew R; Mayer, Gerhard; Omenn, Gilbert S; Orchard, Sandra; Vizcaíno, Juan Antonio; Hermjakob, Henning

2015-01-01

Objective To describe the goals of the Proteomics Standards Initiative (PSI) of the Human Proteome Organization, the methods that the PSI has employed to create data standards, the resulting output of the PSI, lessons learned from the PSI’s evolution, and future directions and synergies for the group. Materials and Methods The PSI has 5 categories of deliverables that have guided the group. These are minimum information guidelines, data formats, controlled vocabularies, resources and software tools, and dissemination activities. These deliverables are produced via the leadership and working group organization of the initiative, driven by frequent workshops and ongoing communication within the working groups. Official standards are subjected to a rigorous document process that includes several levels of peer review prior to release. Results We have produced and published minimum information guidelines describing what information should be provided when making data public, either via public repositories or other means. The PSI has produced a series of standard formats covering mass spectrometer input, mass spectrometer output, results of informatics analysis (both qualitative and quantitative analyses), reports of molecular interaction data, and gel electrophoresis analyses. We have produced controlled vocabularies that ensure that concepts are uniformly annotated in the formats and engaged in extensive software development and dissemination efforts so that the standards can efficiently be used by the community. Conclusion In its first dozen years of operation, the PSI has produced many standards that have accelerated the field of proteomics by facilitating data exchange and deposition to data repositories. We look to the future to continue developing standards for new proteomics technologies and workflows and mechanisms for integration with other omics data types. Our products facilitate the translation of genomics and proteomics findings to clinical and biological phenotypes. The PSI website can be accessed at http://www.psidev.info. PMID:25726569

The integrated supplier: key to cost management and multi-franchise capitation contracting.

PubMed

Schuweiler, R C

1996-05-01

Capitation...most healthcare providers do not work under it, comprehend it, or even want it, yet supply capitation contracting seminars are popping up everywhere creating the feeling that the bandwagon is leaving, and it might be time to get on board. Not true. Supply capitation is not for all organizations. Capitation contracting is not easy and there are not many successful models to help the uninitiated. If a panacea is sought for reducing supply costs, capitation is only one component of a systematic strategy to reduce materiel costs. This article suggests a direction using the Group Health Materiel Management (Group Health Cooperative of Puget Sound, WA) experience as a point of reference. It advocates a systematic approach that focuses on expense reduction in: cost of goods, holding cost of inventory, labor cost associated with all materiel processes, distribution cost (transportation and par stock pick, pack, and replenishment), product utilization, variation in product standards, and waste stream byproducts. At Group Health (GH) these issues are primarily addressed through the use of: information systems, supplier certification/selection processes, group purchasing compliance, supply channel management, supply capitation contracting programs, standardization, and utilization management. Because of managed care organizational structure, Group Health Cooperative supply capitation contracting, as performed at GH, is discussed not as a quick fix solution but in the spirit of sharing our experience with others who may be considering it as a cost savings tactic in the context of a broad-based materiel management strategy. This article highlights the experiences of GH beginning with materiel management's business process assumptions toward multiple-franchise supply capitation.

Effects of a proposed quality improvement process in the proportion of the reported ultrasound findings unsupported by stored images.

PubMed

Schenone, Mauro; Ziebarth, Sarah; Duncan, Jose; Stokes, Lea; Hernandez, Angela

2018-02-05

To investigate the proportion of documented ultrasound findings that were unsupported by stored ultrasound images in the obstetric ultrasound unit, before and after the implementation of a quality improvement process consisting of a checklist and feedback. A quality improvement process was created involving utilization of a checklist and feedback from physician to sonographer. The feedback was based on findings of the physician's review of the report and images using a check list. To assess the impact of this process, two groups were compared. Group 1 consisted of 58 ultrasound reports created prior to initiation of the process. Group 2 included 65 ultrasound reports created after process implementation. Each chart was reviewed by a physician and a sonographer. Findings considered unsupported by stored images by both reviewers were used for analysis, and the proportion of unsupported findings was compared between the two groups. Results are expressed as mean ± standard error. A p value of < .05 was used to determine statistical significance. Univariate analysis of baseline characteristics and potential confounders showed no statistically significant difference between the groups. The mean proportion of unsupported findings in Group 1 was 5.1 ± 0.87, with Group 2 having a significantly lower proportion (2.6 ± 0.62) (p value = .018). Results suggest a significant decrease in the proportion of unsupported findings in ultrasound reports after quality improvement process implementation. Thus, we present a simple yet effective quality improvement process to reduce unsupported ultrasound findings.

Impact of Video Discharge Instructions for Pediatric Fever and Closed Head Injury from the Emergency Department.

PubMed

Ismail, Shareen; McIntosh, Mark; Kalynych, Colleen; Joseph, Madeline; Wylie, Todd; Butterfield, Ryan; Smotherman, Carmen; Kraemer, Dale F; Osian, Sarah R

2016-03-01

Lack of understanding of diagnosis and disease process remains a major complaint of caregivers who bring their children to the pediatric emergency department (PED). Misunderstanding of diagnosis and discharge instructions can lead to unnecessary return visits and health disparities. We attempted to determine if video discharge instructions when added to standard of care written and verbal instruction improved caregivers' comprehension of their child's diagnosis, disease process, and discharge instructions. Caregivers who presented to the PED with a child's chief complaint of fever or closed head injury (CHI) were included and randomized into a control or intervention group. Each group received standard discharge instructions, and the intervention group additionally viewed a video. Participants completed a post-test on knowledge and were followed 2 weeks post-visit to determine follow-up care. Sixty-three caregivers participated in the study. Eleven participants had less than a high school (HS) education and 52 had more than a HS education. Thirty-one children presented with fever and 32 with CHI. The intervention group had significantly higher percentage of correct answers on postintervention tests (median [Mdn] = 88.89) than the control (Mdn = 75.73; p < 0.0001). Participants in the intervention group with less than a HS education (Mdn = 89.47) and more than HS education (Mdn = 88.89) had similar test scores (p = 0.13), whereas those in the control group with less than a HS education (Mdn = 66.67) had significantly lower test scores than those with more than a HS education (Mdn = 77.78; p = 0.03). For caregivers with children who presented to the PED with fever and CHI, video discharge instructions improved caregiver comprehension of the child's diagnosis and disease process when added to verbal and written instructions. Copyright © 2016 Elsevier Inc. All rights reserved.

Randomization to Standard and Concise Informed Consent Forms: Development of Evidence-Based Consent Practices

PubMed Central

Enama, Mary E.; Hu, Zonghui; Gordon, Ingelise; Costner, Pamela; Ledgerwood, Julie E.; Grady, Christine

2012-01-01

Background Consent to participate in research is an important component of the conduct of ethical clinical trials. Current consent practices are largely policy-driven. This study was conducted to assess comprehension of study information and satisfaction with the consent form between subjects randomized to concise or to standard informed consent forms as one approach to developing evidence-based consent practices. Methods Participants (N=111) who enrolled into two Phase I investigational influenza vaccine protocols (VRC 306 and VRC 307) at the NIH Clinical Center were randomized to one of two IRB-approved consents; either a standard or concise form. Concise consents had an average of 63% fewer words. All other aspects of the consent process were the same. Questionnaires about the study and the consent process were completed at enrollment and at the last visit in both studies. Results Subjects using concise consent forms scored as well as those using standard length consents in measures of comprehension (7 versus 7, p=0.79 and 20 versus 21, p=0.13), however, the trend was for the concise consent group to report feeling better informed. Both groups thought the length and detail of the consent form was appropriate. Conclusions Randomization of study subjects to different length IRB-approved consents forms as one method for developing evidence-based consent practices, resulted in no differences in study comprehension or satisfaction with the consent form. A concise consent form may be used ethically in the context of a consent process conducted by well-trained staff with opportunities for discussion and education throughout the study. PMID:22542645

Temperature and Humidity Profiles in the TqJoint Data Group of AIRS Version 6 Product for the Climate Model Evaluation

NASA Technical Reports Server (NTRS)

Ding, Feng; Fang, Fan; Hearty, Thomas J.; Theobald, Michael; Vollmer, Bruce; Lynnes, Christopher

2014-01-01

The Atmospheric Infrared Sounder (AIRS) mission is entering its 13th year of global observations of the atmospheric state, including temperature and humidity profiles, outgoing long-wave radiation, cloud properties, and trace gases. Thus AIRS data have been widely used, among other things, for short-term climate research and observational component for model evaluation. One instance is the fifth phase of the Coupled Model Intercomparison Project (CMIP5) which uses AIRS version 5 data in the climate model evaluation. The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) is the home of processing, archiving, and distribution services for data from the AIRS mission. The GES DISC, in collaboration with the AIRS Project, released data from the version 6 algorithm in early 2013. The new algorithm represents a significant improvement over previous versions in terms of greater stability, yield, and quality of products. The ongoing Earth System Grid for next generation climate model research project, a collaborative effort of GES DISC and NASA JPL, will bring temperature and humidity profiles from AIRS version 6. The AIRS version 6 product adds a new "TqJoint" data group, which contains data for a common set of observations across water vapor and temperature at all atmospheric levels and is suitable for climate process studies. How different may the monthly temperature and humidity profiles in "TqJoint" group be from the "Standard" group where temperature and water vapor are not always valid at the same time? This study aims to answer the question by comprehensively comparing the temperature and humidity profiles from the "TqJoint" group and the "Standard" group. The comparison includes mean differences at different levels globally and over land and ocean. We are also working on examining the sampling differences between the "TqJoint" and "Standard" group using MERRA data.

Building the United States National Vegetation Classification

USGS Publications Warehouse

Franklin, S.B.; Faber-Langendoen, D.; Jennings, M.; Keeler-Wolf, T.; Loucks, O.; Peet, R.; Roberts, D.; McKerrow, A.

2012-01-01

The Federal Geographic Data Committee (FGDC) Vegetation Subcommittee, the Ecological Society of America Panel on Vegetation Classification, and NatureServe have worked together to develop the United States National Vegetation Classification (USNVC). The current standard was accepted in 2008 and fosters consistency across Federal agencies and non-federal partners for the description of each vegetation concept and its hierarchical classification. The USNVC is structured as a dynamic standard, where changes to types at any level may be proposed at any time as new information comes in. But, because much information already exists from previous work, the NVC partners first established methods for screening existing types to determine their acceptability with respect to the 2008 standard. Current efforts include a screening process to assign confidence to Association and Group level descriptions, and a review of the upper three levels of the classification. For the upper levels especially, the expectation is that the review process includes international scientists. Immediate future efforts include the review of remaining levels and the development of a proposal review process.

Neurocognitive Predictors of Mathematical Processing in School-Aged Children with Spina Bifida and Their Typically Developing Peers: Attention, Working Memory, and Fine Motor Skills

PubMed Central

Raghubar, Kimberly P.; Barnes, Marcia A.; Dennis, Maureen; Cirino, Paul T.; Taylor, Heather; Landry, Susan

2015-01-01

Objective Math and attention are related in neurobiological and behavioral models of mathematical cognition. This study employed model-driven assessments of attention and math in children with spina bifida myelomeningocele (SBM), who have known math difficulties and specific attentional deficits, to more directly examine putative relations between attention and mathematical processing. The relation of other domain general abilities and math was also investigated. Method Participants were 9.5-year-old children with SBM (N = 44) and typically developing children (N = 50). Participants were administered experimental exact and approximate arithmetic tasks, and standardized measures of math fluency and calculation. Cognitive measures included the Attention Network Test (ANT), and standardized measures of fine motor skills, verbal working memory (WM), and visual-spatial WM. Results Children with SBM performed similarly to peers on exact arithmetic but more poorly on approximate and standardized arithmetic measures. On the ANT, children with SBM differed from controls on orienting attention but not alerting and executive attention. Multiple mediation models showed that: fine motor skills and verbal WM mediated the relation of group to approximate arithmetic; fine motor skills and visual-spatial WM mediated the relation of group to math fluency; and verbal and visual-spatial WM mediated the relation of group to math calculation. Attention was not a significant mediator of the effects of group for any aspect of math in this study. Conclusions Results are discussed with reference to models of attention, WM, and mathematical cognition. PMID:26011113

Neurocognitive predictors of mathematical processing in school-aged children with spina bifida and their typically developing peers: Attention, working memory, and fine motor skills.

PubMed

Raghubar, Kimberly P; Barnes, Marcia A; Dennis, Maureen; Cirino, Paul T; Taylor, Heather; Landry, Susan

2015-11-01

Math and attention are related in neurobiological and behavioral models of mathematical cognition. This study employed model-driven assessments of attention and math in children with spina bifida myelomeningocele (SBM), who have known math difficulties and specific attentional deficits, to more directly examine putative relations between attention and mathematical processing. The relation of other domain general abilities and math was also investigated. Participants were 9.5-year-old children with SBM (n = 44) and typically developing children (n = 50). Participants were administered experimental exact and approximate arithmetic tasks, and standardized measures of math fluency and calculation. Cognitive measures included the Attention Network Test (ANT), and standardized measures of fine motor skills, verbal working memory (WM), and visual-spatial WM. Children with SBM performed similarly to peers on exact arithmetic, but more poorly on approximate and standardized arithmetic measures. On the ANT, children with SBM differed from controls on orienting attention, but not on alerting and executive attention. Multiple mediation models showed that fine motor skills and verbal WM mediated the relation of group to approximate arithmetic; fine motor skills and visual-spatial WM mediated the relation of group to math fluency; and verbal and visual-spatial WM mediated the relation of group to math calculation. Attention was not a significant mediator of the effects of group for any aspect of math in this study. Results are discussed with reference to models of attention, WM, and mathematical cognition. (c) 2015 APA, all rights reserved).

The Simple View, Instructional Level, and the Plight of Struggling Fifth-/Sixth-Grade Readers

ERIC Educational Resources Information Center

Morris, Darrell; Meyer, Carla; Trathen, Woodrow; McGee, Jennifer; Vines, Nora; Stewart, Trevor; Gill, Tom; Schlagal, Robert

2017-01-01

This study explored print-processing and vocabulary differences among a group of 5th- and 6th-grade students who had scored below the 50th percentile on a standardized reading test. Guided by the simple view of reading, we applied cut scores (low/high) to the students' performance on print-processing and vocabulary tasks. The design allowed for…

Standardized severe maternal morbidity review: rationale and process.

PubMed

Kilpatrick, Sarah J; Berg, Cynthia; Bernstein, Peter; Bingham, Debra; Delgado, Ana; Callaghan, William M; Harris, Karen; Lanni, Susan; Mahoney, Jeanne; Main, Elliot; Nacht, Amy; Schellpfeffer, Michael; Westover, Thomas; Harper, Margaret

2014-08-01

Severe maternal morbidity and mortality have been rising in the United States. To begin a national effort to reduce morbidity, a specific call to identify all pregnant and postpartum women experiencing admission to an intensive care unit or receipt of 4 or more units of blood for routine review has been made. While advocating for review of these cases, no specific guidance for the review process was provided. Therefore, the aim of this expert opinion is to present guidelines for a standardized severe maternal morbidity interdisciplinary review process to identify systems, professional, and facility factors that can be ameliorated, with the overall goal of improving institutional obstetric safety and reducing severe morbidity and mortality among pregnant and recently pregnant women. This opinion was developed by a multidisciplinary working group that included general obstetrician-gynecologists, maternal-fetal medicine subspecialists, certified nurse-midwives, and registered nurses all with experience in maternal mortality reviews. A process for standardized review of severe maternal morbidity addressing committee organization, review process, medical record abstraction and assessment, review culture, data management, review timing, and review confidentiality is presented. Reference is made to a sample severe maternal morbidity abstraction and assessment form.

Design of standard operating procedure production proceses (case study on the home industry Bedugul Baturiti Tabanan Bali)

NASA Astrophysics Data System (ADS)

Kasiani; Suhantono, Djoko; Mirah Kencanawati, AAA

2018-01-01

Candikuning is part of the district of Baturiti, tourism village, better known by the name of Bedugul. No less interesting is the variety of chips produced by two partner groups as a souvenir after the tour, such as Chips: Spinach; beans; Tempeh. The purpose of this research were to design a Standard Operating Procedure (SOP): Production Processes on the Home Industry Bedugul Baturiti Tabanan Bali. The data technic collected use: observation; Documentation; and then interview to collect information. The data analysis technic done by using the Miles & Huberman. Result this research that the draft SOP: Production Processes Chips (Menu). The conclusion in this research SOP Production Processes use with flowchart and description on the Home Industry Bedugul Baturiti Tabanan Bali.

Reporting standards for studies of diagnostic test accuracy in dementia

PubMed Central

Noel-Storr, Anna H.; McCleery, Jenny M.; Richard, Edo; Ritchie, Craig W.; Flicker, Leon; Cullum, Sarah J.; Davis, Daniel; Quinn, Terence J.; Hyde, Chris; Rutjes, Anne W.S.; Smailagic, Nadja; Marcus, Sue; Black, Sandra; Blennow, Kaj; Brayne, Carol; Fiorivanti, Mario; Johnson, Julene K.; Köpke, Sascha; Schneider, Lon S.; Simmons, Andrew; Mattsson, Niklas; Zetterberg, Henrik; Bossuyt, Patrick M.M.; Wilcock, Gordon

2014-01-01

Objective: To provide guidance on standards for reporting studies of diagnostic test accuracy for dementia disorders. Methods: An international consensus process on reporting standards in dementia and cognitive impairment (STARDdem) was established, focusing on studies presenting data from which sensitivity and specificity were reported or could be derived. A working group led the initiative through 4 rounds of consensus work, using a modified Delphi process and culminating in a face-to-face consensus meeting in October 2012. The aim of this process was to agree on how best to supplement the generic standards of the STARD statement to enhance their utility and encourage their use in dementia research. Results: More than 200 comments were received during the wider consultation rounds. The areas at most risk of inadequate reporting were identified and a set of dementia-specific recommendations to supplement the STARD guidance were developed, including better reporting of patient selection, the reference standard used, avoidance of circularity, and reporting of test-retest reliability. Conclusion: STARDdem is an implementation of the STARD statement in which the original checklist is elaborated and supplemented with guidance pertinent to studies of cognitive disorders. Its adoption is expected to increase transparency, enable more effective evaluation of diagnostic tests in Alzheimer disease and dementia, contribute to greater adherence to methodologic standards, and advance the development of Alzheimer biomarkers. PMID:24944261

The Value of Harmonizing Multiple Improvement Technologies: A Process Improvement Professional’s View

DTIC Science & Technology

2008-03-01

maturity models and ISO standards, specifically CMMI, CMMI-ACQ and ISO 12207 . Also, the improvement group supplemented their selection of these...compliant with the technologies and standards that are important to the business. Lockheed Martin IS&GS has integrated CMMI, EIA 632, ISO 12207 , and Six...geographically dispersed organization. [Siviy 07-1] Northrop Grumman Mission Systems has integrated CMMI, ISO 9001, AS9100, and Six Sigma, as well as a

[Comparative studies of personal and steady-state sampling for determining dust exposure in different job groups].

PubMed

Cherneva, P; Lukanova, R

1994-01-01

The variability of the dust concentration in time and space, as well as the change of worker's place during the working process, define the necessity of introducing personal sampling in the hygiene control practice. However, the laboratory equipment with personal devices is still not sufficient. The aim of this work is to assess the dust exposure of the basic professional groups from the ore- and coal production in Bulgaria by personal sampling in comparative studies of the static ambient sampling used up to now. 63 full-shift investigations of the dust factor were performed on professional groups of miners of the polymetal and coal pits by static ambient devices-[Hygitest production] and personal [from firms "Casella", "Strolein" and "Gilian"] devices, after standardized methods. The results are data processed-by means of logarithmic normal distribution of the relation of the respirable dust concentrations, determined personally and by static ambient sampling. The limits of variation of this correlation are from 0.5 to 4.1 at average geometric value -0.95 and standard geometric deviation-1.8 i.e. both types of sampling are intersubstitutional for the examined groups and sites, as in the underground ores the professional risk of respirable dust is underestimated up to 4 times at static ambient sampling.

Process Improvement Project Using Tranexamic Acid Is Cost-Effective in Reducing Blood Loss and Transfusions After Total Hip and Total Knee Arthroplasty.

PubMed

Demos, Harry A; Lin, Zilan X; Barfield, William R; Wilson, Sylvia H; Robertson, Dawn C; Pellegrini, Vincent D

2017-08-01

Tranexamic acid (TXA) has been associated with decreased blood loss and transfusion after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to examine both transfusion utilization and the economic impact of a Process Improvement Project implementing TXA for THA and TKA. After standardization of TXA administration in THA and TKA patients, retrospective data were compared from 12 consecutive months before (group A, n = 336 procedures) and after (group B, n = 436 procedures) project initiation. TXA administration increased with project implementation (group A = 3.57%, group B = 86.01%) and was associated with reductions in perioperative hemoglobin decrement (20.2%), patients transfused (45%), and number of units transfused per patient (61.9%). Cost savings were notable per patient ($128) and annually program wide ($55,884) with the primary THA subgroup contributing the most to the savings. No increase in adverse effects was observed. Standardized administration of TXA is an effective and economically favorable blood-reduction strategy for patients undergoing elective THA or TKA. Although reduction in transfusions with TXA may be greater after TKA, the economic and clinical impact of transfusion reduction is more substantial in THA patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Consensus-based guidelines for Video EEG monitoring in the pre-surgical evaluation of children with epilepsy in the UK.

PubMed

Pressler, Ronit M; Seri, Stefano; Kane, Nick; Martland, Tim; Goyal, Sushma; Iyer, Anand; Warren, Elliott; Notghi, Lesley; Bill, Peter; Thornton, Rachel; Appleton, Richard; Doyle, Sarah; Rushton, Sarah; Worley, Alan; Boyd, Stewart G

2017-08-01

Paediatric Epilepsy surgery in the UK has recently been centralised in order to improve expertise and quality of service available to children. Video EEG monitoring or telemetry is a highly specialised and a crucial component of the pre-surgical evaluation. Although many Epilepsy Monitoring Units work to certain standards, there is no national or international guideline for paediatric video telemetry. Due to lack of evidence we used a modified Delphi process utilizing the clinical and academic expertise of the clinical neurophysiology sub-specialty group of Children's Epilepsy Surgical Service (CESS) centres in England and Wales. This process consisted of the following stages I: Identification of the consensus working group, II: Identification of key areas for guidelines, III: Consensus practice points and IV: Final review. Statements that gained consensus (median score of either 4 or 5 using a five-point Likerttype scale) were included in the guideline. Two rounds of feedback and amendments were undertaken. The consensus guidelines includes the following topics: referral pathways, neurophysiological equipment standards, standards of recording techniques, with specific emphasis on safety of video EEG monitoring both with and without drug withdrawal, a protocol for testing patient's behaviours, data storage and guidelines for writing factual reports and conclusions. All statements developed received a median score of 5 and were adopted by the group. Using a modified Delphi process we were able to develop universally-accepted video EEG guidelines for the UK CESS. Although these recommendations have been specifically developed for the pre-surgical evaluation of children with epilepsy, it is assumed that most components are transferable to any paediatric video EEG monitoring setting. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Effects of hypertonic dextrose on injured rat skeletal muscles.

PubMed

Kunduracioglu, Burak; Ulkar, Bulent; Sabuncuoglu, Bizden T; Can, Belgin; Bayrakci, Kenan

2006-04-01

Histological examination of proliferative therapy effects on the healing process of muscular injury. We performed this study between March and August 2002 at Ankara University, School of Medicine, Laboratory of Animal Experiments, Ankara, Turkey. We used an experimental animal model by conducting a standardized cut injury of the gastrocnemius muscle in 30 adult male albino rats, which we divided into 2 groups; proliferative therapy group and control group. We evaluated the injured rat muscles by light microscopy on the fifth, eight, and twelfth day of injury. The muscular regeneration process began at day 5 in both the control and proliferative therapy groups. The proliferative therapy group revealed a prominent inflammatory reaction, fibroblast migration, and necrosis with accompanying regeneration and excessive connective tissue formation. We cannot consider proliferative therapy an appropriate treatment modality for muscular injuries, unless there is evidence of normal muscle physiology and biomechanics post traumatically.

Effect of a multimedia-assisted informed consent procedure on the information gain, satisfaction, and anxiety of cataract surgery patients.

PubMed

Tipotsch-Maca, Saskia M; Varsits, Ralph M; Ginzel, Christian; Vecsei-Marlovits, Pia V

2016-01-01

To assess whether a multimedia-assisted preoperative informed consent procedure has an effect on patients' knowledge concerning cataract surgery, satisfaction with the informed consent process, and reduction in anxiety levels. Hietzing Hospital, Vienna, Austria. Prospective randomized controlled clinical trial. Patients participated in an informed consent procedure for age-related cataract surgery that included the standard approach only (reading the information brochure and having a standardized face-to-face discussion) or supplemented with a computer-animated video. The main outcome was information retention assessed by a questionnaire. Further outcome measures used were the State-Trait Anxiety Inventory, the Visual Function-14 score, and an assessment of satisfaction. The study included 123 patients (64 in standard-only group; 59 in computer-animated video group). Both groups scored well on the questionnaire; however, patients who watched the video performed better (82% retention versus 72%) (P = .002). Scores tended to decrease with increasing age (r = -0.25, P = .005); however, this decrease was smaller in the group that watched the video. Both groups had elevated anxiety levels (means in video group: anxiety concerning the current situation [S-anxiety] = 63.8 ± 9.6 [SD], general tendency toward anxiety [T-anxiety] = 65.5 ± 7.9; means in control group: S-anxiety = 61.9 ± 10.3, T-anxiety = 66.2 ± 7.8). A high level of information retention was achieved using an informed consent procedure consisting of an information brochure and a standardized face-to-face discussion. A further increase in information retention was achieved, even with increasing patient age, by adding a multimedia presentation. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina.

PubMed

Ausserhofer, Dietmar; Rakic, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Van Malderen, Greet

2016-06-01

We explored how selected 'positive deviant' healthcare facilities in Bosnia and Herzegovina approach the continuous development, adaptation, implementation, monitoring and evaluation of nursing-related standard operating procedures. Standardized nursing care is internationally recognized as a critical element of safe, high-quality health care; yet very little research has examined one of its key instruments: nursing-related standard operating procedures. Despite variability in Bosnia and Herzegovina's healthcare and nursing care quality, we assumed that some healthcare facilities would have developed effective strategies to elevate nursing quality and safety through the use of standard operating procedures. Guided by the 'positive deviance' approach, we used a multiple-case study design to examine a criterion sample of four facilities (two primary healthcare centres and two hospitals), collecting data via focus groups and individual interviews. In each studied facility, certification/accreditation processes were crucial to the initiation of continuous development, adaptation, implementation, monitoring and evaluation of nursing-related SOPs. In one hospital and one primary healthcare centre, nurses working in advanced roles (i.e. quality coordinators) were responsible for developing and implementing nursing-related standard operating procedures. Across the four studied institutions, we identified a consistent approach to standard operating procedures-related processes. The certification/accreditation process is enabling necessary changes in institutions' organizational cultures, empowering nurses to take on advanced roles in improving the safety and quality of nursing care. Standardizing nursing procedures is key to improve the safety and quality of nursing care. Nursing and Health Policy are needed in Bosnia and Herzegovina to establish a functioning institutional framework, including regulatory bodies, educational systems for developing nurses' capacities or the inclusion of nursing-related standard operating procedures in certification/accreditation standards. © 2016 International Council of Nurses.

New vector-like fermions and flavor physics

DOE PAGES

Ishiwata, Koji; Ligeti, Zoltan; Wise, Mark B.

2015-10-06

We study renormalizable extensions of the standard model that contain vector-like fermions in a (single) complex representation of the standard model gauge group. There are 11 models where the vector-like fermions Yukawa couple to the standard model fermions via the Higgs field. These models do not introduce additional fine-tunings. They can lead to, and are constrained by, a number of different flavor-changing processes involving leptons and quarks, as well as direct searches. An interesting feature of the models with strongly interacting vector-like fermions is that constraints from neutral meson mixings (apart from CP violation inmore » $$ {K}^0-{\\overline{K}}^0 $$ mixing) are not sensitive to higher scales than other flavor-changing neutral-current processes. We identify order 1/(4πM) 2 (where M is the vector-like fermion mass) one-loop contributions to the coefficients of the four-quark operators for meson mixing, that are not suppressed by standard model quark masses and/or mixing angles.« less

Taiwanese consumer survey data for investigating the role of information on equivalence of organic standards in directing food choice.

PubMed

Yeh, Ching-Hua; Hartmann, Monika; Hirsch, Stefan

2018-06-01

The presentation of credence attributes such as the product's origin or the production method has a significant influence on consumers' food purchase decisions. The dataset includes survey responses from a discrete choice experiment with 1309 food shoppers in Taiwan using the example of sweet pepper. The survey was carried out in 2014 in the three largest Taiwanese cities. It evaluates the impact of providing information on the equality of organic standards on consumers' preferences at the example of sweet pepper. Equality of organic standards implies that regardless of products' country-of-origin (COO) organic certifications are based on the same production regulation and managerial processes. Respondents were randomly allocated to the information treatment and the control group. The dataset contains the product choices of participants in both groups, as well as their sociodemographic information.

Wheelchair transportation safety on school buses: stakeholder recommendations for priority issues and actions.

PubMed

Buning, Mary Ellen; Karg, Patricia E

2011-01-01

This paper presents results from and provides discussion of a state-of-the-science workshop in which highly informed stakeholders in wheelchair transportation safety for students on school buses were participants. The Nominal Group Technique was used to create a process in which the main issues preventing safe transportation of wheelchair-seated students and key strategies to overcome these issues were identified and ranked. These results, along with a synthesis of group discussion and recommendations for action, are presented along with consideration of current policies, regulations, and political realities. Critical safety shortcomings exist in this highly specialized enterprise that varies from state to state. Recommended strategies include implementing wheelchair requirements in federal transportation safety standards, creation of a clearinghouse for wheelchair transportation best practices and education, creation of national standards for training, practices, and monitoring, and increased "buy-in" to voluntary wheelchair standards by wheelchair manufacturers.

Computational Fluid Dynamics Assessment Associated with Transcatheter Heart Valve Prostheses: A Position Paper of the ISO Working Group.

PubMed

Wei, Zhenglun Alan; Sonntag, Simon Johannes; Toma, Milan; Singh-Gryzbon, Shelly; Sun, Wei

2018-04-19

The governing international standard for the development of prosthetic heart valves is International Organization for Standardization (ISO) 5840. This standard requires the assessment of the thrombus potential of transcatheter heart valve substitutes using an integrated thrombus evaluation. Besides experimental flow field assessment and ex vivo flow testing, computational fluid dynamics is a critical component of this integrated approach. This position paper is intended to provide and discuss best practices for the setup of a computational model, numerical solving, post-processing, data evaluation and reporting, as it relates to transcatheter heart valve substitutes. This paper is not intended to be a review of current computational technology; instead, it represents the position of the ISO working group consisting of experts from academia and industry with regards to considerations for computational fluid dynamic assessment of transcatheter heart valve substitutes.

The Energy Industry Profile of ISO/DIS 19115-1: Facilitating Discovery and Evaluation of, and Access to Distributed Information Resources

NASA Astrophysics Data System (ADS)

Hills, S. J.; Richard, S. M.; Doniger, A.; Danko, D. M.; Derenthal, L.; Energistics Metadata Work Group

2011-12-01

A diverse group of organizations representative of the international community involved in disciplines relevant to the upstream petroleum industry, - energy companies, - suppliers and publishers of information to the energy industry, - vendors of software applications used by the industry, - partner government and academic organizations, has engaged in the Energy Industry Metadata Standards Initiative. This Initiative envisions the use of standard metadata within the community to enable significant improvements in the efficiency with which users discover, evaluate, and access distributed information resources. The metadata standard needed to realize this vision is the initiative's primary deliverable. In addition to developing the metadata standard, the initiative is promoting its adoption to accelerate realization of the vision, and publishing metadata exemplars conformant with the standard. Implementation of the standard by community members, in the form of published metadata which document the information resources each organization manages, will allow use of tools requiring consistent metadata for efficient discovery and evaluation of, and access to, information resources. While metadata are expected to be widely accessible, access to associated information resources may be more constrained. The initiative is being conducting by Energistics' Metadata Work Group, in collaboration with the USGIN Project. Energistics is a global standards group in the oil and natural gas industry. The Work Group determined early in the initiative, based on input solicited from 40+ organizations and on an assessment of existing metadata standards, to develop the target metadata standard as a profile of a revised version of ISO 19115, formally the "Energy Industry Profile of ISO/DIS 19115-1 v1.0" (EIP). The Work Group is participating on the ISO/TC 211 project team responsible for the revision of ISO 19115, now ready for "Draft International Standard" (DIS) status. With ISO 19115 an established, capability-rich, open standard for geographic metadata, EIP v1 is expected to be widely acceptable within the community and readily sustainable over the long-term. The EIP design, also per community requirements, will enable discovery, evaluation, and access to types of information resources considered important to the community, including structured and unstructured digital resources, and physical assets such as hardcopy documents and material samples. This presentation will briefly review the development of this initiative as well as the current and planned Work Group activities. More time will be spent providing an overview of the EIP v1, including the requirements it prescribes, design efforts made to enable automated metadata capture and processing, and the structure and content of its documentation, which was written to minimize ambiguity and facilitate implementation. The Work Group considers EIP v1 a solid initial design for interoperable metadata, and first step toward the vision of the Initiative.

A Novel Decision Aid to Support Informed Decision-Making Process in Patients with a Symptomatic Nonlower Pole Renal Stone <20 mm in Diameter.

PubMed

Gökce, Mehmet İlker; Esen, Barış; Sancı, Adem; Akpınar, Cağrı; Süer, Evren; Gülpınar, Ömer

2017-07-01

Stone disease is an important health problem, and patients have different treatment choices. Shared decision making is recommended for deciding the treatment type, but patient education is necessary. Decision aids (DAs) are used for this aim, and herein, we developed a novel DA for patients with symptomatic nonlower pole renal stones <20 mm in diameter. The DA development process was established based on the recommended guides. General characteristics of the stone disease and details of the shockwave lithotripsy and retrograde intrarenal surgery were included in the content of the DA. The DA was further revised based on the suggestions of different physician groups and patients. The DA was evaluated by three physicians (Delphi assessment-International Patient Decision Aid Standards [IPDAS] Collaboration standards) and 25 patients (questionnaire of six questions with five-point Likert scale). The DA was designed as a booklet, and Delphi group assessment resulted in a total score of 50/54. Patient evaluation of the DA resulted in favorable outcomes, and patients generally recommended its use by other patients. This novel DA for patients with a symptomatic nonlower pole renal stone <20 mm showed promising results and was well accepted by the patients. We believe that this DA will have a positive impact on patients' level of knowledge. Increased level of knowledge will also improve the patients' contribution to the shared decision-making process. A further prospective randomized trial to compare with the standard patient informing process is also planned.

SWOT analysis of Banff: strengths, weaknesses, opportunities and threats of the international Banff consensus process and classification system for renal allograft pathology.

PubMed

Mengel, M; Sis, B; Halloran, P F

2007-10-01

The Banff process defined the diagnostic histologic lesions for renal allograft rejection and created a standardized classification system where none had existed. By correcting this deficit the process had universal impact on clinical practice and clinical and basic research. All trials of new drugs since the early 1990s benefited, because the Banff classification of lesions permitted the end point of biopsy-proven rejection. The Banff process has strengths, weaknesses, opportunities and threats (SWOT). The strength is its self-organizing group structure to create consensus. Consensus does not mean correctness: defining consensus is essential if a widely held view is to be proved wrong. The weaknesses of the Banff process are the absence of an independent external standard to test the classification; and its almost exclusive reliance on histopathology, which has inherent limitations in intra- and interobserver reproducibility, particularly at the interface between borderline and rejection, is exactly where clinicians demand precision. The opportunity lies in the new technology such as transcriptomics, which can form an external standard and can be incorporated into a new classification combining the elegance of histopathology and the objectivity of transcriptomics. The threat is the degree to which the renal transplant community will participate in and support this process.

Rolling capital: managing investments in a value-based care world.

PubMed

Jasuta, Lynette

2016-06-01

The importance of capital planning is increasing as the healthcare industry moves toward value-based care. Replacing unwieldy and inflexible traditional capital planning processes with a rolling capital planning approach can result in: Greater standardization, facilitating better strategic planning across the whole system. Reduced labor intensity in the planning and budgeting process. Reduced costs through being able to plan better for replacement purchases and take advantage of group purchasing and bundling opportunities. Increased transparency in the decision-making process.

40 CFR 63.1335 - General recordkeeping and reporting provisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Precompliance Report. The Administrator may deem alternative controls to be equivalent to the controls required... (CONTINUED) National Emission Standards for Hazardous Air Pollutant Emissions: Group IV Polymers and Resins... malfunction and a program for corrective action for malfunctioning process and air pollution control equipment...

76 FR 70376 - Efficiency and Renewables Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

...-Voltage Dry-Type Distribution Transformers. The Liquid Immersed and Medium-Voltage Dry- Type Group (MV... of distribution transformers, as authorized by the Energy Policy Conservation Act (EPCA) of 1975, as... negotiated rulemaking process to develop proposed energy efficiency standards for distribution transformers...

40 CFR 65.142 - Standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of this subpart apply to Group 2A process vents. (c) Transfer rack requirements. The owner or... route transfer rack emissions through a closed vent system to a flare shall meet the applicable... requirements referenced therein. No other provisions of this subpart apply to transfer rack emissions routed...

High-resolution frequency measurement method with a wide-frequency range based on a quantized phase step law.

PubMed

Du, Baoqiang; Dong, Shaofeng; Wang, Yanfeng; Guo, Shuting; Cao, Lingzhi; Zhou, Wei; Zuo, Yandi; Liu, Dan

2013-11-01

A wide-frequency and high-resolution frequency measurement method based on the quantized phase step law is presented in this paper. Utilizing a variation law of the phase differences, the direct different frequency phase processing, and the phase group synchronization phenomenon, combining an A/D converter and the adaptive phase shifting principle, a counter gate is established in the phase coincidences at one-group intervals, which eliminates the ±1 counter error in the traditional frequency measurement method. More importantly, the direct phase comparison, the measurement, and the control between any periodic signals have been realized without frequency normalization in this method. Experimental results show that sub-picosecond resolution can be easily obtained in the frequency measurement, the frequency standard comparison, and the phase-locked control based on the phase quantization processing technique. The method may be widely used in navigation positioning, space techniques, communication, radar, astronomy, atomic frequency standards, and other high-tech fields.

Diamonds in dense molecular clouds - A challenge to the standard interstellar medium paradigm

NASA Technical Reports Server (NTRS)

Allamandola, L. J.; Sandford, S. A.; Tielens, A. G. G. M.; Herbst, T. M.

1993-01-01

Observations of a newly discovered infrared C-H stretching band indicate that interstellar diamond-like material appears to be characteristic of dense clouds. In sharp contrast, the spectral signature of dust in the diffuse interstellar medium is dominated by -CH2- and -CH3 groups. This dichotomy in the aliphatic organic component between the dense and diffuse media challenges standard assumptions about the processes occurring in, and interactions between, these two media. The ubiquity of this interstellar diamond-like material rules out models for meteoritic diamond formation in unusual circumstellar environments and implies that the formation of the diamond-like material is associated with common interstellar processes or stellar types.

Photobiomodulation laser improves the early repair process of hypothyroid rats

NASA Astrophysics Data System (ADS)

Uzêda e Silva, V. D.; Rodriguez, T. T.; Xavier, F. C. A.; dos Santos, J. N.; Vasconcelos, R. M.; Ramalho, L. M. P.

2018-04-01

Delay in wound healing has been observed in the hypothyroidism disfunction. Laser light can modulate various biological phenomena acting on different cell types. However, there are few reports in the literature regarding the effects of laser on wound healing of hypothyroid models. This study aimed to evaluate the differences in reepithelialization process of cutaneous wounds on hypothyroid and euthyroid rats treated with laser phototherapy. Forty-eight rats were divided into two main groups: euthyroid (EU) and hypothyroid (HYPO). Hypothyroidism was induced by Thyroidectomy. Each group was divided into subgroups: control (without laser) and laser groups. Standard surgical wound was created on the dorsum of each rat. The irradiation protocols (λ660 nm, 40 mW, CW; 10 J/cm2) was carried out immediately after wounding and repeated every 24h during 3 and 7 days. After animal death, specimens were taken, routinely processed, cut, stained with hematoxylin-eosin, and underwent histological analysis. Three days after the surgery, it was possible to observe initial reepithelialization in more advanced stages in the wound area of the irradiated hypothyroid group when compared to control hypothyroid group (p<0.05). No significant difference was found in the experimental period of 7 days among the groups. It was concluded that the laser light did influence reepithelialization process on hypothyroid rats in early stages of healing process.

Examination of a Standardized Test for Evaluating the Degree of Cure of EVA Encapsulation (Presentation)

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

Miller, D.; Wohlgemuth, J.; Gu, X.

2013-11-01

The curing of cross-linkable encapsulation is a critical consideration for photovoltaic (PV) modules manufactured using a lamination process. Concerns related to ethylene-co-vinyl acetate (EVA) include the quality (e.g., expiration and uniformity) of the films or completion (duration) of the cross-linking of the EVA within a laminator. Because these issues are important to both EVA and module manufacturers, an international standard has recently been proposed by the Encapsulation Task-Group within the Working Group 2 (WG2) of the International Electrotechnical Commission (IEC) Technical Committee 82 (TC82) for the quantification of the degree of cure for EVA encapsulation. The present draft of themore » standard calls for the use of differential scanning calorimetry (DSC) as the rapid, enabling secondary (test) method. Both the residual enthalpy- and melt/freeze-DSC methods are identified. The DSC methods are calibrated against the gel content test, the primary (reference) method. Aspects of other established methods, including indentation and rotor cure metering, were considered by the group. Key details of the test procedure will be described.« less

Topical 5% potassium permanganate solution accelerates the healing process in chronic diabetic foot ulcers.

PubMed

Delgado-Enciso, Iván; Madrigal-Perez, Violeta M; Lara-Esqueda, Agustin; Diaz-Sanchez, Martha G; Guzman-Esquivel, Jose; Rosas-Vizcaino, Luis E; Virgen-Jimenez, Oscar O; Kleiman-Trujillo, Juleny; Lagarda-Canales, Maria R; Ceja-Espiritu, Gabriel; Rangel-Salgado, Viridiana; Lopez-Lemus, Uriel A; Delgado-Enciso, Josuel; Lara-Basulto, Agustin D; Soriano Hernández, Alejandro D

2018-02-01

Potassium permanganate has been reported to be an effective treatment for certain types of wounds. The aim of the present study was to evaluate the use of potassium permanganate in the treatment of diabetic foot ulcers. A single-blind, randomized, controlled clinical trial was conducted on patients with type 2 diabetes mellitus that presented with a foot ulcer persisting for >3 months. The control group (n=10) was treated with the current standard treatment, which comprises of measures for reducing pressure in the ulcerated area, daily cleansing of the ulcer with potable water and antiseptic wash solution, and the application of a disinfectant solution on the entire surface area of the ulcer; while the intervention group (n=15) received the standard treatment plus 5% topical potassium permanganate solution applied once a day for 21 days. In the intervention group, 1 patient did not tolerate the treatment and was eliminated from the study on the first day. The remaining patients tolerated the interventions well. At the end of the treatment period, ulcers in the control group had decreased by 38% whereas those in the intervention group decreased by 73% (P<0.009). The degree of decrease was also investigated; the ulcer size was ≥50% decreased in 40% of patients in the control group and in 86% of patients in the intervention group (P=0.02). In conclusion, the results of the present study indicate that topical potassium permanganate is well tolerated and significantly accelerates the healing process of diabetic foot ulcers.

