Comparing Phytophthora ramorum diagnostic protocols for the national Sudden Oak death stream monitoring program

Treesearch

W. Sutton; E.M. Hansen; P. Reeser; A. Kanaskie

2008-01-01

Oregon was a participant in the pilot test of the national stream monitoring protocol for SOD. We routinely and continuously monitor about 50 streams in and near the SOD quarantine area in southwest Oregon using foliage baits. For the national protocol, we added six additional streams beyond the area of known infestation, and compared results from different diagnostic...

Prosthesis Prescription Protocol of the Arm (PPP-Arm): The implementation of a national prosthesis prescription protocol.

PubMed

Wijdenes, Paula; Brouwers, Michael; van der Sluis, Corry K

2018-02-01

In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to structure, underpin, and evaluate the prescription of upper limb prostheses for clients with acquired or congenital arm defects. Prosthesis Prescription Protocol of the Arm (PPP-Arm) was developed on the basis of the International Classification of Functioning and consisted of several layers. All stakeholders (rehabilitation teams, orthopedic workshops, patients, and insurance companies) were involved in development and implementation. A national project coordinator and knowledge brokers in each team were essential for the project. PPP-Arm was successfully developed and implemented in nine Dutch rehabilitation teams. The protocol improved team collaboration, structure, and completeness of prosthesis prescriptions and treatment uniformity and might be interesting for other countries as well. Clinical relevance A national protocol to prescribe upper limb prostheses can be helpful to create uniformity in treatment of patients with upper limb defects. Such a protocol improves quality of care for all patients in the country.

A protocol using coho salmon to monitor Tongass National Forest Land and Resource Management Plan standards and guidelines for fish habitat.

Treesearch

M.D. Bryant; Trent McDonald; R. Aho; B.E. Wright; Michelle Bourassa Stahl

2008-01-01

We describe a protocol to monitor the effectiveness of the Tongass Land Management Plan (TLMP) management standards for maintaining fish habitat. The protocol uses juvenile coho salmon (Oncorhynchus kisutch) in small tributary streams in forested watersheds. We used a 3-year pilot study to develop detailed methods to estimate juvenile salmonid...

The Impact of National Standards Assessment in New Zealand, and National Testing Protocols in Norway on Indigenous Schooling

ERIC Educational Resources Information Center

Özerk, Kamil; Whitehead, David

2012-01-01

This paper first provides a critic of the implementation of compulsory national assessment protocols internationally, and then nationally through a review of the implementation process used for the introduction of National Standards in New Zealand, and National Testing in Norwegian mainstream schools. It then reviews the impact of these two…

Elementary Teachers' Ideas about, Planning for and Implementation of Learner-Directed and Teacher-Directed Inquiry: A Mixed Methods Study

ERIC Educational Resources Information Center

Biggers, Mandy Sue

2013-01-01

Using a framework for variations of classroom inquiry (National Research Council [NRC], 2000, p. 29), this study explored 40 inservice elementary teachers' planning, modification, and enactment of kit-based science curriculum materials. As part of the study, a new observation protocol was modified from an existing protocol (Practices of…

76 FR 24862 - Proposed Information Collection; Comment Request; Protocol for Access to Tissue Specimen Samples...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

... Collection; Comment Request; Protocol for Access to Tissue Specimen Samples From the National Marine Mammal Tissue Bank AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice... National Marine Mammal Tissue Bank (NMMTB) was established by the National Marine Fisheries Service (NMFS...

Aerospace physiology.

DOT National Transportation Integrated Search

2004-01-01

This document defines the protocol standards for the Internet Protocol Suite (IPS), which is commonly referred to as Transmission Control Protocol/Internet Protocol (TCP/IP) protocols used for data communications within the National Airspace System (...

National protocol framework for the inventory and monitoring of bees

USGS Publications Warehouse

Droege, Sam; Engler, Joseph D.; Sellers, Elizabeth A.; Lee O'Brien,

2016-01-01

This national protocol framework is a standardized tool for the inventory and monitoring of the approximately 4,200 species of native and non-native bee species that may be found within the National Wildlife Refuge System (NWRS) administered by the U.S. Fish and Wildlife Service (USFWS). However, this protocol framework may also be used by other organizations and individuals to monitor bees in any given habitat or location. Our goal is to provide USFWS stations within the NWRS (NWRS stations are land units managed by the USFWS such as national wildlife refuges, national fish hatcheries, wetland management districts, conservation areas, leased lands, etc.) with techniques for developing an initial baseline inventory of what bee species are present on their lands and to provide an inexpensive, simple technique for monitoring bees continuously and for monitoring and evaluating long-term population trends and management impacts. The latter long-term monitoring technique requires a minimal time burden for the individual station, yet can provide a good statistical sample of changing populations that can be investigated at the station, regional, and national levels within the USFWS’ jurisdiction, and compared to other sites within the United States and Canada. This protocol framework was developed in cooperation with the United States Geological Survey (USGS), the USFWS, and a worldwide network of bee researchers who have investigated the techniques and methods for capturing bees and tracking population changes. The protocol framework evolved from field and lab-based investigations at the USGS Bee Inventory and Monitoring Laboratory at the Patuxent Wildlife Research Center in Beltsville, Maryland starting in 2002 and was refined by a large number of USFWS, academic, and state groups. It includes a Protocol Introduction and a set of 8 Standard Operating Procedures or SOPs and adheres to national standards of protocol content and organization. The Protocol Narrative describes the history and need for the protocol framework and summarizes the basic elements of objectives, sampling design, field methods, training, data management, analysis, and reporting. The SOPs provide more detail and specific instructions for implementing the protocol framework. A central database, for managing all the resulting data is under development. We welcome use of this protocol framework by our partners, as appropriate for their bee inventory and monitoring objectives.