Topical 5% potassium permanganate solution accelerates the healing process in chronic diabetic foot ulcers

PubMed Central

Delgado-Enciso, Iván; Madrigal-Perez, Violeta M.; Lara-Esqueda, Agustin; Diaz-Sanchez, Martha G.; Guzman-Esquivel, Jose; Rosas-Vizcaino, Luis E.; Virgen-Jimenez, Oscar O.; Kleiman-Trujillo, Juleny; Lagarda-Canales, Maria R.; Ceja-Espiritu, Gabriel; Rangel-Salgado, Viridiana; Lopez-Lemus, Uriel A.; Delgado-Enciso, Josuel; Lara-Basulto, Agustin D.; Soriano Hernández, Alejandro D.

2018-01-01

Potassium permanganate has been reported to be an effective treatment for certain types of wounds. The aim of the present study was to evaluate the use of potassium permanganate in the treatment of diabetic foot ulcers. A single-blind, randomized, controlled clinical trial was conducted on patients with type 2 diabetes mellitus that presented with a foot ulcer persisting for >3 months. The control group (n=10) was treated with the current standard treatment, which comprises of measures for reducing pressure in the ulcerated area, daily cleansing of the ulcer with potable water and antiseptic wash solution, and the application of a disinfectant solution on the entire surface area of the ulcer; while the intervention group (n=15) received the standard treatment plus 5% topical potassium permanganate solution applied once a day for 21 days. In the intervention group, 1 patient did not tolerate the treatment and was eliminated from the study on the first day. The remaining patients tolerated the interventions well. At the end of the treatment period, ulcers in the control group had decreased by 38% whereas those in the intervention group decreased by 73% (P<0.009). The degree of decrease was also investigated; the ulcer size was ≥50% decreased in 40% of patients in the control group and in 86% of patients in the intervention group (P=0.02). In conclusion, the results of the present study indicate that topical potassium permanganate is well tolerated and significantly accelerates the healing process of diabetic foot ulcers. PMID:29435274

Visual processing of emotional expressions in mixed anxious-depressed subclinical state: an event-related potential study on a female sample.

PubMed

Rossignol, M; Philippot, P; Crommelinck, M; Campanella, S

2008-10-01

Controversy remains about the existence and the nature of a specific bias in emotional facial expression processing in mixed anxious-depressed state (MAD). Event-related potentials were recorded in the following three types of groups defined by the Spielberger state and trait anxiety inventory (STAI) and the Beck depression inventory (BDI): a group of anxious participants (n=12), a group of participants with depressive and anxious tendencies (n=12), and a control group (n=12). Participants were confronted with a visual oddball task in which they had to detect, as quickly as possible, deviant faces amongst a train of standard neutral faces. Deviant stimuli changed either on identity, or on emotion (happy or sad expression). Anxiety facilitated emotional processing and the two anxious groups produced quicker responses than control participants; these effects were correlated with an earlier decisional wave (P3b) for anxious participants. Mixed anxious-depressed participants showed enhanced visual processing of deviant stimuli and produced higher amplitude in attentional complex (N2b/P3a), both for identity and emotional trials. P3a was also particularly increased for emotional faces in this group. Anxious state mainly influenced later decision processes (shorter latency of P3b), whereas mixed anxious-depressed state acted on earlier steps of emotional processing (enhanced N2b/P3a complex). Mixed anxious-depressed individuals seemed more reactive to any visual change, particularly emotional change, without displaying any valence bias.

A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

PubMed Central

Strand, Edythe A.; Fourakis, Marios; Jakielski, Kathy J.; Hall, Sheryl D.; Karlsson, Heather B.; Mabie, Heather L.; McSweeny, Jane L.; Tilkens, Christie M.; Wilson, David L.

2017-01-01

Purpose Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS. Method PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay. Results Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings. Conclusions Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits. PMID:28384751

Impact of a web-based prostate cancer treatment decision aid on patient-reported decision process parameters: results from the Prostate Cancer Patient Centered Care trial.

PubMed

Cuypers, Maarten; Lamers, Romy E D; Kil, Paul J M; van de Poll-Franse, Lonneke V; de Vries, Marieke

2018-05-12

To compare patients' evaluation of the treatment decision-making process in localized prostate cancer between counseling that included an online decision aid (DA) and standard counseling. Eighteen Dutch hospitals were randomized to DA counseling (n = 235) or the control group with standard counseling (n = 101) in a pragmatic, cluster randomized controlled trial. The DA was provided to patients at, or soon after diagnosis. Decisional conflict, involvement, knowledge, and satisfaction with information were assessed with a questionnaire after treatment decision-making. Anxiety and depression served as covariates. The levels of decision involvement and conflict were comparable between patients in both groups. Patients with a DA felt more knowledgeable but scored equally well on a knowledge test as patients without a DA. Small significant negative effects were found on satisfaction with information and preparation for decision-making. A preference for print over online and depression and anxiety symptoms was negatively associated with satisfaction and conflict scores in the DA group. The DA aimed to support shared decision-making, while outcomes for a majority of DA users were comparable to patients who received standard counseling. Patients, who are less comfortable with the online DA format or experience anxiety or depression symptoms, could require more guidance toward shared decision-making. To evaluate long-term DA effects, follow-up evaluation on treatment satisfaction and decisional regret will be done.

NASA Standard for Airborne Data: ICARTT Format ESDS-RFC-019

NASA Astrophysics Data System (ADS)

Thornhill, A.; Brown, C.; Aknan, A.; Crawford, J. H.; Chen, G.; Williams, E. J.

2011-12-01

Airborne field studies generate a plethora of data products in the effort to study atmospheric composition and processes. Data file formats for airborne field campaigns are designed to present data in an understandable and organized way to support collaboration and to document relevant and important meta data. The ICARTT file format was created to facilitate data management during the International Consortium for Atmospheric Research on Transport and Transformation (ICARTT) campaign in 2004 that involved government-agencies and university participants from five countries. Since this mission the ICARTT format has been used in subsequent field campaigns such as Polar Study Using Aircraft Remote Sensing, Surface Measurements and Models of Climates, Chemistry, Aerosols, and Transport (POLARCAT) and the first phase of Deriving Information on Surface Conditions from COlumn and VERtically Resolved Observations Relevant to Air Quality (DISCOVER-AQ). The ICARTT file format has been endorsed as a standard format for airborne data by the Standard Process Group (SPG), one of the Earth Science Data Systems Working Groups (ESDSWG) in 2010. The detailed description of the ICARTT format can be found at http://www-air.larc.nasa.gov/missions/etc/ESDS-RFC-019-v1.00.pdf. The ICARTT data format is an ASCII, comma delimited format that was based on the NASA Ames and GTE file formats. The file header is detailed enough to fully describe the data for users outside of the instrument group and includes a description of the meta data. The ICARTT scanning tools, format structure, implementations, and examples will be presented.

Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety.

PubMed

Attias, Samuel; Keinan Boker, Lital; Arnon, Zahi; Ben-Arye, Eran; Bar'am, Ayala; Sroka, Gideon; Matter, Ibrahim; Somri, Mostafa; Schiff, Elad

2016-03-01

Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. Randomized controlled trial. Holding room area Three hundred sixty patients. Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, p<0.0001). In contrast, no significant change was noted in the standard treatment group (4.92-5.44, p=0.15). Individualized CAM treatments did not differ significantly in outcomes. However, CDRGI was less effective than individualized CAM (P<0.001), but better than ST (p=0.005). Individual CAM treatments integrated within ST reduce preoperative anxiety significantly, compared to standard treatment alone, and are more effective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.

An intraorganizational model for developing and spreading quality improvement innovations

PubMed Central

Kellogg, Katherine C.; Gainer, Lindsay A.; Allen, Adrienne S.; O'Sullivan, Tatum; Singer, Sara J.

2017-01-01

Background: Recent policy reforms encourage quality improvement (QI) innovations in primary care, but practitioners lack clear guidance regarding spread inside organizations. Purpose: We designed this study to identify how large organizations can facilitate intraorganizational spread of QI innovations. Methodology/Approach: We conducted ethnographic observation and interviews in a large, multispecialty, community-based medical group that implemented three QI innovations across 10 primary care sites using a new method for intraorganizational process development and spread. We compared quantitative outcomes achieved through the group’s traditional versus new method, created a process model describing the steps in the new method, and identified barriers and facilitators at each step. Findings: The medical group achieved substantial improvement using its new method of intraorganizational process development and spread of QI innovations: standard work for rooming and depression screening, vaccine error rates and order compliance, and Pap smear error rates. Our model details nine critical steps for successful intraorganizational process development (set priorities, assess the current state, develop the new process, and measure and refine) and spread (develop support, disseminate information, facilitate peer-to-peer training, reinforce, and learn and adapt). Our results highlight the importance of utilizing preexisting organizational structures such as established communication channels, standardized roles, common workflows, formal authority, and performance measurement and feedback systems when developing and spreading QI processes inside an organization. In particular, we detail how formal process advocate positions in each site for each role can facilitate the spread of new processes. Practice Implications: Successful intraorganizational spread is possible and sustainable. Developing and spreading new QI processes across sites inside an organization requires creating a shared understanding of the necessary process steps, considering the barriers that may arise at each step, and leveraging preexisting organizational structures to facilitate intraorganizational process development and spread. PMID:27428788

Perceptions and Cost-Analysis of a Multiple Mini-Interview in a Pharmacy School Admissions Process.

PubMed

Corelli, Robin L; Muchnik, Michael A; Beechinor, Ryan J; Fong, Gary; Vogt, Eleanor M; Cocohoba, Jennifer M; Tsourounis, Candy; Hudmon, Karen Suchanek

2015-11-25

To improve the quality of admissions interviews for a doctor of pharmacy program, using a multiple mini-interview (MMI) in place of the standard interview. Stakeholders completed an anonymous web-based survey. This study characterized perceptions of the MMI format across 3 major stakeholders (candidates, interviewers, admissions committee members) and included comparative cost estimates.Costs were estimated using human and facility resources from the 2012 cycle (standard format) and the 2013 cycle (MMI format). Most candidates (65%), interviewers (86%), and admissions committee members (79%) perceived the MMI format as effective for evaluating applicants, and most (59% of candidates, 84% of interviewers, 77% of committee members) agreed that the MMI format should be continued. Cost per candidate interviewed was $136.34 (standard interview) vs $75.30 (MMI). Perceptions of the MMI process were favorable across stakeholder groups, and this format was less costly per candidate interviewed.

Interdisciplinary group approach to occupational safety and health administration standard: reductions in cost and duplication of effort.

PubMed

Canola, T; Kirkis, E J; Meckes, P F; Pitts, S B

1994-06-01

After the December 1991 publication of the Occupational Safety and Health Administration standard, "Occupational Exposure to Bloodborne Pathogens; Final Rule," medical facilities in the United States were challenged to meet the mandates of this standard with massive training in a relatively short time. An interdisciplinary task force composed of representative members of a major health maintenance organization was charged with the task of developing a training plan for 11 Southern California medical centers and their 42 satellite medical offices. The task force ultimately developed, refined, and distributed a Trainer Guidebook that could be used by a variety of disciplines. This guidebook provided a method by which the information could be disseminated concisely, thoroughly, and promptly. The processes used in this project can be applied to other health care educational situations. The purpose of this article is to share these processes.

The caBIG Terminology Review Process

PubMed Central

Cimino, James J.; Hayamizu, Terry F.; Bodenreider, Olivier; Davis, Brian; Stafford, Grace A.; Ringwald, Martin

2009-01-01

The National Cancer Institute (NCI) is developing an integrated biomedical informatics infrastructure, the cancer Biomedical Informatics Grid (caBIG®), to support collaboration within the cancer research community. A key part of the caBIG architecture is the establishment of terminology standards for representing data. In order to evaluate the suitability of existing controlled terminologies, the caBIG Vocabulary and Data Elements Workspace (VCDE WS) working group has developed a set of criteria that serve to assess a terminology's structure, content, documentation, and editorial process. This paper describes the evolution of these criteria and the results of their use in evaluating four standard terminologies: the Gene Ontology (GO), the NCI Thesaurus (NCIt), the Common Terminology for Adverse Events (known as CTCAE), and the laboratory portion of the Logical Objects, Identifiers, Names and Codes (LOINC). The resulting caBIG criteria are presented as a matrix that may be applicable to any terminology standardization effort. PMID:19154797

Hearing, Auditory Processing, and Language Skills of Male Youth Offenders and Remandees in Youth Justice Residences in New Zealand.

PubMed

Lount, Sarah A; Purdy, Suzanne C; Hand, Linda

2017-01-01

International evidence suggests youth offenders have greater difficulties with oral language than their nonoffending peers. This study examined the hearing, auditory processing, and language skills of male youth offenders and remandees (YORs) in New Zealand. Thirty-three male YORs, aged 14-17 years, were recruited from 2 youth justice residences, plus 39 similarly aged male students from local schools for comparison. Testing comprised tympanometry, self-reported hearing, pure-tone audiometry, 4 auditory processing tests, 2 standardized language tests, and a nonverbal intelligence test. Twenty-one (64%) of the YORs were identified as language impaired (LI), compared with 4 (10%) of the controls. Performance on all language measures was significantly worse in the YOR group, as were their hearing thresholds. Nine (27%) of the YOR group versus 7 (18%) of the control group fulfilled criteria for auditory processing disorder. Only 1 YOR versus 5 controls had an auditory processing disorder without LI. Language was an area of significant difficulty for YORs. Difficulties with auditory processing were more likely to be accompanied by LI in this group, compared with the controls. Provision of speech-language therapy services and awareness of auditory and language difficulties should be addressed in youth justice systems.

Wave Properties of a Methyl Group under Ambient Conditions

NASA Astrophysics Data System (ADS)

Bernatowicz, Piotr; Szymański, Sławomir

2002-06-01

Liquid-phase NMR studies on hindered rotation of methyl group in a 9-methyltriptycene derivative are reported where the standard, classical jump model of the methyl dynamics proves inadequate. On the other hand, accurate reproduction of the observed NMR line shape effects is afforded by the use of a recent quantum mechanical model in which the relevant methyl dynamics are described in terms of two quantum rate (coherence-damping) processes, characterized by two different rate constants. For ambient temperatures, such a direct evidence of the quantum nature of a rate process generally believed to be classical seems to have no precedence in the literature.

78 FR 45096 - Standards for Business Practices and Communication Protocols for Public Utilities

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-26

... processing software should be filed in native applications or print-to-PDF format and not in a scanned format... relevant part sub nom. Transmission Access Policy Study Group v. FERC, 225 F.3d 667 (D.C. Cir. 2002), aff'd...

7 CFR 30.2 - Leaf tobacco.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf tobacco. 30.2 Section 30.2 Agriculture... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.2 Leaf... stemming, sweating or fermenting, and conditioning are not regarded as manufacturing processes. Leaf...

7 CFR 30.2 - Leaf tobacco.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf tobacco. 30.2 Section 30.2 Agriculture... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.2 Leaf... stemming, sweating or fermenting, and conditioning are not regarded as manufacturing processes. Leaf...

7 CFR 30.2 - Leaf tobacco.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf tobacco. 30.2 Section 30.2 Agriculture... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.2 Leaf... stemming, sweating or fermenting, and conditioning are not regarded as manufacturing processes. Leaf...

7 CFR 30.2 - Leaf tobacco.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf tobacco. 30.2 Section 30.2 Agriculture... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.2 Leaf... stemming, sweating or fermenting, and conditioning are not regarded as manufacturing processes. Leaf...

7 CFR 30.2 - Leaf tobacco.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf tobacco. 30.2 Section 30.2 Agriculture... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.2 Leaf... stemming, sweating or fermenting, and conditioning are not regarded as manufacturing processes. Leaf...

Comparison of quality attributes of buffalo meat curry at different storage temperature.

PubMed

Kandeepan, Gurunathan; Anjaneyulu, Anne Seet Ram; Kondaiah, Napa; Mendiratta, Sanjod Kumar

2011-01-01

The product quality of curry is determined by the food animal source, raw materials and the method of processing. Moreover the scientific information on processing and quality of traditional buffalo meat curry from different groups of buffaloes is not available. This study was undertaken to develop processed curry from different buffalo groups and to compare its quality during storage at ambient and refrigeration temperature. The meat samples were collected from the longissimus dorsi muscle of the carcasses from each group of buffaloes slaughtered according to the traditional halal method. Buffalo meat curry was prepared in a pressure cooker with the standardized formulation. This final product was subjected to evaluation of quality and shelf life. To evaluate the effect of different groups of meat samples on the quality of curry, product yield, pH, proximate composition, water activity (aw), thiobarbituric acid reactive substances (TBARS), calorific value, sensory attributes and microbiological assay were determined The energy of meat curry from young buffaloes was significantly lower than the meat curry from spent animal groups. The overall acceptability of curry decreased significantly during 3 days ambient storage compared to refrigeration storage. Scientific processing by adopting good manufacturing practices and suitable packaging helped greatly to improve the shelf life of the ambient temperature stored buffalo meat curry. Buffalo meat curry from young male group showed better product characteristics and overall acceptability scores than spent buffalo group.

Food entries in a large allergy data repository

PubMed Central

Plasek, Joseph M.; Goss, Foster R.; Lai, Kenneth H.; Lau, Jason J.; Seger,, Diane L.; Blumenthal, Kimberly G.; Wickner, Paige G.; Slight, Sarah P.; Chang, Frank Y.; Topaz, Maxim; Bates, David W.

2016-01-01

Objective Accurate food adverse sensitivity documentation in electronic health records (EHRs) is crucial to patient safety. This study examined, encoded, and grouped foods that caused any adverse sensitivity in a large allergy repository using natural language processing and standard terminologies. Methods Using the Medical Text Extraction, Reasoning, and Mapping System (MTERMS), we processed both structured and free-text entries stored in an enterprise-wide allergy repository (Partners’ Enterprise-wide Allergy Repository), normalized diverse food allergen terms into concepts, and encoded these concepts using the Systematized Nomenclature of Medicine – Clinical Terms (SNOMED-CT) and Unique Ingredient Identifiers (UNII) terminologies. Concept coverage also was assessed for these two terminologies. We further categorized allergen concepts into groups and calculated the frequencies of these concepts by group. Finally, we conducted an external validation of MTERMS’s performance when identifying food allergen terms, using a randomized sample from a different institution. Results We identified 158 552 food allergen records (2140 unique terms) in the Partners repository, corresponding to 672 food allergen concepts. High-frequency groups included shellfish (19.3%), fruits or vegetables (18.4%), dairy (9.0%), peanuts (8.5%), tree nuts (8.5%), eggs (6.0%), grains (5.1%), and additives (4.7%). Ambiguous, generic concepts such as “nuts” and “seafood” accounted for 8.8% of the records. SNOMED-CT covered more concepts than UNII in terms of exact (81.7% vs 68.0%) and partial (14.3% vs 9.7%) matches. Discussion Adverse sensitivities to food are diverse, and existing standard terminologies have gaps in their coverage of the breadth of allergy concepts. Conclusion New strategies are needed to represent and standardize food adverse sensitivity concepts, to improve documentation in EHRs. PMID:26384406

Food entries in a large allergy data repository.

PubMed

Plasek, Joseph M; Goss, Foster R; Lai, Kenneth H; Lau, Jason J; Seger, Diane L; Blumenthal, Kimberly G; Wickner, Paige G; Slight, Sarah P; Chang, Frank Y; Topaz, Maxim; Bates, David W; Zhou, Li

2016-04-01

Accurate food adverse sensitivity documentation in electronic health records (EHRs) is crucial to patient safety. This study examined, encoded, and grouped foods that caused any adverse sensitivity in a large allergy repository using natural language processing and standard terminologies. Using the Medical Text Extraction, Reasoning, and Mapping System (MTERMS), we processed both structured and free-text entries stored in an enterprise-wide allergy repository (Partners' Enterprise-wide Allergy Repository), normalized diverse food allergen terms into concepts, and encoded these concepts using the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) and Unique Ingredient Identifiers (UNII) terminologies. Concept coverage also was assessed for these two terminologies. We further categorized allergen concepts into groups and calculated the frequencies of these concepts by group. Finally, we conducted an external validation of MTERMS's performance when identifying food allergen terms, using a randomized sample from a different institution. We identified 158 552 food allergen records (2140 unique terms) in the Partners repository, corresponding to 672 food allergen concepts. High-frequency groups included shellfish (19.3%), fruits or vegetables (18.4%), dairy (9.0%), peanuts (8.5%), tree nuts (8.5%), eggs (6.0%), grains (5.1%), and additives (4.7%). Ambiguous, generic concepts such as "nuts" and "seafood" accounted for 8.8% of the records. SNOMED-CT covered more concepts than UNII in terms of exact (81.7% vs 68.0%) and partial (14.3% vs 9.7%) matches. Adverse sensitivities to food are diverse, and existing standard terminologies have gaps in their coverage of the breadth of allergy concepts. New strategies are needed to represent and standardize food adverse sensitivity concepts, to improve documentation in EHRs. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Using standard treatment protocols to manage costs and quality of hospital services.

PubMed

Meyer, J W; Feingold, M G

1993-06-01

The current health care environment has made it critically important that hospital costs and quality be managed in an integrated fashion. Promised health care reforms are expected to make cost reduction and quality enhancement only more important. Traditional methods of hospital cost and quality control have largely been replaced by such approaches as practice parameters, outcomes measurement, clinical indicators, clinical paths, benchmarking, patient-centered care, and a focus on patient selection criteria. This Special Report describes an integrated process for strategically managing costs and quality simultaneously, incorporating key elements of many important new quality and cost control tools. By using a multidisciplinary group process to develop standard treatment protocols, hospitals and their medical staffs address the most important services provided within major product lines. Using both clinical and financial data, groups of physicians, nurses, department managers, financial analysts, and administrators redesign key patterns of care within their hospital, incorporating the best practices of their own and other institutions. The outcome of this process is a new, standardized set of clinical guidelines that reduce unnecessary variation in care, eliminate redundant interventions, establish clear lines of communication for all caregivers, and reduce the cost of each stay. The hospital, medical staff, and patients benefit from the improved opportunities for managed care contracting, more efficient hospital systems, consensus-based quality measures, and reductions in the cost of care. STPs offer a workable and worthwhile approach to positioning the hospital of the 1990s for operational efficiency and cost and quality competitiveness.

Using formative research to lay the foundation for community level HIV prevention efforts: an example from the AIDS Community Demonstration Projects.

PubMed Central

Higgins, D L; O'Reilly, K; Tashima, N; Crain, C; Beeker, C; Goldbaum, G; Elifson, C S; Galavotti, C; Guenther-Grey, C

1996-01-01

The AIDS Community Demonstration Projects provided community-level HIV prevention interventions to historically hard-to-reach groups at high risk for HIV infection. The projects operated under a common research protocol which encompassed formative research, intervention delivery, process evaluation, and outcome evaluation. A formative research process specifically focusing on intervention development was devised to assist project staff in identifying, prioritizing, accessing, and understanding the intervention target groups. This process was central to the creation of interventions that were acceptable and unique to the target populations. Intended to be rapid, the process took 6 months to complete. Drawn from the disciplines of anthropology, community psychology, sociology, and public health, the formative research process followed distinct steps which included (a) defining the populations at high-risk for HIV; (b) gathering information about these populations through interviews with persons who were outside of, but who had contact with, the target groups (such as staff from the health department and alcohol and drug treatment facilities, as well as persons who interacted in an informal manner with the target groups, such as clerks in neighborhood grocery stores and bartenders); (c) interviewing people with access to the target populations (gatekeepers), and conducting observations in areas where these high-risk groups were reported to gather (from previous interviews); (d) interviewing members of these groups at high risk for HIV infection or transmission; and (e) systematically integrating information throughout the process. Semistructured interview schedules were used for all data collection in this process. This standardized systematic method yielded valuable information about the focal groups in each demonstration project site. The method, if adopted by others, would assist community intervention specialists in developing interventions that are culturally appropriate and meaningful to their respective target populations. PMID:8862154

Standard terminology and labeling of ocular tissue for transplantation.

PubMed

Armitage, W John; Ashford, Paul; Crow, Barbara; Dahl, Patricia; DeMatteo, Jennifer; Distler, Pat; Gopinathan, Usha; Madden, Peter W; Mannis, Mark J; Moffatt, S Louise; Ponzin, Diego; Tan, Donald

2013-06-01

To develop an internationally agreed terminology for describing ocular tissue grafts to improve the accuracy and reliability of information transfer, to enhance tissue traceability, and to facilitate the gathering of comparative global activity data, including denominator data for use in biovigilance analyses. ICCBBA, the international standards organization for terminology, coding, and labeling of blood, cells, and tissues, approached the major Eye Bank Associations to form an expert advisory group. The group met by regular conference calls to develop a standard terminology, which was released for public consultation and amended accordingly. The terminology uses broad definitions (Classes) with modifying characteristics (Attributes) to define each ocular tissue product. The terminology may be used within the ISBT 128 system to label tissue products with standardized bar codes enabling the electronic capture of critical data in the collection, processing, and distribution of tissues. Guidance on coding and labeling has also been developed. The development of a standard terminology for ocular tissue marks an important step for improving traceability and reducing the risk of mistakes due to transcription errors. ISBT 128 computer codes have been assigned and may now be used to label ocular tissues. Eye banks are encouraged to adopt this standard terminology and move toward full implementation of ISBT 128 nomenclature, coding, and labeling.

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.

Quality of haemophilia care in The Netherlands: new standards for optimal care.

PubMed

Leebeek, Frank W G; Fischer, Kathelijn

2014-04-01

In the Netherlands, the first formal haemophilia comprehensive care centre was established in 1964, and Dutch haemophilia doctors have been organised since 1972. Although several steps were taken to centralise haemophilia care and maintain quality of care, treatment was still delivered in many hospitals, and formal criteria for haemophilia treatment centres as well as a national haemophilia registry were lacking. In collaboration with patients and other stakeholders, Dutch haemophilia doctors have undertaken a formal process to draft new quality standards for the haemophilia treatment centres. First a project group including doctors, nurses, patients and the institute for harmonisation of quality standards undertook a literature study on quality standards and performed explorative visits to several haemophilia treatment centres in the Netherlands. Afterwards concept standards were defined and validated in two treatment centres. Next, the concept standards were evaluated by haemophilia doctors, patients, health insurance representatives and regulators. Finally, the final version of the standards of care was approved by Central body of Experts on quality standards in clinical care and the Dutch Ministry of Health. A team of expert auditors have been trained and, together with an independent auditor, will perform audits in haemophilia centres applying for formal certification. Concomitantly, a national registry for haemophilia and allied disorders is being set up. It is expected that these processes will lead to further concentration and improved quality of haemophilia care in the Netherlands.

Carr-Purcell echo spectra in the studies of lineshape effects. Nonclassical hindered rotation of methyl groups in 1,2,3,4-tetrachloro-9,10-dimethyltriptycene

NASA Astrophysics Data System (ADS)

Bernatowicz, P.; Czerski, I.; Jaźwiński, J.; Szymański, S.

2004-08-01

In the standard NMR spectra, the lineshape patterns produced by a molecular rate process are often poorly structured. When alternative theoretical models of such a process are to be compared, even quantitative lineshape fits may then give inconclusive results. A detailed description is presented of an approach involving fits of the competing models to series of Carr-Purcell echo spectra. Its high discriminative power has already been exploited in a number of cases of practical significance. An explanation is given why it can be superior to methods based on the standard spectra. Its applicability in practice is now illustrated on example of the methyl proton spectra in 1,2,3,4-tetrachloro-9,10-dimethyltriptycene TCDMT. It is shown that, in the echo spectra, the recently discovered effect of nonclassical stochastic reorientation of the methyl group can be identified clearly while it is practically nondiscernible in the standard spectra of TCDMT. This is the first detection of the effect at temperatures above 200 K. It is also shown that in computer-assisted interpretation of exchange-broadened echo spectra, the usual description of the stimulating radiofrequency pulses in terms of rotation operators ought to be replaced by a more realistic pulse model.

Report from the First CERT-RMM Users Group Workshop Series

DTIC Science & Technology

2012-04-01

deploy processes to support our programs – Benchmark our programs to determine current gaps – Complements current work in CMMI® and ISO 27001 19...benchmarking program performance through process analytics and Lean/Six Sigma activities to ensure Performance Excellence. • Provides ISO Standards...Office www.cmu.edu/ iso 29 Carnegie Mellon University • Est 1967 in Pittsburgh, PA • Global, private research university • Ranked 22nd • 15,000

Current Status of Multidisciplinary Care in Psoriatic Arthritis in Spain: NEXUS 2.0 Project.

PubMed

Queiro, Rubén; Coto, Pablo; Joven, Beatriz; Rivera, Raquel; Navío Marco, Teresa; de la Cueva, Pablo; Alvarez Vega, Jose Luis; Narváez Moreno, Basilio; Rodriguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Rodríguez, Jesús; Notario, Jaume; Pujol Busquets, Manel; García Font, Mercè; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea-Arana, Ana; Hergueta, Merce; López Montilla, M Dolores; Vélez García-Nieto, Antonio; Maceiras, Francisco; Rodríguez Pazos, Laura; Rubio Romero, Esteban; Rodríguez Fernandez Freire, Lourdes; Luelmo, Jesús; Gratacós, Jordi

2018-02-26

1) To analyze the implementation of multidisciplinary care models in psoriatic arthritis (PsA) patients, 2) To define minimum and excellent standards of care. A survey was sent to clinicians who already performed multidisciplinary care or were in the process of undertaking it, asking: 1) Type of multidisciplinary care model implemented; 2) Degree, priority and feasibility of the implementation of quality standards in the structure, process and result for care. In 6 regional meetings the results of the survey were presented and discussed, and the ultimate priority of quality standards for care was defined. At a nominal meeting group, 11 experts (rheumatologists and dermatologists) analyzed the results of the survey and the regional meetings. With this information, they defined which standards of care are currently considered as minimum and which are excellent. The simultaneous and parallel models of multidisciplinary care are those most widely implemented, but the implementation of quality standards is highly variable. In terms of structure it ranges from 22% to 74%, in those related to process from 17% to 54% and in the results from 2% to 28%. Of the 25 original quality standards for care, 9 were considered only minimum, 4 were excellent and 12 defined criteria for minimum level and others for excellence. The definition of minimum and excellent quality standards for care will help achieve the goal of multidisciplinary care for patients with PAs, which is the best healthcare possible. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Applying emerging digital video interface standards to airborne avionics sensor and digital map integrations: benefits outweigh the initial costs

NASA Astrophysics Data System (ADS)

Kuehl, C. Stephen

1996-06-01

Video signal system performance can be compromised in a military aircraft cockpit management system (CMS) with the tailoring of vintage Electronics Industries Association (EIA) RS170 and RS343A video interface standards. Video analog interfaces degrade when induced system noise is present. Further signal degradation has been traditionally associated with signal data conversions between avionics sensor outputs and the cockpit display system. If the CMS engineering process is not carefully applied during the avionics video and computing architecture development, extensive and costly redesign will occur when visual sensor technology upgrades are incorporated. Close monitoring and technical involvement in video standards groups provides the knowledge-base necessary for avionic systems engineering organizations to architect adaptable and extendible cockpit management systems. With the Federal Communications Commission (FCC) in the process of adopting the Digital HDTV Grand Alliance System standard proposed by the Advanced Television Systems Committee (ATSC), the entertainment and telecommunications industries are adopting and supporting the emergence of new serial/parallel digital video interfaces and data compression standards that will drastically alter present NTSC-M video processing architectures. The re-engineering of the U.S. Broadcasting system must initially preserve the electronic equipment wiring networks within broadcast facilities to make the transition to HDTV affordable. International committee activities in technical forums like ITU-R (former CCIR), ANSI/SMPTE, IEEE, and ISO/IEC are establishing global consensus on video signal parameterizations that support a smooth transition from existing analog based broadcasting facilities to fully digital computerized systems. An opportunity exists for implementing these new video interface standards over existing video coax/triax cabling in military aircraft cockpit management systems. Reductions in signal conversion processing steps, major improvement in video noise reduction, and an added capability to pass audio/embedded digital data within the digital video signal stream are the significant performance increases associated with the incorporation of digital video interface standards. By analyzing the historical progression of military CMS developments, establishing a systems engineering process for CMS design, tracing the commercial evolution of video signal standardization, adopting commercial video signal terminology/definitions, and comparing/contrasting CMS architecture modifications using digital video interfaces; this paper provides a technical explanation on how a systems engineering process approach to video interface standardization can result in extendible and affordable cockpit management systems.

Adequate number of clinicians on usability tests lacking, says study.

PubMed

2015-12-01

A new study reveals that some of the largest EMR vendors failed to meet certification standards, specifying that they state their user-centered design processes, and that they include at least 15 representative end-user participants in their usability tests. It is not clear why these vendors were certified despite not meeting the standards established by Office of the National Coordinator for Health Information Technology (ONC), but investigators suggest that emergency clinicians and administrators should engage with vendors early on, querying them about their user-centered processes. An analysis of the usability tests performed by 41 of some the largest EMR vendors found that 34% of them did not meet certification standards, specifying that they state their user-centered design process. Also, 63% of the vendors failed to include at least 15 representative end-users in their usability tests. Only 15% of the vendors used at least 15 participants who had clinical backgrounds in their usability tests. Experts urge clinicians to engage with EMR user groups to share best practices for optimizing specific EMR products.

Comparison of porcelain bond strength of different metal frameworks prepared by using conventional and recently introduced fabrication methods.

PubMed

Kaleli, Necati; Saraç, Duygu

2017-07-01

Most studies evaluating dental laser sintering systems have focused on the marginal accuracy of the restorations. However, the bond strength at the metal-ceramic interface is another important factor that affects the survival of restorations, and currently, few studies focus on this aspect. The purpose of this in vitro study was to compare the porcelain bond strength of cobalt-chromium (Co-Cr) metal frameworks prepared by using the conventional lost-wax technique, milling, direct metal laser sintering (DMLS), and laser cusing, a direct process powder-bed system. A total of 96 metal frameworks (n=24 in each group) were prepared by using conventional lost-wax (group C), milling (group M), DMLS (group LS), and direct process powder-bed (group LC) methods according to International Organization for Standardization standard ISO 9693-1. After porcelain application, a 3-point bend test was applied to each specimen by using a universal testing machine. Data were statistically analyzed using 1-way ANOVA and Tukey honest significant difference tests (α=.05). Failure types at the metal-ceramic interfaces were examined using stereomicroscopy. Additionally, 1 specimen from each group was prepared for scanning electron microscopy analysis to evaluate the surface topography of metal frameworks. The mean bond strength was 38.08 ±3.82 MPa for group C, 39.29 ±3.51 MPa for group M, 40.73 ±3.58 MPa for group LS, and 41.24 ±3.75 MPa for group LC. Statistically significant differences were observed among the 4 groups (P=.016). All groups, except for LS, exhibited adhesive and mixed type bond failure. Both of the laser sintering methods were found to be successful in terms of metal-ceramic bond strength. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Social-Information-Processing Patterns Mediate the Impact of Preventive Intervention on Adolescent Antisocial Behavior

PubMed Central

Dodge, Kenneth A.; Godwin, Jennifer

2013-01-01

In the study reported here, we tested the hypothesis that the Fast Track preventive intervention’s positive impact on antisocial behavior in adolescence is mediated by its impact on social-cognitive processes during elementary school. Fast Track is the largest and longest federally funded preventive intervention trial for children showing aggressive behavior at an early age. Participants were 891 high-risk kindergarten children (69% male, 31% female; 49% ethnic minority, 51% ethnic majority) who were randomly assigned to an intervention or a control group by school cluster. Multiyear intervention addressed social-cognitive processes through social-skill training groups, parent groups, classroom curricula, peer coaching, and tutoring. Assigning children to the intervention decreased their mean antisocial-behavior score after Grade 9 by 0.16 standardized units (p < .01). Structural equation models indicated that 27% of the intervention’s impact on antisocial behavior was mediated by its impact on three social-cognitive processes: reducing hostile-attribution biases, increasing competent response generation to social problems, and devaluing aggression. These findings support a model of antisocial behavioral development mediated by social-cognitive processes, and they guide prevention planners to focus on these processes. PMID:23406610

A Simple Graphical Method for Quantification of Disaster Management Surge Capacity Using Computer Simulation and Process-control Tools.

PubMed

Franc, Jeffrey Michael; Ingrassia, Pier Luigi; Verde, Manuela; Colombo, Davide; Della Corte, Francesco

2015-02-01

Surge capacity, or the ability to manage an extraordinary volume of patients, is fundamental for hospital management of mass-casualty incidents. However, quantification of surge capacity is difficult and no universal standard for its measurement has emerged, nor has a standardized statistical method been advocated. As mass-casualty incidents are rare, simulation may represent a viable alternative to measure surge capacity. Hypothesis/Problem The objective of the current study was to develop a statistical method for the quantification of surge capacity using a combination of computer simulation and simple process-control statistical tools. Length-of-stay (LOS) and patient volume (PV) were used as metrics. The use of this method was then demonstrated on a subsequent computer simulation of an emergency department (ED) response to a mass-casualty incident. In the derivation phase, 357 participants in five countries performed 62 computer simulations of an ED response to a mass-casualty incident. Benchmarks for ED response were derived from these simulations, including LOS and PV metrics for triage, bed assignment, physician assessment, and disposition. In the application phase, 13 students of the European Master in Disaster Medicine (EMDM) program completed the same simulation scenario, and the results were compared to the standards obtained in the derivation phase. Patient-volume metrics included number of patients to be triaged, assigned to rooms, assessed by a physician, and disposed. Length-of-stay metrics included median time to triage, room assignment, physician assessment, and disposition. Simple graphical methods were used to compare the application phase group to the derived benchmarks using process-control statistical tools. The group in the application phase failed to meet the indicated standard for LOS from admission to disposition decision. This study demonstrates how simulation software can be used to derive values for objective benchmarks of ED surge capacity using PV and LOS metrics. These objective metrics can then be applied to other simulation groups using simple graphical process-control tools to provide a numeric measure of surge capacity. Repeated use in simulations of actual EDs may represent a potential means of objectively quantifying disaster management surge capacity. It is hoped that the described statistical method, which is simple and reusable, will be useful for investigators in this field to apply to their own research.

Advance notification letters increase adherence in colorectal cancer screening: a population-based randomized trial.

PubMed

van Roon, A H C; Hol, L; Wilschut, J A; Reijerink, J C I Y; van Vuuren, A J; van Ballegooijen, M; Habbema, J D F; van Leerdam, M E; Kuipers, Ernst J

2011-06-01

The population benefit of screening depends not only on the effectiveness of the test, but also on adherence, which, for colorectal cancer (CRC) screening remains low. An advance notification letter may increase adherence, however, no population-based randomized trials have been conducted to provide evidence of this. In 2008, a representative sample of the Dutch population (aged 50-74 years) was randomized. All 2493 invitees in group A were sent an advance notification letter, followed two weeks later by a standard invitation. The 2507 invitees in group B only received the standard invitation. Non-respondents in both groups were sent a reminder 6 weeks after the invitation. The advance notification letters resulted in a significantly higher adherence (64.4% versus 61.1%, p-value 0.019). Multivariate logistic regression analysis showed no significant interactions between group and age, sex, or socio-economic status. Cost analysis showed that the incremental cost per additional detected advanced neoplasia due to sending an advance notification letter was € 957. This population-based randomized trial demonstrates that sending an advance notification letter significantly increases adherence by 3.3%. The incremental cost per additional detected advanced neoplasia is acceptable. We therefore recommend that such letters are incorporated within the standard CRC-screening invitation process. Copyright © 2011 Elsevier Inc. All rights reserved.

Validity of the WISC-IV Spanish for a clinically referred sample of Hispanic children.

PubMed

San Miguel Montes, Liza E; Allen, Daniel N; Puente, Antonio E; Neblina, Cris

2010-06-01

The Wechsler Intelligence Scale for Children (WISC) is the most commonly used intelligence test for children. Five years ago, a Spanish version of the WISC-IV was published (WISC-IV Spanish; Wechsler, 2005), but a limited amount of published information is available regarding its utility when assessing clinical samples. The current study included 107 children who were Spanish speaking and of Puerto Rican descent that had been administered the WISC-IV Spanish. They were subdivided into a clinical sample of 35 children with diagnoses of various forms of brain dysfunction (primarily learning disability, attention-deficit/hyperactivity disorder, and epilepsy) and a comparison group made up of 72 normal children who were part of the WISC-IV Spanish version standardization sample. Comparisons between these groups and the standardization sample were performed for the WISC-IV Spanish index and subtest scores. Results indicated that the clinical sample performed worse than the comparison samples on the Working Memory and Processing Speed Indexes, although findings varied to some extent depending on whether the clinical group was compared with the normal comparison group or the standardization sample. These findings provide support for the criterion validity of the WISC-IV Spanish when it is used to assess a clinically referred sample with brain dysfunction.

The Application of an Evidence-Based Clinical Nursing Path for Improving the Preoperative and Postoperative Quality of Care of Pediatric Retroperitoneal Neuroblastoma Patients: A Randomized Controlled Trial at a Tertiary Medical Institution.

PubMed

Liu, Yang; Mo, Lin; Tang, Yan; Wang, Qiuhong; Huang, Xiaoyan

A clinical nursing path (CNP) that encourages patients and their families to become actively involved in healthcare decision-making processes may improve outcomes of pediatric retroperitoneal neuroblastoma (NB) patients. The aim of this study was to evaluate the utility and value of an evidence-based CNP provided to pediatric retroperitoneal NB patients undergoing resection surgery. One hundred twenty NB cases were assigned to a control group or a CNP group. The control group was provided with standard nursing care. The CNP group was provided with nursing care in accordance with an evidence-based CNP. The utility and value of the CNP were compared with standard nursing care. Outcome measures included rates of postoperative complications, lengths of hospital stay, and cost of hospitalization, as well as preoperative and postoperative quality of care and patient satisfaction with care. The rates of postoperative complications, length of preoperative hospitalization, total length of hospital stay, and costs of hospitalization were significantly lower for patients receiving the CNP compared with the control group. Preoperative and postoperative quality of care and patient satisfaction with care were significantly higher in patients receiving the CNP compared with the control group. Adoption of a CNP for preoperative and postoperative care of pediatric retroperitoneal NB patients undergoing resection surgery improves clinical outcomes and patient satisfaction with care. A CNP can increase families' participation in a patient's recovery process, enhance nurses' understanding of the services they are providing, and improve the quality of healthcare received by patients.

Framing effects in younger and older adults.

PubMed

Kim, Sunghan; Goldstein, David; Hasher, Lynn; Zacks, Rose T

2005-07-01

A growing literature on decision making in older adults suggests that they are more likely to use heuristic processing than are younger adults. We assessed this tendency in the context of a framing effect, a decision-making phenomenon whereby the language used to describe options greatly influences the decision maker's choice. We compared decision making under a standard ("heuristic") condition and also under a "justification" condition known to reduce reliance on heuristics. In the standard condition, older adults were more susceptible than younger adults to framing but the two groups did not differ when participants were asked to provide a justification. Thus, although older adults may spontaneously rely more on heuristic processing than younger adults, they can be induced to take a more systematic approach to decision making.

Non-prescription medicines: a process for standards development and testing in community pharmacy.

PubMed

Benrimoj, Shalom Charlie I; Gilbert, Andrew; Quintrell, Neil; Neto, Abilio C de Almeida

2007-08-01

The objective of the study was to develop and test standards of practice for handling non-prescription medicines. In consultation with pharmacy registering authorities, key professional and consumer groups and selected community pharmacists, standards of practice were developed in the areas of Resource Management; Professional Practice; Pharmacy Design and Environment; and Rights and Needs of Customers. These standards defined and described minimum professional activities required in the provision of non-prescription medicines at a consistent and measurable level of practice. Seven standards were described and further defined by 20 criteria, including practice indicators. The Standards were tested in 40 community pharmacies in two States and after further adaptation, endorsed by all Australian pharmacy registering authorities and major Australian pharmacy and consumer organisations. The consultation process effectively engaged practicing pharmacists in developing standards to enable community pharmacists meet their legislative and professional responsibilities. Community pharmacies were audited against a set of standards of practice for handling non-prescription medicines developed in this project. Pharmacies were audited on the Standards at baseline, mid-intervention and post-intervention. Behavior of community pharmacists and their staff in relation to these standards was measured by conducting pseudo-patron visits to participating pharmacies. The testing process demonstrated a significant improvement in the quality of service delivered by staff in community pharmacies in the management of requests involving non-prescription medicines. The use of pseudo-patron visits, as a training tool with immediate feedback, was an acceptable and effective method of achieving changes in practice. Feedback from staff in the pharmacies regarding the pseudo-patron visits was very positive. Results demonstrated the methodology employed was effective in increasing overall compliance with the Standards from a rate of 47.4% to 70.0% (P < 0.01). This project led to a recommendation for the development and execution of a national implementation strategy.

Developing better practices at the institutional level leads to better outcomes after pancreaticoduodenectomy in 3,378 patients: domestic audit of the Japanese Society of Pancreatic Surgery.

PubMed

Satoi, Sohei; Yamamoto, Tomohisa; Yoshitomi, Hideyuki; Motoi, Fuyuhiko; Kawai, Manabu; Fujii, Tsutomu; Wada, Keita; Arimitsu, Hidehito; Sho, Masayuki; Matsumoto, Ippei; Hirano, Satoshi; Yanagimoto, Hiroaki; Ohtsuka, Masayuki; Unno, Michiaki; Yamaue, Hiroki; Kon, Masanori

2017-09-01

The aim of the present study was to assess recent trends in pancreaticoduodenectomy (PD) and the role of institutional standardization on the development of postoperative complications in 3,378 patients who underwent PD in Japan. Data were collected from 3,378 patients who underwent PD in 2006, 2010 and 2014 at 53 institutions. A standardized institution (SI) was defined as one that implements ≥7 of 13 quality initiatives according to departmental policy. There were 1,223 patients in the SI group and 2,155 in the non-SI group. Clinical parameters were compared over time, and between groups. Risk factors for morbidity and mortality were assessed by logistic regression analysis with a mixed-effects model. The number of patients who underwent PD in SIs increased from 16.5% in 2006 to 46.4% in 2014. The SI group experienced an improved process of care and a lower frequency of severe complications vs. the non-SI group (P < 0.001). Multivariate analysis revealed that the SI group was associated with a lower incidence of delayed gastric emptying (odds ratio -0.499, P = 0.008) and incisional surgical site infection (odds ratio -0.999, P < 0.001). Standardization of care in PD may be important in reducing post-PD complications, and is a critical element for improving clinical outcomes. © 2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Revision of the design of a standard for the dimensions of school furniture.

PubMed

Molenbroek, J F M; Kroon-Ramaekers, Y M T; Snijders, C J

2003-06-10

In this study an anthropometric design process was followed. The aim was to improve the fit of school furniture sizes for European children. It was demonstrated statistically that the draft of a European standard does not cover the target population. No literature on design criteria for sizes exists, and in practice it is common to calculate the fit for only the mean values (P50). The calculations reported here used body dimensions of Dutch children, measured by the authors' Department, and used data from German and British national standards. A design process was followed that contains several steps, including: Target group, Anthropometric model and Percentage exclusion. The criteria developed in this study are (1) a fit on the basis of 1% exclusion (P1 or P99), and (2) a prescription based on popliteal height. Based on this new approach it was concluded that prescription of a set size should be based on popliteal height rather than body height. The drafted standard, Pren 1729, can be improved with this approach. A European standard for school furniture should include the exception that for Dutch children an extra large size is required.

Sandia National Laboratories, California Environmental Management System program manual.

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

Larsen, Barbara L.

2012-03-01

The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004and Department of Energy (DOE) Order 436.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a setmore » of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site first received ISO 14001 certification in September 2006 and recertification in 2009. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy and Water Resource Management and Fleet Services programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has several groups operating at Sandia National Laboratories, New Mexico (SNL/NM). Although these groups, from an organizational perspective, are part of Division 8000, they are managed locally and fall under the environmental requirements specific to their New Mexico location. The New Mexico groups in Division 8000 follow the corporate EMS Program for New Mexico operations.« less

Competency standards for newly graduated prosthetist/orthotists in Sweden.

PubMed

Ramstrand, Nerrolyn; Ramstrand, Simon

2018-05-01

There are currently no national competency standards upon which to develop educational objectives for prosthetist/orthotists in Sweden. While standards have been developed in other countries, they cannot be applied without confirming their relevance in a Swedish context. To describe and obtain consensus on core competencies required for newly graduated prosthetist/orthotists in Sweden. Modified Delphi process. A modified Delphi technique was carried out. Focus groups were initially used to identify core competency domains. Two consecutive questionnaires, containing a list of potential competency items, were sent to a group of stakeholders with ties to the prosthetic and orthotic profession. Stakeholders were requested to rate their level of agreement with each competency item and provide written comments. Finally, two focus groups were conducted to obtain feedback on the draft competency standards. Forty-four competency items, listed under five key domains of practice, were identified as essential for newly graduated prosthetist/orthotists in Sweden. Many similarities exist in core competency descriptions for prosthetist/orthotists in Sweden when compared to other countries. Regional differences do however exist, and it is important to confirm the relevance of core competency items at a national level before they are applied. Clinical relevance Competency standards developed in this study can be used to guide development of learning objectives within an undergraduate prosthetic and orthotic program, provide a framework for workforce development, assist professional organizations in understanding the needs of their members, and prepare for international accreditation.

Comparison of the nutrient-based standards for school lunches among South Korea, Japan, and Taiwan.

PubMed

Kim, Meeyoung; Abe, Satoko; Zhang, Chengyu; Kim, Soyoung; Choi, Jiyu; Hernandez, Emely; Nozue, Miho; Yoon, Jihyun

2017-01-01

Nutritional standards are important guidelines for providing students with nutritionally-balanced school meals. This study compared nutrient-based school lunch standards regulated by South Korea, Japan, and Taiwan. The data were collected from relevant literature and websites of each country during September 2014. The number of classification groups of target students was 8, 5, and 5 for South Korea, Japan, and Taiwan, respectively. Gender was considered across all age groups in South Korea but only for high school students in Taiwan. Gender was not considered in Japan. Along with energy, the number of nutrients included in the standards for South Korea, Japan and Taiwan was 9, 12, and 4, respectively. The standards for all three countries included protein and fat among macronutrients. The standards for South Korea and Japan included vitamin A, B-1, B-2, and C, while the standards for Taiwan did not include any vitamins. Calcium was the only mineral commonly included in the three standards. The proportions of recommended daily intakes as reference values for each nutrient differed among the countries. Japan differentiated the proportions among 33%, 40%, or 50%, reflecting the target students' intake status of the respective nutrients. Taiwan differentiated either two-fifths or one-third of the recommended daily intakes. South Korea applied the proportion of recommended daily intake as one-third for all selected nutrients. This study could be valuable information for countries in developing nutrient-based standards for school lunches and for South Korea, Japan, and Taiwan in the process of reforming nutrient-based standards.

Specifications of Standards in Systems and Synthetic Biology.

PubMed

Schreiber, Falk; Bader, Gary D; Golebiewski, Martin; Hucka, Michael; Kormeier, Benjamin; Le Novère, Nicolas; Myers, Chris; Nickerson, David; Sommer, Björn; Waltemath, Dagmar; Weise, Stephan

2015-09-04

Standards shape our everyday life. From nuts and bolts to electronic devices and technological processes, standardised products and processes are all around us. Standards have technological and economic benefits, such as making information exchange, production, and services more efficient. However, novel, innovative areas often either lack proper standards, or documents about standards in these areas are not available from a centralised platform or formal body (such as the International Standardisation Organisation). Systems and synthetic biology is a relatively novel area, and it is only in the last decade that the standardisation of data, information, and models related to systems and synthetic biology has become a community-wide effort. Several open standards have been established and are under continuous development as a community initiative. COMBINE, the ‘COmputational Modeling in BIology’ NEtwork has been established as an umbrella initiative to coordinate and promote the development of the various community standards and formats for computational models. There are yearly two meeting, HARMONY (Hackathons on Resources for Modeling in Biology), Hackathon-type meetings with a focus on development of the support for standards, and COMBINE forums, workshop-style events with oral presentations, discussion, poster, and breakout sessions for further developing the standards. For more information see http://co.mbine.org/. So far the different standards were published and made accessible through the standards’ web- pages or preprint services. The aim of this special issue is to provide a single, easily accessible and citable platform for the publication of standards in systems and synthetic biology. This special issue is intended to serve as a central access point to standards and related initiatives in systems and synthetic biology, it will be published annually to provide an opportunity for standard development groups to communicate updated specifications.

Time-Efficiency Analysis Comparing Digital and Conventional Workflows for Implant Crowns: A Prospective Clinical Crossover Trial.

PubMed

Joda, Tim; Brägger, Urs

2015-01-01

To compare time-efficiency in the production of implant crowns using a digital workflow versus the conventional pathway. This prospective clinical study used a crossover design that included 20 study participants receiving single-tooth replacements in posterior sites. Each patient received a customized titanium abutment plus a computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia suprastructure (for those in the test group, using digital workflow) and a standardized titanium abutment plus a porcelain-fused-to-metal crown (for those in the control group, using a conventional pathway). The start of the implant prosthetic treatment was established as the baseline. Time-efficiency analysis was defined as the primary outcome, and was measured for every single clinical and laboratory work step in minutes. Statistical analysis was calculated with the Wilcoxon rank sum test. All crowns could be provided within two clinical appointments, independent of the manufacturing process. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different. The mean ± standard deviation (SD) time was 185.4 ± 17.9 minutes for the digital workflow process and 223.0 ± 26.2 minutes for the conventional pathway (P = .0001). Therefore, digital processing for overall treatment was 16% faster. Detailed analysis for the clinical treatment revealed a significantly reduced mean ± SD chair time of 27.3 ± 3.4 minutes for the test group compared with 33.2 ± 4.9 minutes for the control group (P = .0001). Similar results were found for the mean laboratory work time, with a significant decrease of 158.1 ± 17.2 minutes for the test group vs 189.8 ± 25.3 minutes for the control group (P = .0001). Only a few studies have investigated efficiency parameters of digital workflows compared with conventional pathways in implant dental medicine. This investigation shows that the digital workflow seems to be more time-efficient than the established conventional production pathway for fixed implant-supported crowns. Both clinical chair time and laboratory manufacturing steps could be effectively shortened with the digital process of intraoral scanning plus CAD/CAM technology.

Effect of Active Music Therapy and Individualized Listening to Music on Dementia: A Multicenter Randomized Controlled Trial.

PubMed

Raglio, Alfredo; Bellandi, Daniele; Baiardi, Paola; Gianotti, Marta; Ubezio, Maria Chiara; Zanacchi, Elisa; Granieri, Enrico; Imbriani, Marcello; Stramba-Badiale, Marco

2015-08-01

To assess the effects of active music therapy (MT) and individualized listening to music (LtM) on behavioral and psychological symptoms of dementia (BPSDs) in persons with dementia (PWDs). Randomized controlled trial. Nine Italian institutions. Persons with moderate to severe dementia and BPSDs (N = 120) were randomized to one of three treatments. All groups received standard care (SC), and two groups attended 20 individualized MT or LtM sessions, twice a week, in addition to SC. The Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Cornell-Brown Scale for Quality of Life in Dementia (CBS-QoL) were administered before treatment, after treatment, and at follow-up to evaluate behavioral and psychological outcomes. A specific coding scheme (Music Therapy Check List-Dementia) was used to evaluate the MT process. Behavioral assessment did not show significant differences between groups. All groups showed a reduction over time in NPI global score (P ≤ .001), CSDD (P = .001), and CBS-QoL (P = .01). The NPI global score fell 28% in the MT group, 12% in the LtM group, and 21% in the SC group at the end of treatment. An exploratory post hoc analysis showed similar within-group improvements for the NPI Delusion, Anxiety, and Disinhibition subscales. In the MT group, communication and relationships between the music therapists and PWDs showed a positive albeit nonsignificant trend during treatment. The addition of MT or LtM to standard care did not have a significant effect on BPSDs in PWDs. Further studies on the effects of the integration of standard care with different types of music interventions on BPSD in PWD are warranted. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Influence of cognitive style and interstimulus interval on the hemispheric processing of tactile stimuli.

PubMed

Minagawa, N; Kashu, K

1989-06-01

16 adult subjects performed a tactile recognition task. According to our 1984 study, half of the subjects were classified as having a left hemispheric preference for the processing of visual stimuli, while the other half were classified as having a right hemispheric preference for the processing of visual stimuli. The present task was conducted according to the S1-S2 matching paradigm. The standard stimulus was a readily recognizable object and was presented tactually to either the left or right hand of each subject. The comparison stimulus was an object-picture and was presented visually by slide in a tachistoscope. The interstimulus interval was .05 sec. or 2.5 sec. Analysis indicated that the left-preference group showed right-hand superiority, and the right-preference group showed left-hand superiority. The notion of individual hemisphericity was supported in tactile processing.

Developing Carbon Nanotube Standards at NASA

NASA Technical Reports Server (NTRS)

Nikolaev, Pasha; Arepalli, Sivaram; Sosa, Edward; Gorelik, Olga; Yowell, Leonard

2007-01-01

Single wall carbon nanotubes (SWCNTs) are currently being produced and processed by several methods. Many researchers are continuously modifying existing methods and developing new methods to incorporate carbon nanotubes into other materials and utilize the phenomenal properties of SWCNTs. These applications require availability of SWCNTs with known properties and there is a need to characterize these materials in a consistent manner. In order to monitor such progress, it is critical to establish a means by which to define the quality of SWCNT material and develop characterization standards to evaluate of nanotube quality across the board. Such characterization standards should be applicable to as-produced materials as well as processed SWCNT materials. In order to address this issue, NASA Johnson Space Center has developed a protocol for purity and dispersion characterization of SWCNTs (Ref.1). The NASA JSC group is currently working with NIST, ANSI and ISO to establish purity and dispersion standards for SWCNT material. A practice guide for nanotube characterization is being developed in cooperation with NIST (Ref.2). Furthermore, work is in progress to incorporate additional characterization methods for electrical, mechanical, thermal, optical and other properties of SWCNTs.

Developing Carbon Nanotube Standards at NASA

NASA Technical Reports Server (NTRS)

Nikolaev, Pasha; Arepalli, Sivaram; Sosa, Edward; Gorelik, Olga; Yowell, Leonard

2007-01-01

Single wall carbon nanotubes (SWCNTs) are currently being produced and processed by several methods. Many researchers are continuously modifying existing methods and developing new methods to incorporate carbon nanotubes into other materials and utilize the phenomenal properties of SWCNTs. These applications require availability of SWCNTs with known properties and there is a need to characterize these materials in a consistent manner. In order to monitor such progress, it is critical to establish a means by which to define the quality of SWCNT material and develop characterization standards to evaluate of nanotube quality across the board. Such characterization standards should be applicable to as-produced materials as well as processed SWCNT materials. In order to address this issue, NASA Johnson Space Center has developed a protocol for purity and dispersion characterization of SWCNTs. The NASA JSC group is currently working with NIST, ANSI and ISO to establish purity and dispersion standards for SWCNT material. A practice guide for nanotube characterization is being developed in cooperation with NIST. Furthermore, work is in progress to incorporate additional characterization methods for electrical, mechanical, thermal, optical and other properties of SWCNTs.

Interactive large-group teaching in a dermatology course.

PubMed

Ochsendorf, F R; Boehncke, W-H; Sommerlad, M; Kaufmann, R

2006-12-01

This is a prospective study to find out whether an interactive large-group case-based teaching approach combined with small-group bedside teaching improves student satisfaction and learning outcome in a practical dermatology course. During two consecutive terms a rotating system of large-group interactive case-study-method teaching with two tutors (one content expert, one process facilitator) and bedside teaching with randomly appointed tutors was evaluated with a nine-item questionnaire and multiple-choice test performed at the beginning and the end of the course (n = 204/231 students evaluable). The results of three different didactic approaches utilized over the prior year served as a control. The interactive course was rated significantly better (p < 0.0001) than the standard course with regard to all items. The aggregate mark given by the students for the whole course was 1.58-0.61 (mean +/- SD, range 1 (good)-5 (poor)). This was significantly better than the standard course (p < 0.0001) and not different from small-group teaching approaches. The mean test results in the final examination improved significantly (p < 0.01). The combination of large-group interactive teaching and small-group bedside teaching was well accepted, improved the learning outcome, was rated as good as a small-group didactic approach and needed fewer resources in terms of personnel.

Packet telemetry and packet telecommand - The new generation of spacecraft data handling techniques

NASA Technical Reports Server (NTRS)

Hooke, A. J.

1983-01-01

Because of rising costs and reduced reliability of spacecraft and ground network hardware and software customization, standardization Packet Telemetry and Packet Telecommand concepts are emerging as viable alternatives. Autonomous packets of data, within each concept, which are created within ground and space application processes through the use of formatting techniques, are switched end-to-end through the space data network to their destination application processes through the use of standard transfer protocols. This process may result in facilitating a high degree of automation and interoperability because of completely mission-independent-designed intermediate data networks. The adoption of an international guideline for future space telemetry formatting of the Packet Telemetry concept, and the advancement of the NASA-ESA Working Group's Packet Telecommand concept to a level of maturity parallel to the of Packet Telemetry are the goals of the Consultative Committee for Space Data Systems. Both the Packet Telemetry and Packet Telecommand concepts are reviewed.

Standardizing Navigation Data: A Status Update

NASA Technical Reports Server (NTRS)

VanEepoel, John M.; Berry, David S.; Pallaschke, Siegmar; Foliard, Jacques; Kiehling, Reinhard; Ogawa, Mina; Showell, Avanaugh; Fertig, Juergen; Castronuovo, Marco

2007-01-01

This paper presents the work of the Navigation Working Group of the Consultative Committee for Space Data Systems (CCSDS) on development of standards addressing the transfer of orbit, attitude and tracking data for space objects. Much progress has been made since the initial presentation of the standards in 2004, including the progression of the orbit data standard to an accepted standard, and the near completion of the attitude and tracking data standards. The orbit, attitude and tracking standards attempt to address predominant parameterizations for their respective data, and create a message format that enables communication of the data across space agencies and other entities. The messages detailed in each standard are built upon a keyword = value paradigm, where a fixed list of keywords is provided in the standard where users specify information about their data, and also use keywords to encapsulate their data. The paper presents a primer on the CCSDS standardization process to put in context the state of the message standards, and the parameterizations supported in each standard, then shows examples of these standards for orbit, attitude and tracking data. Finalization of the standards is expected by the end of calendar year 2007.

Does wearing unstable shoes reduce low back pain and disability in nurses? A randomized controlled pilot study.

PubMed

Vieira, Edgar R; Brunt, Denis

2016-02-01

To evaluate if wearing unstable shoes reduces low back pain and disability in nurses. A randomized controlled trial. Hospitals and homecare. A total of 20 matched female registered nurses with low back pain. The mean (standard deviation) age was 31 years (5) for the control and 34 years (6) for the intervention group; height was 161 cm (5) and 165 cm (7), respectively. The intervention group received unstable shoes at Week 2 to wear for at least 36 h/week for a month. The Oswestry Low Back Pain Disability Questionnaire and a visual analogue pain scale. The mean (standard deviation) pain level was 6 (1) at baseline vs. 6 (2) at Week 6 for the control group, and 5 (1) vs. 1 (1) for the intervention group. The mean (standard deviation) disability level was 31% (9) at baseline vs. 28% (7) at Week 6 for the control, and 27% (12) vs. 13% (5) for the intervention group. There were no significant changes over time on pain or disability levels for the control group. The intervention group reported lower levels of pain on Weeks 4 (mean difference ⩾-1.4, p ⩽ 0.009) and 6 (mean difference ⩾-3.1, p < 0.001). Disability levels were also lower on Weeks 4 (mean difference = -4.5%, p NS) and 6 (mean difference = -14.1%, p = 0.020). Wearing unstable shoes reduced low back pain and disability in nurses and might be helpful as part of the back pain rehabilitation process. © The Author(s) 2015.

Biocompatibility of nanosilver-coated orthodontic brackets: an in vivo study.

PubMed

Metin-Gürsoy, Gamze; Taner, Lale; Barış, Emre

2016-12-01

Nanosilver particles of which antibacterial and antifungal properties have been shown in various in vitro and in vivo studies are used in many medical and dental fields for the prevention of infection. In this study, it is intended to evaluate the biocompatibility of nanosilver-coated brackets. Nanosilver coating process was applied to the standard orthodontic brackets by a physical vapor deposition system. Brackets were coated with nanosilver particles of 1 μ thickness. A total of 12 Wistar Albino rats were included in the study (six) and control (six) groups. For the study and control groups, four nanosilver-coated and four standard brackets were aseptically implanted subcutaneously in the dorsal region of each rat. The brackets were removed with the surrounding tissues on days 7, 14, 30, and 60. The specimens were evaluated for inflammatory response. No significant difference was found in terms of tissue reaction between the study and control groups. On day 7, randomly distributed brown-black granules were seen in the granulation tissue adjacent to the bracket in the study group. These foreign particles continued along the bracket cavity in a few samples, but the inflammatory response was insignificant between the groups. Mast cell count was found to be significantly smaller only on day 7 in the study group than in the control group. Nanosilver-coated orthodontic brackets were found to be similar with the standard type concerning inflammation. Further researches are needed with regard to the assessment of the brown-black granules, especially on the deposition of the vessel walls.

A cost analysis of orthopedic foot surgery: can outpatient continuous regional analgesia provide the same standard of care for postoperative pain control at home without shifting costs?

PubMed

Saporito, Andrea; Calciolari, Stefano; Ortiz, Laura Gonzalez; Anselmi, Luciano; Borgeat, Alain; Aguirre, José

2016-11-01

Same-day surgery is common for foot surgery. Continuous regional anesthesia for outpatients has been shown effective but the economic impact on the perioperative process-related healthcare costs remains unclear. One hundred twenty consecutive patients were included in this assessor-blinded, prospective cohort study and allocated according to inclusion criteria in the day-care or in the in-patient group. Standardized continuous popliteal sciatic nerve block was performed in both groups for 48 h using an elastomeric pump delivering ropivacaine 0.2 % at a rate of 5 ml/h with an additional 5 ml bolus every 60 min. Outpatients were discharged the day of surgery and followed with standardized telephone interviews. The total direct health costs of both groups were compared. Moreover, the difference in treatment costs and the difference in terms of quality of care and effectiveness between the groups were compared. Total management costs were significantly reduced in the day-care group. There was no difference between the groups regarding pain at rest and with motion, persistent pain after catheter removal and the incidence of PONV. Persistent motor block and catheter inflammation/infection were comparable in both groups. There was neither a difference in the number of unscheduled ambulatory visits nor in the number of readmissions. Day-care continuous regional analgesia leads to an overall positive impact on costs by decreasing the incidence of unplanned ambulatory visits and unscheduled readmissions, without compromising on the quality of analgesia, patients' satisfaction, and safety.

Application fields for the new Object Management Group (OMG) Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN) in the perioperative field.

PubMed

Wiemuth, M; Junger, D; Leitritz, M A; Neumann, J; Neumuth, T; Burgert, O

2017-08-01

Medical processes can be modeled using different methods and notations. Currently used modeling systems like Business Process Model and Notation (BPMN) are not capable of describing the highly flexible and variable medical processes in sufficient detail. We combined two modeling systems, Business Process Management (BPM) and Adaptive Case Management (ACM), to be able to model non-deterministic medical processes. We used the new Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN). First, we explain how CMMN, DMN and BPMN could be used to model non-deterministic medical processes. We applied this methodology to model 79 cataract operations provided by University Hospital Leipzig, Germany, and four cataract operations provided by University Eye Hospital Tuebingen, Germany. Our model consists of 85 tasks and about 20 decisions in BPMN. We were able to expand the system with more complex situations that might appear during an intervention. An effective modeling of the cataract intervention is possible using the combination of BPM and ACM. The combination gives the possibility to depict complex processes with complex decisions. This combination allows a significant advantage for modeling perioperative processes.

Neonatal Jaundice Detection System.

PubMed

Aydın, Mustafa; Hardalaç, Fırat; Ural, Berkan; Karap, Serhat

2016-07-01

Neonatal jaundice is a common condition that occurs in newborn infants in the first week of life. Today, techniques used for detection are required blood samples and other clinical testing with special equipment. The aim of this study is creating a non-invasive system to control and to detect the jaundice periodically and helping doctors for early diagnosis. In this work, first, a patient group which is consisted from jaundiced babies and a control group which is consisted from healthy babies are prepared, then between 24 and 48 h after birth, 40 jaundiced and 40 healthy newborns are chosen. Second, advanced image processing techniques are used on the images which are taken with a standard smartphone and the color calibration card. Segmentation, pixel similarity and white balancing methods are used as image processing techniques and RGB values and pixels' important information are obtained exactly. Third, during feature extraction stage, with using colormap transformations and feature calculation, comparisons are done in RGB plane between color change values and the 8-color calibration card which is specially designed. Finally, in the bilirubin level estimation stage, kNN and SVR machine learning regressions are used on the dataset which are obtained from feature extraction. At the end of the process, when the control group is based on for comparisons, jaundice is succesfully detected for 40 jaundiced infants and the success rate is 85 %. Obtained bilirubin estimation results are consisted with bilirubin results which are obtained from the standard blood test and the compliance rate is 85 %.

The OCLC-SERHOLD connection: an evolution in health sciences union listing.

PubMed Central

Battistella, M S

1991-01-01

The OCLC Union List Subsystem (OCLC ULS) provides a standard, high quality, and widely used means of managing union list data. Over the last several years, OCLC ULS tape products have been used by thirteen health sciences libraries or groups to update SERHOLD. These thirteen libraries or groups were surveyed to examine practices in using OCLC to update SERHOLD. The National Library of Medicine's (NLM) processing of OCLC tape products was assessed to determine how OCLC data are handled by SERHOLD. Most important are the assignment of OCLC holdings symbols, OCLC record selection criteria, tape pull cycles, and the processing of exception reports produced by NLM as a result of tape loads. PMID:1958909

The OCLC-SERHOLD connection: an evolution in health sciences union listing.

PubMed

Battistella, M S

1991-10-01

The OCLC Union List Subsystem (OCLC ULS) provides a standard, high quality, and widely used means of managing union list data. Over the last several years, OCLC ULS tape products have been used by thirteen health sciences libraries or groups to update SERHOLD. These thirteen libraries or groups were surveyed to examine practices in using OCLC to update SERHOLD. The National Library of Medicine's (NLM) processing of OCLC tape products was assessed to determine how OCLC data are handled by SERHOLD. Most important are the assignment of OCLC holdings symbols, OCLC record selection criteria, tape pull cycles, and the processing of exception reports produced by NLM as a result of tape loads.

Characteristics of Kodak Insight, an F-speed intraoral film.

PubMed

Ludlow, J B; Platin, E; Mol, A

2001-01-01

This study reports film speed, contrast, exposure latitude, resolution, and response to processing solution depletion of Kodak Insight intraoral film. Densitometric curves were generated by using International Standards Organization protocol. Additional curves were generated for Ultra-speed, Ektaspeed Plus, and Insight films developed in progressively depleted processing solutions. Eight observers viewed images of a resolution test tool for maximum resolution assessment. Images of an aluminum step-wedge were reviewed to determine useful exposure latitude. Insight's sensitivity in fresh automatic processor solutions places it in the F-speed group. An average gradient of 1.8 was found with all film types. Insight provided 93% of the useful exposure latitude of Ektaspeed Plus film. Insight maintained contrast in progressively depleted processing solutions. Like Ektaspeed Plus, Insight was able to resolve at least 20 line-pairs per millimeter. Under International Standards Organization conditions, Insight required only 77% of the exposure of Ektaspeed Plus film. Insight film provided stable contrast in depleted processing solutions.

NBS (National Bureau of Standards): Materials measurements. [space processing experiments

NASA Technical Reports Server (NTRS)

Manning, J. R.

1983-01-01

Work directed toward the measurement of materials properties important to the design and interpretation of space processing experiments and determinations of how the space environment may offer a unique opportunity for performing improved measurements and producing materials with improved properties is reported. Surface tensions and their variations with temperature and impurities; convection during undirectional solidification; and measurement of the high temperature thermophysical properties of tungsten group liquids and solids are discussed and results are summarized.

The Development of a Dental Diagnostic Terminology

PubMed Central

Kalenderian, Elsbeth; Ramoni, Rachel L.; White, Joel M.; Schoonheim-Klein, Meta E.; Stark, Paul C.; Kimmes, Nicole S.; Zeller, Gregory G.; Willis, George P.; Walji, Muhammad F.

2011-01-01

There is no commonly accepted standardized terminology for oral diagnoses. The purpose of this article is to report the development of a standardized dental diagnostic terminology by a work group of dental faculty members. The work group developed guiding principles for decision making and adhered to principles of terminology development. The members used an iterative process to develop a terminology incorporating concepts represented in the Toronto/University of California, San Francisco/Creighton University and International Classification of Diseases (ICD)-9/10 codes and periodontal and endodontic diagnoses. Domain experts were consulted to develop a final list of diagnostic terms. A structure was developed, consisting of thirteen categories, seventy-eight subcategories, and 1,158 diagnostic terms, hierarchically organized and mappable to other terminologies and ontologies. Use of this standardized diagnostic terminology will reinforce the diagnosis-treatment link and will facilitate clinical research, quality assurance, and patient communication. Future work will focus on implementation and approaches to enhance the validity and reliability of diagnostic term utilization. PMID:21205730

Electrocortical Reactivity During Self-referential Processing in Female Youth With Borderline Personality Disorder.

PubMed

Auerbach, Randy P; Tarlow, Naomi; Bondy, Erin; Stewart, Jeremy G; Aguirre, Blaise; Kaplan, Cynthia; Yang, Wenhui; Pizzagalli, Diego A

2016-07-01

Borderline personality disorder (BPD) is debilitating, and theoretical models have postulated that cognitive-affective biases contribute to the onset and maintenance of BPD symptoms. Despite advances, our understanding of BPD pathophysiology in youth is limited. The present study used event-related potentials (ERPs) to identify cognitive-affective processes that underlie negative self-referential processing in BPD youth. Healthy females ( n = 33) and females with BPD ( n = 26) 13 to 22 years of age completed a self-referential encoding task while 128-channel electroencephalography data were recorded to examine early (i.e., P1 and P2) and late (late positive potential [LPP]) ERP components. Whole-brain standardized low-resolution electromagnetic tomography explored intracortical sources underlying significant scalp ERP effects. Compared to healthy females, participants with BPD endorsed, recalled, and recognized fewer positive and more negative words. Moreover, unlike the healthy group, females with BPD had faster reaction times to endorse negative versus positive words. In the scalp ERP analyses, the BPD group had greater P2 and late LPP positivity to negative as opposed to positive words. For P2 and late LPP, whole-brain standardized low-resolution electromagnetic tomography analyses suggested that females with BPD overrecruit frontolimbic circuitry in response to negative stimuli. Collectively, these findings show that females with BPD process negative self-relevant information differently than healthy females. Clinical implications and future directions are discussed.

Electrocortical Reactivity During Self-referential Processing in Female Youth With Borderline Personality Disorder

PubMed Central

Auerbach, Randy P.; Tarlow, Naomi; Bondy, Erin; Stewart, Jeremy G.; Aguirre, Blaise; Kaplan, Cynthia; Yang, Wenhui; Pizzagalli, Diego A.

2016-01-01

BACKGROUND Borderline personality disorder (BPD) is debilitating, and theoretical models have postulated that cognitive-affective biases contribute to the onset and maintenance of BPD symptoms. Despite advances, our understanding of BPD pathophysiology in youth is limited. The present study used event-related potentials (ERPs) to identify cognitive-affective processes that underlie negative self-referential processing in BPD youth. METHODS Healthy females (n = 33) and females with BPD (n = 26) 13 to 22 years of age completed a self-referential encoding task while 128-channel electroencephalography data were recorded to examine early (i.e., P1 and P2) and late (late positive potential [LPP]) ERP components. Whole-brain standardized low-resolution electromagnetic tomography explored intracortical sources underlying significant scalp ERP effects. RESULTS Compared to healthy females, participants with BPD endorsed, recalled, and recognized fewer positive and more negative words. Moreover, unlike the healthy group, females with BPD had faster reaction times to endorse negative versus positive words. In the scalp ERP analyses, the BPD group had greater P2 and late LPP positivity to negative as opposed to positive words. For P2 and late LPP, whole-brain standardized low-resolution electromagnetic tomography analyses suggested that females with BPD overrecruit frontolimbic circuitry in response to negative stimuli. CONCLUSIONS Collectively, these findings show that females with BPD process negative self-relevant information differently than healthy females. Clinical implications and future directions are discussed. PMID:28626812

A minority perspective in the diagnosis of child language disorders.

PubMed

Seymour, H N; Bland, L

1991-01-01

The effective diagnosis and treatment of persons from diverse minority language backgrounds has become an important issue in the field of speech and language pathology. Yet, many SLPs have had little or no formal training in minority language, there is a paucity of normative data on language acquisition in minority groups, and there are few standardized speech and language tests appropriate for these groups. We described a diagnostic process that addresses these problems. The diagnostic protocol we have proposed for a child from a Black English-speaking background characterizes many of the major issues in treating minority children. In summary, we proposed four assessment strategies: gathering referral source data; making direct observations; using standardized tests of non-speech and language behavior (cognition, perception, motor, etc.); and eliciting language samples and probes.

The Advancement of Cool Roof Standards in China from 2010 to 2015

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

Ge, Jing; Levinson, Ronnen M.

Since the initiation of the U.S.-China Clean Energy Research Center-Building Energy Efficiency (CERC-BEE) cool roof research collaboration between the Lawrence Berkeley National Laboratory Heat Island Group and Chinese institutions in 2010, new cool surface credits (insulation trade- offs) have been adopted in Chinese building energy efficiency standards, industry standards, and green building standards. JGJ 75-2012: Design Standard for Energy Efficiency of Residential Buildings in Hot Summer and Warm Winter Zone became the first national level standard to provide cool surface credits. GB/T 50378-2014: Assessment Standard for Green Building is the first national level green building standard that offers points formore » heat island mitigation. JGJ/T 359-2015: Technical Specification for Application of Architectural Reflective Thermal Insulation Coating is the first industry standard that offers cool coating credits for both public and residential buildings in all hot-summer climates (Hot Summer/Cold Winter, Hot Summer/Warm Winter). As of December 2015, eight provinces or municipalities in hot-summer regions have credited cool surfaces credits in their residential and/or public building design standards; five other provinces or municipalities in hot-summer regions recommend, but do not credit, the use of cool surfaces in their building design standards. Cool surfaces could be further advanced in China by including cool roof credits for residential and public building energy efficiency standards in all hot-summer regions; developing a standardized process for natural exposure and aged-property rating of cool roofing products; and adapting the U.S.-developed laboratory aging process for roofing materials to replicate solar reflectance changes induced by natural exposure in China.« less

Software tool for physics chart checks.

PubMed

Li, H Harold; Wu, Yu; Yang, Deshan; Mutic, Sasa

2014-01-01

Physics chart check has long been a central quality assurance (QC) measure in radiation oncology. The purpose of this work is to describe a software tool that aims to accomplish simplification, standardization, automation, and forced functions in the process. Nationally recognized guidelines, including American College of Radiology and American Society for Radiation Oncology guidelines and technical standards, and the American Association of Physicists in Medicine Task Group reports were identified, studied, and summarized. Meanwhile, the reported events related to physics chart check service were analyzed using an event reporting and learning system. A number of shortfalls in the chart check process were identified. To address these problems, a software tool was designed and developed under Microsoft. Net in C# to hardwire as many components as possible at each stage of the process. The software consists of the following 4 independent modules: (1) chart check management; (2) pretreatment and during treatment chart check assistant; (3) posttreatment chart check assistant; and (4) quarterly peer-review management. The users were a large group of physicists in the author's radiation oncology clinic. During over 1 year of use the tool has proven very helpful in chart checking management, communication, documentation, and maintaining consistency. The software tool presented in this work aims to assist physicists at each stage of the physics chart check process. The software tool is potentially useful for any radiation oncology clinics that are either in the process of pursuing or maintaining the American College of Radiology accreditation.

Feedback data sources that inform physician self-assessment.

PubMed

Lockyer, Jocelyn; Armson, Heather; Chesluk, Benjamin; Dornan, Timothy; Holmboe, Eric; Loney, Elaine; Mann, Karen; Sargeant, Joan

2011-01-01

Self-assessment is a process of interpreting data about one's performance and comparing it to explicit or implicit standards. To examine the external data sources physicians used to monitor themselves. Focus groups were conducted with physicians who participated in three practice improvement activities: a multisource feedback program; a program providing patient and chart audit data; and practice-based learning groups. We used grounded theory strategies to understand the external sources that stimulated self-assessment and how they worked. Data from seven focus groups (49 physicians) were analyzed. Physicians used information from structured programs, other educational activities, professional colleagues, and patients. Data were of varying quality, often from non-formal sources with implicit (not explicit) standards. Mandatory programs elicited variable responses, whereas data and activities the physicians selected themselves were more likely to be accepted. Physicians used the information to create a reference point against which they could weigh their performance using it variably depending on their personal interpretation of its accuracy, application, and utility. Physicians use and interpret data and standards of varying quality to inform self-assessment. Physicians may benefit from regular and routine feedback and guidance on how to seek out data for self-assessment.

The Study of Influence of Different Methods of Local Treatment on Wound Healing in Patients with Diabetic Foot Ulcers.

PubMed

Zaitseva, E L; Tokmakova, A Y; Shestakova, M V; Galstyan, G R; Doronina, L P

To evaluate the influence of different methods of local treatment on tissue repair in patients with diabetic foot ulcers. We evaluated such clinical characteristics as wound size and local perfusion after using negative pressure wound therapy (NPWT), local collagen, and standard care in patients with diabetic foot ulcers. We observed 63 patients with neuropathic and neuroischemic forms of diabetic foot (without critical ischemia) after surgical debridement. After that 21 patients received NPWT, 21 local collagen treatment and 21 ― standard care. After using NPWT wound area and depth decreased in 19,8% and 42,8% (p<0.05), in group of collagen dressings in 26,4 and 30,4% (p<0.05). In control group those parameters were 17,0 и 16.6% respectively (p<0.05). There was found the significant increase of local perfusion according to oxygen monitoring in group of NPWT (p<0.05). The received data showed that the intensity of lower limb tissue repair processes increases more significant after using NPWT and collagen dressings in comparison to standard care which is found according to wound size and tissue perfusion alterations.

Developing 21st century accreditation standards for teaching hospitals: the Taiwan experience.

PubMed

Huang, Chung-I; Wung, Cathy; Yang, Che-Ming

2009-12-15

The purpose of this study is to establish teaching hospital accreditation standards anew with the hope that Taiwan's teaching hospitals can live up to the expectations of our society and ensure quality teaching. The development process lasted two years, 2005-2006, and was separated into three stages. The first stage centered on leadership meetings and consensus building, the second on drafting the new standards with expert focus groups, and the third on a pilot study and subsequent revision. Our new teaching hospital accreditation standards have six categories and 95 standards as follows: educational resources (20 items), teaching and training plans and outcomes (42 items), research and results (9 items), development of clinical faculty and continuing education (8 items), academic exchanges and community education (8 items), and administration (8 items). The new standards have proven feasible and posed reasonable challenges in the pilot study. We hope the new standards will strengthen teaching and research, and improve the quality of hospital services at the same time.

Intermediate Cognitive Phenotypes in Bipolar Disorder

PubMed Central

Langenecker, Scott A.; Saunders, Erika F.H.; Kade, Allison M.; Ransom, Michael T.; McInnis, Melvin G.

2013-01-01

Background Intermediate cognitive phenotypes (ICPs) are measurable and quantifiable states that may be objectively assessed in a standardized method, and can be integrated into association studies, including genetic, biochemical, clinical, and imaging based correlates. The present study used neuropsychological measures as ICPs, with factor scores in executive functioning, attention, memory, fine motor function, and emotion processing, similar to prior work in schizophrenia. Methods Healthy control subjects (HC, n=34) and euthymic (E, n=66), depressed (D, n=43), or hypomanic/mixed (HM, n=13) patients with bipolar disorder (BD) were assessed with neuropsychological tests. These were from eight domains consistent with previous literature; auditory memory, visual memory, processing speed with interference resolution, verbal fluency and processing speed, conceptual reasoning and set-shifting, inhibitory control, emotion processing, and fine motor dexterity. Results Of the eight factor scores, the HC group outperformed the E group in three (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity), the D group in seven (all except Inhibitory Control), and the HM group in four (Inhibitory Control, Processing Speed with Interference Resolution, Fine Motor Dexterity, and Auditory Memory). Limitations The HM group was relatively small, thus effects of this phase of illness may have been underestimated. Effects of medication could not be fully controlled without a randomized, double-blind, placebo-controlled study. Conclusions Use of the factor scores can assist in determining ICPs for BD and related disorders, and may provide more specific targets for development of new treatments. We highlight strong ICPs (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity) for further study, consistent with the existing literature. PMID:19800130

The obviously ill patient in need of treatment: a fourth standard for civil commitment.

PubMed

Treffert, D A

1985-03-01

The three relatively standard criteria currently contained in most state civil commitment laws (danger to self, danger to others, and gravely disabled) have forced many obviously ill patients to deteriorate to the point of dangerousness before receiving treatment, to become criminalized, or to wander the streets untreated. After discussing the origins of present civil commitment laws and the plight of obviously ill patients, the author details the cooperative effort of several groups in Wisconsin to codify a fourth standard for civil commitment that would ensure that obviously ill patients receive treatment with proper procedural and due process safeguards. Other statutory alternatives to remedy the plight of obviously ill patients are also discussed.

Social Information Processing and Group-Induced Response Shifts

DTIC Science & Technology

1984-01-01

34). The rationale for not using a standard task attributes measure such as the JDS (Hackman . & Oldham, 1975) or JCI (Sims, Szilagyi , & Keller, 1976...68588 P4-5/B5 LIST 15 (Continued) 452:KD:716:enj 78u452-883 24 June 1981 Dr. H. Wallace Sinaiko Program Director, Manpower Research and

The ISO Edi Conceptual Model Activity and Its Relationship to OSI.

ERIC Educational Resources Information Center

Fincher, Judith A.

1990-01-01

The edi conceptual model is being developed to define common structures, services, and processes that syntax-specific standards like X12 and EDIFACT could adopt. Open Systems Interconnection (OSI) is of interest to edi because of its potential to help enable global interoperability across Electronic Data Interchange (EDI) functional groups. A…

Who Needs Lewis Structures to Get VSEPR Geometries?

ERIC Educational Resources Information Center

Lindmark, Alan F.

2010-01-01

Teaching the VSEPR (valence shell electron-pair repulsion) model can be a tedious process. Traditionally, Lewis structures are drawn and the number of "electron clouds" (groups) around the central atom are counted and related to the standard VSEPR table of possible geometries. A simpler method to deduce the VSEPR structure without first drawing…

The Effects of Stereotype Threat on Standardized Mathematics Test Performance and Cognitive Processing

ERIC Educational Resources Information Center

Arbuthnot, Keena

2009-01-01

Although research has extensively documented sources for differential item functioning and stereotype threat--especially among women and black college students--little is known about group differences in test-taking strategies among black adolescent students. In this article, Arbuthnot presents findings from two studies that seek to explore how…

Development of the Gross Motor Function Classification System (1997)

ERIC Educational Resources Information Center

Morris, Christopher

2008-01-01

To address the need for a standardized system to classify the gross motor function of children with cerebral palsy, the authors developed a five-level classification system analogous to the staging and grading systems used in medicine. Nominal group process and Delphi survey consensus methods were used to examine content validity and revise the…

Collaborative writing: Tools and tips.

PubMed

Eapen, Bell Raj

2007-01-01

Majority of technical writing is done by groups of experts and various web based applications have made this collaboration easy. Email exchange of word processor documents with tracked changes used to be the standard technique for collaborative writing. However web based tools like Google docs and Spreadsheets have made the process fast and efficient. Various versioning tools and synchronous editors are available for those who need additional functionality. Having a group leader who decides the scheduling, communication and conflict resolving protocols is important for successful collaboration.

Teaching undergraduates the process of peer review: learning by doing.

PubMed

Rangachari, P K

2010-09-01

An active approach allowed undergraduates in Health Sciences to learn the dynamics of peer review at first hand. A four-stage process was used. In stage 1, students formed self-selected groups to explore specific issues. In stage 2, each group posted their interim reports online on a specific date. Each student read all the other reports and prepared detailed critiques. In stage 3, each report was discussed at sessions where the lead discussant was selected at random. All students participated in the peer review process. The written critiques were collated and returned to each group, who were asked to resubmit their revised reports within 2 wk. In stage 4, final submissions accompanied by rebuttals were graded. Student responses to a questionnaire were highly positive. They recognized the individual steps in the standard peer review, appreciated the complexities involved, and got a first-hand experience of some of the inherent variabilities involved. The absence of formal presentations and the opportunity to read each other's reports permitted them to study issues in greater depth.

Brain responses to sound intensity changes dissociate depressed participants and healthy controls.

PubMed

Ruohonen, Elisa M; Astikainen, Piia

2017-07-01

Depression is associated with bias in emotional information processing, but less is known about the processing of neutral sensory stimuli. Of particular interest is processing of sound intensity which is suggested to indicate central serotonergic function. We tested weather event-related brain potentials (ERPs) to occasional changes in sound intensity can dissociate first-episode depressed, recurrent depressed and healthy control participants. The first-episode depressed showed larger N1 amplitude to deviant sounds compared to recurrent depression group and control participants. In addition, both depression groups, but not the control group, showed larger N1 amplitude to deviant than standard sounds. Whether these manifestations of sensory over-excitability in depression are directly related to the serotonergic neurotransmission requires further research. The method based on ERPs to sound intensity change is fast and low-cost way to objectively measure brain activation and holds promise as a future diagnostic tool. Copyright © 2017 Elsevier B.V. All rights reserved.

Electrocortical processing of food and emotional pictures in anorexia nervosa and bulimia nervosa.

PubMed

Blechert, Jens; Feige, Bernd; Joos, Andreas; Zeeck, Almut; Tuschen-Caffier, Brunna

2011-06-01

Objective To compare the electrocortical processing of food pictures in participants with anorexia nervosa (n = 21), bulimia nervosa (n = 22), and healthy controls (HCs) (n = 32) by measuring the early posterior negativity, an event-related potential that reflects stimulus salience and selective attention. Methods We exposed these three groups to a rapid stream of high- and low-calorie food pictures, as well as standard emotional and neutral pictures. Results Event-related potentials in the time range of 220 milliseconds to 310 milliseconds on posterior electrodes differed between groups: patients with eating disorders showed facilitated processing of both high- and low-calorie food pictures relative to neutral pictures, whereas HC participants did so only for the high-calorie pictures. Subjective palatability of the pictures was rated highest by patients with anorexia nervosa, followed by the HC and bulimia nervosa groups. Conclusions Patients with eating disorders show a generalized attentional bias for food images, regardless of caloric value. This might explain the persistent preoccupation with food in these individuals.

Examining the role of attention and instruction in at-risk kindergarteners: electrophysiological measures of selective auditory attention before and after an early literacy intervention.

PubMed

Stevens, Courtney; Harn, Beth; Chard, David J; Currin, Jeff; Parisi, Danielle; Neville, Helen

2013-01-01

Several studies report that adults and adolescents with reading disabilities also experience difficulties with selective attention. In the present study, event-related brain potentials (ERPs) were used to examine the neural mechanisms of selective attention in kindergarten children at risk for reading disabilities (AR group, n = 8) or on track in early literacy skills (OT group, n = 6) across the first semester of kindergarten. The AR group also received supplemental instruction with the Early Reading Intervention (ERI). Following ERI, the AR group demonstrated improved skills on standardized early literacy measures such that there were no significant differences between the AR and OT groups at posttest or winter follow-up. Analysis of the ERP data revealed that at the start of kindergarten, the AR group displayed reduced effects of attention on sensorineural processing compared to the OT group. Following intervention, this difference between groups disappeared, with the AR group only showing improvements in the effect of attention on sensorineural processing. These data indicate that the neural mechanisms of selective attention are atypical in kindergarten children at risk for reading failure but can be improved by effective reading interventions.

Proficiency Differences in Syntactic Processing of Monolingual Native Speakers Indexed by Event-related Potentials

PubMed Central

Pakulak, Eric; Neville, Helen J.

2010-01-01

While anecdotally there appear to be differences in the way native speakers use and comprehend their native language, most empirical investigations of language processing study university students and none have studied differences in language proficiency which may be independent of resource limitations such as working memory span. We examined differences in language proficiency in adult monolingual native speakers of English using an event-related potential (ERP) paradigm. ERPs were recorded to insertion phrase structure violations in naturally spoken English sentences. Participants recruited from a wide spectrum of society were given standardized measures of English language proficiency, and two complementary ERP analyses were performed. In between-groups analyses, participants were divided, based on standardized proficiency scores, into Lower Proficiency (LP) and Higher Proficiency (HP) groups. Compared to LP participants, HP participants showed an early anterior negativity that was more focal, both spatially and temporally, and a larger and more widely distributed positivity (P600) to violations. In correlational analyses, we utilized a wide spectrum of proficiency scores to examine the degree to which individual proficiency scores correlated with individual neural responses to syntactic violations in regions and time windows identified in the between-group analyses. This approach also employed partial correlation analyses to control for possible confounding variables. These analyses provided evidence for the effects of proficiency that converged with the between-groups analyses. These results suggest that adult monolingual native speakers of English who vary in language proficiency differ in the recruitment of syntactic processes that are hypothesized to be at least in part automatic as well as of those thought to be more controlled. These results also suggest that in order to fully characterize neural organization for language in native speakers it is necessary to include participants of varying proficiency. PMID:19925188

Better infrastructure for critical care trials: nomenclature, etymology, and informatics.

PubMed

Singh, Jeffrey M; Ferguson, Niall D

2009-01-01

The goals of this review article are to review the importance and value of standardized definitions in clinical research, as well as to propose the necessary tools and infrastructure needed to advance nosology and medial taxonomy to improve the quality of clinical trials in the field of critical care. We searched MEDLINE for relevant articles, reviewed those selected and their reference lists, and consulted personal files for relevant information. When the pathobiology of diseases is well understood, standard disease definitions can be extremely specific and precise; however, when the pathobiology of the disease is less well understood or more complex, biological markers may not be diagnostically useful or even available. In these cases, syndromic definitions effectively classify and group illnesses with similar symptoms and clinical signs. There is no clear gold standard for the diagnosis of many clinical entities in the intensive care unit, including notably both acute respiratory distress syndrome and sepsis. There are several types of consensus methods that can be used to explicate the judgmental approach that is often needed in these cases, including interactive or consensus groups, the nominal group technique, and the Delphi technique. Ideally, the definition development process will create clear and unambiguous language in which each definition accurately reflects the current understanding of the disease state. The development, implementation, evaluation, revision, and reevaluation of standardized definitions are keys for advancing the quality of clinical trials in the critical care arena.

The MCCB impairment profile for schizophrenia outpatients: results from the MATRICS psychometric and standardization study.

PubMed

Kern, Robert S; Gold, James M; Dickinson, Dwight; Green, Michael F; Nuechterlein, Keith H; Baade, Lyle E; Keefe, Richard S E; Mesholam-Gately, Raquelle I; Seidman, Larry J; Lee, Cathy; Sugar, Catherine A; Marder, Stephen R

2011-03-01

The MATRICS Psychometric and Standardization Study was conducted as a final stage in the development of the MATRICS Consensus Cognitive Battery (MCCB). The study included 176 persons with schizophrenia or schizoaffective disorder and 300 community residents. Data were analyzed to examine the cognitive profile of clinically stable schizophrenia patients on the MCCB. Secondarily, the data were analyzed to identify which combination of cognitive domains and corresponding cut-off scores best discriminated patients from community residents, and patients competitively employed vs. those not. Raw scores on the ten MCCB tests were entered into the MCCB scoring program which provided age- and gender-corrected T-scores on seven cognitive domains. To test for between-group differences, we conducted a 2 (group)×7 (cognitive domain) MANOVA with follow-up independent t-tests on the individual domains. Classification and regression trees (CART) were used for the discrimination analyses. Examination of patient T-scores across the seven cognitive domains revealed a relatively compact profile with T-scores ranging from 33.4 for speed of processing to 39.3 for reasoning and problem-solving. Speed of processing and social cognition best distinguished individuals with schizophrenia from community residents; speed of processing along with visual learning and attention/vigilance optimally distinguished patients competitively employed from those who were not. The cognitive profile findings provide a standard to which future studies can compare results from other schizophrenia samples and related disorders; the classification results point to specific areas and levels of cognitive impairment that may advance work rehabilitation efforts. Published by Elsevier B.V.

The MCCB Impairment Profile for Schizophrenia Outpatients:Results from the MATRICS Psychometric and Standardization Study

PubMed Central

Kern, Robert S.; Gold, James M.; Dickinson, Dwight; Green, Michael F.; Nuechterlein, Keith H.; Baade, Lyle E.; Keefe, Richard S. E.; Mesholam-Gately, Raquelle I.; Seidman, Larry J.; Lee, Cathy; Sugar, Catherine A.; Marder, Stephen R.

2010-01-01

The MATRICS Psychometric and Standardization Study was conducted as a final stage in the development of the MATRICS Consensus Cognitive Battery (MCCB). The study included 176 persons with schizophrenia or schizoaffective disorder and 300 community residents. Data were analyzed to examine the cognitive profile of clinically stable schizophrenia patients on the MCCB. Secondarily, the data were analyzed to identify which combination of cognitive domains and corresponding cut-off scores best discriminated patients from community residents, and patients competitively employed vs. those not. Raw scores on the ten MCCB tests were entered into the MCCB scoring program which provided age-and gender-corrected T-scores on seven cognitive domains. To test for between-group differences, we conducted a 2 (group) × 7 (cognitive domain) MANOVA with follow-up independent t – tests on the individual domains. Classification and regression trees (CART) were used for the discrimination analyses. Examination of patient T-scores across the seven cognitive domains revealed a relatively compact profile with T-scores ranging from 33.4 for speed of processing to 39.3 for reasoning and problem-solving. Speed of processing and social cognition best distinguished individuals with schizophrenia from community residents; speed of processing along with visual learning and attention/vigilance optimally distinguished patients competitively employed from those who were not. The cognitive profile findings provide a standard to which future studies can compare results from other schizophrenia samples and related disorders; the classification results point to specific areas and levels of cognitive impairment that may advance work rehabilitation efforts. PMID:21159492

Assessment of the hydrolysis process for the determination of okadaic acid-group toxin ester: presence of okadaic acid 7-O-acyl-ester derivates in Spanish shellfish.

PubMed

Villar-González, A; Rodríguez-Velasco, M L; Ben-Gigirey, B; Yasumoto, T; Botana, L M

2008-04-01

The contamination of different types of shellfish by okadaic acid (OA)-group toxin esters is an important problem that presents serious risk for human health. During previous investigations carried out in our laboratory by liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS), the occurrence of a high percentage of esters in relation to the total OA equivalents has been observed in several shellfish species. The determination of these kinds of toxins using LC/MS or other chemical methods requires a hydrolysis step in order to convert the sterified compounds into the parent toxins, OA, dinophysistoxins-1 (DTX-1) and dinophysistoxins-2 (DTX-2). Most of the hydrolysis procedures are based on an alkaline hydrolysis reaction. However, despite hydrolysis being a critical step within the analysis, it has not been studied in depth up to now. The present paper reports the results obtained after evaluating the hydrolysis process of an esterified form of OA by using a standard of 7-O-acyl ester with palmitoyl as the fatty acid (palOA). Investigations were focused on checking the effectiveness of the hydrolysis for palOA using methanol as solvent standard and matrices matched standards. From the results obtained, no matrix influence on the hydrolysis process was observed and the quantity of palOA converted into OA was always above 80%. The analyses of different Spanish shellfish samples showed percentages of palOA in relation to the total OA esters ranging from 27% to 90%, depending on the shellfish specie.

High- and low-temperature manipulation during late incubation: effects on embryonic development, the hatching process, and metabolism in broilers.

PubMed

Willemsen, H; Kamers, B; Dahlke, F; Han, H; Song, Z; Ansari Pirsaraei, Z; Tona, K; Decuypere, E; Everaert, N

2010-12-01

Temperatures continuously higher and lower than the standard incubation temperature by 3°C from embryonic d 16 until embryonic d 18.5 result in differential effects on embryonic development, the hatching process, and embryonic metabolism. Embryos in the high-temperature group were forced into a state of malnutrition by the temperature treatment, as reflected by reduced embryo growth and yolk consumption, resulting in a significantly lower chick weight at hatch. In addition, altered air cell and blood gases as well as a retarded hatching process further indicated reduced growth of embryos exposed to higher incubation temperatures during the latter part of incubation. In addition, hatchability was significantly reduced by the high-temperature treatment due to higher embryonic mortality during the treatment period and the hatching process. Levels of blood glucose, lactate, liver glycogen, plasma triglycerides, and nonesterified fatty acids indicated an altered carbohydrate and lipid metabolism for the high-temperature group. Although the hatching process of embryos exposed to lower incubation temperatures was also significantly retarded, their embryonic development and growth were strikingly similar to those of the control group.

Standardization of noncontact 3D measurement

NASA Astrophysics Data System (ADS)

Takatsuji, Toshiyuki; Osawa, Sonko; Sato, Osamu

2008-08-01

As the global R&D competition is intensified, more speedy measurement instruments are required both in laboratories and production process. In machinery areas, while contact type coordinate measuring machines (CMM) have been widely used, noncontact type CMMs are growing its market share which are capable of measuring enormous number of points at once. Nevertheless, since no industrial standard concerning an accuracy test of noncontact CMMs exists, each manufacturer writes the accuracy of their product according to their own rules, and this situation gives confusion to customers. The working group ISO/TC 213/WG 10 is trying to make a new ISO standard which stipulates an accuracy test of noncontact CMMs. The concept and the situation of discussion of this new standard will be explained. In National Metrology Institute of Japan (NMIJ), we are collecting measurement data which serves as a technical background of the standards together with a consortium formed by users and manufactures. This activity will also be presented.

Letter-Sound Reading: Teaching Preschool Children Print-to-Sound Processing

PubMed Central

2015-01-01

This intervention study investigated the growth of letter sound reading and growth of consonant–vowel–consonant (CVC) word decoding abilities for a representative sample of 41 US children in preschool settings. Specifically, the study evaluated the effectiveness of a 3-step letter-sound teaching intervention in teaching pre-school children to decode, or read, single letters. The study compared a control group, which received the preschool’s standard letter-sound instruction, to an intervention group which received a 3-step letter-sound instruction intervention. The children’s growth in letter-sound reading and CVC word decoding abilities were assessed at baseline and 2, 4, 6 and 8 weeks. When compared to the control group, the growth of letter-sound reading ability was slightly higher for the intervention group. The rate of increase in letter-sound reading was significantly faster for the intervention group. In both groups, too few children learned to decode any CVC words to allow for analysis. Results of this study support the use of the intervention strategy in preschools for teaching children print-to-sound processing. PMID:26839494

Event-Related Potential Measures of Attention Capture in Adolescent Inpatients With Acute Suicidal Behavior.

PubMed

Tavakoli, Paniz; Boafo, Addo; Dale, Allyson; Robillard, Rebecca; Greenham, Stephanie L; Campbell, Kenneth

2018-01-01

Impaired executive functions, modulated by the frontal lobes, have been suggested to be associated with suicidal behavior. The present study examines one of these executive functions, attentional control, maintaining attention to the task-at-hand. A group of inpatient adolescents with acute suicidal behavior and healthy controls were studied using a passively presented auditory optimal paradigm. This "optimal" paradigm consisted of a series of frequently presented homogenous pure tone "standards" and different "deviants," constructed by changing one or more features of the standard. The optimal paradigm has been shown to be a more time-efficient replacement to the traditional oddball paradigm, which makes it suitable for use in clinical populations. The extent of processing of these "to-be-ignored" auditory stimuli was measured by recording event-related potentials (ERPs). The P3a ERP component is thought to reflect processes associated with the capturing of attention. Rare and novel stimuli may result in an executive decision to switch attention away from the current cognitive task and toward a probe of the potentially more relevant "interrupting" auditory input. On the other hand, stimuli that are quite similar to the standard should not elicit P3a. The P3a has been shown to be larger in immature brains in early compared to later adolescence. An overall enhanced P3a was observed in the suicidal group. The P3a was larger in this group for both the environmental sound and white noise deviants, although only the environmental sound P3a attained significance. Other deviants representing only a small change from the standard did not elicit a P3a in healthy controls. They did elicit a small P3a in the suicidal group. These findings suggest a lowered threshold for the triggering of the involuntary switch of attention in these patients, which may play a role in their reported distractibility. The enhanced P3a is also suggestive of an immature frontal central executive and may provide a promising marker for early identification of some of the risk factors for some of the cognitive difficulties linked to suicidality.

[Effect of manual cleaning and machine cleaning for dental handpiece].

PubMed

Zhou, Xiaoli; Huang, Hao; He, Xiaoyan; Chen, Hui; Zhou, Xiaoying

2013-08-01

Comparing the dental handpiece' s cleaning effect between manual cleaning and machine cleaning. Eighty same contaminated dental handpieces were randomly divided into experimental group and control group, each group contains 40 pieces. The experimental group was treated by full automatic washing machine, and the control group was cleaned manually. The cleaning method was conducted according to the operations process standard, then ATP bioluminescence was used to test the cleaning results. Average relative light units (RLU) by ATP bioluminescence detection were as follows: Experimental group was 9, control group was 41. The two groups were less than the recommended RLU value provided by the instrument manufacturer (RLU < or = 45). There was significant difference between the two groups (P < 0.05). The cleaning quality of the experimental group was better than that of control group. It is recommended that the central sterile supply department should clean dental handpieces by machine to ensure the cleaning effect and maintain the quality.

Improving Patient Safety in Public Hospitals: Developing Standard Measures to Track Medical Errors and Process Breakdowns.

PubMed

Ackerman, Sara L; Gourley, Gato; Le, Gem; Williams, Pamela; Yazdany, Jinoos; Sarkar, Urmimala

2018-03-14

The aim of the study was to develop standards for tracking patient safety gaps in ambulatory care in safety net health systems. Leaders from five California safety net health systems were invited to participate in a modified Delphi process sponsored by the Safety Promotion Action Research and Knowledge Network (SPARKNet) and the California Safety Net Institute in 2016. During each of the three Delphi rounds, the feasibility and validity of 13 proposed patient safety measures were discussed and prioritized. Surveys and transcripts from the meetings were analyzed to understand the decision-making process. The Delphi process included eight panelists. Consensus was reached to adopt 9 of 13 proposed measures. All 9 measures were unanimously considered valid, but concern was expressed about the feasibility of implementing several of the measures. Although safety net health systems face high barriers to standardized measurement, our study demonstrates that consensus can be reached on acceptable and feasible methods for tracking patient safety gaps in safety net health systems. If accompanied by the active participation key stakeholder groups, including patients, clinicians, staff, data system professionals, and health system leaders, the consensus measures reported here represent one step toward improving ambulatory patient safety in safety net health systems.

Framing Effects in Younger and Older Adults

PubMed Central

Kim, Sunghan; Goldstein, David; Hasher, Lynn; Zacks, Rose T.

2006-01-01

A growing literature on decision making in older adults suggests that they are more likely to use heuristic processing than are younger adults. We assessed this tendency in the context of a framing effect, a decision-making phenomenon whereby the language used to describe options greatly influences the decision maker’s choice. We compared decision making under a standard (“heuristic”) condition and also under a “justification” condition known to reduce reliance on heuristics. In the standard condition, older adults were more susceptible than younger adults to framing but the two groups did not differ when participants were asked to provide a justification. Thus, although older adults may spontaneously rely more on heuristic processing than younger adults, they can be induced to take a more systematic approach to decision making. PMID:15980289

The AIST Managed Cloud Environment

NASA Astrophysics Data System (ADS)

Cook, S.

2016-12-01

ESTO is currently in the process of developing and implementing the AIST Managed Cloud Environment (AMCE) to offer cloud computing services to ESTO-funded PIs to conduct their project research. AIST will provide projects access to a cloud computing framework that incorporates NASA security, technical, and financial standards, on which project can freely store, run, and process data. Currently, many projects led by research groups outside of NASA do not have the awareness of requirements or the resources to implement NASA standards into their research, which limits the likelihood of infusing the work into NASA applications. Offering this environment to PIs will allow them to conduct their project research using the many benefits of cloud computing. In addition to the well-known cost and time savings that it allows, it also provides scalability and flexibility. The AMCE will facilitate infusion and end user access by ensuring standardization and security. This approach will ultimately benefit ESTO, the science community, and the research, allowing the technology developments to have quicker and broader applications.

Influence of diet with kale on lipid peroxides and malondialdehyde levels in blood serum of laboratory rats over intoxication with paraquat.

PubMed

Sikora, Elżbieta; Bodziarczyk, Izabela

2013-01-01

Organism's lipid peroxidation is one of the most often examined and known physiological process evoked by free radicals. It concerns oxidation reaction of unsaturated fatty acid and/or other lipids leading to lipid oxidation products (LOP), which as a result of further changes generate among others the malondialdehyde molecules. The aim of the work was an estimation if raw or cooked kale addition to rat's diet influences antioxidant defense efficiency in their organisms in comparison to rats fed with standard AIN-93G diet. The experiment was conducted with 36 Wistar strain, male rats over 21 days. The rats were divided into 3 groups (each 12 stuck) which were fed with: standard diet AIN-93G (2 groups), AIN-93G diet with 10% addition of raw kale (2 groups), and AIN-93G with 10% addition of cooked lyophilised kale. The total content of polyphenols (FC method) and antioxidant activity (ABTS+•) were previously determined in raw and then in cooked kale. On the 20th day of experiment, half of rats (6 stuck) of each kind of the diet were injected intraperitoneally by the solution of paraquat (PQ) in physiological salt to evoke the oxidative stress. The next day animals were stunned and blood from their hearts was sampled. In the obtained serum, the levels of lipid oxidation products (LOP) and malondialdehyde (MDA) were assessed. It was observed that in blood serum of rats fed with modified diet with raw and cooked lyophilised kale addition the lipid oxides level was lower in comparison to control group fed with standard diet (p < 0.05). It was found that intoxication with paraquat caused growth of MDA and LOP levels in blood serum of all rats in comparison to not intoxicated groups but that growth was the lowest in group fed diet with cooked kale addition. Diet with kale, both raw and cooked, efficiently inhibited the lipid peroxidation process in rats' organisms, ongoing during natural metabolism and during evoked oxidative stress.

Knowledge Management Orientation: An Innovative Perspective to Hospital Management.

PubMed

Ghasemi, Matina; Ghadiri Nejad, Mazyar; Bagzibagli, Kemal

2017-12-01

By considering innovation as a new project in hospitals, all the project management's standard steps should be followed in execution. This study investigated the validation of a new set of measures in terms of providing a procedure for knowledge management-oriented innovation that enriches the hospital management system. The relation between innovation and all the knowledge management areas, as the main constructs of project management, was illustrated by referring to project management standard steps and previous studies. Through consultations and meetings with a committee of professional project managers, a questionnaire was developed to measure ten knowledge management areas in hospital's innovation process. Additionally, a group of experts from hospital managers were invited to comment on the applicability of the questionnaires by considering if the items are measurable in hospitals practically. A close-ended, Likert-type scale items, consisted of ten sections, were developed based on project management body of knowledge thorough Delphi technique. It enables the managers to evaluate hospitals' situation to be aware whether the organization follows the knowledge management standards in innovation process or not. By pilot study, confirmatory factor analysis and exploratory factor analysis were conducted to ensure the validity and reliability of the measurement items. The developed items seem to have a potential to help hospital managers and subsequently delivering new products/services successfully based on the standard procedures in their organization. In all innovation processes, the knowledge management areas and their standard steps help hospital managers by a new tool as questionnaire format.

On the Automatic Decellularisation of Porcine Aortae: A Repeatability Study Using a Non-Enzymatic Approach.

PubMed

O'Connor Mooney, Rory; Davis, Niall Francis; Hoey, David; Hogan, Lisa; McGloughlin, Timothy M; Walsh, Michael T

2016-01-01

To investigate the repeatability of automatic decellularisation of porcine aortae using a non-enzymatic approach, addressing current limitations associated with other automatic decellularisation processes. Individual porcine aortae (n = 3) were resected and every third segment (n = 4) was allocated to one of three different groups: a control or a manually or automatically decellularised group. Manual and automatic decellularisation was performed using Triton X-100 (2% v/v) and sodium deoxycholate. Protein preservation and the elimination of a galactosyl-α(1,3)galactose (GAL) epitope were measured using immunohistochemistry and protein binding assays. The presence of residual DNA was determined with gel electrophoresis and spectrophotometry. Scaffold integrity was characterised with scanning electron microscopy and uni-axial tensile testing. Manual and automatic results were compared to one another, to control groups and to current gold standards. The results were comparable to those of current gold standard decellularisation techniques. Successful repeatability was achieved, both manually and automatically, with little effect on mechanical characteristics. Complete acellularity was not confirmed in either decellularisation group. Protein preservation was consistent in both the manually and automatically decellularised groups and between each individual aorta. Elimination of GAL was not achieved. Repeatable automatic decellularisation of porcine aortae is feasible using a Triton X-100-sodium deoxycholate protocol. Protein preservation was satisfactory; however, gold standard thresholds for permissible residual DNA levels were not achieved. Future research will focus on addressing this issue by optimisation of the existing protocol for thick tissues. © 2016 S. Karger AG, Basel.

Automatic Lung-RADS™ classification with a natural language processing system.

PubMed

Beyer, Sebastian E; McKee, Brady J; Regis, Shawn M; McKee, Andrea B; Flacke, Sebastian; El Saadawi, Gilan; Wald, Christoph

2017-09-01

Our aim was to train a natural language processing (NLP) algorithm to capture imaging characteristics of lung nodules reported in a structured CT report and suggest the applicable Lung-RADS™ (LR) category. Our study included structured, clinical reports of consecutive CT lung screening (CTLS) exams performed from 08/2014 to 08/2015 at an ACR accredited Lung Cancer Screening Center. All patients screened were at high-risk for lung cancer according to the NCCN Guidelines ® . All exams were interpreted by one of three radiologists credentialed to read CTLS exams using LR using a standard reporting template. Training and test sets consisted of consecutive exams. Lung screening exams were divided into two groups: three training sets (500, 120, and 383 reports each) and one final evaluation set (498 reports). NLP algorithm results were compared with the gold standard of LR category assigned by the radiologist. The sensitivity/specificity of the NLP algorithm to correctly assign LR categories for suspicious nodules (LR 4) and positive nodules (LR 3/4) were 74.1%/98.6% and 75.0%/98.8% respectively. The majority of mismatches occurred in cases where pulmonary findings were present not currently addressed by LR. Misclassifications also resulted from the failure to identify exams as follow-up and the failure to completely characterize part-solid nodules. In a sub-group analysis among structured reports with standardized language, the sensitivity and specificity to detect LR 4 nodules were 87.0% and 99.5%, respectively. An NLP system can accurately suggest the appropriate LR category from CTLS exam findings when standardized reporting is used.

Automatic Lung-RADS™ classification with a natural language processing system

PubMed Central

Beyer, Sebastian E.; Regis, Shawn M.; McKee, Andrea B.; Flacke, Sebastian; El Saadawi, Gilan; Wald, Christoph

2017-01-01

Background Our aim was to train a natural language processing (NLP) algorithm to capture imaging characteristics of lung nodules reported in a structured CT report and suggest the applicable Lung-RADS™ (LR) category. Methods Our study included structured, clinical reports of consecutive CT lung screening (CTLS) exams performed from 08/2014 to 08/2015 at an ACR accredited Lung Cancer Screening Center. All patients screened were at high-risk for lung cancer according to the NCCN Guidelines®. All exams were interpreted by one of three radiologists credentialed to read CTLS exams using LR using a standard reporting template. Training and test sets consisted of consecutive exams. Lung screening exams were divided into two groups: three training sets (500, 120, and 383 reports each) and one final evaluation set (498 reports). NLP algorithm results were compared with the gold standard of LR category assigned by the radiologist. Results The sensitivity/specificity of the NLP algorithm to correctly assign LR categories for suspicious nodules (LR 4) and positive nodules (LR 3/4) were 74.1%/98.6% and 75.0%/98.8% respectively. The majority of mismatches occurred in cases where pulmonary findings were present not currently addressed by LR. Misclassifications also resulted from the failure to identify exams as follow-up and the failure to completely characterize part-solid nodules. In a sub-group analysis among structured reports with standardized language, the sensitivity and specificity to detect LR 4 nodules were 87.0% and 99.5%, respectively. Conclusions An NLP system can accurately suggest the appropriate LR category from CTLS exam findings when standardized reporting is used. PMID:29221286

A strategic approach for managing conflict in hospitals: responding to the Joint Commission leadership standard, Part 1.

PubMed

Scott, Charity; Gerardi, Debra

2011-02-01

The Joint Commission's leadership standard for conflict management in hospitals, LD.02.04.01, states, "The hospital manages conflict between leadership groups to protect the quality and safety of care." This standard is one of numerous standards and alerts issued by The Joint Commission that address conflict and communication. They underscore the significant impact of relational dynamics on patient safety and quality of care and the critical need for a strategic approach to conflict in health care organizations. Whether leadership conflicts openly threaten a major disruption of hospital operations or whether unresolved conflicts lurk beneath the surface of daily interactions, unaddressed conflict can undermine a hospital's efforts to ensure safe, high-quality patient care. How leaders manage organizational conflict has a significant impact on achieving strategic objectives. Aligning conflict management approaches with quality and safety goals is the first step in adopting a strategic approach to conflict management. A strategic approach goes beyond reducing costs of litigation or improving grievance processes--it integrates a collaborative mind-set and individual conflict competency with nonadversarial processes. Conflict assessment should determine how conflicts are handled among the leaders at the hospital, the degree of conflict competence already present among the leaders, where the most significant conflicts occur, and how leaders think a conflict management system might work for them. Strategically aligning a conflict management approach that addresses conflict among leadership groups as a means of protecting the quality and safety of patient care is at the heart of LD.02.04.01.

The INPE handouts to the 6th LANDSAT Technical Working Group (LTWG) Meeting

NASA Technical Reports Server (NTRS)

Debarrosaguirre, J. L. (Principal Investigator); Parada, L. E. M.; Depaulapereira, S.

1984-01-01

LANDSAT receiving and processing system in its present configuration and status are described, as well as the experience already obtained with LANDSATs 4 and 5. The revised table of station plans for TM reception and products and of implementation schedule for data formats employing superstructure conventions is updated. Standardization of the worldwide reference systems is proposed. The INPE preliminary TM products price list is included. A TM image received and processed is shown to illustrate the appearance of the products offered.

The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures.

PubMed

Donati, Filippo; Gobbi, Giuseppe; Campistol, Jaume; Rapatz, Guenter; Daehler, Maja; Sturm, Yvonne; Aldenkamp, Albert P

2007-12-01

To investigate the effect of oxcarbazepine against standard antiepileptic drug therapy (carbamazepine and valproate) on cognitive function in children and adolescents (aged 6 to <17 years) with newly diagnosed partial seizures. A multicentre, open-label, randomised, active-control, three-arm, parallel-group, 6-month study. The primary cognitive variable, the Computerized Visual Searching Task (CVST), assessed mental information processing speed and attention. Secondary variables included additional tests assessing psychomotor speed, alertness, memory and learning, and non-verbal intelligence. Of 112 patients randomised, 99 completed the study. The dropout rate was 11.6%; 13 patients discontinued due to adverse events (n=5) or unsatisfactory therapeutic effect (n=8). Mean CVST time decreased in all groups, indicating an improvement of mental processing speed and no cognitive impairment in any treatment group. No statistically significant difference was observed between oxcarbazepine and combined carbamazepine/valproate. Analysis of secondary variables did not show statistically significant differences between oxcarbazepine, carbamazepine and valproate. Analysis of intelligence test results showed that the number of correct answers increased at end point in all groups. The percentage of patients remaining seizure free throughout treatment was comparable across all groups (oxcarbazepine 58%; carbamazepine 46%; valproate 54%; carbamazepine/valproate 50%). The most common adverse events were fatigue and headache for oxcarbazepine, fatigue and rash for carbamazepine, and headache, increased appetite and alopecia for valproate. Oxcarbazepine treatment over 6 months does not display any differential effects on cognitive function and intelligence in children and adolescents with newly diagnosed partial seizures relative to standard antiepileptic drug therapy. No impairment in cognitive function was observed in any treatment group over a 6-month period.

Recommendations for reporting economic evaluations of haemophilia prophylaxis: a nominal groups consensus statement on behalf of the Economics Expert Working Group of The International Prophylaxis Study Group.

PubMed

Nicholson, A; Berger, K; Bohn, R; Carcao, M; Fischer, K; Gringeri, A; Hoots, K; Mantovani, L; Schramm, W; van Hout, B A; Willan, A R; Feldman, B M

2008-01-01

The need for clearly reported studies evaluating the cost of prophylaxis and its overall outcomes has been recommended from previous literature. To establish minimal ''core standards'' that can be followed when conducting and reporting economic evaluations of hemophilia prophylaxis. Ten members of the IPSG Economic Analysis Working Group participated in a consensus process using the Nominal Groups Technique (NGT). The following topics relating to the economic analysis of prophylaxis studies were addressed; Whose perspective should be taken? Which is the best methodological approach? Is micro- or macro-costing the best costing strategy? What information must be presented about costs and outcomes in order to facilitate local and international interpretation? The group suggests studies on the economic impact of prophylaxis should be viewed from a societal perspective and be reported using a Cost Utility Analysis (CUA) (with consideration of also reporting Cost Benefit Analysis [CBA]). All costs that exceed $500 should be used to measure the costs of prophylaxis (macro strategy) including items such as clotting factor costs, hospitalizations, surgical procedures, productivity loss and number of days lost from school or work. Generic and disease specific quality of lífe and utility measures should be used to report the outcomes of the study. The IPSG has suggested minimal core standards to be applied to the reporting of economic evaluations of hemophilia prophylaxis. Standardized reporting will facilitate the comparison of studies and will allow for more rational policy decisions and treatment choices.

Scenarios of physics beyond the standard model

NASA Astrophysics Data System (ADS)

Fok, Ricky

This dissertation discusses three topics on scenarios beyond the Standard Model. Topic one is the effects from a fourth generation of quarks and leptons on electroweak baryogenesis in the early universe. The Standard Model is incapable of electroweak baryogenesis due to an insufficiently strong enough electroweak phase transition (EWPT) as well as insufficient CP violation. We show that the presence of heavy fourth generation fermions solves the first problem but requires additional bosons to be included to stabilize the electroweak vacuum. Introducing supersymmetric partners of the heavy fermions, we find that the EWPT can be made strong enough and new sources of CP violation are present. Topic two relates to the lepton avor problem in supersymmetry. In the Minimal Supersymmetric Standard Model (MSSM), the off-diagonal elements in the slepton mass matrix must be suppressed at the 10-3 level to avoid experimental bounds from lepton avor changing processes. This dissertation shows that an enlarged R-parity can alleviate the lepton avor problem. An analysis of all sensitive parameters was performed in the mass range below 1 TeV, and we find that slepton maximal mixing is possible without violating bounds from the lepton avor changing processes: mu → egamma; mu → e conversion, and mu → 3e. Topic three is the collider phenomenology of quirky dark matter. In this model, quirks are particles that are gauged under the electroweak group, as well as a dark" color SU(2) group. The hadronization scale of this color group is well below the quirk masses. As a result, the dark color strings never break. Quirk and anti-quirk pairs can be produced at the LHC. Once produced, they immediately form a bound state of high angular momentum. The quirk pair rapidly shed angular momentum by emitting soft radiation before they annihilate into observable signals. This dissertation presents the decay branching ratios of quirkonia where quirks obtain their masses through electroweak symmetry breaking. This dissertation includes previously published and unpublished co-authored material.

Brief report: Response inhibition and processing speed in children with motor difficulties and developmental coordination disorder.

PubMed

Bernardi, Marialivia; Leonard, Hayley C; Hill, Elisabeth L; Henry, Lucy A

2016-01-01

A previous study reported that children with poor motor skills, classified as having motor difficulties (MD) or Developmental Coordination Disorder (DCD), produced more errors in a motor response inhibition task compared to typically developing (TD) children but did not differ in verbal inhibition errors. The present study investigated whether these groups differed in the length of time they took to respond in order to achieve these levels of accuracy, and whether any differences in response speed could be explained by generally slow information processing in children with poor motor skills. Timing data from the Verbal Inhibition Motor Inhibition test were analyzed to identify differences in performance between the groups on verbal and motor inhibition, as well as on processing speed measures from standardized batteries. Although children with MD and DCD produced more errors in the motor inhibition task than TD children, the current analyses found that they did not take longer to complete the task. Children with DCD were slower at inhibiting verbal responses than TD children, while the MD group seemed to perform at an intermediate level between the other groups in terms of verbal inhibition speed. Slow processing speed did not account for these group differences. Results extended previous research into response inhibition in children with poor motor skills by explicitly comparing motor and verbal responses, and suggesting that slow performance, even when accurate, may be attributable to an inefficient way of inhibiting responses, rather than slow information processing speed per se.

Effects of Guided Written Disclosure Protocol on mood states and psychological symptoms among parents of off-therapy acute lymphoblastic leukemia children.

PubMed

Martino, Maria Luisa; Freda, Maria Francesca; Camera, Flavia

2013-06-01

This study assesses the effects of Guided Written Disclosure Protocol on psychological distress in mothers and fathers of off-therapy acute lymphoblastic leukemia children. An experimental group participated in the writing intervention with a control group subject only to test-taking standards. The Symptom Questionnaire and Profile of Mood States were administered at baseline, post-intervention, and follow-up. Guided Written Disclosure Protocol had significant effects on the progressive reduction of anxiety, depression, somatic symptoms, hostility, tension-anxiety, and fatigue-inertia within the experimental group. However, the control group distress levels tended to worsen over time. The mediating role of emotional processing was highlighted.

Effective management tools for participants at Codex Committee on Residues of Veterinary Drugs meetings.

PubMed

Kay, Jack F

2016-05-01

The Codex Committee on Residues of Veterinary Drugs in Food (CCRVDF) fulfils a number of functions revolving around standard setting. The core activities of the CCRVDF include agreeing priorities for assessing veterinary drug residues, recommending maximum residue limits for veterinary drugs in foods of animal origin, considering methods of sampling and analyses, and developing codes of practice. Draft standards are developed and progress through an agreed series of steps common to all Codex Alimentarius Commission Committees. Meetings of the CCRVDF are held at approximately 18-month intervals. To ensure effective progress is made with meetings at this frequency, the CCRVDF makes use of a number of management tools. These include circular letters to interested parties, physical and electronic drafting groups between plenary sessions, meetings of interested parties immediately prior to sessions, as well as break out groups within sessions and detailed discussions within the CCRVDF plenary sessions. A range of these approaches is required to assist advances within the standards setting process and can be applied to other Codex areas and international standard setting more generally. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology.

PubMed

Barkan, Güliz A; Wojcik, Eva M; Nayar, Ritu; Savic-Prince, Spasenija; Quek, Marcus L; Kurtycz, Daniel F I; Rosenthal, Dorothy L

2016-07-01

The main purpose of urine cytology is to detect high-grade urothelial carcinoma. With this principle in mind, The Paris System (TPS) Working Group, composed of cytopathologists, surgical pathologists, and urologists, has proposed and published a standardized reporting system that includes specific diagnostic categories and cytomorphologic criteria for the reliable diagnosis of high-grade urothelial carcinoma. This paper outlines the essential elements of TPS and the process that led to the formation and rationale of the reporting system. TPS Working Group, organized at the 2013 International Congress of Cytology, conceived a standardized platform on which to base cytologic interpretation of urine samples. The widespread dissemination of this approach to cytologic examination and reporting of urologic samples and the scheme's universal acceptance by pathologists and urologists is critical for its success. For urologists, understanding the diagnostic criteria, their clinical implications, and limitations of TPS is essential if they are to utilize urine cytology and noninvasive ancillary tests in a thoughtful and practical manner. This is the first international/inclusive attempt at standardizing urinary cytology. The success of TPS will depend on the pathology and urology communities working collectively to improve this seminal paradigm shift, and optimize the impact on patient care.

Multilevel principal component analysis (mPCA) in shape analysis: A feasibility study in medical and dental imaging.

PubMed

Farnell, D J J; Popat, H; Richmond, S

2016-06-01

Methods used in image processing should reflect any multilevel structures inherent in the image dataset or they run the risk of functioning inadequately. We wish to test the feasibility of multilevel principal components analysis (PCA) to build active shape models (ASMs) for cases relevant to medical and dental imaging. Multilevel PCA was used to carry out model fitting to sets of landmark points and it was compared to the results of "standard" (single-level) PCA. Proof of principle was tested by applying mPCA to model basic peri-oral expressions (happy, neutral, sad) approximated to the junction between the mouth/lips. Monte Carlo simulations were used to create this data which allowed exploration of practical implementation issues such as the number of landmark points, number of images, and number of groups (i.e., "expressions" for this example). To further test the robustness of the method, mPCA was subsequently applied to a dental imaging dataset utilising landmark points (placed by different clinicians) along the boundary of mandibular cortical bone in panoramic radiographs of the face. Changes of expression that varied between groups were modelled correctly at one level of the model and changes in lip width that varied within groups at another for the Monte Carlo dataset. Extreme cases in the test dataset were modelled adequately by mPCA but not by standard PCA. Similarly, variations in the shape of the cortical bone were modelled by one level of mPCA and variations between the experts at another for the panoramic radiographs dataset. Results for mPCA were found to be comparable to those of standard PCA for point-to-point errors via miss-one-out testing for this dataset. These errors reduce with increasing number of eigenvectors/values retained, as expected. We have shown that mPCA can be used in shape models for dental and medical image processing. mPCA was found to provide more control and flexibility when compared to standard "single-level" PCA. Specifically, mPCA is preferable to "standard" PCA when multiple levels occur naturally in the dataset. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

COSPAR/PRBEM international working group activities report

NASA Astrophysics Data System (ADS)

Bourdarie, S.; Blake, B.; Cao, J. B.; Friedel, R.; Miyoshi, Y.; Panasyuk, M.; Underwood, C.

It is now clear to everybody that the current standard AE8 AP8 model for ionising particle specification in the radiation belts must be updated But such an objective is quite difficult to reach just as a reminder to develop AE8 AP8 model in the seventies was 10 persons full time for ten years It is clear that world-wide efforts must be combined because not any individual group has the human resource to perform these new models by themselves Under COSPAR umbrella an international group of expert well distributed around the world has been created to set up a common framework for everybody involved in this field Planned activities of the international group of experts are to - Define users needs - Provide guidelines for standard file format for ionising measurements - Set up guidelines to process in-situ data on a common basis - Decide in which form the new models will have to be - Centralise all progress done world-wide to advise the community - Try to organise world-wide activities as a project to ensure complementarities and more efficiencies between all efforts done Activities of this working group since its creation will be reported as well as future plans

Seasonal skin darkening in Chinese women: the Shanghaiese experience of daily sun protection.

PubMed

Qiu, Huixia; Flament, Frederic; Long, Xiaohui; Wu, Jun; Xu, Mengzhi; Leger, Didier Saint; Meaudre, Helene; Senee, Jerome; Piot, Bertrand; Bazin, Roland

2013-01-01

The facial skin tone of two groups of Chinese women from Shanghai was compared using standard colorimetric space techniques during a 6-month interval between January and July 2011. During the study period, one group of women (n = 40) applied a potent sun-protective cosmetic product daily, while the other group (n = 40) did not use any sun protection. The results, based on images taken using a standardized digital camera coupled to a spectroradiometer, showed that sun protection largely mitigated changes in the components of skin tone, ie, lightness, melanization, and individual typology angle parameters. The skin darkening process appeared to be reduced or prevented in the sun-protected group when compared with the control group. The sun-protected women had participated in an earlier study in 2008, which confirmed that seasonal skin darkening occurs from winter through summer in Shanghaiese women. Comparing the data obtained in the winters of 2008 and 2011, we were able to identify better the impact of 3 years of aging on the components of skin tone. Comparing data between seasons on the same women with (2011 study) and without (2008 study) sun protection highlights the role of the test product in preventing skin darkening.

Histological analysis of the alterations on cortical bone channels network after radiotherapy: A rabbit study.

PubMed

Rabelo, Gustavo Davi; Beletti, Marcelo Emílio; Dechichi, Paula

2010-10-01

The aim of this study was to evaluate the effects of radiotherapy in cortical bone channels network. Fourteen rabbits were divided in two groups and test group received single dose of 15 Gy cobalt-60 radiation in tibia, bilaterally. The animals were sacrificed and a segment of tibia was removed and histologically processed. Histological images were taken and had their bone channels segmented and called regions of interest (ROI). Images were analyzed through developed algorithms using the SCILAB mathematical environment, getting percentage of bone matrix, ROI areas, ROI perimeters, their standard deviations and Lacunarity. The osteocytes and empty lacunae were also counted. Data were evaluated using Kolmogorov-Smirnov, Mann Whitney, and Student's t test (P < 0.05). Significant differences in bone matrix percentage, area and perimeters of the channels, their respective standard deviations and lacunarity were found between groups. In conclusion, the radiotherapy causes reduction of bone matrix and modifies the morphology of bone channels network. © 2010 Wiley-Liss, Inc.

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

Miller, D. C.; Gu, X.; Haldenman, S.

The curing of cross-linkable encapsulation is a critical consideration for photovoltaic (PV) modules manufactured using a lamination process. Concerns related to ethylene-co-vinyl acetate (EVA) include the quality (e.g., expiration and uniformity) of the films or completion (duration) of the cross-linking of the EVA within a laminator. Because these issues are important to both EVA and module manufacturers, an international standard has recently been proposed by the Encapsulation Task-Group within the Working Group 2 (WG2) of the International Electrotechnical Commission (IEC) Technical Committee 82 (TC82) for the quantification of the degree of cure for EVA encapsulation. The present draft of themore » standard calls for the use of differential scanning calorimetry (DSC) as the rapid, enabling secondary (test) method. Both the residual enthalpy- and melt/freeze-DSC methods are identified. The DSC methods are calibrated against the gel content test, the primary (reference) method. Aspects of other established methods, including indentation and rotor cure metering, were considered by the group. Key details of the test procedure will be described.« less

Appraisal on the wound healing activity of different extracts obtained from Aegle marmelos and Mucuna pruriens by in vivo experimental models.

PubMed

Toppo, F A; Pawar, R S

2016-01-01

The use of a simple and reproducible model is inevitable for an objective statement of the effects of external factors on wound healing. Hence, the present study was conducted to evaluate wound healing activities of sequential different extracts of Aegle marmelos leaves (AM) and Mucuna pruriens seeds (MP) by in vivo experimental models. Wistar albino rats were subjected to excision, incision and dead space wounds measuring approximately 250 mm2, 3 cm and implanting sterilized polyvinyl chloride tube on the back of each rat near either side of the vertebral column respectively. The experimental animals were randomized into eight groups (n = 6), control, standard and treatment groups. Hydrogel of different extracts were applied topically once daily. The parameters observed were percentage of wound contraction, epithelization period, tensile strength, hydroxyproline content of the granulation tissue, and histological changes during wound healing. The statistical study revealed that in excision, incision, and dead space wound models all formulations have significant (P < 0.01) wound healing potential. However, methanolic extract formulation was found to be superior to all other treatments as evidenced by rapid wound contraction, lesser number of days required for complete epithelization, increased tensile strength and significant increase in hydroxyproline content. As compared to the reference standard treated group the wound healing process of the experimental groups was decelerated. All extracts obtained from AM and MP facilitated the wound healing process in all experimental models.

77 FR 16508 - National Emission Standards for Hazardous Air Pollutant Emissions: Group IV Polymers and Resins...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

... National Emission Standards for Hazardous Air Pollutant Emissions: Group IV Polymers and Resins; Pesticide... Hazardous Air Pollutant Emissions: Group IV Polymers and Resins; National Emission Standards for Hazardous... proposed rule titled, National Emission Standards for Hazardous Air Pollutant Emissions: Group IV Polymers...

76 FR 22565 - National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins; Marine Tank...-AO91 National Emission Standards for Hazardous Air Pollutant Emissions: Group I Polymers and Resins... Emissions Standards for Group I Polymers and Resins (Butyl Rubber Production, Epichlorohydrin Elastomers...

Standardization of chemical analytical techniques for pyrolysis bio-oil: history, challenges, and current status of methods

DOE PAGES

Ferrell, Jack R.; Olarte, Mariefel V.; Christensen, Earl D.; ...

2016-07-05

Here, we discuss the standardization of analytical techniques for pyrolysis bio-oils, including the current status of methods, and our opinions on future directions. First, the history of past standardization efforts is summarized, and both successful and unsuccessful validation of analytical techniques highlighted. The majority of analytical standardization studies to-date has tested only physical characterization techniques. In this paper, we present results from an international round robin on the validation of chemical characterization techniques for bio-oils. Techniques tested included acid number, carbonyl titrations using two different methods (one at room temperature and one at 80 °C), 31P NMR for determination ofmore » hydroxyl groups, and a quantitative gas chromatography–mass spectrometry (GC-MS) method. Both carbonyl titration and acid number methods have yielded acceptable inter-laboratory variabilities. 31P NMR produced acceptable results for aliphatic and phenolic hydroxyl groups, but not for carboxylic hydroxyl groups. As shown in previous round robins, GC-MS results were more variable. Reliable chemical characterization of bio-oils will enable upgrading research and allow for detailed comparisons of bio-oils produced at different facilities. Reliable analytics are also needed to enable an emerging bioenergy industry, as processing facilities often have different analytical needs and capabilities than research facilities. We feel that correlations in reliable characterizations of bio-oils will help strike a balance between research and industry, and will ultimately help to -determine metrics for bio-oil quality. Lastly, the standardization of additional analytical methods is needed, particularly for upgraded bio-oils.« less

Standardization of chemical analytical techniques for pyrolysis bio-oil: history, challenges, and current status of methods

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

Ferrell, Jack R.; Olarte, Mariefel V.; Christensen, Earl D.

Here, we discuss the standardization of analytical techniques for pyrolysis bio-oils, including the current status of methods, and our opinions on future directions. First, the history of past standardization efforts is summarized, and both successful and unsuccessful validation of analytical techniques highlighted. The majority of analytical standardization studies to-date has tested only physical characterization techniques. In this paper, we present results from an international round robin on the validation of chemical characterization techniques for bio-oils. Techniques tested included acid number, carbonyl titrations using two different methods (one at room temperature and one at 80 °C), 31P NMR for determination ofmore » hydroxyl groups, and a quantitative gas chromatography–mass spectrometry (GC-MS) method. Both carbonyl titration and acid number methods have yielded acceptable inter-laboratory variabilities. 31P NMR produced acceptable results for aliphatic and phenolic hydroxyl groups, but not for carboxylic hydroxyl groups. As shown in previous round robins, GC-MS results were more variable. Reliable chemical characterization of bio-oils will enable upgrading research and allow for detailed comparisons of bio-oils produced at different facilities. Reliable analytics are also needed to enable an emerging bioenergy industry, as processing facilities often have different analytical needs and capabilities than research facilities. We feel that correlations in reliable characterizations of bio-oils will help strike a balance between research and industry, and will ultimately help to -determine metrics for bio-oil quality. Lastly, the standardization of additional analytical methods is needed, particularly for upgraded bio-oils.« less

Microbial consortium role in processing liquid waste of vegetables in Keputran Market Surabaya as organic liquid fertilizer ferti-plus

NASA Astrophysics Data System (ADS)

Rizqi, Fauziah; Supriyanto, Agus; Lestari, Intan; Lita Indri D., L.; Elmi Irmayanti, A.; Rahmaniyah, Fadilatur

2016-03-01

Many activities in this market is directly proportional to increase production of vegetables waste, especially surabaya. Therefore, in this study aims to utilize liquid waste of vegetables into liquid organic fertilizer by mixing microbial consorsium. The microbial consorsium consist of Azotobacter chrococcum, Azospirillum brasilense, Rhizobium leguminosarum, Bacillus subtilis, Bacillus megaterium, Pseudomonas putida, and Pseudomonas fluorescens. Ttreatment of microbial concentrations (5%, 10%, 15%) and the length of the incubation period (7 days, 14 days, 21 days) used in this research. The parameters used are: C/N ratio, levels of CNP, and BOD value. This study uses a standard organic fertilizer value according SNI19-7030-2004, The results show the value of C/N ratio comply with the ISO standards. C levels showed an increase during the incubation period but not compare with standards. N levels that compare with standards are microbial treatment in all group concentration except control group with an incubation period of 21 days is > 7. P levels compare with the existing standards in the group of microbe concentration of 10% and 15% during the incubation period. The value of the initial BOD liquid waste of vegetable is 790.25 mg / L, this value indicates that the waste should not go into the water body. Accordingly, the results of this study can not be used as a liquid organic fertilizer, but potentially if it is used as a natural career or build natural soil. The Building natural soil is defined as the natural ingredients that can be used to improve soil properties.

Cyclic fatigue resistance of four nickel-titanium rotary instruments: a comparative study.

PubMed

Pedullà, Eugenio; Plotino, Gianluca; Grande, Nicola Maria; Pappalardo, Alfio; Rapisarda, Ernesto

2012-04-01

The aim of this study is to investigate cyclic fatigue resistance of four nickel - titanium rotary (NTR) instruments produced by a new method or traditional grinding processes. FOUR NTR INSTRUMENTS FROM DIFFERENT BRANDS WERE SELECTED: group 1. Twisted File produced by a new thermal treatment of nickel - titanium alloy; group 2. Revo S SU; group 3. Mtwo and group 4. BioRaCe BR3 produced by traditional grinding processes. A total of 80 instruments (20 for each group) were tested for cyclic fatigue resistance inside a curved artificial canal with a 60 degree angle of curvature and 5 mm radius of curvature. Time to fracture (TtF) from the start of the test until the moment of file breakage and the length of the fractured tip was recorded for each instrument. Means and standard deviations (SD) of TtF and fragment length were calculated. Data were subjected to one-way analysis of variance (ANOVA). Group 1 (Twisted File) showed the highest value of TtF means. Cyclic fatigue resistance of Twisted File and Mtwo was significantly higher than group 2 (Revo S SU) and 4 (BioRace BR3), while no significant differences were found between group 1 (Twisted File) and 3 (Mtwo) or group 2 (Revo S SU) and 4 (BioRaCe BR3). The cyclic fatigue resistance of Twisted File was significantly frigher than instruments produced with traditional grinding process except of Mtwo files.

Cyclic fatigue resistance of four nickel-titanium rotary instruments: a comparative study

PubMed Central

Pedullà, Eugenio; Plotino, Gianluca; Grande, Nicola Maria; Pappalardo, Alfio; Rapisarda, Ernesto

2012-01-01

Summary Aims The aim of this study is to investigate cyclic fatigue resistance of four nickel – titanium rotary (NTR) instruments produced by a new method or traditional grinding processes. Methods Four NTR instruments from different brands were selected: group 1. Twisted File produced by a new thermal treatment of nickel – titanium alloy; group 2. Revo S SU; group 3. Mtwo and group 4. BioRaCe BR3 produced by traditional grinding processes. A total of 80 instruments (20 for each group) were tested for cyclic fatigue resistance inside a curved artificial canal with a 60 degree angle of curvature and 5 mm radius of curvature. Time to fracture (TtF) from the start of the test until the moment of file breakage and the length of the fractured tip was recorded for each instrument. Means and standard deviations (SD) of TtF and fragment length were calculated. Data were subjected to one-way analysis of variance (ANOVA). Results Group 1 (Twisted File) showed the highest value of TtF means. Cyclic fatigue resistance of Twisted File and Mtwo was significantly higher than group 2 (Revo S SU) and 4 (BioRace BR3), while no significant differences were found between group 1 (Twisted File) and 3 (Mtwo) or group 2 (Revo S SU) and 4 (BioRaCe BR3). Conclusions The cyclic fatigue resistance of Twisted File was significantly frigher than instruments produced with traditional grinding process except of Mtwo files. PMID:23087787

Cognitive and neural mechanisms of decision biases in recognition memory.

PubMed

Windmann, Sabine; Urbach, Thomas P; Kutas, Marta

2002-08-01

In recognition memory tasks, stimuli can be classified as "old" either on the basis of accurate memory or a bias to respond "old", yet bias has received little attention in the cognitive neuroscience literature. Here we examined the pattern and timing of bias-related effects in event-related brain potentials (ERPs) to determine whether the bias is linked more to memory retrieval or to response verification processes. Participants were divided into a High Bias and a Low Bias group according to their bias to respond "old". These groups did not differ in recognition accuracy or in the ERP pattern to items that actually were old versus new (Objective Old/New Effect). However, when the old/new distinction was based on each subject's perspective, i.e. when items judged "old" were compared with those judged "new" (Subjective Old/New Effect), significant group differences were observed over prefrontal sites with a timing (300-500 ms poststimulus) more consistent with bias acting early on memory retrieval processes than on post-retrieval response verification processes. In the standard old/new effect (Hits vs Correct Rejections), these group differences were intermediate to those for the Objective and the Subjective comparisons, indicating that such comparisons are confounded by response bias. We propose that these biases are top-down controlled processes mediated by prefrontal cortex areas.

Is post-event processing a social anxiety specific or transdiagnostic cognitive process in the anxiety spectrum?

PubMed

Laposa, Judith M; Collimore, Kelsey C; Rector, Neil A

2014-11-01

Research on post-event processing (PEP), where individuals conduct a post-mortem evaluation of a social situation, has focused primarily on its relationship with social anxiety. The current study examined: 1) levels of PEP for a standardized event in different anxiety disorders; 2) the relationship between peak anxiety levels during this event and subsequent PEP; and 3) the relationship between PEP and disorder-specific symptom severity. Participants with primary DSM-IV diagnoses of social anxiety disorder (SAD), obsessive compulsive disorder (OCD), panic disorder with/without agoraphobia (PD/A), or generalized anxiety disorder (GAD) completed diagnosis specific symptom measures before attending group cognitive behavioural therapy (CBT) specific to their diagnosis. Participants rated their peak anxiety level during the first group therapy session, and one week later rated PEP in the context of CBT. The results indicated that all anxiety disorder groups showed heightened and equivalent PEP ratings. Peak state anxiety during the first CBT session predicted subsequent level of PEP, irrespective of diagnostic group. PEP ratings were found to be associated with disorder-specific symptom severity in SAD, GAD, and PD/A, but not in OCD. PEP may be a transdiagnostic process with relevance to a broad range of anxiety disorders, not just SAD.

[Revelation of purchase system of developed nation to large medical equipment group purchase in our country].

PubMed

Tao, Lin; Guan, Bing; Liu, Shan

2011-01-01

There were some features of purchase system in developed nation, such as clear purchase objectives flexible methods, standard programming, emphasis on competition and open process. The measures suggested include playing the role of competition purchasing; establishing the e-business modern purchasing information system; establishing legislation system; and completing business purchasing.

Analysis of Research and Lecturing Proposals That Meet Fulbright Quality Standards.

ERIC Educational Resources Information Center

Mauch, James E.

Information on how to make an application for a Fulbright Award is presented to assist faculty members, young scholars, and women and minority group members who are often underrepresented in these scholarly opportunities. Ways to help applicants improve their chances of selection in a competitive process are identified. Every year, there are about…

Through Mathematical Eyes: Exploring Functional Relationships in Math and Science. Moving Middle Schools.

ERIC Educational Resources Information Center

Ritchhart, Ron, Ed.

In six sites across the United States teams of teachers began creating "portfolio cultures"--classrooms where growth towards high common standards and reflection was emphasized for both students and teachers. Working groups of teachers became involved in a 2-year process to develop curriculum. This book is a part of this series…

RICIS Symposium 1992: Mission and Safety Critical Systems Research and Applications

NASA Technical Reports Server (NTRS)

1992-01-01

This conference deals with computer systems which control systems whose failure to operate correctly could produce the loss of life and or property, mission and safety critical systems. Topics covered are: the work of standards groups, computer systems design and architecture, software reliability, process control systems, knowledge based expert systems, and computer and telecommunication protocols.

Making Healthy Eating and Physical Activity Policy Practice: Process Evaluation of a Group Randomized Controlled Intervention in Afterschool Programs

ERIC Educational Resources Information Center

Weaver, R. Glenn; Beets, Michael W.; Hutto, Brent; Saunders, Ruth P.; Moore, Justin B.; Turner-McGrievy, Gabrielle; Huberty, Jennifer L.; Ward, Dianne S.; Pate, Russell R.; Beighle, Aaron; Freedman, Darcy

2015-01-01

This study describes the link between level of implementation and outcomes from an intervention to increase afterschool programs' (ASPs) achievement of healthy eating and physical activity (HE-PA) Standards. Ten intervention ASPs implemented the Strategies-To-Enhance-Practice (STEPs), a multi-component, adaptive intervention framework identifying…

An effective purification method using large bottles for human pancreatic islet isolation

PubMed Central

Shimoda, Masayuki; Itoh, Takeshi; Iwahashi, Shuichi; Takita, Morihito; Sugimoto, Koji; Kanak, Mazhar A.; Chujo, Daisuke; Naziruddin, Bashoo; Levy, Marlon F.; Grayburn, Paul A.; Matsumoto, Shinichi

2012-01-01

The purification process is one of the most difficult procedures in pancreatic islet isolation. It was demonstrated that the standard purification method using a COBE 2991 cell processor with Ficoll density gradient solution harmed islets mechanically by high shear force. We reported that purification using large bottles with a lower viscosity gradient solution could improve the efficacy of porcine islet purification. In this study, we examined whether the new bottle purification method could improve the purification of human islets. Nine human pancreata from brain-dead donors were used. After pancreas digestion, the digested tissue was divided into three groups. Each group was purified by continuous density gradient using ET-Kyoto and iodixanol gradient solution with either the standard COBE method (COBE group) or the top loading (top group) or bottom loading (bottom group) bottle purification methods. Islet yield, purity, recovery rate after purification, and in vitro and in vivo viability were compared. Islet yield per pancreas weight (IE/g) and the recovery rate in the top group were significantly higher than in the COBE and bottom groups. Furthermore, the average size of purified islets in the top group was significantly larger than in the COBE group, which indicated that the bottle method could reduce the shear force to the islets. In vivo viability was also significantly higher in the top group compared with the COBE group. In conclusion, the top-loading bottle method could improve the quality and quantity of human islets after purification. PMID:23221740

The Effects of Face Expertise Training on the Behavioral Performance and Brain Activity of Adults with High Functioning Autism Spectrum Disorders

PubMed Central

Webb, Sara Jane; Jones, Emily; Merkle, Kristen; Kamara, Dana; Bavaro, Joshua; Aylward, Elizabeth; Dawson, Geraldine

2013-01-01

The effect of expertise training with faces was studied in adults with ASD who showed initial impairment in face recognition. Participants were randomly assigned to a computerized training program involving either faces or houses. Pre- and post-testing included standardized and experimental measures of behavior and event-related brain potentials (ERPs), as well as interviews after training. After training, all participants met behavioral criteria for expertise with the specific stimuli on which they received training. Scores on standardized measures improved after training for both groups, but only the face training group showed an increased face inversion effect behaviorally and electrophysiological changes to faces in the P100 component. These findings suggest that individuals with ASD can gain expertise in face processing through training. PMID:21484517

Exploring the transition to DRGs in Developing Countries: A case study in Shanghai, China

PubMed Central

Wang, Zhaoxin; Liu, Rui; Li, Ping; Jiang, Chenghua

2014-01-01

Objective: With the success of DRGs (Diagnosis Related Groups) in developing countries, this prospective payment system has been imported into China from the early 21st century. However, DRGs has been struggling and has made little progress since (its adoption in) 2004. This study contributes to the debate on how to bridge the pay-for-service (system/scheme) and DRGs (Diagnosis Related Groups) during the transitional period of payment reform in China. Methods: From 2008 to 2012, sixty regional general hospitals in Shanghai were divided into three groups according to their economic level, and one hospital was picked from each group randomly. After ranking of morbidity, 22130 patients with hypertension or coronary heart disease were chosen as sample. Using multiple linear regression analysis, the inter relationships between the total medical expenses of the inpatients, and age, gender of the inpatients, length of stay, region and economic level of the hospitals were examined. Results: The main findings were (1) Age, LOS and the economic level of treatment location had a statistically significant impact on patients with hypertension or coronary heart disease. However, gender is only a significant factor to patients with coronary heart disease. The results suggested that age, LOS and the economic level of treatment location should be considered in formulating pricing standards for the hypertension patient group. Besides the above mentioned factors, gender should also be considered in formulating pricing standards for the coronary heart disease patient group. (2) Under the premise of limited resources, developing countries should first narrow down to screen for common and frequently occurring diseases, then study the key factors which affect the treatment cost of the diseases. Conclusion: Simplification of the DRGs standard- setting process based on standardized clinical pathways and accurate costing will greatly increase the efficiency of implementing DRGs in the developing world. PMID:24772121

Modeling Healthcare Processes Using Commitments: An Empirical Evaluation.

PubMed

Telang, Pankaj R; Kalia, Anup K; Singh, Munindar P

2015-01-01

The two primary objectives of this paper are: (a) to demonstrate how Comma, a business modeling methodology based on commitments, can be applied in healthcare process modeling, and (b) to evaluate the effectiveness of such an approach in producing healthcare process models. We apply the Comma approach on a breast cancer diagnosis process adapted from an HHS committee report, and presents the results of an empirical study that compares Comma with a traditional approach based on the HL7 Messaging Standard (Traditional-HL7). Our empirical study involved 47 subjects, and two phases. In the first phase, we partitioned the subjects into two approximately equal groups. We gave each group the same requirements based on a process scenario for breast cancer diagnosis. Members of one group first applied Traditional-HL7 and then Comma whereas members of the second group first applied Comma and then Traditional-HL7-each on the above-mentioned requirements. Thus, each subject produced two models, each model being a set of UML Sequence Diagrams. In the second phase, we repartitioned the subjects into two groups with approximately equal distributions from both original groups. We developed exemplar Traditional-HL7 and Comma models; we gave one repartitioned group our Traditional-HL7 model and the other repartitioned group our Comma model. We provided the same changed set of requirements to all subjects and asked them to modify the provided exemplar model to satisfy the new requirements. We assessed solutions produced by subjects in both phases with respect to measures of flexibility, time, difficulty, objective quality, and subjective quality. Our study found that Comma is superior to Traditional-HL7 in flexibility and objective quality as validated via Student's t-test to the 10% level of significance. Comma is a promising new approach for modeling healthcare processes. Further gains could be made through improved tooling and enhanced training of modeling personnel.

Modeling Healthcare Processes Using Commitments: An Empirical Evaluation

PubMed Central

2015-01-01

The two primary objectives of this paper are: (a) to demonstrate how Comma, a business modeling methodology based on commitments, can be applied in healthcare process modeling, and (b) to evaluate the effectiveness of such an approach in producing healthcare process models. We apply the Comma approach on a breast cancer diagnosis process adapted from an HHS committee report, and presents the results of an empirical study that compares Comma with a traditional approach based on the HL7 Messaging Standard (Traditional-HL7). Our empirical study involved 47 subjects, and two phases. In the first phase, we partitioned the subjects into two approximately equal groups. We gave each group the same requirements based on a process scenario for breast cancer diagnosis. Members of one group first applied Traditional-HL7 and then Comma whereas members of the second group first applied Comma and then Traditional-HL7—each on the above-mentioned requirements. Thus, each subject produced two models, each model being a set of UML Sequence Diagrams. In the second phase, we repartitioned the subjects into two groups with approximately equal distributions from both original groups. We developed exemplar Traditional-HL7 and Comma models; we gave one repartitioned group our Traditional-HL7 model and the other repartitioned group our Comma model. We provided the same changed set of requirements to all subjects and asked them to modify the provided exemplar model to satisfy the new requirements. We assessed solutions produced by subjects in both phases with respect to measures of flexibility, time, difficulty, objective quality, and subjective quality. Our study found that Comma is superior to Traditional-HL7 in flexibility and objective quality as validated via Student’s t-test to the 10% level of significance. Comma is a promising new approach for modeling healthcare processes. Further gains could be made through improved tooling and enhanced training of modeling personnel. PMID:26539985

Addressing group dynamics in a brief motivational intervention for college student drinkers.

PubMed

Faris, Alexander S; Brown, Janice M

2003-01-01

Previous research indicates that brief motivational interventions for college student drinkers may be less effective in group settings than individual settings. Social psychological theories about counterproductive group dynamics may partially explain this finding. The present study examined potential problems with group motivational interventions by comparing outcomes from a standard group motivational intervention (SGMI; n = 25), an enhanced group motivational intervention (EGMI; n = 27) designed to suppress counterproductive processes, and a no intervention control (n = 23). SGMI and EGMI participants reported disruptive group dynamics as evidenced by low elaboration likelihood, production blocking, and social loafing, though the level of disturbance was significantly lower for EGMI individuals (p = .001). Despite counteracting group dynamics in the EGMI condition, participants in the two interventions were statistically similar in post-intervention problem recognition and future drinking intentions. The results raise concerns over implementing individually-based interventions in group settings without making necessary adjustments.

Active music therapy approach for stroke patients in the post-acute rehabilitation.

PubMed

Raglio, Alfredo; Zaliani, Alberto; Baiardi, Paola; Bossi, Daniela; Sguazzin, Cinzia; Capodaglio, Edda; Imbriani, Chiara; Gontero, Giulia; Imbriani, Marcello

2017-05-01

Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach. Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes. In this randomized controlled pilot trial, relational active music therapy approaches were tested in the post-acute phase of disease. Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups. The experimental group underwent the standard of care (physiotherapy and occupational therapy daily sessions) and relational active music therapy treatments. The control group underwent the standard of care only. Motor functions and psychological aspects were assessed before and after treatments. Music therapy process was also evaluated using a specific rating scale. All groups showed a positive trend in quality of life, functional and disability levels, and gross mobility. The experimental group showed a decrease of anxiety and, in particular, of depression (p = 0.016). In addition, the strength of non-dominant hand (grip) significantly increased in the experimental group (p = 0.041). Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships. Future studies, including a greater number of patients and follow-up evaluations, are needed to confirm promising results of this study.

Auditory Processing in Noise Is Associated With Complex Patterns of Disrupted Functional Connectivity in Autism Spectrum Disorder

PubMed Central

Mamashli, Fahimeh; Khan, Sheraz; Bharadwaj, Hari; Michmizos, Konstantinos; Ganesan, Santosh; Garel, Keri-Lee A.; Hashmi, Javeria Ali; Herbert, Martha R.; Hämäläinen, Matti; Kenet, Tal

2017-01-01

Autism spectrum disorder (ASD) is associated with difficulty in processing speech in a noisy background, but the neural mechanisms that underlie this deficit have not been mapped. To address this question, we used magnetoencephalography to compare the cortical responses between ASD and typically developing (TD) individuals to a passive mismatch paradigm. We repeated the paradigm twice, once in a quiet background, and once in the presence of background noise. We focused on both the evoked mismatch field (MMF) response in temporal and frontal cortical locations, and functional connectivity with spectral specificity between those locations. In the quiet condition, we found common neural sources of the MMF response in both groups, in the right temporal gyrus and inferior frontal gyrus (IFG). In the noise condition, the MMF response in the right IFG was preserved in the TD group, but reduced relative to the quiet condition in ASD group. The MMF response in the right IFG also correlated with severity of ASD. Moreover, in noise, we found significantly reduced normalized coherence (deviant normalized by standard) in ASD relative to TD, in the beta band (14–25 Hz), between left temporal and left inferior frontal sub-regions. However, unnormalized coherence (coherence during deviant or standard) was significantly increased in ASD relative to TD, in multiple frequency bands. Our findings suggest increased recruitment of neural resources in ASD irrespective of the task difficulty, alongside a reduction in top-down modulations, usually mediated by the beta band, needed to mitigate the impact of noise on auditory processing. PMID:27910247

Treatment adherence in cognitive processing therapy for combat-related PTSD with history of mild TBI.

PubMed

Davis, Jeremy J; Walter, Kristen H; Chard, Kathleen M; Parkinson, R Bruce; Houston, Wes S

2013-02-01

This retrospective study examined treatment adherence in Cognitive Processing Therapy (CPT) for combat-related posttraumatic stress disorder (PTSD) in Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) with and without history of mild traumatic brain injury (mTBI). Medical record review of consecutive referrals to an outpatient PTSD clinic identified veterans diagnosed with combat-related PTSD who began treatment with CPT. The sample (N = 136) was grouped according to positive (n = 44) and negative (n = 92) mTBI history. Groups were compared in terms of presenting symptoms and treatment adherence. The groups were not different on a pretreatment measure of depression, but self-reported and clinician-rated PTSD symptoms were higher in veterans with history of mTBI. The treatment completion rate was greater than 61% in both groups. The number of sessions attended averaged 9.6 for the PTSD group and 7.9 for the mTBI/PTSD group (p = .05). Given the lack of marked group differences in treatment adherence, these initial findings suggest that standard CPT for PTSD may be a tolerable treatment for OEF/OIF veterans with a history of PTSD and mTBI as well as veterans with PTSD alone.

The effect of various veneering techniques on the marginal fit of zirconia copings.

PubMed

Torabi, Kianoosh; Vojdani, Mahroo; Giti, Rashin; Taghva, Masumeh; Pardis, Soheil

2015-06-01

This study aimed to evaluate the fit of zirconia ceramics before and after veneering, using 3 different veneering processes (layering, press-over, and CAD-on techniques). Thirty standardized zirconia CAD/CAM frameworks were constructed and divided into three groups of 10 each. The first group was veneered using the traditional layering technique. Press-over and CAD-on techniques were used to veneer second and third groups. The marginal gap of specimens was measured before and after veneering process at 18 sites on the master die using a digital microscope. Paired t-test was used to evaluate mean marginal gap changes. One-way ANOVA and post hoc tests were also employed for comparison among 3 groups (α=.05). Marginal gap of 3 groups was increased after porcelain veneering. The mean marginal gap values after veneering in the layering group (63.06 µm) was higher than press-over (50.64 µm) and CAD-on (51.50 µm) veneered groups (P<.001). Three veneering methods altered the marginal fit of zirconia copings. Conventional layering technique increased the marginal gap of zirconia framework more than pressing and CAD-on techniques. All ceramic crowns made through three different veneering methods revealed clinically acceptable marginal fit.

Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial.

PubMed

Sherman, Kerry A; Shaw, Laura-Kate E; Winch, Caleb J; Harcourt, Diana; Boyages, John; Cameron, Linda D; Brown, Paul; Lam, Thomas; Elder, Elisabeth; French, James; Spillane, Andrew

2016-10-01

Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making. Women (n = 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants' decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret. Linear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants' ratings for BRECONDA demonstrated high user acceptability and overall satisfaction. Women who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision.

The Fragility of Individual-Based Explanations of Social Hierarchies: A Test Using Animal Pecking Orders

PubMed Central

2016-01-01

The standard approach in accounting for hierarchical differentiation in biology and the social sciences considers a hierarchy as a static distribution of individuals possessing differing amounts of some valued commodity, assumes that the hierarchy is generated by micro-level processes involving individuals, and attempts to reverse engineer the processes that produced the hierarchy. However, sufficient experimental and analytical results are available to evaluate this standard approach in the case of animal dominance hierarchies (pecking orders). Our evaluation using evidence from hierarchy formation in small groups of both hens and cichlid fish reveals significant deficiencies in the three tenets of the standard approach in accounting for the organization of dominance hierarchies. In consequence, we suggest that a new approach is needed to explain the organization of pecking orders and, very possibly, by implication, for other kinds of social hierarchies. We develop an example of such an approach that considers dominance hierarchies to be dynamic networks, uses dynamic sequences of interaction (dynamic network motifs) to explain the organization of dominance hierarchies, and derives these dynamic sequences directly from observation of hierarchy formation. We test this dynamical explanation using computer simulation and find a good fit with actual dynamics of hierarchy formation in small groups of hens. We hypothesize that the same dynamic sequences are used in small groups of many other animal species forming pecking orders, and we discuss the data required to evaluate our hypothesis. Finally, we briefly consider how our dynamic approach may be generalized to other kinds of social hierarchies using the example of the distribution of empty gastropod (snail) shells occupied in populations of hermit crabs. PMID:27410230

Standardization Process for Space Radiation Models Used for Space System Design

NASA Technical Reports Server (NTRS)

Barth, Janet; Daly, Eamonn; Brautigam, Donald

2005-01-01

The space system design community has three concerns related to models of the radiation belts and plasma: 1) AP-8 and AE-8 models are not adequate for modern applications; 2) Data that have become available since the creation of AP-8 and AE-8 are not being fully exploited for modeling purposes; 3) When new models are produced, there is no authorizing organization identified to evaluate the models or their datasets for accuracy and robustness. This viewgraph presentation provided an overview of the roadmap adopted by the Working Group Meeting on New Standard Radiation Belt and Space Plasma Models.

Updating contextualized clinical practice guidelines on stroke rehabilitation and low back pain management using a novel assessment framework that standardizes decisions.

PubMed

Gambito, Ephraim D V; Gonzalez-Suarez, Consuelo B; Grimmer, Karen A; Valdecañas, Carolina M; Dizon, Janine Margarita R; Beredo, Ma Eulalia J; Zamora, Marcelle Theresa G

2015-11-04

Clinical practice guidelines need to be regularly updated with current literature in order to remain relevant. This paper reports on the approach taken by the Philippine Academy of Rehabilitation Medicine (PARM). This dovetails with its writing guide, which underpinned its foundational work in contextualizing guidelines for stroke and low back pain (LBP) in 2011. Working groups of Filipino rehabilitation physicians and allied health practitioners met to reconsider and modify, where indicated, the 'typical' Filipino patient care pathways established in the foundation guidelines. New clinical guidelines on stroke and low back pain which had been published internationally in the last 3 years were identified using a search of electronic databases. The methodological quality of each guideline was assessed using the iCAHE Guideline Quality Checklist, and only those guidelines which provided full text references, evidence hierarchy and quality appraisal of the included literature, were included in the PARM update. Each of the PARM-endorsed recommendations was then reviewed, in light of new literature presented in the included clinical guidelines. A novel standard updating approach was developed based on the criteria reported by Johnston et al. (Int J Technol Assess Health Care 19(4):646-655, 2003) and then modified to incorporate wording from the foundational PARM writing guide. The new updating tool was debated, pilot-tested and agreed upon by the PARM working groups, before being applied to the guideline updating process. Ten new guidelines on stroke and eleven for low back pain were identified. Guideline quality scores were moderate to good, however not all guidelines comprehensively linked the evidence body underpinning recommendations with the literature. Consequently only five stroke and four low back pain guidelines were included. The modified PARM updating guide was applied by all working groups to ensure standardization of the wording of updated recommendations and the underpinning evidence bases. The updating tool provides a simple, standard and novel approach that incorporates evidence hierarchy and quality, and wordings of recommendations. It could be used efficiently by other guideline updaters particularly in developing countries, where resources for guideline development and updates are limited. When many people are involved in guideline writing, there is always the possibility of 'slippage' in use of wording and interpretation of evidence. The PARM updating tool provides a mechanism for maintaining a standard process for guideline updating processes that can be followed by clinicians with basic training in evidence-based practice principles.

Process Analytical Technology (PAT): batch-to-batch reproducibility of fermentation processes by robust process operational design and control.

PubMed

Gnoth, S; Jenzsch, M; Simutis, R; Lübbert, A

2007-10-31

The Process Analytical Technology (PAT) initiative of the FDA is a reaction on the increasing discrepancy between current possibilities in process supervision and control of pharmaceutical production processes and its current application in industrial manufacturing processes. With rigid approval practices based on standard operational procedures, adaptations of production reactors towards the state of the art were more or less inhibited for long years. Now PAT paves the way for continuous process and product improvements through improved process supervision based on knowledge-based data analysis, "Quality-by-Design"-concepts, and, finally, through feedback control. Examples of up-to-date implementations of this concept are presented. They are taken from one key group of processes in recombinant pharmaceutical protein manufacturing, the cultivations of genetically modified Escherichia coli bacteria.

Application of ISO standard 27048: dose assessment for the monitoring of workers for internal radiation exposure.

PubMed

Henrichs, K

2011-03-01

Besides ongoing developments in the dosimetry of incorporated radionuclides, there are various efforts to improve the monitoring of workers for potential or real intakes of radionuclides. The disillusioning experience with numerous intercomparison projects identified substantial differences between national regulations, concepts, applied programmes and methods, and dose assessment procedures. Measured activities were not directly comparable because of significant differences between measuring frequencies and methods, but also results of case studies for dose assessments revealed differences of orders of magnitude. Besides the general common interest in reliable monitoring results, at least the cross-border activities of workers (e.g. nuclear power plant services) require consistent approaches and comparable results. The International Standardization Organization therefore initiated projects to standardise programmes for the monitoring of workers, the requirements for measuring laboratories and the processes for the quantitative evaluation of monitoring results in terms of internal assessed doses. The strength of the concepts applied by the international working group consists in a unified approach defining the requirements, databases and processes. This paper is intended to give a short introduction into the standardization project followed by a more detailed description of the dose assessment standard, which will be published in the very near future.

Value of Collaboration With Standardized Patients and Patient Facilitators in Enhancing Reflection During the Process of Building a Simulation.

PubMed

Stanley, Claire; Lindsay, Sally; Parker, Kathryn; Kawamura, Anne; Samad Zubairi, Mohammad

2018-05-09

We previously reported that experienced clinicians find the process of collectively building and participating in simulations provide (1) a unique reflective opportunity; (2) a venue to identify different perspectives through discussion and action in a group; and (3) a safe environment for learning. No studies have assessed the value of collaborating with standardized patients (SPs) and patient facilitators (PFs) in the process. In this work, we describe this collaboration in building a simulation and the key elements that facilitate reflection. Three simulation scenarios surrounding communication were built by teams of clinicians, a PF, and SPs. Six build sessions were audio recorded, transcribed, and thematically analyzed through an iterative process to (1) describe the steps of building a simulation scenario and (2) identify the key elements involved in the collaboration. The five main steps to build a simulation scenario were (1) storytelling and reflection; (2) defining objectives and brainstorming ideas; (3) building a stem and creating a template; (4) refining the scenario with feedback from SPs; and (5) mock run-throughs with follow-up discussion. During these steps, the PF shared personal insights, challenging participants to reflect deeper to better understand and consider the patient's perspective. The SPs provided unique outside perspective to the group. In addition, the interaction between the SPs and the PF helped refine character roles. A collaborative approach incorporating feedback from PFs and SPs to create a simulation scenario is a valuable method to enhance reflective practice for clinicians.

Dysphoria and children's processing of supportive interactions.

PubMed

Shirk, S R; Van Horn, M; Leber, D

1997-06-01

This study examined the processing of supportive interactions by dysphoric and nondysphoric preteens and early adolescents. Seventy-two youngsters between the ages of 10 and 13 evaluated the supportiveness and helpfulness of standardized, videotaped interactions between a distressed preadolescent and a maternal figure. The tape presentations varied in terms of the level of depicted maternal support and instructional condition (degree of self-reference). The results indicated that dysphoric youngsters evaluated both the supportiveness and helpfulness of interactions less positively than nondysphoric agemates. Group differences in support evaluations were most pronounced in the self-referenced condition. The level of depicted support did not affect processing differences. Dysphoric subjects reported lower levels of emotional support in prior relationships and a greater tendency to view supportive behavior as ingenuine than nondysphoric peers. Variation in prior support experiences accounted for group differences in the evaluation of the supportiveness of new interactions.

A Standards-Based Inventory of Foundation Competencies in Social Work with Groups

ERIC Educational Resources Information Center

Macgowan, Mark J.

2012-01-01

Objective: This article describes the development of a measure of foundation competencies in group work derived from the Standards for Social Work Practice with Groups. Developed by the Association for the Advancement of Social Work with Groups, the Standards have not been widely used. An instrument based on the Standards can help advance…

Using a Multimedia Presentation to Enhance Informed Consent in a Pediatric Emergency Department.

PubMed

Spencer, Sandra P; Stoner, Michael J; Kelleher, Kelly; Cohen, Daniel M

2015-08-01

Informed consent is an ethical process for ensuring patient autonomy. Multimedia presentations (MMPs) often aid the informed consent process for research studies. Thus, it follows that MMPs would improve informed consent in clinical settings. The aim of this study was to determine if an MMP for the informed consent process for ketamine sedation improves parental satisfaction and comprehension as compared with standard practice. This 2-phase study compared 2 methods of informed consent for ketamine sedation of pediatric patients. Phase 1 was a randomized, prospective study that compared the standard verbal consent to an MMP. Phase 2 implemented the MMP into daily work flow to validate the previous year's results. Parents completed a survey evaluating their satisfaction of the informed consent process and assessing their knowledge of ketamine sedation. Primary outcome measures were parental overall satisfaction with the informed consent process and knowledge of ketamine sedation. One hundred eighty-four families from a free-standing, urban, tertiary pediatric emergency department with over 85,000 annual visits were enrolled. Different demographics were not associated with a preference for the MMP or improved scores on the content quiz. Intervention families were more likely "to feel involved in the decision to use ketamine" and to understand that "they had the right to refuse the ketamine" as compared with control families. The intervention group scored significantly higher overall on the content section than the control group. Implementation and intervention families responded similarly to all survey sections. Multimedia presentation improves parental understanding of ketamine sedation, whereas parental satisfaction with the informed consent process remains unchanged. Use of MMP in the emergency department for informed consent shows potential for both patients and providers.

Intelligence Reach for Expertise (IREx)

NASA Astrophysics Data System (ADS)

Hadley, Christina; Schoening, James R.; Schreiber, Yonatan

2015-05-01

IREx is a search engine for next-generation analysts to find collaborators. U.S. Army Field Manual 2.0 (Intelligence) calls for collaboration within and outside the area of operations, but finding the best collaborator for a given task can be challenging. IREx will be demonstrated as part of Actionable Intelligence Technology Enabled Capability Demonstration (AI-TECD) at the E15 field exercises at Ft. Dix in July 2015. It includes a Task Model for describing a task and its prerequisite competencies, plus a User Model (i.e., a user profile) for individuals to assert their capabilities and other relevant data. These models use a canonical suite of ontologies as a foundation for these models, which enables robust queries and also keeps the models logically consistent. IREx also supports learning validation, where a learner who has completed a course module can search and find a suitable task to practice and demonstrate that their new knowledge can be used in the real world for its intended purpose. The IREx models are in the initial phase of a process to develop them as an IEEE standard. This initiative is currently an approved IEEE Study Group, after which follows a standards working group, then a balloting group, and if all goes well, an IEEE standard.

A new quality assurance package for hospital palliative care teams: the Trent Hospice Audit Group model.

PubMed

Hunt, J; Keeley, V L; Cobb, M; Ahmedzai, S H

2004-07-19

Cancer patients in hospitals are increasingly cared for jointly by palliative care teams, as well as oncologists and surgeons. There has been a considerable growth in the number and range of hospital palliative care teams (HPCTs) in the United Kingdom. HPCTs can include specialist doctors and nurses, social workers, chaplains, allied health professionals and pharmacists. Some teams work closely with existing cancer multidisciplinary teams (MDTs) while others are less well integrated. Quality assurance and clinical governance requirements have an impact on the monitoring of such teams, but so far there is no standardised way of measuring the amount and quality of HPCTs' workload. Trent Hospice Audit Group (THAG) is a multiprofessional research group, which has been developing standards and audit tools for palliative care since the 1990s. These follow a format of structure-process-outcome for standards and measures. We describe a collaborative programme of work with HPCTs that has led to a new set of standards and audit tools. Nine HPCTs participated in three rounds of consultation, piloting and modification of standard statements and tools. The final pack of HPCT quality assurance tools covers: policies and documentation; medical notes review; questionnaires for ward-based staff. The tools measure the HPCT workload and casemix; the views of ward-based staff on the supportive role of the HPCT and the effectiveness of HPCT education programmes, particularly in changing practice. The THAG HPCT quality assurance pack is now available for use in cancer peer review.

Utilizing the Experience of Consumers in Consultation to Develop the Australasian Oncofertility Consortium Charter.

PubMed

Anazodo, Antoinette C; Gerstl, Brigitte; Stern, Catharyn J; McLachlan, Robert I; Agresta, Franca; Jayasinghe, Yasmin; Cohn, Richard J; Wakefield, Claire E; Chapman, Michael; Ledger, William; Sullivan, Elizabeth A

2016-09-01

In Australia and New Zealand, there has not been a national systematic development of oncofertility services for cancer patients of reproductive age although many cancer and fertility centers have independently developed services. A number of barriers exist to the development of these services, including a lack of clear referral pathways, a lack of communication between clinicians and patients about fertility preservation, differences in the knowledge base of clinicians about the risk of cancer treatment causing infertility and fertility preservation options, a lack of national health insurance funding covering all aspects of fertility preservation, and storage costs and cultural, religious, and ethical barriers. The development of strategies to overcome these barriers is a high priority for oncofertility care to ensure that equitable access to the best standard of care is available for all patients. The FUTuRE Fertility Research Group led a collaborative consultation process with the Australasian Oncofertility Consumer group and oncofertility specialists to explore consumers' experiences of oncofertility care. Consumers participated in qualitative focus group meetings to define and develop a model of consumer driven or informed "gold standard oncofertility care" with the aim of putting together a Charter that specifically described this. The finalized Australasian Oncofertility Consortium Charter documents eight key elements of gold standard oncofertility care that will be used to monitor the implementation of oncofertility services nationally, to ensure that these key elements are incorporated into standard practice over time.

Implications of the Next Generation Science Standards for Earth and Space Sciences

NASA Astrophysics Data System (ADS)

Wysession, M. E.; Colson, M.; Duschl, R. A.; Huff, K.; Lopez, R. E.; Messina, P.; Speranza, P.; Matthews, T.; Childress, J.

2012-12-01

The Next Generation Science Standards (NGSS), due to be released in 2013, set a new direction for K-12 science education in America. These standards will put forth significant changes for Earth and space sciences. The NGSS are based upon the recommendations of the National Research Council's 2011 report "A Framework for K-12 Science Education: Practices, Cross-Cutting Concepts, and Core Ideas." The standards are being written by a large group of authors who represent many different constituencies, including 26 participating states, in a process led by Achieve, Inc. The standards encourage innovative ways to teach science at the K-12 level, including enhanced integration between the content, practices, and crosscutting ideas of science and greater assimilation among the sciences and engineering, and among the sciences, mathematics, and English language arts. The NGSS presents a greater emphasis on Earth and space sciences than in previous standards, recommending a year at both the middle and high school levels. The new standards also present a greater emphasis on areas of direct impact between humans and the Earth system, including climate change, natural hazards, resource management, and sustainability.

Implementing the space shuttle data processing system with the space generic open avionics architecture

NASA Technical Reports Server (NTRS)

Wray, Richard B.; Stovall, John R.

1993-01-01

This paper presents an overview of the application of the Space Generic Open Avionics Architecture (SGOAA) to the Space Shuttle Data Processing System (DPS) architecture design. This application has been performed to validate the SGOAA, and its potential use in flight critical systems. The paper summarizes key elements of the Space Shuttle avionics architecture, data processing system requirements and software architecture as currently implemented. It then summarizes the SGOAA architecture and describes a tailoring of the SGOAA to the Space Shuttle. The SGOAA consists of a generic system architecture for the entities in spacecraft avionics, a generic processing external and internal hardware architecture, a six class model of interfaces and functional subsystem architectures for data services and operations control capabilities. It has been proposed as an avionics architecture standard with the National Aeronautics and Space Administration (NASA), through its Strategic Avionics Technology Working Group, and is being considered by the Society of Aeronautic Engineers (SAE) as an SAE Avionics Standard. This architecture was developed for the Flight Data Systems Division of JSC by the Lockheed Engineering and Sciences Company, Houston, Texas.

Sentence processing selectivity in Broca's area: evident for structure but not syntactic movement.

PubMed

Rogalsky, Corianne; Almeida, Diogo; Sprouse, Jon; Hickok, Gregory

The role of Broca's area in sentence processing is hotly debated. Prominent hypotheses include that Broca's area supports sentence comprehension via syntax-specific processes ("syntactic movement" in particular), hierarchical structure building or working memory. In the present fMRI study we adopt a within subject, across task approach using targeted sentence-level contrasts and non-sentential comparison tasks to address these hypotheses regarding the role of Broca's area in sentence processing. For clarity, we have presented findings as three experiments: (i) Experiment 1 examines selectivity for a particular type of sentence construction, namely those containing syntactic movement. Standard syntactic movement distance effects in Broca's area were replicated but no difference was found between movement and non-movement sentences in Broca's area at the group level or consistently in individual subjects. (ii) Experiment 2 examines selectivity for sentences versus non-sentences, to assess claims regarding the role of Broca's area in hierarchical structure building. Group and individual results differ, but both identify subregions of Broca's area that are selective for sentence structure. (iii) Experiment 3 assesses whether activations in Broca's area are selective for sentences when contrasted with simple subvocal articulation. Group results suggest shared resources for sentence processing and articulation in Broca's area, but individual subject analyses contradict this finding. We conclude that Broca's area is not selectively involved in processing syntactic movement, but that subregions are selectively responsive to sentence structure. Our findings also reinforce Fedorenko & Kanwishser's call for the use of more individual subject analyses in functional imaging studies of sentence processing in Broca's area, as group findings can obscure selective response patterns.

ISBT 128 Standard for Coding Medical Products of Human Origin

PubMed Central

Ashford, Paul; Delgado, Matthew

2017-01-01

Background ISBT 128 is an international standard for the terminology, coding, labeling, and identification of medical products of human origin (MPHO). Full implementation of ISBT 128 improves traceability, transparency, vigilance and surveillance, and interoperability. Methods ICCBBA maintains the ISBT 128 standard through the activities of a network of expert volunteers, including representatives from professional scientific societies, governments and users, to standardize and maintain MPHO identification. These individuals are organized into Technical Advisory Groups and work within a structured framework as part of a quality-controlled standards development process. Results The extensive involvement of international scientific and professional societies in the development of the standard has ensured that ISBT 128 has gained widespread recognition. The user community has developed confidence in the ability of the standard to adapt to new developments in their fields of interest. The standard is fully compatible with Single European Code requirements for tissues and cells and is utilized by many European tissue establishments. ISBT 128's flexibility and robustness has allowed for expansions into subject areas such as cellular therapy, regenerative medicine, and tissue banking. Conclusion ISBT 128 is the internationally recognized standard for coding MPHO and has gained widespread use globally throughout the past two decades. PMID:29344013

Processes in the development of international specialist competencies and standards: the Sports Physiotherapy for All Project.

PubMed

Bulley, Catherine; Donaghy, Marie

2008-01-01

In a world of rapidly developing knowledge it is important that professions describe their roles and capabilities. The need for a thorough description of sports physiotherapy was addressed through collaboration between the International Federation of Sports Physiotherapy (IFSP) and five European higher education institutions. This resulted in the Sports Physiotherapy for All Project, which has been successful in developing internationally accepted competencies and standards for sports physiotherapists. This article describes and reflects on the process to communicate useful lessons. A competency model was chosen to facilitate differentiation and communication of aspects of sports physiotherapy practice. Documentation relating to sports physiotherapy practice was collected from 16 countries and analysed thematically. A cut and paste method was used by a panel of experts to allocate themes to areas of practice within the competency model. Theme groups were used to select areas of practice for description in competency form. Standards were derived from competencies following in depth discussion with the expert panel, and triangulation with themes derived from international documentation. A rigorous process of international review and revision led to the final list of 11 competencies and related standards, both accepted by the IFSP. This work provides a foundation for the development of an audit toolkit to guide demonstration and evaluation of competencies and standards. This provides a foundation for targeted career development activities, appropriate provision of training opportunities, and quality enhancement. The experiences gained during this project can inform other health professions and their specialisms when embarking on a similar journey.

Knowledge Management Orientation: An Innovative Perspective to Hospital Management

PubMed Central

GHASEMI, Matina; GHADIRI NEJAD, Mazyar; BAGZIBAGLI, Kemal

2017-01-01

Background: By considering innovation as a new project in hospitals, all the project management’s standard steps should be followed in execution. This study investigated the validation of a new set of measures in terms of providing a procedure for knowledge management-oriented innovation that enriches the hospital management system. Methods: The relation between innovation and all the knowledge management areas, as the main constructs of project management, was illustrated by referring to project management standard steps and previous studies. Through consultations and meetings with a committee of professional project managers, a questionnaire was developed to measure ten knowledge management areas in hospital’s innovation process. Additionally, a group of experts from hospital managers were invited to comment on the applicability of the questionnaires by considering if the items are measurable in hospitals practically. Results: A close-ended, Likert-type scale items, consisted of ten sections, were developed based on project management body of knowledge thorough Delphi technique. It enables the managers to evaluate hospitals’ situation to be aware whether the organization follows the knowledge management standards in innovation process or not. By pilot study, confirmatory factor analysis and exploratory factor analysis were conducted to ensure the validity and reliability of the measurement items. Conclusion: The developed items seem to have a potential to help hospital managers and subsequently delivering new products/services successfully based on the standard procedures in their organization. In all innovation processes, the knowledge management areas and their standard steps help hospital managers by a new tool as questionnaire format. PMID:29259938

Development of an orthopedic surgery trauma patient handover checklist.

PubMed

LeBlanc, Justin; Donnon, Tyrone; Hutchison, Carol; Duffy, Paul

2014-02-01

In surgery, preoperative handover of surgical trauma patients is a process that must be made as safe as possible. We sought to determine vital clinical information to be transferred between patient care teams and to develop a standardized handover checklist. We conducted standardized small-group interviews about trauma patient handover. Based on this information, we created a questionnaire to gather perspectives from all Canadian Orthopaedic Association (COA) members about which topics they felt would be most important on a handover checklist. We analyzed the responses to develop a standardized handover checklist. Of the 1106 COA members, 247 responded to the questionnaire. The top 7 topics felt to be most important for achieving patient safety in the handover were comorbidities, diagnosis, readiness for the operating room, stability, associated injuries, history/mechanism of injury and outstanding issues. The expert recommendations were to have handover completed the same way every day, all appropriate radiographs available, adequate time, all appropriate laboratory work and more time to spend with patients with more severe illness. Our main recommendations for safe handover are to use standardized checklists specific to the patient and site needs. We provide an example of a standardized checklist that should be used for preoperative handovers. To our knowledge, this is the first checklist for handover developed by a group of experts in orthopedic surgery, which is both manageable in length and simple to use.

Terminology and global standardization of endoscopic information: Minimal Standard Terminology (MST).

PubMed

Fujino, Masayuki A; Bito, Shigeru; Takei, Kazuko; Mizuno, Shigeto; Yokoi, Hideto

2006-01-01

Since 1994, following the leading efforts by the European Society for Gastrointestinal Endoscopy, Organisation Mondiale d'Endoscopie Digestive (OMED) has succeeded in compiling minimal number of terms required for computer generation of digestive endoscopy reports nicknamed MST (Minimal Standard Terminology). Though with some insufficiencies, and though developed only for digestive endoscopy, MST has been the only available terminology that is globally standardized in medicine. By utilizing the merits of a unified, structured terminology that can be used in multiple languages we can utilize the data stored in different languages as a common database. For this purpose, a standing, terminology-managing organization that manages and maintains and, when required, expands the terminology on a global level, is absolutely necessary. Unfortunately, however, the organization that performs version control of MST (OMED terminology, standardization and data processing committee) is currently suspending its activity. Medical practice of the world demands more and more specialization, with resultant needs for information exchange among specialized territories. As the cooperation between endoscopy and pathology has become currently the most important problem in the Endoscopy Working Group of Integrating Healthcare Enterprise-Japan (IHE-J,) the cooperation among different specialties is essential. There are DICOM or HL7 standards as the protocols for storage, and exchange (communication) of the data, but there is yet no organization that manages the terminology itself astride different specialties. We hereby propose to establish, within IEEE, for example, a system that promotes standardization of the terminology that can transversely describe a patient, and that can control different societies and groups, as far as the terminology is concerned.

Energy Systems Integration Newsletter | Energy Systems Integration Facility

Science.gov Websites

-one that other utilities, even in mainland states, will be able to follow as they embark on their own distributed energy resources (DERs), is one example of this process. With leadership from NREL, the IEEE P1547 Working Group completed revisions to the standard in the fall of 2017 after four years of significant

Energy Systems Integration Newsletter April 2018 | Energy Systems

Science.gov Websites

-one that other utilities, even in mainland states, will be able to follow as they embark on their own distributed energy resources (DERs), is one example of this process. With leadership from NREL, the IEEE P1547 Working Group completed revisions to the standard in the fall of 2017 after four years of significant

Teaching Formative Assessment Strategies to Preservice Teachers: Exploring the Use of Handheld Computing to Facilitate the Action Research Process

ERIC Educational Resources Information Center

Bennett, Kristin Redington; Cunningham, Ann C.

2009-01-01

Appropriate classroom assessment now tends to utilize formative measures with greater frequency, especially in the early grades and with learner groups at risk of not passing state-mandated standardized tests. Within the authentic context of an action research project, teacher candidates were given handheld computers equipped with data-collection…

Manufacturing and quality control of interconnecting wire harnesses, Volume 4

NASA Technical Reports Server (NTRS)

1972-01-01

The document covers interconnecting wire harnesses defined in the design standard, including type 8, flat conductor cable. Volume breadth covers installations of groups of harnesses in a major assembly and the associated post installation inspections and electrical tests. Knowledge gained through experience on the Saturn 5 program coupled with recent advances in techniques, materials, and processes was incorporated into this document.

Salovum egg yolk containing antisecretory factor as an adjunct therapy in severe cholera in adult males: a pilot study.

PubMed

Alam, Nur H; Ashraf, Hasan; Olesen, Maryam; Salam, Mohammed A; Gyr, Niklaus; Meier, Remy

2011-08-01

Cholera involves stimulation of intestinal secretory process in response to cholera toxin leading to profuse watery diarrhoea that might cause death due to dehydration unless timely rehydration therapy is initiated. Efforts to identify and test potential antisecretory agents are ongoing. Antisecretory factor (AF) is a naturally-occurring protein produced in the human secretory organs, including the intestine, with antisectory properties demonstrated in animal and human models of secretory diarrhoea. Salovum egg yolk powder contains antisecretory proteins in a much higher (500 times) concentration than that of normal hen eggs. This is achieved by feeding hens with specially-processed cereals, capable of inducing antisecretory proteins in the yolk. The aim of the study was to examine the effect of Salovum egg yolk powder containing AF in the treatment of adult cholera patients. In an open, randomized controlled trial (pilot study), 40 adult male patients with severe cholera were studied: 20 received standard treatment (oral rehydration solution, antibiotic, and usual hospital diet) plus Salovum egg yolk powder (study group) and 20 received standard treatment alone (control group). All the patients received tablet doxycycline (300 mg) once immediately after randomization. Written informed consent was obtained from each subject before enrollment. The main outcome measures were stool weight and duration of diarrhoea. The demographic and baseline clinical characteristics of the study patients were comparable between the groups. No significant differences were found in the mean stool weight, g/kg of body-weight during the first 24 hours [study vs control group, mean +/- standard deviation (SD), 218 +/- 119 vs 195 +/- 136], second 24 hours (mean +/- SD, 23 +/- 39 vs 22 +/- 34), and cumulative up to 72 hours (mean +/- SD, 245 +/- 152 vs 218 +/- 169). The duration (hours) of diarrhoea after admission in the hospital was also similar in both the groups (mean +/- SD, 33 +/- 14 vs 32 +/- 10). No adverse effect was observed. Salovum egg powder containing AF as an adjunct therapy in the treatment of severe cholera could not demonstrate any beneficial effect. Further studies with higher doses of Salovum egg yolk powder might be considered in future to establish its antisecretory effect.

Performance and Challenges of Point of Use Devices for Lead ...

EPA Pesticide Factsheets

this presentation summarizes the performance of POU devices for the removal of lead and some other metals, in Flint, Michigan. The mechanism of POU filters for metal removal is described as being a combination of physical filtration with surface sorption and adherence to embedded functional groups in the carbon block, along with the certification process and how to find certified products from the web listings. Finally, there is a discussion of several alternative approaches for possible improvement of the NSF/ANSI 53 and 42 standards to improve the amount of protection afforded by the devices, in the future. this presentation summarizes the performance of POU devices for the removal of lead and some other metals, in Flint, Michigan. The mechanism of POU filters for metal removal is described as being a combination of physical filtration with surface sorption and adherence to embedded functional groups in the carbon block, along with the certification process and how to find certified products from the web listings. Finally, there is a discussion of several alternative approaches for possible improvement of the NSF/ANSI 53 and 42 standards to improve the amount of protection afforded by the devices, in the future.

[Effectiveness of a micronized purified flavonoid fraction (MPFF) in the healing process of lower limb ulcers. An open multicentre study, controlled and randomized].

PubMed

Glinski, W; Chodynicka, B; Roszkiewicz, J; Bogdanowski, T; Lecewicz-Torun, B; Kaszuba, A; Bowszyc, J; Nowak, A; Wnorowski, J; Wasik, F; Glinska-Ferenz, M; Blaszczyk, M; Strzyga, P; Pachocki, R

2001-04-01

To determine the increase in healing rate of venous ulcer in patients receiving a micronised purified flavonoid fraction (MPFF) as supplementation to standard local care. A randomised, open, controlled, multicentre study. Departments of Dermatology and University Outpatients Clinics. One hundred and forty patients with chronic venous insufficiency and venous ulcers. PATIENTS received standard compressive therapy plus external treatment alone or 2 tablets of MPFF daily in addition to the above treatment for 24 weeks. Healing of ulcers and their reduction in size after 24 weeks of treatment. The percentage of patients whose ulcers healed completely was found to be markedly higher in those receiving MPFF in addition to standard external and compressive treatment than in those treated with conventional therapy alone (46.5% vs 27.5%; p<0.05. OR=2.3, 95% CI 1.1-4.6). Ulcers with diameters <3 cm were cured in 71% of patients in the MPFF group and in 50% of patients in the control group, whereas ulcers between 3 and 6 cm in diameter were cured in 60% and 32% of patients (p<0.05), respectively. The mean reduction in ulcer size was also found to be greater in patients treated with MPFF (80%) than in the control group (65%) (p<0.05). The cost-effectiveness ratio (cost per healed ulcer) in the MPFF group was 1026.2 compared with 1871.8 in the control group. These results indicate that MPFF significantly improves the cure rate in patients with chronic venous insufficiency.

Development and standardization of Arabic words in noise test in Egyptian children.

PubMed

Abdel Rahman, Tayseer Taha

2018-05-01

To develop and establish norms of Arabic Words in Noise test in Egyptian children. Total number of participants was 152 with normal hearing and ranging in age from 5 to 12 years. They are subdivided into two main groups (standardization group) which comprised 120 children with normal scholastic achievement and (application group) which comprised 32 children with different types of central auditory processing disorders. Arabic version of both Speech perception in noise (SPIN) and Words in Noise (WIN) tests were presented in each ear at zero signal to-noise ratio (SNR) using ipsilateral Cafeteria noise fixed at 50 dB sensation level (dBSL). The least performance in WIN test occurred between 5 and 7 years and highest scores from 9 to 12 years. However, no statistically significant difference was found among the three standardization age groups. Moreover, no statistically significant difference was found between the right and left ears scores or among the three lists. When the WIN test was compared to SPIN test in children with and without abnormal SPIN scores it showed highly consistent results except in children suffering from memory deficit reflecting that WIN test is more accurate than SPIN in this group of children. The Arabic WIN test can be used in children as young as 5 years. Also, it can be a good cross check test with SPIN test or used to follow up children after rehabilitation program in hearing impaired children or follow up after central auditory remediation of children with selective auditory attention deficit. Copyright © 2017. Published by Elsevier B.V.

Enhanced startle reflexivity during presentation of visual nurture cues in young adults who experienced parental divorce in early childhood.

PubMed

Hengesch, Xenia; Larra, Mauro F; Finke, Johannes B; Blumenthal, Terry D; Schächinger, Hartmut

2017-10-01

Adverse childhood experiences (ACE) may influence stress and affective processing in adulthood. Animal and human studies show enhanced startle reflexivity in adult participants with ACE. This study examined the impact of one of the most common ACE, parental divorce, on startle reflexivity in adulthood. Affective modulation of acoustically-elicited startle eye blink was assessed in a group of 23 young adults with self-reported history of parental divorce, compared to an age- and sex-matched control group (n=18). Foreground pictures were either aversive (e.g. mutilation and injury), standard appetitive (e.g. erotic, recreational sport), or nurture pictures (e.g. related to early life, parental care), intermixed with neutral pictures (e.g. household objects), and organized in three valence blocks delivered in a balanced, pseudo-randomized sequence. During picture viewing startle eye blinks were elicited by binaural white noise bursts (50ms, 105 dB) via headphones and recorded at the left orbicularis oculi muscle via EMG. A significant interaction of group×picture valence (p=0.01) was observed. Contrast with controls revealed blunted startle responsiveness of the ACE group during presentation of aversive pictures, but enhanced startle during presentation of nurture-related pictures. No group differences were found during presentation of standard appetitive pictures. ACE participants rated nurture pictures as more arousing (p=0.02) than did control participants. Results suggest that divorce in childhood led to altered affective context information processing in early adulthood. When exposed to unpleasant (vs. neutral) pictures participants with ACE showed less startle potentiation than controls. Nurture context, however, potentiated startle in ACE participants, suggesting visual cuing to activate protective behavioral responses. Copyright © 2017 Elsevier B.V. All rights reserved.

Accounting for group differences in appraisals of social inequality: differential injustice standards.

PubMed

Miron, Anca M; Warner, Ruth H; Branscombe, Nyla R

2011-06-01

We tested whether differential appraisals of inequality are a function of the injustice standards used by different groups. A confirmatory standard of injustice is defined as the amount of evidence needed to arrive at the conclusion that injustice has occurred. Consistent with a motivational shifting of standards view, we found that advantaged and disadvantaged group members set different standards of injustice when judging the magnitude of gender (Study 1) and racial (Study 2) wage inequality. In addition, because advantaged and disadvantaged group members formed - based on their differential standards - divergent appraisals of wage inequality, they experienced differential desire to restore inter-group justice. We discuss the implications of promoting low confirmatory standards for changing perceptions of social reality and for motivating justice-restorative behaviour. ©2011 The British Psychological Society.

REFLECTIONS ON THE ROLE OF THE PHARMACY REGULATORY AUTHORITY IN ENHANCING QUALITY RELATED EVENT REPORTING IN COMMUNITY PHARMACIESi

PubMed Central

Boyle, Todd A.; Bishop, Andrea C.; Mahaffey, Thomas; MacKinnon, Neil J.; Ashcroft, Darren; Zwicker, Bev; Reid, Carolyn

2016-01-01

Background Given the demanding nature of providing pharmacy services, coupled with the expanded scope of practice of the professions in jurisdictions around the world, greater commitment to continuous quality improvement through adoption of quality related event (QRE) reporting is necessary to ensure patient safety. Pharmacy regulatory authorities (PRAs) are in a unique position to enhance QRE reporting and learning through the standardization of expected practice Objective This study aims to better understand the perceived roles of PRAs in enhancing QRE reporting and learning in community pharmacies and identifying regulatory best practices to execute such roles. Methods A purposive case sampling approach was used to identify PRA staff members from two groups (deputy registrars and pharmacy inspectors) in 10 Canadian jurisdictions to participate in focus groups in the fall of 2011. Focus groups were used to explore perceptions of the role of PRAs in enhancing and promoting QRE reporting and learning, and perceived barriers to effective implementation in practice. Thematic analysis was used to analyze the qualitative data. Results Two focus groups were conducted, one with seven deputy registrars/practice managers and one with nine pharmacy inspectors. Five themes were identified, including (1) defining QRE reporting and compliance, (2) navigating role conflict, (3) educating for enhanced QRE reporting and learning, (4) promoting the positive/removing the fear of QREs, and (5) tailoring QRE reporting and learning consistency. Conclusions Overall, participants perceived a strong role for PRAs in enhancing QRE reporting and learning and providing education for pharmacies to support their compliance with reporting standards. However, PRAs must navigate the conflict inherent in both educating and promoting a process for achieving a standard while simultaneously inspecting compliance to that standard. Ensuring pharmacies have autonomy in operationalizing standards may help to mitigate this conflict. Finally, greater education for PRAs themselves to better inspect compliance and in order to better communicate the benefits of QRE reporting and learning to pharmacies would be beneficial. PMID:23830506

Activation and characterization of waste coffee grounds as bio-sorbent

NASA Astrophysics Data System (ADS)

Mariana; Marwan; Mulana, F.; Yunardi; Ismail, T. A.; Hafdiansyah, M. F.

2018-03-01

As the city well known for its culture of coffee drinkers, modern and traditional coffee shops are found everywhere in Banda Aceh, Indonesia. High number of coffee shops in the city generates large quantities of spent coffee grounds as waste without any effort to convert them as other valuable products. In an attempt to reduce environmental problems caused by used coffee grounds, this research was conducted to utilize waste coffee grounds as an activated carbon bio-sorbent. The specific purpose of this research is to improve the performance of coffee grounds bio-sorbent through chemical and physical activation, and to characterize the produced bio-sorbent. Following physical activation by carbonization, a chemical activation was achieved by soaking the carbonized waste coffee grounds in HCl solvent and carbonization process. The activated bio-sorbent was characterized for its morphological properties using Scanning Electron Microscopy (SEM), its functional groups by Fourier Transform Infra-Red Spectrophotometer (FTIR), and its material characteristics using X-Ray Diffraction (XRD). Characterization of the activated carbon prepared from waste coffee grounds shows that it meets standard quality requirement in accordance with Indonesian National Standard, SNI 06-3730-1995. Activation process has modified the functional groups of the waste coffee grounds. Comparing to natural waste coffee grounds, the resulted bio-sorbent demonstrated a more porous surface morphology following activation process. Consequently, such bio-sorbent is a potential source to be used as an adsorbent for various applications.

Finger tapping and pre-attentive sensorimotor timing in adults with ADHD.

PubMed

Hove, Michael J; Gravel, Nickolas; Spencer, Rebecca M C; Valera, Eve M

2017-12-01

Sensorimotor timing deficits are considered central to attention-deficit/hyperactivity disorder (ADHD). However, the tasks establishing timing impairments often involve interconnected processes, including low-level sensorimotor timing and higher level executive processes such as attention. Thus, the source of timing deficits in ADHD remains unclear. Low-level sensorimotor timing can be isolated from higher level processes in a finger-tapping task that examines the motor response to unexpected shifts of metronome onsets. In this study, adults with ADHD and ADHD-like symptoms (n = 25) and controls (n = 26) performed two finger-tapping tasks. The first assessed tapping variability in a standard tapping task (metronome-paced and unpaced). In the other task, participants tapped along with a metronome that contained unexpected shifts (±15, 50 ms); the timing adjustment on the tap following the shift captures pre-attentive sensorimotor timing (i.e., phase correction) and thus should be free of potential higher order confounds (e.g., attention). In the standard tapping task, as expected, the ADHD group had higher timing variability in both paced and unpaced tappings. However, in the pre-attentive task, performance did not differ between the ADHD and control groups. Together, results suggest that low-level sensorimotor timing and phase correction are largely preserved in ADHD and that some timing impairments observed in ADHD may stem from higher level factors (such as sustained attention).

Microbial Transglutaminase Used in Bread Preparation at Standard Bakery Concentrations Does Not Increase Immunodetectable Amounts of Deamidated Gliadin.

PubMed

Heil, Andreas; Ohsam, Jürgen; van Genugten, Bernard; Diez, Oscar; Yokoyama, Keiichi; Kumazawa, Yoshiyuki; Pasternack, Ralf; Hils, Martin

2017-08-16

The effect of standard bakery concentrations of microbial transglutaminase (MTG) in wheat bread preparation on the immunoreactivity of sera of celiac disease (CD) patients was investigated. Immunoblotting using monoclonal antibodies specific to unmodified and/or deamidated gliadin showed no differences between control bread and MTG bread. Deamidation of gliadin could not be detected at standard MTG concentrations. Sera of CD patients were characterized using anti-gliadin and anti-deamidated gliadin peptide (DGP) enzyme-linked immunosorbent assay and grouped into DGP high- and low-titer pools. The recognition pattern obtained after using both CD sera pools for immunoblotting did not reveal differences between control and MTG-treated bread protein extracts. Our results indicate that MTG treatment of wheat bread prepared with typical MTG concentrations used in standard bakery processes does not lead to immunodetectable amounts of CD immunotoxic deamidated gliadins.

Effect of a new tension system, used in acrylic resin flasking, on the dimensional stability of denture bases.

PubMed

Consani, Rafael Leonardo Xediek; Domitti, Saide Sarckis; Consani, Simonides

2002-09-01

The pressure of final closure may be released when the flask is removed from the mechanical or pneumatic press and placed in the spring clamp. This release in pressure may result in dimensional changes that distort the denture base. The purpose of this study was to investigate differences between the dimensional stability of standardized simulated denture bases processed by traditional moist heat-polymerization and those processed by use of a new tension system. A metal master die was fabricated to simulate an edentulous maxillary arch without irregularities in the alveolar ridge walls. A silicone mold of this metallic die was prepared, and 40 stone casts were formed from the mold with type III dental stone. The casts were randomly assigned to 4 test groups (A-D) of 10 specimens each. A uniform denture base pattern was made on each stone cast with a 1.5-mm thickness of base-plate wax, measured with a caliper. The patterns were invested for traditional hot water processing. A polymethyl methacrylate dough was prepared and packed for processing. The flasks in groups A and B were closed with the traditional pressure technique and placed in spring clamps after final closure. The flasks in groups C and D were pressed between the metallic plates of the new tension system after the final closure. The group A and C flasks were immediately immersed in the water processing unit at room temperature (25 degrees +/- 2 degrees C). The unit was programmed to raise the temperature to 74 degrees C over 1 hour, and then maintained the temperature at 74 degrees C for 8 hours. The group B and D flasks were bench stored at room temperature (25 degrees +/- 2 degrees C) for 6 hours and were then subjected to the same moist heat polymerization conditions as groups A and C. All processed dentures were bench cooled for 3 hours. After recovery from the flasks, the base-cast sets were transversally sectioned into 3 parts (corresponding to 3 zones): (1) distal of the canines, (2) mesial of the first molars, and (3) mesial of the posterior palate). These areas had been previously established and standardized by use of a pattern denture in the sawing device to determine the sections in each base-cast set. Base-cast gaps were measured at 5 predetermined points on each section with an optical micrometer that had a tolerance of 0.001 mm. Collected data were analyzed with analysis of variance and Tukey's test. Denture bases processed with the new tension system exhibited significantly better base adaptation than those processed with traditional acrylic resin packing. Immediately after polymerization (Groups A and C), mean dimensional change values were 0.213 +/- 0.055 mm for the traditional packing technique and 0.173 +/- 0.050 mm for new tension system. After delayed polymerization (Groups B and D), the values were 0.216 +/- 0.074 mm for the traditional packing technique and 0.164 +/- 0.032 mm for new tension system. With both techniques, dimensional changes in the posterior palatal zone were greater (conventional = 0.286 +/- 0.038 mm; new system = 0.214 +/- 0.024 mm) than those elsewhere on the base-cast set. Within the limitations of this study, the new tension packing system was associated with decreased dimensional changes in the simulated maxillary denture bases processed with heat-polymerization.

Performance Analysis of Entropy Methods on K Means in Clustering Process

NASA Astrophysics Data System (ADS)

Dicky Syahputra Lubis, Mhd.; Mawengkang, Herman; Suwilo, Saib

2017-12-01

K Means is a non-hierarchical data clustering method that attempts to partition existing data into one or more clusters / groups. This method partitions the data into clusters / groups so that data that have the same characteristics are grouped into the same cluster and data that have different characteristics are grouped into other groups.The purpose of this data clustering is to minimize the objective function set in the clustering process, which generally attempts to minimize variation within a cluster and maximize the variation between clusters. However, the main disadvantage of this method is that the number k is often not known before. Furthermore, a randomly chosen starting point may cause two points to approach the distance to be determined as two centroids. Therefore, for the determination of the starting point in K Means used entropy method where this method is a method that can be used to determine a weight and take a decision from a set of alternatives. Entropy is able to investigate the harmony in discrimination among a multitude of data sets. Using Entropy criteria with the highest value variations will get the highest weight. Given this entropy method can help K Means work process in determining the starting point which is usually determined at random. Thus the process of clustering on K Means can be more quickly known by helping the entropy method where the iteration process is faster than the K Means Standard process. Where the postoperative patient dataset of the UCI Repository Machine Learning used and using only 12 data as an example of its calculations is obtained by entropy method only with 2 times iteration can get the desired end result.

Proposed Clinical Decision Rules to Diagnose Acute Rhinosinusitis Among Adults in Primary Care.

PubMed

Ebell, Mark H; Hansen, Jens Georg

2017-07-01

To reduce inappropriate antibiotic prescribing, we sought to develop a clinical decision rule for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis. Multivariate analysis and classification and regression tree (CART) analysis were used to develop clinical decision rules for the diagnosis of acute rhinosinusitis, defined using 3 different reference standards (purulent antral puncture fluid or abnormal finding on a computed tomographic (CT) scan; for acute bacterial rhinosinusitis, we used a positive bacterial culture of antral fluid). Signs, symptoms, C-reactive protein (CRP), and reference standard tests were prospectively recorded in 175 Danish patients aged 18 to 65 years seeking care for suspected acute rhinosinusitis. For each reference standard, we developed 2 clinical decision rules: a point score based on a logistic regression model and an algorithm based on a CART model. We identified low-, moderate-, and high-risk groups for acute rhinosinusitis or acute bacterial rhinosinusitis for each clinical decision rule. The point scores each had between 5 and 6 predictors, and an area under the receiver operating characteristic curve (AUROCC) between 0.721 and 0.767. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a 16%, 49%, and 73% likelihood of acute bacterial rhinosinusitis, respectively. CART models had an AUROCC ranging from 0.783 to 0.827. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a likelihood of acute bacterial rhinosinusitis of 6%, 31%, and 59% respectively. We have developed a series of clinical decision rules integrating signs, symptoms, and CRP to diagnose acute rhinosinusitis and acute bacterial rhinosinusitis with good accuracy. They now require prospective validation and an assessment of their effect on clinical and process outcomes. © 2017 Annals of Family Medicine, Inc.

Earthworm responses to different reclamation processes in post opencast mining lands during succession.

PubMed

Hlava, Jakub; Hlavová, Anna; Hakl, Josef; Fér, Miroslav

2015-01-01

This study provides earthworm population data obtained from localities with a substantial anthropogenic impact spoils. The spoil heaps were reclaimed at the end of an opencast brown coal mining period. We studied spoils reclaimed by the two most commonly used reclamation processes: forestry and agricultural. The results show the significance of the locality age and the utilized reclamation process and treatment and their effect on earthworm communities. Our data indicate that apart from soil physical and chemical properties, the reclamation process itself may also induce viability and distribution of earthworm communities. Under standardized soil properties, the changes in earthworm populations during the succession were larger within the agricultural reclamation process as opposed to the forestry reclamation process for earthworm ecological groups and individual species.

Comparison of owner-reported behavioral characteristics among genetically clustered breeds of dog (Canis familiaris).

PubMed Central

Tonoike, Akiko; Nagasawa, Miho; Mogi, Kazutaka; Serpell, James A.; Ohtsuki, Hisashi; Kikusui, Takefumi

2015-01-01

During the domestication process, dogs were selected for their suitability for multiple purposes, resulting in a variety of behavioral characteristics. In particular, the ancient group of breeds that is genetically closer to wolves may show different behavioral characteristics when compared to other breed groups. Here, we used questionnaire evaluations of dog behavior to investigate whether behavioral characteristics of dogs were different among genetically clustered breed groups. A standardized questionnaire, the Canine Behavioral Assessment and Research Questionnaire (C-BARQ), was used, and breed group differences of privately-owned dogs from Japan (n = 2,951) and the United States (n = 10,389) were analyzed. Results indicated that dogs in the ancient and spitz breed group showed low attachment and attention-seeking behavior. This characteristic distinguished the ancient group from any other breed groups with presumed modern European origins, and may therefore, be an ancestral trait. PMID:26680442

Drafting standards on cognitive accessibility: a global collaboration.

PubMed

Steel, Emily J; Janeslätt, Gunnel

2017-05-01

The International Organization for Standardization (ISO) is working on accessibility of products to support people with cognitive impairment. Working Group 10, within the technical committee 173 (assistive products for persons with disability) was formed in 2014 to draft standards for assistive products that support people with cognitive impairment. This article explains the scope and purpose of the working group and the context for its formation, and describes the plans and process for drafting and publishing new international standards. The proposed suite of standards is presented, with examples from a draft standard on daily time management. It draws on international research evidence for the effectiveness of assistive products designed to support time management in people with cognitive impairment. Examples of assistive products and their key features are provided based on domains of time as defined in the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). The proposed standards will provide design recommendations for features and functions that increase the accessibility of products used by people with cognitive impairment. They are intended to be used by designers, manufactures, educators and services providers, to facilitate their commitment to inclusion and demonstrate their willingness to work with accessibility regulation. Implications for Rehabilitation New standards based on universal design (UD) principles can guide the design of more user-friendly assistive products for people with cognitive impairment. Greater usability of assistive products, whether mainstream or specially-designed, will make it easier for practitioners to find and introduce assistive solutions to individuals with cognitive impairment. Greater usability of assistive products for daily time management can decrease the need for user training and support and enable participation.

Ethical tissue: a not-for-profit model for human tissue supply.

PubMed

Adams, Kevin; Martin, Sandie

2011-02-01

Following legislative changes in 2004 and the establishment of the Human Tissue Authority, access to human tissues for biomedical research became a more onerous and tightly regulated process. Ethical Tissue was established to meet the growing demand for human tissues, using a process that provided ease of access by researchers whilst maintaining the highest ethical and regulatory standards. The establishment of a licensed research tissue bank entailed several key criteria covering ethical, legal, financial and logistical issues being met. A wide range of stakeholders, including the HTA, University of Bradford, flagged LREC, hospital trusts and clinical groups were also integral to the process.

Improving the preparticipation exam process.

PubMed

Reed, F E

2001-08-01

The Preparticipation Exam for too long has been a mandatory yearly athletic exam and not the base from which a process of continuous athletic care took place. The purpose of this article is not only to introduce improvements in the exam itself but to also describe some extensions of the process that allow us to improve athletic care in South Carolina. It is hoped that a software scanning program will allow compiling of demographic data from individual and group examinations and thus support the method of exam preferred by all physicians in our state. Standard forms will also facilitate communication within the Athletic Care Unit and between physicians involved in athletic care.

The Effect of the Physical Presence of Co-Players on Perceived Ostracism and Event-Related Brain Potentials in the Cyberball Paradigm

PubMed Central

Weschke, Sarah; Niedeggen, Michael

2013-01-01

The affective and cognitive mechanisms elicited by the experience of social exclusion—or ostracism—have recently been explored using behavioral and neurocognitive methods. Most of the studies took advantage of the Cyberball paradigm, a virtual ball tossing game with presumed co-players connected via the internet. Consistent behavioral findings indicate that exclusion obviously threatens fundamental social needs (belonging, self-esteem, meaningful existence, and control) and lowers mood. In this study, we followed the question whether the credibility of the setting affects the processing of social exclusion. In contrast to a control group (standard Cyberball setup), co-players were physically present in an experimental group. Although the credibility of the virtual ball tossing game was significantly enhanced in the experimental group, self-reported negative mood and need threat were not enhanced compared to the control group. Event-related brain potentials (ERPs), however, indicated a differential processing of social exclusion. The N2 amplitude triggered by occasional ball receptions was significantly reduced in the experimental group. This effect was restricted for an early time range (130–210 ms), and did not extend to the following P3 components. The ERP effect in the N2 time range can be related to a differential social reward processing in ostracism if co-players are physically present. The lack of a corresponding correlate in the behavioral data indicates that some facets of ostracism processing are not covered by questionnaire data. PMID:23951269

Processing and validation of JEFF-3.1.1 and ENDF/B-VII.0 group-wise cross section libraries for shielding calculations

NASA Astrophysics Data System (ADS)

Pescarini, M.; Sinitsa, V.; Orsi, R.; Frisoni, M.

2013-03-01

This paper presents a synthesis of the ENEA-Bologna Nuclear Data Group programme dedicated to generate and validate group-wise cross section libraries for shielding and radiation damage deterministic calculations in nuclear fission reactors, following the data processing methodology recommended in the ANSI/ANS-6.1.2-1999 (R2009) American Standard. The VITJEFF311.BOLIB and VITENDF70.BOLIB finegroup coupled n-γ (199 n + 42 γ - VITAMIN-B6 structure) multi-purpose cross section libraries, based on the Bondarenko method for neutron resonance self-shielding and respectively on JEFF-3.1.1 and ENDF/B-VII.0 evaluated nuclear data, were produced in AMPX format using the NJOY-99.259 and the ENEA-Bologna 2007 Revision of the SCAMPI nuclear data processing systems. Two derived broad-group coupled n-γ (47 n + 20 γ - BUGLE-96 structure) working cross section libraries in FIDO-ANISN format for LWR shielding and pressure vessel dosimetry calculations, named BUGJEFF311.BOLIB and BUGENDF70.BOLIB, were generated by the revised version of SCAMPI, through problem-dependent cross section collapsing and self-shielding from the cited fine-group libraries. The validation results on the criticality safety benchmark experiments for the fine-group libraries and the preliminary validation results for the broad-group working libraries on the PCA-Replica and VENUS-3 engineering neutron shielding benchmark experiments are reported in synthesis.

Tomato (Lycopersicon esculentum) or lycopene supplementation attenuates ventricular remodeling after myocardial infarction through different mechanistic pathways.

PubMed

Pereira, Bruna L B; Reis, Patrícia P; Severino, Fábio E; Felix, Tainara F; Braz, Mariana G; Nogueira, Flávia R; Silva, Renata A C; Cardoso, Ana C; Lourenço, Maria A M; Figueiredo, Amanda M; Chiuso-Minicucci, Fernanda; Azevedo, Paula S; Polegato, Bertha F; Okoshi, Katashi; Fernandes, Ana A H; Paiva, Sergio A R; Zornoff, Leonardo A M; Minicucci, Marcos F

2017-08-01

The objective of this study was to evaluate the influence of tomato or lycopene supplementation on cardiac remodeling after myocardial infarction (MI). Male Wistar rats were assigned to four groups: the sham group (animals that underwent simulated surgery) that received a standard chow (S; n=18), the infarcted group that received a standard chow (MI; n=13), the infarcted group supplemented with lycopene (1 mg of lycopene/kg body weight/day) (MIL; n=16) and the infarcted group supplemented with tomato (MIT; n=16). After 3 months, morphological, functional and biochemical analyses were performed. The groups MIL and MIT showed decreased interstitial fibrosis induced by infarction. Tomato supplementation attenuated the hypertrophy induced by MI. In addition, tomato and lycopene improved diastolic dysfunction evaluated by echocardiographic and isolated heart studies, respectively. The MI group showed higher levels of cardiac TNF-α compared to the MIL and MIT groups. Decreased nuclear factor E2-related factor 2 was measured in the MIL group. Lipid hydroperoxide levels were higher in the infarcted groups; however, the MIT group had a lower concentration than did the MI group [S=223±20.8, MI=298±19.5, MIL=277±26.6, MIT=261±28.8 (nmol/g); n=8; P<.001]. We also examined left ventricle miRNA expression; when compared to the S group, the MIL group uniquely down-regulated the expression of eight miRNAs. No miRNA was found to be up-regulated uniquely in the MIT and MIL groups. In conclusion, tomato or lycopene supplementation attenuated the cardiac remodeling process and improved diastolic function after MI. However, the effect of lycopene and tomato supplementation occurred through different mechanistic pathways. Copyright © 2017 Elsevier Inc. All rights reserved.

Anticipation measures of sequence learning: manual versus oculomotor versions of the serial reaction time task.

PubMed

Vakil, Eli; Bloch, Ayala; Cohen, Haggar

2017-03-01

The serial reaction time (SRT) task has generated a very large amount of research. Nevertheless the debate continues as to the exact cognitive processes underlying implicit sequence learning. Thus, the first goal of this study is to elucidate the underlying cognitive processes enabling sequence acquisition. We therefore compared reaction time (RT) in sequence learning in a standard manual activated (MA) to that in an ocular activated (OA) version of the task, within a single experimental setting. The second goal is to use eye movement measures to compare anticipation, as an additional indication of sequence learning, between the two versions of the SRT. Performance of the group given the MA version of the task (n = 29) was compared with that of the group given the OA version (n = 30). The results showed that although overall, RT was faster for the OA group, the rate of sequence learning was similar to that of the MA group performing the standard version of the SRT. Because the stimulus-response association is automatic and exists prior to training in the OA task, the decreased reaction time in this version of the task reflects a purer measure of the sequence learning that occurs in the SRT task. The results of this study show that eye tracking anticipation can be measured directly and can serve as a direct measure of sequence learning. Finally, using the OA version of the SRT to study sequence learning presents a significant methodological contribution by making sequence learning studies possible among populations that struggle to perform manual responses.

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge.

PubMed

Brownstein, Catherine A; Beggs, Alan H; Homer, Nils; Merriman, Barry; Yu, Timothy W; Flannery, Katherine C; DeChene, Elizabeth T; Towne, Meghan C; Savage, Sarah K; Price, Emily N; Holm, Ingrid A; Luquette, Lovelace J; Lyon, Elaine; Majzoub, Joseph; Neupert, Peter; McCallie, David; Szolovits, Peter; Willard, Huntington F; Mendelsohn, Nancy J; Temme, Renee; Finkel, Richard S; Yum, Sabrina W; Medne, Livija; Sunyaev, Shamil R; Adzhubey, Ivan; Cassa, Christopher A; de Bakker, Paul I W; Duzkale, Hatice; Dworzyński, Piotr; Fairbrother, William; Francioli, Laurent; Funke, Birgit H; Giovanni, Monica A; Handsaker, Robert E; Lage, Kasper; Lebo, Matthew S; Lek, Monkol; Leshchiner, Ignaty; MacArthur, Daniel G; McLaughlin, Heather M; Murray, Michael F; Pers, Tune H; Polak, Paz P; Raychaudhuri, Soumya; Rehm, Heidi L; Soemedi, Rachel; Stitziel, Nathan O; Vestecka, Sara; Supper, Jochen; Gugenmus, Claudia; Klocke, Bernward; Hahn, Alexander; Schubach, Max; Menzel, Mortiz; Biskup, Saskia; Freisinger, Peter; Deng, Mario; Braun, Martin; Perner, Sven; Smith, Richard J H; Andorf, Janeen L; Huang, Jian; Ryckman, Kelli; Sheffield, Val C; Stone, Edwin M; Bair, Thomas; Black-Ziegelbein, E Ann; Braun, Terry A; Darbro, Benjamin; DeLuca, Adam P; Kolbe, Diana L; Scheetz, Todd E; Shearer, Aiden E; Sompallae, Rama; Wang, Kai; Bassuk, Alexander G; Edens, Erik; Mathews, Katherine; Moore, Steven A; Shchelochkov, Oleg A; Trapane, Pamela; Bossler, Aaron; Campbell, Colleen A; Heusel, Jonathan W; Kwitek, Anne; Maga, Tara; Panzer, Karin; Wassink, Thomas; Van Daele, Douglas; Azaiez, Hela; Booth, Kevin; Meyer, Nic; Segal, Michael M; Williams, Marc S; Tromp, Gerard; White, Peter; Corsmeier, Donald; Fitzgerald-Butt, Sara; Herman, Gail; Lamb-Thrush, Devon; McBride, Kim L; Newsom, David; Pierson, Christopher R; Rakowsky, Alexander T; Maver, Aleš; Lovrečić, Luca; Palandačić, Anja; Peterlin, Borut; Torkamani, Ali; Wedell, Anna; Huss, Mikael; Alexeyenko, Andrey; Lindvall, Jessica M; Magnusson, Måns; Nilsson, Daniel; Stranneheim, Henrik; Taylan, Fulya; Gilissen, Christian; Hoischen, Alexander; van Bon, Bregje; Yntema, Helger; Nelen, Marcel; Zhang, Weidong; Sager, Jason; Zhang, Lu; Blair, Kathryn; Kural, Deniz; Cariaso, Michael; Lennon, Greg G; Javed, Asif; Agrawal, Saloni; Ng, Pauline C; Sandhu, Komal S; Krishna, Shuba; Veeramachaneni, Vamsi; Isakov, Ofer; Halperin, Eran; Friedman, Eitan; Shomron, Noam; Glusman, Gustavo; Roach, Jared C; Caballero, Juan; Cox, Hannah C; Mauldin, Denise; Ament, Seth A; Rowen, Lee; Richards, Daniel R; San Lucas, F Anthony; Gonzalez-Garay, Manuel L; Caskey, C Thomas; Bai, Yu; Huang, Ying; Fang, Fang; Zhang, Yan; Wang, Zhengyuan; Barrera, Jorge; Garcia-Lobo, Juan M; González-Lamuño, Domingo; Llorca, Javier; Rodriguez, Maria C; Varela, Ignacio; Reese, Martin G; De La Vega, Francisco M; Kiruluta, Edward; Cargill, Michele; Hart, Reece K; Sorenson, Jon M; Lyon, Gholson J; Stevenson, David A; Bray, Bruce E; Moore, Barry M; Eilbeck, Karen; Yandell, Mark; Zhao, Hongyu; Hou, Lin; Chen, Xiaowei; Yan, Xiting; Chen, Mengjie; Li, Cong; Yang, Can; Gunel, Murat; Li, Peining; Kong, Yong; Alexander, Austin C; Albertyn, Zayed I; Boycott, Kym M; Bulman, Dennis E; Gordon, Paul M K; Innes, A Micheil; Knoppers, Bartha M; Majewski, Jacek; Marshall, Christian R; Parboosingh, Jillian S; Sawyer, Sarah L; Samuels, Mark E; Schwartzentruber, Jeremy; Kohane, Isaac S; Margulies, David M

2014-03-25

There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups.

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge

PubMed Central

2014-01-01

Background There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. Results A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. Conclusions The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups. PMID:24667040

Identifying the Barriers and Enablers to Nutrition Care in Head and Neck and Esophageal Cancers: An International Qualitative Study.

PubMed

Martin, Lisa; de van der Schueren, Marian A E; Blauwhoff-Buskermolen, Susanne; Baracos, Vickie; Gramlich, Leah

2016-03-01

The goal of this work was to identify barriers and enablers to the implementation of nutrition care in head and neck and esophageal (HNE) cancers and to prioritize barriers to help improve the nutrition care process. This study used a multimethod qualitative study design (including semistructured interviews, focus group). Interviews (n = 29) were conducted at 5 European sites providing care and treatment to patients with HNE cancers. A focus group (n = 21) reviewed and corroborated interview findings and identified priorities for nutrition care. Participants were healthcare providers and researchers with direct experience in the field of HNE cancer. Five themes with accompanying barriers and enablers were identified related to nutrition care: (1) evidence for the benefit of nutrition interventions, (2) implementation of nutrition care processes (assessment, intervention, and follow-up), (3) characteristics of healthcare providers, (4) site factors, and (5) patient characteristics. Focus group discussions identified 2 priorities that must be acted on to improve nutrition care: (1) improve the evidence base and (2) develop standardized nutrition care pathways. Themes related to nutrition care in HNE cancers were similar between sites, but barriers and enablers differed. Interview and focus group participants agreed the following actions will result in improvements in nutrition care: (1) enhance the evidence base to test the benefit of nutrition interventions, with a focus on resolving specific controversies regarding nutrition therapy, and (2) establish a minimum data set with a goal to create standardized nutrition care pathways where roles and responsibilities for care are clearly defined. © 2014 American Society for Parenteral and Enteral Nutrition.

Effectiveness of Visual Methods in Information Procedures for Stem Cell Recipients and Donors

PubMed Central

Sarıtürk, Çağla; Gereklioğlu, Çiğdem; Korur, Aslı; Asma, Süheyl; Yeral, Mahmut; Solmaz, Soner; Büyükkurt, Nurhilal; Tepebaşı, Songül; Kozanoğlu, İlknur; Boğa, Can; Özdoğu, Hakan

2017-01-01

Objective: Obtaining informed consent from hematopoietic stem cell recipients and donors is a critical step in the transplantation process. Anxiety may affect their understanding of the provided information. However, use of audiovisual methods may facilitate understanding. In this prospective randomized study, we investigated the effectiveness of using an audiovisual method of providing information to patients and donors in combination with the standard model. Materials and Methods: A 10-min informational animation was prepared for this purpose. In total, 82 participants were randomly assigned to two groups: group 1 received the additional audiovisual information and group 2 received standard information. A 20-item questionnaire was administered to participants at the end of the informational session. Results: A reliability test and factor analysis showed that the questionnaire was reliable and valid. For all participants, the mean overall satisfaction score was 184.8±19.8 (maximum possible score of 200). However, for satisfaction with information about written informed consent, group 1 scored significantly higher than group 2 (p=0.039). Satisfaction level was not affected by age, education level, or differences between the physicians conducting the informative session. Conclusion: This study shows that using audiovisual tools may contribute to a better understanding of the informed consent procedure and potential risks of stem cell transplantation. PMID:27476890

Fast group matching for MR fingerprinting reconstruction.

PubMed

Cauley, Stephen F; Setsompop, Kawin; Ma, Dan; Jiang, Yun; Ye, Huihui; Adalsteinsson, Elfar; Griswold, Mark A; Wald, Lawrence L

2015-08-01

MR fingerprinting (MRF) is a technique for quantitative tissue mapping using pseudorandom measurements. To estimate tissue properties such as T1 , T2 , proton density, and B0 , the rapidly acquired data are compared against a large dictionary of Bloch simulations. This matching process can be a very computationally demanding portion of MRF reconstruction. We introduce a fast group matching algorithm (GRM) that exploits inherent correlation within MRF dictionaries to create highly clustered groupings of the elements. During matching, a group specific signature is first used to remove poor matching possibilities. Group principal component analysis (PCA) is used to evaluate all remaining tissue types. In vivo 3 Tesla brain data were used to validate the accuracy of our approach. For a trueFISP sequence with over 196,000 dictionary elements, 1000 MRF samples, and image matrix of 128 × 128, GRM was able to map MR parameters within 2s using standard vendor computational resources. This is an order of magnitude faster than global PCA and nearly two orders of magnitude faster than direct matching, with comparable accuracy (1-2% relative error). The proposed GRM method is a highly efficient model reduction technique for MRF matching and should enable clinically relevant reconstruction accuracy and time on standard vendor computational resources. © 2014 Wiley Periodicals, Inc.

Reverse breech extraction versus the standard approach of pushing the impacted fetal head up through the vagina in caesarean section for obstructed labour: A randomised controlled trial.

PubMed

Nooh, Ahmed Mohamed; Abdeldayem, Hussein Mohammed; Ben-Affan, Othman

2017-05-01

The objective of this study was to assess effectiveness and safety of the reverse breech extraction approach in Caesarean section for obstructed labour, and compare it with the standard approach of pushing the fetal head up through the vagina. This randomised controlled trial included 192 women. In 96, the baby was delivered by the 'reverse breech extraction approach', and in the remaining 96, by the 'standard approach'. Extension of uterine incision occurred in 18 participants (18.8%) in the reverse breech extraction approach group, and 46 (47.9%) in the standard approach group (p = .0003). Two women (2.1%) in the reverse breech extraction approach group needed blood transfusion and 11 (11.5%) in the standard approach group (p = .012). Pyrexia developed in 3 participants (3.1%) in the reverse breech extraction approach group, and 19 (19.8%) in the standard approach group (p = .0006). Wound infection occurred in 2 women (2.1%) in the reverse breech extraction approach group, and 12 (12.5%) in the standard approach group (p = .007). Apgar score <7 at 5 minutes was noted in 8 babies (8.3%) in the reverse breech extraction approach group, and 21 (21.9%) in the standard approach group (p = .015). In conclusion, reverse breech extraction in Caesarean section for obstructed labour is an effective and safe alternative to the standard approach of pushing the fetal head up through the vagina.

Weekly, low-dose docetaxel combined with estramustine for Japanese castration-resistant prostate cancer: its efficacy and safety profile compared with tri-weekly standard-dose treatment.

PubMed

Nakai, Yasutomo; Nishimura, Kazuo; Nakayama, Masashi; Uemura, Motohide; Takayama, Hitoshi; Nonomura, Norio; Tsujimura, Akira

2014-02-01

We retrospectively investigated the efficacy and safety profile of weekly low-dose docetaxel (DTX) with estramustine in comparison with triweekly standard-dose DTX treatment for Japanese patients with castration-resistant prostate cancer (CRPC). Between April 2002 and January 2011, 75 CRPC patients were treated with triweekly DTX (60-75 mg/m(2) every 3 weeks) (standard-dose group), and 76 CRPC patients were treated with weekly low-dose DTX (20-30 mg/m(2) on days 2 and 9 with estramustine 560 mg on days 1-3 and 8-10) every 3 weeks (low-dose group). Prostate-specific antigen (PSA) response and progression-free and overall survival were analyzed in each group. Median serum PSA level of the standard-dose group and low-dose group was 25.0 and 35.5 ng/ml, respectively. In the standard-dose and low-dose groups, 57.8 and 65.2 % of patients, respectively, achieved a PSA decline ≥ 50 %. There was no significant difference in either median time to progression between the standard-dose group (10.0 months) and low-dose group (7.1 months) or in median duration of survival between the standard-dose group (24.2 months) and low-dose group (30.6 months). Multivariate analysis with a Cox proportional hazards regression model showed that DTX treatment protocol did not influence the risk of death. Incidences of grade 3-4 neutropenia, febrile neutropenia, and thrombocytopenia were significantly higher in the standard-dose versus low-dose group (58.7 vs. 7.9 %, 16.0 vs. 3.9 %, and 8.0 vs. 0 %, respectively). For Japanese CRPC patients, weekly low-dose DTX combined with estramustine has similar efficacy to standard-dose DTX but with fewer adverse events.

A randomized trial of protocol-based care for early septic shock.

PubMed

Yealy, Donald M; Kellum, John A; Huang, David T; Barnato, Amber E; Weissfeld, Lisa A; Pike, Francis; Terndrup, Thomas; Wang, Henry E; Hou, Peter C; LoVecchio, Frank; Filbin, Michael R; Shapiro, Nathan I; Angus, Derek C

2014-05-01

In a single-center study published more than a decade ago involving patients presenting to the emergency department with severe sepsis and septic shock, mortality was markedly lower among those who were treated according to a 6-hour protocol of early goal-directed therapy (EGDT), in which intravenous fluids, vasopressors, inotropes, and blood transfusions were adjusted to reach central hemodynamic targets, than among those receiving usual care. We conducted a trial to determine whether these findings were generalizable and whether all aspects of the protocol were necessary. In 31 emergency departments in the United States, we randomly assigned patients with septic shock to one of three groups for 6 hours of resuscitation: protocol-based EGDT; protocol-based standard therapy that did not require the placement of a central venous catheter, administration of inotropes, or blood transfusions; or usual care. The primary end point was 60-day in-hospital mortality. We tested sequentially whether protocol-based care (EGDT and standard-therapy groups combined) was superior to usual care and whether protocol-based EGDT was superior to protocol-based standard therapy. Secondary outcomes included longer-term mortality and the need for organ support. We enrolled 1341 patients, of whom 439 were randomly assigned to protocol-based EGDT, 446 to protocol-based standard therapy, and 456 to usual care. Resuscitation strategies differed significantly with respect to the monitoring of central venous pressure and oxygen and the use of intravenous fluids, vasopressors, inotropes, and blood transfusions. By 60 days, there were 92 deaths in the protocol-based EGDT group (21.0%), 81 in the protocol-based standard-therapy group (18.2%), and 86 in the usual-care group (18.9%) (relative risk with protocol-based therapy vs. usual care, 1.04; 95% confidence interval [CI], 0.82 to 1.31; P=0.83; relative risk with protocol-based EGDT vs. protocol-based standard therapy, 1.15; 95% CI, 0.88 to 1.51; P=0.31). There were no significant differences in 90-day mortality, 1-year mortality, or the need for organ support. In a multicenter trial conducted in the tertiary care setting, protocol-based resuscitation of patients in whom septic shock was diagnosed in the emergency department did not improve outcomes. (Funded by the National Institute of General Medical Sciences; ProCESS ClinicalTrials.gov number, NCT00510835.).

Operating Room Time Savings with the Use of Splint Packs: A Randomized Controlled Trial

PubMed Central

Gonzalez, Tyler A.; Bluman, Eric M.; Palms, David; Smith, Jeremy T.; Chiodo, Christopher P.

2016-01-01

Background: The most expensive variable in the operating room (OR) is time. Lean Process Management is being used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP) contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS) splint application. Methods: Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB) prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. Results: The retrieval time, preparation time and total splinting time were significantly less (p<0.001) in the SP group compared with the BS group. There was no significant difference in application time between the SP group and BS group. Conclusion: The use of SP made the process of splinting more lean. This has resulted in an average of 2 minutes 52 seconds saved in total splinting time compared to BS, making it an effective cost-cutting and time saving technique. For high volume ORs, use of splint packs may contribute to substantial time and cost savings without impacting patient safety. PMID:26894212

The Effect of Material Removal on the Corrosion Resistance and Biocompatibility of Nitinol Laser-Cut and Wire-Form Products

NASA Astrophysics Data System (ADS)

Decker, Jennifer Fino; Trépanier, Christine; Vien, Lot; Pelton, Alan R.

2011-07-01

Laser cutting and wire forming are two of the most commonly used processes in the manufacture of Nitinol medical devices. This study explores how varying the amount of material removed during the final surface treatment steps affects the corrosion resistance of Z-type stents that have either been laser-cut from tube or shape set from wire. All parts were subjected to a typical heat treatment process necessary to achieve an Austenite finish (Af) temperature of 25 ± 5 °C, and were subsequently post-processed with an electrochemical passivation process. The total weight loss during post-processing was recorded and the process adjusted to create groups with less than 5%, less than 10%, and less than 25% amounts of weight loss. The parts were then crimped to 6 mm and allowed to expand back to their original diameter. The corrosion test results showed that on average both groups of Z-stents experienced an increase in the corrosion breakdown potential and a decrease in the standard deviation with increasing amounts of material removal. In addition, less material removal is required from the wire-form Z-stents as compared to the laser-cut Z-stents to achieve high corrosion resistance. Finally, 7 day nickel ion release tests performed on the wire-formed Z-stents showed a dramatic decrease from 0.0132 mg of nickel leached per day for the low weight loss group to approximately 0.001 mg/day for the medium and high weight loss groups.

Applying total quality management concepts to public health organizations.

PubMed Central

Kaluzny, A D; McLaughlin, C P; Simpson, K

1992-01-01

Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

Standardizing the intrinsic brain: Towards robust measurement of inter-individual variation in 1000 functional connectomes

PubMed Central

Yan, Chao-Gan; Craddock, R. Cameron; Zuo, Xi-Nian; Zang, Yu-Feng; Milham, Michael P.

2014-01-01

As researchers increase their efforts to characterize variations in the functional connectome across studies and individuals, concerns about the many sources of nuisance variation present and their impact on resting state fMRI (R-fMRI) measures continue to grow. Although substantial within-site variation can exist, efforts to aggregate data across multiple sites such as the 1000 Functional Connectomes Project (FCP) and International Neuroimaging Data-sharing Initiative (INDI) datasets amplify these concerns. The present work draws upon standardization approaches commonly used in the microarray gene expression literature, and to a lesser extent recent imaging studies, and compares them with respect to their impact on relationships between common R-fMRI measures and nuisance variables (e.g., imaging site, motion), as well as phenotypic variables of interest (age, sex). Standardization approaches differed with regard to whether they were applied post-hoc vs. during pre-processing, and at the individual vs. group level; additionally they varied in whether they addressed additive effects vs. additive + multiplicative effects, and were parametric vs. non-parametric. While all standardization approaches were effective at reducing undesirable relationships with nuisance variables, post-hoc approaches were generally more effective than global signal regression (GSR). Across approaches, correction for additive effects (global mean) appeared to be more important than for multiplicative effects (global SD) for all R-fMRI measures, with the exception of amplitude of low frequency fluctuations (ALFF). Group-level post-hoc standardizations for mean-centering and variance-standardization were found to be advantageous in their ability to avoid the introduction of artifactual relationships with standardization parameters; though results between individual and group-level post-hoc approaches were highly similar overall. While post-hoc standardization procedures drastically increased test–retest (TRT) reliability for ALFF, modest reductions were observed for other measures after post-hoc standardizations—a phenomena likely attributable to the separation of voxel-wise from global differences among subjects (global mean and SD demonstrated moderate TRT reliability for these measures). Finally, the present work calls into question previous observations of increased anatomical specificity for GSR over mean centering, and draws attention to the near equivalence of global and gray matter signal regression. PMID:23631983

College of American Pathologists' laboratory standards for next-generation sequencing clinical tests.

PubMed

Aziz, Nazneen; Zhao, Qin; Bry, Lynn; Driscoll, Denise K; Funke, Birgit; Gibson, Jane S; Grody, Wayne W; Hegde, Madhuri R; Hoeltge, Gerald A; Leonard, Debra G B; Merker, Jason D; Nagarajan, Rakesh; Palicki, Linda A; Robetorye, Ryan S; Schrijver, Iris; Weck, Karen E; Voelkerding, Karl V

2015-04-01

The higher throughput and lower per-base cost of next-generation sequencing (NGS) as compared to Sanger sequencing has led to its rapid adoption in clinical testing. The number of laboratories offering NGS-based tests has also grown considerably in the past few years, despite the fact that specific Clinical Laboratory Improvement Amendments of 1988/College of American Pathologists (CAP) laboratory standards had not yet been developed to regulate this technology. To develop a checklist for clinical testing using NGS technology that sets standards for the analytic wet bench process and for bioinformatics or "dry bench" analyses. As NGS-based clinical tests are new to diagnostic testing and are of much greater complexity than traditional Sanger sequencing-based tests, there is an urgent need to develop new regulatory standards for laboratories offering these tests. To develop the necessary regulatory framework for NGS and to facilitate appropriate adoption of this technology for clinical testing, CAP formed a committee in 2011, the NGS Work Group, to deliberate upon the contents to be included in the checklist. Results . -A total of 18 laboratory accreditation checklist requirements for the analytic wet bench process and bioinformatics analysis processes have been included within CAP's molecular pathology checklist (MOL). This report describes the important issues considered by the CAP committee during the development of the new checklist requirements, which address documentation, validation, quality assurance, confirmatory testing, exception logs, monitoring of upgrades, variant interpretation and reporting, incidental findings, data storage, version traceability, and data transfer confidentiality.

Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

PubMed

Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana

2016-10-15

Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing.

Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine

PubMed Central

Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana

2016-01-01

Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard – fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline – second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing. PMID:27812301

Benchmarking of municipal waste water treatment plants (an Austrian project).

PubMed

Lindtner, S; Kroiss, H; Nowak, O

2004-01-01

An Austrian research project focused on the development of process indicators for treatment plants with different process and operation modes. The whole treatment scheme was subdivided into four processes, i.e. mechanical pretreatment (Process 1), mechanical-biological waste water treatment (Process 2), sludge thickening and stabilisation (Process 3) and further sludge treatment and disposal (Process 4). In order to get comparable process indicators it was necessary to subdivide the sample of 76 individual treatment plants all over Austria into five groups according to their mean organic load (COD) in the influent. The specific total yearly costs, the yearly operating costs and the yearly capital costs of the four processes have been related to the yearly average of the measured organic load expressed in COD (110 g COD/pe/d). The specific investment costs for the whole treatment plant and for Process 2 have been related to a calculated standard design capacity of the mechanical-biological part of the treatment plant expressed in COD. The capital costs of processes 1, 3 and 4 have been related to the design capacity of the treatment plant. For each group (related to the size of the plant) a benchmark band has been defined for the total yearly costs, the total yearly operational costs and the total yearly capital costs. For the operational costs of the Processes 1 to 4 one benchmark ([see symbol in text] per pe/year) has been defined for each group. In addition a theoretical cost reduction potential has been calculated. The cost efficiency in regard to water protection and some special sub-processes such as aeration and sludge dewatering has been analysed.

Couple Relationship Standards and Migration: Comparing Hong Kong Chinese with Australian Chinese.

PubMed

Halford, W Kim; Leung, Patrick; Hung-Cheung, Chan; Chau-Wan, Lau; Hiew, Danika; van de Vijver, Fons J R

2017-12-14

Rates of international migration are increasing, which raises the question of how migration might influence couple relationship standards and impact on the standards of migrants forming intercultural relationships. We compared relationship standards in n = 286 Chinese living in Hong Kong, China, with standards in n = 401 Chinese migrants to a Western country (Australia) by administering the Chinese-Western Intercultural Couple Standards Scale (CWICSS). We also compared these two groups to n = 312 Westerners living in Australia. We first tested the structural invariance of the CWICSS across the three samples with a multigroup confirmatory factor analysis. There was marginal but acceptable fit of a model of two positively correlated latent factors: Couple Bond (with four indicators, such as demonstration of love and caring) and Family Responsibility (also with four indicators, such as extended family relations and preserving face). Within the limitations of the study, results suggest migration is associated predominantly with differences in women's, but not men's, relationship standards. Migrant Chinese women show alignment of Couple Bond standards with Western standards, and divergence of Family Responsibility standards from Western standards. Discussion focused on how migration and intercultural relationship experiences might differentially influence various domains of relationship standards, gender differences in migration effects on standards, and the implications for working with culturally diverse couples. © 2017 Family Process Institute.

Effect of standards on new equipment design by new international standards and industry restraints

NASA Astrophysics Data System (ADS)

Endelman, Lincoln L.

1991-01-01

The use of international standards to further trade is one of the objectives of creating a standard. By having form fit and function compatible the free interchange of manufactured goods can be handled without hindrance. Unfortunately by setting up standards that are peculiar to a particular country or district it is possible to exclude competition from a group of manufacturers. A major effort is now underway to develop international laser standards. In the May I 990 issue of Laser Focus World Donald R. Johnson the director of industrial technology services for the National Institute of Standards and Technology (NIST formerly the National Bureau of Standards) is quoted as follows: " The common means of protectionism has been through certification for the market place. " The article goes on to say " Mr. Johnson expects this tradition to continue and that the new European Community (EC) will demand not just safety standards but performance standards as well. . . . the American laser industry must move very quickly on this issue or risk being left behind the European standards bandwagon. " The article continues laser companies must get involved in the actual standards negotiating process if they are to have a say in future policy. A single set of standards would reduce the need to repeatedly recalibrate products for different national markets. " As a member of ISO TC-72 SC9 I am

[Enhancement of quality by employing qualification-oriented staff and team-oriented cooperation].

PubMed

Meyenburg-Altwarg, Iris; Tecklenburg, Andreas

2010-01-01

Taking three practical examples from a university hospital the present article describes how quality can be improved by linking deployment of qualification-oriented staff with team-oriented cooperation, especially with regard to the professional groups of physicians and nurses. In the first example, a cross-professional work group defined tasks which--in a legally acceptable manner--allow selected activities to be transferred from physicians to nurses, improving the work processes of all persons concerned. Work and duty profiles, training and modified work processes were created and implemented according to the PDCA circle-based process. The first evaluation took place after nine months using interviews, questionnaires (patients, physicians, and nurses) as well as CIRS. In the second example, emphasis was placed on offers of supplementary services for private patients resulting in a lightening of the workload on the nursing staff. These supplementary services are intended to enhance the wellbeing of the patients. Special external-service staff provide high standard hotel services. These services consistently receive high ratings from the patients. The methods used for introduction and evaluation are analogous to those used in the first example. The third example is concerned with the extension of nursing care and patient empowerment beyond the boundaries of ward and hospital. The guidelines were the implementation of the national expert standard for discharge management according to the DNQP. The methods of introduction were analogous to those used in example 1. For the evaluation interviews were conducted with all participating groups. In all examples actual quantitative measures (key ratios) are not yet available; however, the data collected from the interviews and questionnaires of all the participants are promising.

Implementation of the fugitive emissions system program: The OxyChem experience

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

Deshmukh, A.

An overview is provided for the Fugitive Emissions System (FES) that has been implemented at Occidental Chemical in conjunction with the computer-based maintenance system called PassPort{reg_sign} developed by Indus Corporation. The goal of PassPort{reg_sign} FES program has been to interface with facilities data, equipment information, work standards and work orders. Along the way, several implementation hurdles had to be overcome before a monitoring and regulatory system could be standardized for the appropriate maintenance, process and environmental groups. This presentation includes step-by-step account of several case studies that developed during the implementation of the FES system.

Methods of analysis by the U.S. Geological Survey National Water Quality Laboratory; processing, taxonomy, and quality control of benthic macroinvertebrate samples

USGS Publications Warehouse

Moulton, Stephen R.; Carter, James L.; Grotheer, Scott A.; Cuffney, Thomas F.; Short, Terry M.

2000-01-01

Qualitative and quantitative methods to process benthic macroinvertebrate (BMI) samples have been developed and tested by the U.S. Geological Survey?s National Water Quality Laboratory Biological Group. The qualitative processing method is based on visually sorting a sample for up to 2 hours. Sorting focuses on attaining organisms that are likely to result in taxonomic identifications to lower taxonomic levels (for example, Genus or Species). Immature and damaged organisms are also sorted when they are likely to result in unique determinations. The sorted sample remnant is scanned briefly by a second person to determine if obvious taxa were missed. The quantitative processing method is based on a fixed-count approach that targets some minimum count, such as 100 or 300 organisms. Organisms are sorted from randomly selected 5.1- by 5.1-centimeter parts of a gridded subsampling frame. The sorted remnant from each sample is resorted by a second individual for at least 10 percent of the original sort time. A large-rare organism search is performed on the unsorted remnant to sort BMI taxa that were not likely represented in the sorted grids. After either qualitatively or quantitatively sorting the sample, BMIs are identified by using one of three different types of taxonomic assessment. The Standard Taxonomic Assessment is comparable to the U.S. Environmental Protection Agency Rapid Bioassessment Protocol III and typically provides Genus- or Species-level taxonomic resolution. The Rapid Taxonomic Assessment is comparable to the U.S. Environmental Protection Agency Rapid Bioassessment Protocol II and provides Familylevel and higher taxonomic resolution. The Custom Taxonomic Assessment provides Species-level resolution whenever possible for groups identified to higher taxonomic levels by using the Standard Taxonomic Assessment. The consistent use of standardized designations and notes facilitates the interpretation of BMI data within and among water-quality studies. Taxonomic identifications are quality assured by verifying all referenced taxa and randomly reviewing 10 percent of the taxonomic identifications performed weekly by Biological Group taxonomists. Taxonomic errors discovered during this review are corrected. BMI data are reviewed for accuracy and completeness prior to release. BMI data are released phylogenetically in spreadsheet format and unprocessed abundances are corrected for laboratory and field subsampling when necessary.

Report of the Association of Coloproctology of Great Britain and Ireland/British Society of Gastroenterology Colorectal Polyp Working Group: the development of a complex colorectal polyp minimum dataset.

PubMed

Chattree, A; Barbour, J A; Thomas-Gibson, S; Bhandari, P; Saunders, B P; Veitch, A M; Anderson, J; Rembacken, B J; Loughrey, M B; Pullan, R; Garrett, W V; Lewis, G; Dolwani, S; Rutter, M D

2017-01-01

The management of large non-pedunculated colorectal polyps (LNPCPs) is complex, with widespread variation in management and outcome, even amongst experienced clinicians. Variations in the assessment and decision-making processes are likely to be a major factor in this variability. The creation of a standardized minimum dataset to aid decision-making may therefore result in improved clinical management. An official working group of 13 multidisciplinary specialists was appointed by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) to develop a minimum dataset on LNPCPs. The literature review used to structure the ACPGBI/BSG guidelines for the management of LNPCPs was used by a steering subcommittee to identify various parameters pertaining to the decision-making processes in the assessment and management of LNPCPs. A modified Delphi consensus process was then used for voting on proposed parameters over multiple voting rounds with at least 80% agreement defined as consensus. The minimum dataset was used in a pilot process to ensure rigidity and usability. A 23-parameter minimum dataset with parameters relating to patient and lesion factors, including six parameters relating to image retrieval, was formulated over four rounds of voting with two pilot processes to test rigidity and usability. This paper describes the development of the first reported evidence-based and expert consensus minimum dataset for the management of LNPCPs. It is anticipated that this dataset will allow comprehensive and standardized lesion assessment to improve decision-making in the assessment and management of LNPCPs. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

Making tomorrow's mistakes today: Evolutionary prototyping for risk reduction and shorter development time

NASA Astrophysics Data System (ADS)

Friedman, Gary; Schwuttke, Ursula M.; Burliegh, Scott; Chow, Sanguan; Parlier, Randy; Lee, Lorrine; Castro, Henry; Gersbach, Jim

1993-03-01

In the early days of JPL's solar system exploration, each spacecraft mission required its own dedicated data system with all software applications written in the mainframe's native assembly language. Although these early telemetry processing systems were a triumph of engineering in their day, since that time the computer industry has advanced to the point where it is now advantageous to replace these systems with more modern technology. The Space Flight Operations Center (SFOC) Prototype group was established in 1985 as a workstation and software laboratory. The charter of the lab was to determine if it was possible to construct a multimission telemetry processing system using commercial, off-the-shelf computers that communicated via networks. The staff of the lab mirrored that of a typical skunk works operation -- a small, multi-disciplinary team with a great deal of autonomy that could get complex tasks done quickly. In an effort to determine which approaches would be useful, the prototype group experimented with all types of operating systems, inter-process communication mechanisms, network protocols, packet size parameters. Out of that pioneering work came the confidence that a multi-mission telemetry processing system could be built using high-level languages running in a heterogeneous, networked workstation environment. Experience revealed that the operating systems on all nodes should be similar (i.e., all VMS or all PC-DOS or all UNIX), and that a unique Data Transport Subsystem tool needed to be built to address the incompatibilities of network standards, byte ordering, and socket buffering. The advantages of building a telemetry processing system based on emerging industry standards were numerous: by employing these standards, we would no longer be locked into a single vendor. When new technology came to market which offered ten times the performance at one eighth the cost, it would be possible to attach the new machine to the network, re-compile the application code, and run. In addition, we would no longer be plagued with lack of manufacturer support when we encountered obscure bugs. And maybe, hopefully, the eternal elusive goal of software portability across different vendors' platforms would finally be available. Some highlights of our prototyping efforts are described.

Making tomorrow's mistakes today: Evolutionary prototyping for risk reduction and shorter development time

NASA Technical Reports Server (NTRS)

Friedman, Gary; Schwuttke, Ursula M.; Burliegh, Scott; Chow, Sanguan; Parlier, Randy; Lee, Lorrine; Castro, Henry; Gersbach, Jim

1993-01-01

In the early days of JPL's solar system exploration, each spacecraft mission required its own dedicated data system with all software applications written in the mainframe's native assembly language. Although these early telemetry processing systems were a triumph of engineering in their day, since that time the computer industry has advanced to the point where it is now advantageous to replace these systems with more modern technology. The Space Flight Operations Center (SFOC) Prototype group was established in 1985 as a workstation and software laboratory. The charter of the lab was to determine if it was possible to construct a multimission telemetry processing system using commercial, off-the-shelf computers that communicated via networks. The staff of the lab mirrored that of a typical skunk works operation -- a small, multi-disciplinary team with a great deal of autonomy that could get complex tasks done quickly. In an effort to determine which approaches would be useful, the prototype group experimented with all types of operating systems, inter-process communication mechanisms, network protocols, packet size parameters. Out of that pioneering work came the confidence that a multi-mission telemetry processing system could be built using high-level languages running in a heterogeneous, networked workstation environment. Experience revealed that the operating systems on all nodes should be similar (i.e., all VMS or all PC-DOS or all UNIX), and that a unique Data Transport Subsystem tool needed to be built to address the incompatibilities of network standards, byte ordering, and socket buffering. The advantages of building a telemetry processing system based on emerging industry standards were numerous: by employing these standards, we would no longer be locked into a single vendor. When new technology came to market which offered ten times the performance at one eighth the cost, it would be possible to attach the new machine to the network, re-compile the application code, and run. In addition, we would no longer be plagued with lack of manufacturer support when we encountered obscure bugs. And maybe, hopefully, the eternal elusive goal of software portability across different vendors' platforms would finally be available. Some highlights of our prototyping efforts are described.

Constraints of beyond Standard Model parameters from the study of neutrinoless double beta decay

NASA Astrophysics Data System (ADS)

Stoica, Sabin

2017-12-01

Neutrinoless double beta (0νββ) decay is a beyond Standard Model (BSM) process whose discovery would clarify if the lepton number is conserved, decide on the neutrinos character (are they Dirac or Majorana particles?) and give a hint on the scale of their absolute masses. Also, from the study of 0νββ one can constrain other BSM parameters related to different scenarios by which this process can occur. In this paper I make first a short review on the actual challenges to calculate precisely the phase space factors and nuclear matrix elements entering the 0νββ decay lifetimes, and I report results of our group for these quantities. Then, taking advance of the most recent experimental limits for 0νββ lifetimes, I present new constraints of the neutrino mass parameters associated with different mechanisms of occurrence of the 0νββ decay mode.

Removal combined with reduction of hexavalent chromium from aqueous solution by Fe-ethylene glycol complex microspheres

NASA Astrophysics Data System (ADS)

Zhang, Yong-Xing; Jia, Yong

2016-12-01

Three-dimensional Fe-ethylene glycol (Fe-EG) complex microspheres were synthesized by a facile hydrothermal method, and were characterized by field emission scanning electron microscopy and transmission electron microscopy. The adsorption as well as reduction properties of the obtained Fe-EG complex microspheres towards Cr(VI) ions were studied. The experiment data of adsorption kinetic and isotherm were fitted by nonlinear regression approach. In neutral condition, the maximum adsorption capacity was 49.78 mg g-1 at room temperature, and was increased with the increasing of temperature. Thermodynamic parameters including the Gibbs free energy, standard enthalpy and standard entropy revealed that adsorption of Cr(VI) was a feasible, spontaneous and endothermic process. Spectroscopic analysis revealed the adsorption of Cr(VI) was a physical adsorption process. The adsorbed CrO42- ions were partly reduced to Cr(OH)3 by Fe(II) ions and the organic groups in the Fe-EG complex.

Treatment of severe and moderate acute malnutrition in low- and middle-income settings: a systematic review, meta-analysis and Delphi process

PubMed Central

2013-01-01

Background Globally, moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) affect approximately 52 million children under five. This systematic review evaluates the effectiveness of interventions for SAM including the World Health Organization (WHO) protocol for inpatient management and community-based management with ready-to-use-therapeutic food (RUTF), as well as interventions for MAM in children under five years in low- and middle-income countries. Methods We systematically searched the literature and included 14 studies in the meta-analysis. Study quality was assessed using CHERG adaptation of GRADE criteria. A Delphi process was undertaken to complement the systematic review in estimating case fatality and recovery rates that were necessary for modelling in the Lives Saved Tool (LiST). Results Case fatality rates for inpatient treatment of SAM using the WHO protocol ranged from 3.4% to 35%. For community-based treatment of SAM, children given RUTF were 51% more likely to achieve nutritional recovery than the standard care group. For the treatment of MAM, children in the RUSF group were significantly more likely to recover and less likely to be non-responders than in the CSB group. In both meta-analyses, weight gain in the intervention group was higher, and although statistically significant, these differences were small. Overall limitations in our analysis include considerable heterogeneity in many outcomes and an inability to evaluate intervention effects separate from commodity effect. The Delphi process indicated that adherence to standardized protocols for the treatment of SAM and MAM should have a marked positive impact on mortality and recovery rates; yet, true consensus was not achieved. Conclusions Gaps in our ability to estimate effectiveness of overall treatment approaches for SAM and MAM persist. In addition to further impact studies conducted in a wider range of settings, more high quality program evaluations need to be conducted and the results disseminated. PMID:24564235

Evaluation of phototherapy in the differentiation of mesenchymal stem cells in the tissue repair of rats submitted to a hyperlipidemic diet

NASA Astrophysics Data System (ADS)

Oliveira, C. R. B.; Santos, L. S.; Silva, V. D. U.; Vitória, L. A.; Rodriguez, T. T.; Marques, A. M. C.; Xavier, F. C. A.; Ramalho, L.

2018-04-01

Obese people present a greater risk of developing other systemic diseases and comorbidities such as compromising the tissue repair process. Laser phototherapy can contribute to this repair by improving cellular functions, since stem cells may play an important role in repair due to their pluripotent potential. In this way, the influence of Laser Phototherapy (LP) was evaluated in the tissue repair of rats submitted to a hyperlipid diet through CD49 immunostaining for adipose stem cells. Forty-eight Wistar albinus rats were divided into two experimental groups: Standard Diet (SD) and Hyperlipid Diet (HD) for 20 weeks. After this period, excisional dorsal cutaneous wounds of 1 cm2 were made. The groups were subdivided into control and laser, the laser groups were irradiated (Diode Laser of Gallium and Aluminum Arsenide, λ660nm, 40mW, 6J / cm2) immediately after the surgery and every 48 hours. A group of rats were killed on day 7 and the other group on day 14 and the specimens processed by the immunohistochemical technique. The SD group presented antibodies marked with moderate to intense intensity, whereas in the HD group the weak staining for the time of 14 days prevailed. The irradiation protocol employed had no influence on the CD49 marker when compared to the control and irradiated groups over the same period. According to the methodology used and the results obtained it is concluded that laser light does not influence the recruitment of adipoderivative stem cells for the tissue repair process.

Measuring Growth and Decline in Visual-Motor Processes with the Bender-Gestalt Second Edition

ERIC Educational Resources Information Center

Decker, Scott L.

2008-01-01

The purpose of this study is to develop a change-sensitive scale for evaluating developmental change in visual-motor ability across the life span. A partial-credit item-response model is used to estimate theta values for each age group between 4 and 90 using the Bender-Gestalt II standardization sample (N = 4,000). Results from this study suggest…

Development of Avionics Installation Interface Standards.

DTIC Science & Technology

1981-12-01

design and manufacturing process routinely used to minimize the susceptibility of the equipment to corrosion . 4.2.7 Form/Fit Working Group The Form...since it would include both the LRU repack- aging and the required aircraft reconfiguration. The smallest impact is achieved when an avionics or...Smith ARINC Research Corporation X D. Snell Boeing Aerospace Corporation .. Steele Masterite Industries E. Straub ARINC Research Corporation X 1

[THE IMPACT OF ACCREDITATION - ACHIEVEMENTS, BENEFITS AND BARRIERS: COMPARING THE VIEWPOINTS OF THE PROCESS LEADERS AND THE HOSPITAL STAFF].

PubMed

Tal, Orna; Rassin, Michal

2018-05-01

Evaluating the impact of the accreditation process on the basis of achievements, benefits and barriers from the viewpoint of leaders of the hospital accreditation in comparison to the hospital staff members. The implementation of standards for accreditation aim to improve the safety and quality of treatment. Partaking in this process has raised dilemmas regarding the actual benefits of accreditation in relation to the efforts invested in its achievement. Examining the standpoints of leaders of the process can reflect on the influence of this mechanism both on hospital activity and on hospital staff. A survey was conducted among two groups: The first group, the JCI accreditation leaders group, included 35 participants (the steering committee, 15 chapter heads and the hospital management); and 71 participants from the extended headquarters (senior physicians, nurses and administration staff). The second group included 564 hospital personnel from the medical, nursing, alternative medicine, administrators and housekeeping staff. The questionnaire included 46 statements in five fields: the effectiveness and benefit from the process, weaknesses, barriers, leadership and administration of the accreditation. All the respondents to the survey perceived the process as a leverage for implementing significant changes in all levels of the organization. There were high levels of agreement on the benefit of the process regarding the effective and affective contribution - high morale, feelings of accomplishment and team pride, improvement in communication, cooperation and social cohesion. The weaknesses of the process, including financial costs, bureaucracy, paper overflow and work overload, were awarded relatively low scores. The advantages of the process were ranked high in both groups; the accreditation leaders group attributed the process benefits to the organization as a whole, ranking it significantly higher, as well as for the individual. The hospital staff rated as significantly higher: the contribution of the process on the department level and the opportunity to promote accomplishments that were not reached in the past. The survey raised organizational discussion which minimized the objections to the process of change. Focusing on chosen aspects bridged between managers and on-site staff to find effective solutions. In order to promote successful inter-organizational processes the hospital requires both leadership and a well-formulated strategic program. The secondary gains from the broad process encompassing the whole organization, such as in the case of accreditation, are expressed in the form of social cohesion, cooperation, group pride and high staff morale.

The effect of various veneering techniques on the marginal fit of zirconia copings

PubMed Central

Torabi, Kianoosh; Vojdani, Mahroo; Giti, Rashin; Pardis, Soheil

2015-01-01

PURPOSE This study aimed to evaluate the fit of zirconia ceramics before and after veneering, using 3 different veneering processes (layering, press-over, and CAD-on techniques). MATERIALS AND METHODS Thirty standardized zirconia CAD/CAM frameworks were constructed and divided into three groups of 10 each. The first group was veneered using the traditional layering technique. Press-over and CAD-on techniques were used to veneer second and third groups. The marginal gap of specimens was measured before and after veneering process at 18 sites on the master die using a digital microscope. Paired t-test was used to evaluate mean marginal gap changes. One-way ANOVA and post hoc tests were also employed for comparison among 3 groups (α=.05). RESULTS Marginal gap of 3 groups was increased after porcelain veneering. The mean marginal gap values after veneering in the layering group (63.06 µm) was higher than press-over (50.64 µm) and CAD-on (51.50 µm) veneered groups (P<.001). CONCLUSION Three veneering methods altered the marginal fit of zirconia copings. Conventional layering technique increased the marginal gap of zirconia framework more than pressing and CAD-on techniques. All ceramic crowns made through three different veneering methods revealed clinically acceptable marginal fit. PMID:26140175

Toward an International Classification of Functioning, Disability and Health clinical data collection tool: the Italian experience of developing simple, intuitive descriptions of the Rehabilitation Set categories.

PubMed

Selb, Melissa; Gimigliano, Francesca; Prodinger, Birgit; Stucki, Gerold; Pestelli, Germano; Iocco, Maurizio; Boldrini, Paolo

2017-04-01

As part of international efforts to develop and implement national models including the specification of ICF-based clinical data collection tools, the Italian rehabilitation community initiated a project to develop simple, intuitive descriptions of the ICF Rehabilitation Set, highlighting the core concept of each category in user-friendly language. This paper outlines the Italian experience in developing simple, intuitive descriptions of the ICF Rehabilitation Set as an ICF-based clinical data collection tool for Italy. Consensus process. Expert conference. Multidisciplinary group of rehabilitation professionals. The first of a two-stage consensus process involved developing an initial proposal for simple, intuitive descriptions of each ICF Rehabilitation Set category based on descriptions generated in a similar process in China. Stage two involved a consensus conference. Divided into three working groups, participants discussed and voted (vote A) whether the initially proposed descriptions of each ICF Rehabilitation Set category was simple and intuitive enough for use in daily practice. Afterwards the categories with descriptions considered ambiguous i.e. not simple and intuitive enough, were divided among the working groups, who were asked to propose a new description for the allocated categories. These proposals were then voted (vote B) on in a plenary session. The last step of the consensus conference required each working group to develop a new proposal for each and the same categories with descriptions still considered ambiguous. Participants then voted (final vote) for which of the three proposed descriptions they preferred. Nineteen clinicians from diverse rehabilitation disciplines from various regions of Italy participated in the consensus process. Three ICF categories already achieved consensus in vote A, while 20 ICF categories were accepted in vote B. The remaining 7 categories were decided in the final vote. The findings were discussed in light of current efforts toward developing strategies for ICF implementation, specifically for the application of an ICF-based clinical data collection tool, not only for Italy but also for the rest of Europe. Promising as minimal standards for monitoring the impact of interventions and for standardized reporting of functioning as a relevant outcome in rehabilitation.

Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi.

PubMed

Pitchford, Nicola J

2015-01-01

Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child's developmental stage.

Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi

PubMed Central

Pitchford, Nicola J.

2015-01-01

Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1–3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1–3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child’s developmental stage. PMID:25954236

Local contextual processing of abstract and meaningful real-life images in professional athletes.

PubMed

Fogelson, Noa; Fernandez-Del-Olmo, Miguel; Acero, Rafael Martín

2012-05-01

We investigated the effect of abstract versus real-life meaningful images from sports on local contextual processing in two groups of professional athletes. Local context was defined as the occurrence of a short predictive series of stimuli occurring before delivery of a target event. EEG was recorded in 10 professional basketball players and 9 professional athletes of individual sports during three sessions. In each session, a different set of visual stimuli were presented: triangles facing left, up, right, or down; four images of a basketball player throwing a ball; four images of a baseball player pitching a baseball. Stimuli consisted of 15 % targets and 85 % of equal numbers of three types of standards. Recording blocks consisted of targets preceded by randomized sequences of standards and by sequences including a predictive sequence signaling the occurrence of a subsequent target event. Subjects pressed a button in response to targets. In all three sessions, reaction times and peak P3b latencies were shorter for predicted targets compared with random targets, the last most informative stimulus of the predictive sequence induced a robust P3b, and N2 amplitude was larger for random targets compared with predicted targets. P3b and N2 peak amplitudes were larger in the professional basketball group in comparison with professional athletes of individual sports, across the three sessions. The findings of this study suggest that local contextual information is processed similarly for abstract and for meaningful images and that professional basketball players seem to allocate more attentional resources in the processing of these visual stimuli.

Optimizing the post-graduate institutional program evaluation process.

PubMed

Lypson, Monica L; Prince, Mark E P; Kasten, Steven J; Osborne, Nicholas H; Cohan, Richard H; Kowalenko, Terry; Dougherty, Paul J; Reynolds, R Kevin; Spires, M Catherine; Kozlow, Jeffrey H; Gitlin, Scott D

2016-02-17

Reviewing program educational efforts is an important component of postgraduate medical education program accreditation. The post-graduate review process has evolved over time to include centralized oversight based on accreditation standards. The institutional review process and the impact on participating faculty are topics not well described in the literature. We conducted multiple Plan-Do-Study-Act (PDSA) cycles to identify and implement areas for change to improve productivity in our institutional program review committee. We also conducted one focus group and six in-person interviews with 18 committee members to explore their perspectives on the committee's evolution. One author (MLL) reviewed the transcripts and performed the initial thematic coding with a PhD level research associate and identified and categorized themes. These themes were confirmed by all participating committee members upon review of a detailed summary. Emergent themes were triangulated with the University of Michigan Medical School's Admissions Executive Committee (AEC). We present an overview of adopted new practices to the educational program evaluation process at the University of Michigan Health System that includes standardization of meetings, inclusion of resident members, development of area content experts, solicitation of committed committee members, transition from paper to electronic committee materials, and focus on continuous improvement. Faculty and resident committee members identified multiple improvement areas including the ability to provide high quality reviews of training programs, personal and professional development, and improved feedback from program trainees. A standing committee that utilizes the expertise of a group of committed faculty members and which includes formal resident membership has significant advantages over ad hoc or other organizational structures for program evaluation committees.

Object-based neglect in number processing

PubMed Central

2013-01-01

Recent evidence suggests that neglect patients seem to have particular problems representing relatively smaller numbers corresponding to the left part of the mental number line. However, while this indicates space-based neglect for representational number space little is known about whether and - if so - how object-based neglect influences number processing. To evaluate influences of object-based neglect in numerical cognition, a group of neglect patients and two control groups had to compare two-digit numbers to an internally represented standard. Conceptualizing two-digit numbers as objects of which the left part (i.e., the tens digit should be specifically neglected) we were able to evaluate object-based neglect for number magnitude processing. Object-based neglect was indicated by a larger unit-decade compatibility effect actually reflecting impaired processing of the leftward tens digits. Additionally, faster processing of within- as compared to between-decade items provided further evidence suggesting particular difficulties in integrating tens and units into the place-value structure of the Arabic number system. In summary, the present study indicates that, in addition to the spatial representation of number magnitude, also the processing of place-value information of multi-digit numbers seems specifically impaired in neglect patients. PMID:23343126

Effects of adding Braun jejunojejunostomy to standard Whipple procedure on reduction of afferent loop syndrome - a randomized clinical trial.

PubMed

Kakaei, Farzad; Beheshtirouy, Samad; Nejatollahi, Seyed Moahammad Reza; Rashidi, Iqbal; Asvadi, Touraj; Habibzadeh, Afshin; Oliaei-Motlagh, Mohammad

2015-12-01

Whipple surgery (pancreaticodeudenectomy) has a high complication rate. We aimed to evaluate whether adding Braun jejunojejunostomy (side-to-side anastomosis of afferent and efferent loops distal to the gastrojejunostomy site) to a standard Whipple procedure would reduce postoperative complications. We conducted a randomized clinical trial comparing patients who underwent standard Whipple surgery (standard group) and patients who underwent standard Whipple surgery with Braun jejunojejunostomy (Braun group). Patients were followed for 1 month after the procedure and postoperative complications were recorded. Our study included 30 patients: 15 in the Braun and 15 in the standard group. In the Braun group, 4 (26.7%) patients experienced 6 complications, whereas in the standard group, 7 (46.7%) patients experienced 11 complications (p = 0.14). Complications in the Braun group were gastrointestinal bleeding and wound infection (n = 1 each) and delayed gastric emptying and pulmonary infection (n = 2 each). Complications in the standard group were death, pancreatic anastomosis leak and biliary anastomosis leak (n = 1 each); gastrointestinal bleeding (n = 2); and afferent loop syndrome and delayed gastric emptying (n = 3 each). There was no significant difference between groups in the subtypes of complications. Our results showed that adding Braun jejunojejunostomy to standard Whipple procedure was associated with lower rates of afferent loop syndrome and delayed gastric emptying. However, more studies are needed to define the role of Braun jejunojejunostomy in this regard. IRCT2014020316473N1 (www.irct.ir).

76 FR 58078 - Thirteenth Meeting: RTCA Special Committee 214: Working Group 78: Standards for Air Traffic Data...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... Committee 214: Working Group 78: Standards for Air Traffic Data Communication Services AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of RTCA Special Committee 214: Working Group 78... public of a meeting of the RTCA Special Committee 214: Working Group 78: Standards for Air Traffic Data...

Contact networks and the study of contagion.

PubMed

Hartigan, P M

1980-09-01

The contact network among individuals in a patient group and in a control group is examined. The probability of knowing another person is modelled with parameters assigned to various factors, such as age, sex or disease, which may influence this probability. Standard likelihood techniques are used to estimate the parameters and to test the significance of the hypotheses, in particular the hypothesis of contagion, generated in the modelling process. The method is illustrated in a study of the Yale student body, in which infectious mononucleosis patients of the opposite sex are shown to know each other significantly more frequently than expected.

Tracking zebrafish larvae in group – Status and perspectives☆

PubMed Central

Martineau, Pierre R.; Mourrain, Philippe

2013-01-01

Video processing is increasingly becoming a standard procedure in zebrafish behavior investigations as it enables higher research throughput and new or better measures. This trend, fostered by the ever increasing performance-to-price ratio of the required recording and processing equipment, should be expected to continue in the foreseeable future, with video-processing based methods permeating more and more experiments and, as a result, expanding the very role of behavioral studies in zebrafish research. To assess whether the routine video tracking of zebrafish larvae directly in the Petri dish is a capability that can be expected in the near future, the key processing concepts are discussed and illustrated on published zebrafish studies when available or other animals when not. PMID:23707495

When standards are wide of the mark: nonselective superiority and inferiority biases in comparative judgments of objects and concepts.

PubMed

Giladi, Eilath E; Klar, Yechiel

2002-12-01

People are frequently required to judge how particular group members measure up against others in their group. According to the local-comparisons-general-standards (LOGE) approach, in these member-to-group comparisons, people fail to use the normatively appropriate local (group) standard and are infelicitously affected by a more general standard (involving instances from outside the judged group). Within positive groups, target group members are judged superior to the other members of the group, and within negative groups, inferior. To date, these nonselective superiority and inferiority biases have been demonstrated solely in judgments about human beings. In 6 experiments, nonselective biases were found in perceptual, affective, and cognitive judgments of nonhuman targets, objects, and concepts, thus supporting a cognitive rather than a social account.

30 CFR 828.11 - In situ processing: Performance standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false In situ processing: Performance standards. 828... STANDARDS-IN SITU PROCESSING § 828.11 In situ processing: Performance standards. (a) The person who conducts in situ processing activities shall comply with 30 CFR 817 and this section. (b) In situ processing...

30 CFR 828.11 - In situ processing: Performance standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false In situ processing: Performance standards. 828... STANDARDS-IN SITU PROCESSING § 828.11 In situ processing: Performance standards. (a) The person who conducts in situ processing activities shall comply with 30 CFR 817 and this section. (b) In situ processing...

30 CFR 828.11 - In situ processing: Performance standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false In situ processing: Performance standards. 828... STANDARDS-IN SITU PROCESSING § 828.11 In situ processing: Performance standards. (a) The person who conducts in situ processing activities shall comply with 30 CFR 817 and this section. (b) In situ processing...

30 CFR 828.11 - In situ processing: Performance standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false In situ processing: Performance standards. 828... STANDARDS-IN SITU PROCESSING § 828.11 In situ processing: Performance standards. (a) The person who conducts in situ processing activities shall comply with 30 CFR 817 and this section. (b) In situ processing...

30 CFR 828.11 - In situ processing: Performance standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false In situ processing: Performance standards. 828... STANDARDS-IN SITU PROCESSING § 828.11 In situ processing: Performance standards. (a) The person who conducts in situ processing activities shall comply with 30 CFR 817 and this section. (b) In situ processing...

Efficacy and safety of sunitinib alternate day regimen in patients with metastatic renal cell carcinoma in Japan: Comparison with standard 4/2 schedule.

PubMed

Ohba, Kojiro; Miyata, Yasuyoshi; Yasuda, Takuji; Asai, Akihiro; Mitsunari, Kensuke; Matsuo, Tomohiro; Mochizuki, Yasushi; Matsunaga, Noriko; Sakai, Hideki

2018-06-01

Sunitinib is a standard agent for metastatic renal cell carcinoma (mRCC). The standard schedule, 4 weeks-on followed by 2 weeks-off (4/2 schedule), often does not maintain an adequate dosage because of the severe adverse events (AEs). We compared the efficacy and safety of an alternative every other day (q.a.d.) dosing with that of the 4/2 schedule in mRCC patients. Of the 55 Japanese patients, 32 and 23 were administered 4/2 (standard group) and q.a.d. schedules (50 or 37.5 mg, every other day; experimental groups), respectively. The AEs, anticancer effects, and trough plasma concentrations of sunitinib were compared between them. The most common AE in the standard group was thrombocytopenia (43.2%), but it was observed in only two patients in the experimental group (8.7%). Although leukopenia and hand-foot syndrome were both detected in six patients (18.8%) in the standard group, no patients had these AEs in the experimental group. The incidence of dose interruption in the experimental group (21.7%) was significantly lower than that in the standard group was (59.4%, P = 0.005). Time to progression (TTP) and overall survival (OS) of the experimental group were better than those of the standard group (P < 0.001 and P = 0.002, respectively). Mean plasma levels in the experimental group (64.83 ng/mL) were significantly lower than those in the standard group (135.82 ng/mL, P < 0.001) were. Sunitinib administered q.a.d. was safe and effective for mRCC patients. We speculate that the persistent optimal drug plasma concentrations contributed to these effects. © 2018 The Authors. Asia-Pacific Journal of Clinical Oncology Published by John Wiley & Sons Australia, Ltd.

Life skills programmes for chronic mental illnesses

PubMed Central

Tungpunkom, Patraporn; Maayan, Nicola; Soares-Weiser, Karla

2014-01-01

Background Most people with schizophrenia have a cyclical pattern of illness characterised by remission and relapses. The illness can reduce the ability of self-care and functioning and can lead to the illness becoming disabling. Life skills programmes, emphasising the needs associated with independent functioning, are often a part of the rehabilitation process. These programmes have been developed to enhance independent living and quality of life for people with schizophrenia. Objectives To review the effects of life skills programmes compared with standard care or other comparable therapies for people with chronic mental health problems. Search methods We searched the Cochrane Schizophrenia Group Trials Register (June 2010). We supplemented this process with handsearching and scrutiny of references. We inspected references of all included studies for further trials. Selection criteria We included all relevant randomised or quasi-randomised controlled trials for life skills programmes versus other comparable therapies or standard care involving people with serious mental illnesses. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis, based on a random-effects model. For continuous data, we calculated mean differences (MD), again based on a random-effects model. Main results We included seven randomised controlled trials with a total of 483 participants. These evaluated life skills programmes versus standard care, or support group. We found no significant difference in life skills performance between people given life skills training and standard care (1 RCT, n = 32, MD −1.10; 95% CI −7.82 to 5.62). Life skills training did not improve or worsen study retention (5 RCTs, n = 345, RR 1.16; 95% CI 0.40 to 3.36). We found no significant difference in PANSS positive, negative or total scores between life skills intervention and standard care. We found quality of life scores to be equivocal between participants given life skills training (1 RCT, n = 32, MD −0.02; 95% CI −0.07 to 0.03) and standard care. Life skills compared with support groups also did not reveal any significant differences in PANSS scores, quality of life, or social performance skills (1 RCT, n = 158, MD −0.90; 95% CI −3.39 to 1.59). Authors’ conclusions Currently there is no good evidence to suggest life skills programmes are effective for people with chronic mental illnesses. More robust data are needed from studies that are adequately powered to determine whether life skills training is beneficial for people with chronic mental health problems. PMID:22258941

Consumption of ultra-processed foods and body fat during childhood and adolescence: a systematic review.

PubMed

Costa, Caroline Santos; Del-Ponte, Bianca; Assunção, Maria Cecília Formoso; Santos, Iná Silva

2018-01-01

To review the available literature on the association between consumption of ultra-processed foods and body fat during childhood and adolescence. A systematic review was conducted in the PubMed, Web of Science and LILACS databases. Studies that evaluated the association between consumption of ultra-processed food (exposure) and body fat (outcome) during childhood and adolescence were eligible. Healthy children and adolescents. Twenty-six studies that evaluated groups of ultra-processed foods (such as snacks, fast foods, junk foods and convenience foods) or specific ultra-processed foods (soft drinks/sweetened beverages, sweets, chocolate and ready-to-eat cereals) were selected. Most of the studies (n 15) had a cohort design. Consumption was generally evaluated by means of FFQ or food records; and body composition, by means of double indirect methods (bioelectrical impedance analysis and skinfolds). Most of the studies that evaluated consumption of groups of ultra-processed foods and soft drinks/sweetened beverages found positive associations with body fat. Our review showed that most studies have found positive associations between consumption of ultra-processed food and body fat during childhood and adolescence. There is a need to use a standardized classification that considers the level of food processing to promote comparability between studies.

Developing a Standard Set of Patient-Centred Outcomes for Inflammatory Bowel Disease-an International, Cross-disciplinary Consensus.

PubMed

Kim, Andrew H; Roberts, Charlotte; Feagan, Brian G; Banerjee, Rupa; Bemelman, Willem; Bodger, Keith; Derieppe, Marc; Dignass, Axel; Driscoll, Richard; Fitzpatrick, Ray; Gaarentstroom-Lunt, Janette; Higgins, Peter D; Kotze, Paulo Gustavo; Meissner, Jillian; O'Connor, Marian; Ran, Zhi-Hua; Siegel, Corey A; Terry, Helen; van Deen, Welmoed K; van der Woude, C Janneke; Weaver, Alandra; Yang, Suk-Kyun; Sands, Bruce E; Vermeire, Séverine; Travis, Simon Pl

2018-03-28

Success in delivering value-based healthcare involves measuring outcomes that matter most to patients. Our aim was to develop a minimum Standard Set of patient-centred outcome measures for inflammatory bowel disease [IBD], for use in different healthcare settings. An international working group [n = 25] representing patients, patient associations, gastroenterologists, surgeons, specialist nurses, IBD registries and patient-reported outcome measure [PROM] methodologists participated in a series of teleconferences incorporating a modified Delphi process. Systematic review of existing literature, registry data, patient focus groups and open review periods were used to reach consensus on a minimum set of standard outcome measures and risk adjustment variables. Similar methodology has been used in 21 other disease areas [www.ichom.org]. A minimum Standard Set of outcomes was developed for patients [aged ≥16] with IBD. Outcome domains included survival and disease control [survival, disease activity/remission, colorectal cancer, anaemia], disutility of care [treatment-related complications], healthcare utilization [IBD-related admissions, emergency room visits] and patient-reported outcomes [including quality of life, nutritional status and impact of fistulae] measured at baseline and at 6 or 12 month intervals. A single PROM [IBD-Control questionnaire] was recommended in the Standard Set and minimum risk adjustment data collected at baseline and annually were included: demographics, basic clinical information and treatment factors. A Standard Set of outcome measures for IBD has been developed based on evidence, patient input and specialist consensus. It provides an international template for meaningful, comparable and easy-to-interpret measures as a step towards achieving value-based healthcare in IBD.

Group Cooperation without Group Selection: Modest Punishment Can Recruit Much Cooperation.

PubMed

Krasnow, Max M; Delton, Andrew W; Cosmides, Leda; Tooby, John

2015-01-01

Humans everywhere cooperate in groups to achieve benefits not attainable by individuals. Individual effort is often not automatically tied to a proportionate share of group benefits. This decoupling allows for free-riding, a strategy that (absent countermeasures) outcompetes cooperation. Empirically and formally, punishment potentially solves the evolutionary puzzle of group cooperation. Nevertheless, standard analyses appear to show that punishment alone is insufficient, because second-order free riders (those who cooperate but do not punish) can be shown to outcompete punishers. Consequently, many have concluded that other processes, such as cultural or genetic group selection, are required. Here, we present a series of agent-based simulations that show that group cooperation sustained by punishment easily evolves by individual selection when you introduce into standard models more biologically plausible assumptions about the social ecology and psychology of ancestral humans. We relax three unrealistic assumptions of past models. First, past models assume all punishers must punish every act of free riding in their group. We instead allow punishment to be probabilistic, meaning punishers can evolve to only punish some free riders some of the time. This drastically lowers the cost of punishment as group size increases. Second, most models unrealistically do not allow punishment to recruit labor; punishment merely reduces the punished agent's fitness. We instead realistically allow punished free riders to cooperate in the future to avoid punishment. Third, past models usually restrict agents to interact in a single group their entire lives. We instead introduce realistic social ecologies in which agents participate in multiple, partially overlapping groups. Because of this, punitive tendencies are more expressed and therefore more exposed to natural selection. These three moves toward greater model realism reveal that punishment and cooperation easily evolve by direct selection--even in sizeable groups.

Group Cooperation without Group Selection: Modest Punishment Can Recruit Much Cooperation

PubMed Central

Cosmides, Leda; Tooby, John

2015-01-01

Humans everywhere cooperate in groups to achieve benefits not attainable by individuals. Individual effort is often not automatically tied to a proportionate share of group benefits. This decoupling allows for free-riding, a strategy that (absent countermeasures) outcompetes cooperation. Empirically and formally, punishment potentially solves the evolutionary puzzle of group cooperation. Nevertheless, standard analyses appear to show that punishment alone is insufficient, because second-order free riders (those who cooperate but do not punish) can be shown to outcompete punishers. Consequently, many have concluded that other processes, such as cultural or genetic group selection, are required. Here, we present a series of agent-based simulations that show that group cooperation sustained by punishment easily evolves by individual selection when you introduce into standard models more biologically plausible assumptions about the social ecology and psychology of ancestral humans. We relax three unrealistic assumptions of past models. First, past models assume all punishers must punish every act of free riding in their group. We instead allow punishment to be probabilistic, meaning punishers can evolve to only punish some free riders some of the time. This drastically lowers the cost of punishment as group size increases. Second, most models unrealistically do not allow punishment to recruit labor; punishment merely reduces the punished agent’s fitness. We instead realistically allow punished free riders to cooperate in the future to avoid punishment. Third, past models usually restrict agents to interact in a single group their entire lives. We instead introduce realistic social ecologies in which agents participate in multiple, partially overlapping groups. Because of this, punitive tendencies are more expressed and therefore more exposed to natural selection. These three moves toward greater model realism reveal that punishment and cooperation easily evolve by direct selection—even in sizeable groups. PMID:25893241

Assessing the service quality of Iran military hospitals: Joint Commission International standards and Analytic Hierarchy Process (AHP) technique

PubMed Central

Bahadori, Mohammadkarim; Ravangard, Ramin; Yaghoubi, Maryam; Alimohammadzadeh, Khalil

2014-01-01

Background: Military hospitals are responsible for preserving, restoring and improving the health of not only armed forces, but also other people. According to the military organizations strategy, which is being a leader and pioneer in all areas, providing quality health services is one of the main goals of the military health care organizations. This study was aimed to evaluate the service quality of selected military hospitals in Iran based on the Joint Commission International (JCI) standards and comparing these hospitals with each other and ranking them using the analytic hierarchy process (AHP) technique in 2013. Materials and Methods: This was a cross-sectional and descriptive study conducted on five military hospitals, selected using the purposive sampling method, in 2013. Required data collected using checklists of accreditation standards and nominal group technique. AHP technique was used for prioritizing. Furthermore, Expert Choice 11.0 was used to analyze the collected data. Results: Among JCI standards, the standards of access to care and continuity of care (weight = 0.122), quality improvement and patient safety (weight = 0.121) and leadership and management (weight = 0.117) had the greatest importance, respectively. Furthermore, in the overall ranking, BGT (weight = 0.369), IHM (0.238), SAU (0.202), IHK (weight = 0.125) and SAB (weight = 0.066) ranked first to fifth, respectively. Conclusion: AHP is an appropriate technique for measuring the overall performance of hospitals and their quality of services. It is a holistic approach that takes all hospital processes into consideration. The results of the present study can be used to improve hospitals performance through identifying areas, which are in need of focus for quality improvement and selecting strategies to improve service quality. PMID:25250364

Variability in Wechsler Adult Intelligence Scale-IV subtest performance across age.

PubMed

Wisdom, Nick M; Mignogna, Joseph; Collins, Robert L

2012-06-01

Normal Wechsler Adult Intelligence Scale (WAIS)-IV performance relative to average normative scores alone can be an oversimplification as this fails to recognize disparate subtest heterogeneity that occurs with increasing age. The purpose of the present study is to characterize the patterns of raw score change and associated variability on WAIS-IV subtests across age groupings. Raw WAIS-IV subtest means and standard deviations for each age group were tabulated from the WAIS-IV normative manual along with the coefficient of variation (CV), a measure of score dispersion calculated by dividing the standard deviation by the mean and multiplying by 100. The CV further informs the magnitude of variability represented by each standard deviation. Raw mean scores predictably decreased across age groups. Increased variability was noted in Perceptual Reasoning and Processing Speed Index subtests, as Block Design, Matrix Reasoning, Picture Completion, Symbol Search, and Coding had CV percentage increases ranging from 56% to 98%. In contrast, Working Memory and Verbal Comprehension subtests were more homogeneous with Digit Span, Comprehension, Information, and Similarities percentage of the mean increases ranging from 32% to 43%. Little change in the CV was noted on Cancellation, Arithmetic, Letter/Number Sequencing, Figure Weights, Visual Puzzles, and Vocabulary subtests (<14%). A thorough understanding of age-related subtest variability will help to identify test limitations as well as further our understanding of cognitive domains which remain relatively steady versus those which steadily decline.

Group Health's participation in a shared decision-making demonstration yielded lessons, such as role of culture change.

PubMed

King, Jaime; Moulton, Benjamin

2013-02-01

In 2007 Washington State became the first state to enact legislation encouraging the use of shared decision making and decision aids to address deficiencies in the informed-consent process. Group Health volunteered to fulfill a legislated mandate to study the costs and benefits of integrating these shared decision-making processes into clinical practice across a range of conditions for which multiple treatment options are available. The Group Health Demonstration Project, conducted during 2009-11, yielded five key lessons for successful implementation, including the synergy between efforts to reduce practice variation and increase shared decision making; the need to support modifications in practice with changes in physician training and culture; and the value of identifying best implementation methods through constant evaluation and iterative improvement. These lessons, and the legislated provisions that supported successful implementation, can guide other states and health care institutions moving toward informed patient choice as the standard of care for medical decision making.

Subjective age-of-acquisition norms for 600 Turkish words from four age groups.

PubMed

Göz, İlyas; Tekcan, Ali I; Erciyes, Aslı Aktan

2017-10-01

The main purpose of this study was to report age-based subjective age-of-acquisition (AoA) norms for 600 Turkish words. A total of 115 children, 100 young adults, 115 middle-aged adults, and 127 older adults provided AoA estimates for 600 words on a 7-point scale. The intraclass correlations suggested high reliability, and the AoA estimates were highly correlated across the four age groups. Children gave earlier AoA estimates than the three adult groups; this was true for high-frequency as well as low-frequency words. In addition to the means and standard deviations of the AoA estimates, we report word frequency, concreteness, and imageability ratings, as well as word length measures (numbers of syllables and letters), for the 600 words as supplemental materials. The present ratings represent a potentially useful database for researchers working on lexical processing as well as other aspects of cognitive processing, such as autobiographical memory.

A participatory model for improving occupational health and safety: improving informal sector working conditions in Thailand.

PubMed

Manothum, Aniruth; Rukijkanpanich, Jittra; Thawesaengskulthai, Damrong; Thampitakkul, Boonwa; Chaikittiporn, Chalermchai; Arphorn, Sara

2009-01-01

The purpose of this study was to evaluate the implementation of an Occupational Health and Safety Management Model for informal sector workers in Thailand. The studied model was characterized by participatory approaches to preliminary assessment, observation of informal business practices, group discussion and participation, and the use of environmental measurements and samples. This model consisted of four processes: capacity building, risk analysis, problem solving, and monitoring and control. The participants consisted of four local labor groups from different regions, including wood carving, hand-weaving, artificial flower making, and batik processing workers. The results demonstrated that, as a result of applying the model, the working conditions of the informal sector workers had improved to meet necessary standards. This model encouraged the use of local networks, which led to cooperation within the groups to create appropriate technologies to solve their problems. The authors suggest that this model could effectively be applied elsewhere to improve informal sector working conditions on a broader scale.

The ethics of peer review in bioethics.

PubMed

Wendler, David; Miller, Franklin

2014-10-01

A good deal has been written on the ethics of peer review, especially in the scientific and medical literatures. In contrast, we are unaware of any articles on the ethics of peer review in bioethics. Recognising this gap, we evaluate the extant proposals regarding ethical standards for peer review in general and consider how they apply to bioethics. We argue that scholars have an obligation to perform peer review based on the extent to which they personally benefit from the peer review process. We also argue, contrary to existing proposals and guidelines, that it can be appropriate for peer reviewers to benefit in their own scholarship from the manuscripts they review. With respect to bioethics in particular, we endorse double-blind review and suggest several ways in which the peer review process might be improved. 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.

The use, publication and future directions of immunocytochemistry in veterinary medicine: a consensus of the Oncology-Pathology Working Group.

PubMed

Priest, H L; Hume, K R; Killick, D; Kozicki, A; Rizzo, V L; Seelig, D; Snyder, L A; Springer, N L; Wright, Z M; Robat, C

2017-09-01

One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects of and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this document, the authors provide descriptions of the literature reviewed, the review process, and a summary of the information gathered on immunocytochemistry. The intent of this publication is to help educate practitioners and pathologists on the process of immunocytochemistry and to provide a guide for the use of this technique in veterinary medicine. This document represents the opinions of the working group and the authors and does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society. © 2016 John Wiley & Sons Ltd.

Abatement of waste gases and water during the processes of semiconductor fabrication.

PubMed

Wen, Rui-mei; Liang, Jun-wu

2002-10-01

The purpose of this article is to examine the methods and equipment for abating waste gases and water produced during the manufacture of semiconductor materials and devices. Three separating methods and equipment are used to control three different groups of electronic wastes. The first group includes arsine and phosphine emitted during the processes of semiconductor materials manufacture. The abatement procedure for this group of pollutants consists of adding iodates, cupric and manganese salts to a multiple shower tower (MST) structure. The second group includes pollutants containing arsenic, phosphorus, HF, HCl, NO2, and SO3 emitted during the manufacture of semiconductor materials and devices. The abatement procedure involves mixing oxidants and bases in an oval column with a separator in the middle. The third group consists of the ions of As, P and heavy metals contained in the waste water. The abatement procedure includes adding CaCO3 and ferric salts in a flocculation-sedimentation compact device equipment. Test results showed that all waste gases and water after the abatement procedures presented in this article passed the discharge standards set by the State Environmental Protection Administration of China.

Virtual reality exposure therapy for social anxiety disorder: a randomized controlled trial.

PubMed

Anderson, Page L; Price, Matthew; Edwards, Shannan M; Obasaju, Mayowa A; Schmertz, Stefan K; Zimand, Elana; Calamaras, Martha R

2013-10-01

This is the first randomized trial comparing virtual reality exposure therapy to in vivo exposure for social anxiety disorder. Participants with a principal diagnosis of social anxiety disorder who identified public speaking as their primary fear (N = 97) were recruited from the community, resulting in an ethnically diverse sample (M age = 39 years) of mostly women (62%). Participants were randomly assigned to and completed 8 sessions of manualized virtual reality exposure therapy, exposure group therapy, or wait list. Standardized self-report measures were collected at pretreatment, posttreatment, and 12-month follow-up, and process measures were collected during treatment. A standardized speech task was delivered at pre- and posttreatment, and diagnostic status was reassessed at 3-month follow-up. Analysis of covariance showed that, relative to wait list, people completing either active treatment significantly improved on all but one measure (length of speech for exposure group therapy and self-reported fear of negative evaluation for virtual reality exposure therapy). At 12-month follow-up, people showed significant improvement from pretreatment on all measures. There were no differences between the active treatments on any process or outcome measure at any time, nor differences on achieving partial or full remission. Virtual reality exposure therapy is effective for treating social fears, and improvement is maintained for 1 year. Virtual reality exposure therapy is equally effective as exposure group therapy; further research with a larger sample is needed, however, to better control and statistically test differences between the treatments.

Policy decision-making under scientific uncertainty: radiological risk assessment and the role of expert advisory groups.

PubMed

Mossman, Kenneth L

2009-08-01

Standard-setting agencies such as the U.S. Nuclear Regulatory Commission and the U.S. Environmental Protection Agency depend on advice from external expert advisory groups on matters of public policy and standard-setting. Authoritative bodies including the National Research Council and the National Council on Radiation Protection and Measurements provide analyses and recommendations that enable the technical and scientific soundness in decision-making. In radiological protection the nature of the scientific evidence is such that risk assessment at radiation doses typically encountered in environmental and occupational settings is highly uncertain, and several policy alternatives are scientifically defensible. The link between science and policy is problematic. The fundamental issue is the failure to properly consider risk assessment, risk communication, and risk management and then consolidate them in a process that leads to sound policy. Authoritative bodies should serve as unbiased brokers of policy choices by providing balanced and objective scientific analyses. As long as the policy-decision environment is characterized by high scientific uncertainty and a lack of values consensus, advisory groups should present unbiased evaluations of all scientifically plausible alternatives and recommend selection criteria that decision makers can use in the policy-setting process. To do otherwise (e.g., by serving as single position advocates) weakens decision-making by eliminating options and narrowing discussions of scientific perspectives. Understanding uncertainties and the limitations on available scientific information and conveying such information to policy makers remain key challenges for the technical and policy communities.

Development of Seasonal Influenza Vaccination Recommendations: Relevance and Influence of the Evidence on the Decision-Making Process in France and the Netherlands.

PubMed

Silva, Maria Laura; Paget, W John; Mosnier, Anne; Buthion, Valérie; Cohen, Jean Marie; Perrier, Lionel; Späth, Hans Martin

2016-01-01

Target groups for seasonal influenza vaccination are defined at the country level and are based on several factors. However, little is known about the national decision-making procedures. The purpose of this study was to compare the evidence used for the development of recommendations and its impact on the choice of target groups in France and the Netherlands. A preliminary documentary analysis identified institutions to include in the assessment: governmental authorities, research institutions, associations, and manufacturers. At least one expert from each group was invited to our study. Thirty-three semi-structured interviews were conducted in 2013 (16 France, 17 the Netherlands). We used NVivo10® to perform a thematic content analysis. Clinical/epidemiological studies were the evidence most used in both countries. Economic models were increasingly being used; these had greater influence on the decision making in the Netherlands than in France, probably because of the presence of a modeler. Generally, the quality of the evidence used was poor, although no systematic use of standard protocol for its assessment was observed. A general protocol was sometimes used in France; however, the personal judgment of the experts was crucial for the assessment in both countries. There were differences in the target groups, for example, pregnant women, recommended only in France. France and the Netherlands use similar evidence for developing vaccination recommendations, although different decisions are sometimes made regarding target groups. This could be associated with the lack of systematic standard appraisals, increasing the influence of the experts' judgment on decision making. The development of standards for the appraisal of evidence is recommended. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Functional MRI in Medulloblastoma Survivors Supports Prophylactic Reading Intervention during Tumor Treatment

PubMed Central

Zou, Ping; Conklin, Heather M.; Scoggins, Matthew A.; Li, Yimei; Li, Xingyu; Jones, Melissa M.; Palmer, Shawna L.; Gajjar, Amar; Ogg, Robert J.

2015-01-01

Background Development of reading skills is vulnerable to disruption in children treated for brain tumors. Interventions, remedial and prophylactic, are needed to mitigate reading and other learning difficulties faced by survivors. A functional magnetic resonance imaging (fMRI) study was conducted to investigate long-term effects of a prophylactic reading intervention administered during radiation therapy in children treated for medulloblastoma. Methods The fMRI study included 19 reading-intervention (age 11.7±0.6 years) and 21 standard-of-care (age 12.1±0.6 years) medulloblastoma survivors, and 21 typically developing children (age 12.3±0.6 years). The survivors were 2.5 [1.2, 5.4] years after completion of tumor therapies and reading-intervention survivors were 2.9 [1.6, 5.9] years after intervention. Five fMRI tasks (Rapid Automatized Naming, Continuous Performance Test using faces and letters, orthographic and phonological processing of letter pairs, implicit word reading, and story reading) were used to probe reading-related neural activation. Woodcock-Johnson Reading Fluency, Word Attack, and Sound Awareness subtests were used to evaluate reading abilities. Results At the time of fMRI, Sound Awareness scores were significantly higher in the reading-intervention group than in the standard-of-care group (p = 0.046). Brain activation during the fMRI tasks was detected in left inferior frontal, temporal, ventral occipitotemporal, and subcortical regions, and differed among the groups (p<0.05, FWE). The pattern of group activation differences, across brain areas and tasks, was a normative trend in the reading-intervention group. Conclusions Standardized reading scores and patterns of brain activation provide evidence of long-term effects of prophylactic reading intervention in children treated for medulloblastoma. PMID:25967954

The process, logistics and challenges of implementing clinical supervision in a generalist tertiary referral hospital.

PubMed

Brunero, Scott; Lamont, Scott

2012-03-01

Clinical supervision (CS) has been identified within nursing as a process for improving clinical practice and reducing the emotional burden of nursing practice. Little is known about its implementation across large tertiary referral hospitals. The purpose of this study is to evaluate the implementation of clinical supervision across several different nursing specialities at a teaching hospital in Sydney, Australia. Using a model of nursing implementation science, a process was developed at the study site that facilitated the development, implementation and evaluation of the project. After a 6-month study period, the CS groups were postevaluated using a survey tool developed for the project. A total of nine CS groups were in operation over the 6-month study period. A predominant focus within the sessions was one of the collegial support and developing standards of practice. The process was able to achieve wide hospital-based support for the role of CS from the senior nurse executives to junior nurses. Whilst there was overall positive support for the CS groups, logistical and resource challenges remain, in the effective roll out of CS to large numbers of nurses. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

Self-reported tolerance influences prefrontal cortex hemodynamics and affective responses.

PubMed

Tempest, Gavin; Parfitt, Gaynor

2016-02-01

The relationship between cognitive and sensory processes in the brain contributes to the regulation of affective responses (pleasure-displeasure). Exercise can be used to manipulate sensory processes (by increasing physiological demand) in order to examine the role of dispositional traits that may influence an individual's ability to cognitively regulate these responses. With the use of near infrared spectroscopy, in this study we examined the influence of self-reported tolerance upon prefrontal cortex (PFC) hemodynamics and affective responses. The hemodynamic response was measured in individuals with high or low tolerance during an incremental exercise test. Sensory manipulation was standardized against metabolic processes (ventilatory threshold [VT] and respiratory compensation point [RCP]), and affective responses were recorded. The results showed that the high-tolerance group displayed a larger hemodynamic response within the right PFC above VT (which increased above RCP). The low-tolerance group showed a larger hemodynamic response within the left PFC above VT. The high-tolerance group reported a more positive/less negative affective response above VT. These findings provide direct neurophysiological evidence of differential hemodynamic responses within the PFC that are associated with tolerance in the presence of increased physiological demands. This study supports the role of dispositional traits and previous theorizing into the underlying mechanisms (cognitive vs. sensory processes) of affective responses.

First among Others? Cohen's "d" vs. Alternative Standardized Mean Group Difference Measures

ERIC Educational Resources Information Center

Cahan, Sorel; Gamliel, Eyal

2011-01-01

Standardized effect size measures typically employed in behavioral and social sciences research in the multi-group case (e.g., [eta][superscript 2], f[superscript 2]) evaluate between-group variability in terms of either total or within-group variability, such as variance or standard deviation--that is, measures of dispersion about the mean. In…