Development and Implementation of Clinical Trial Protocol Templates at the National Institute of Allergy and Infectious Diseases

PubMed Central

Bridge, Heather; Smolskis, Mary; Bianchine, Peter; Dixon, Dennis O.; Kelly, Grace; Herpin, Betsey; Tavel, Jorge

2009-01-01

Background: A clinical research protocol document must reflect both sound scientific rationale as well as local, national and, when applicable, international regulatory and human subject protections requirements. These requirements originate from a variety of sources, undergo frequent revision and are subject to interpretation. Tools to assist clinical investigators in the production of clinical protocols could facilitate navigating these requirements and ultimately increase the efficiency of clinical research. Purpose: The National Institute of Allergy and Infectious Diseases (NIAID) developed templates for investigators to serve as the foundation for protocol development. These protocol templates are designed as tools to support investigators in developing clinical protocols. Methods: NIAID established a series of working groups to determine how to improve its capacity to conduct clinical research more efficiently and effectively. The Protocol Template Working Group was convened to determine what protocol templates currently existed within NIAID and whether standard NIAID protocol templates should be produced. After review and assessment of existing protocol documents and requirements, the group reached consensus about required and optional content, determined the format and identified methods for distribution as well as education of investigators in the use of these templates. Results: The templates were approved by the NIAID Executive Committee in 2006 and posted as part of the NIAID Clinical Research Toolkit[1]website for broad access. These documents require scheduled revisions to stay current with regulatory and policy changes. Limitations: The structure of any clinical protocol template, whether comprehensive or specific to a particular study phase, setting or design, affects how it is used by investigators. Each structure presents its own set of advantages and disadvantages. While useful, protocol templates are not stand-alone tools for creating an optimal protocol document but must be complemented by institutional resources and support. Education and guidance of investigators in the appropriate use of templates is necessary to ensure a complete yet concise protocol document. Due to changing regulatory requirements, clinical protocol templates cannot become static but require frequent revisions. Conclusions: Standard protocol templates that meet applicable regulations can be important tools to assist investigators in the effective conduct of clinical research, but they require dedicated resources and ongoing input from key stakeholders. PMID:19625326

The Behavior of TCP and Its Extensions in Space

NASA Technical Reports Server (NTRS)

Wang, Ruhai; Horan, Stephen

2001-01-01

The performance of Transmission Control Protocol (TCP) in space has been examined from the observations of simulation and experimental tests for several years at National Aeronautics and Space Administration (NASA), Department of Defense (DoD) and universities. At New Mexico State University (NMSU), we have been concentrating on studying the performance of two protocol suites: the file transfer protocol (ftp) running over Transmission Control Protocol/Internet Protocol (TCP/IP) stack and the file protocol (fp) running over the Space Communications Protocol Standards (SCPS)-Transport Protocol (TP) developed under the Consultative Committee for Space Data Systems (CCSDS) standards process. SCPS-TP is considered to be TCP's extensions for space communications. This dissertation experimentally studies the behavior of TCP and SCPS-TP by running the protocol suites over both the Space-to-Ground Link Simulator (SGLS) test-bed and realistic satellite link. The study concentrates on comparing protocol behavior by plotting the averaged file transfer times for different experimental configurations and analyzing them using Statistical Analysis System (SAS) based procedures. The effects of different link delays and various Bit-Error-Rates (BERS) on each protocol performance are also studied and linear regression models are built for experiments over SGLS test-bed to reflect the relationships between the file transfer time and various transmission conditions.

Protocol Coordinator | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases. CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. KEY ROLES/RESPONSIBILITIES The Protocol Coordinator II: Provides comprehensive clinical and administrative support to the Brain Tumor Trial Collaborative, Neuro-Oncology Branch, NCI, National Institutes of Health Serves as a liaison with Principal Investigators (PIs), the associated study teams and a variety of offices associated with protocol development and approvals Orchestrates meetings with investigators and other key medical staff to identify required support Coordinates the writing and regulatory review processes that occur in tandem, facilitates the bi-directional dialogue and feedback between various teams, and assists investigators and medical writers on the production/revision of clinical research protocols Assists research staff in coordinating/navigating requirements for special circumstances and facilitates access to necessary services Facilitates initiation of intramural research by providing assistance in obtaining required approvals Coordinates with investigators and medical writers to ensure Institutional Review Board (IRB) and Food and Drug Administration (FDA) stipulations are appropriately addressed in a timely manner Provides consultation and assistance for all aspects of the protocol lifecycle including initial Investigational New Drug (IND) submission, IRB submission, continuing review applications, protocol amendments, annual reports, and protocol inactivation with IRB and FDA Tracks a portfolio of protocols through each lifecycle step; processes and tracks appropriate approvals (e.g., IRB, Data and Safety Monitoring Board, Radiation Safety, Office of Protocol Services, etc.) Provides administrative support to Scientific Review Committees (SRC), reviews proposed protocol documents to ensure they are complete, distributes to reviewers, documents meeting minutes, enters data into the IRIS database, facilitates processes to obtain approval to initiate and continue clinical research Creates, maintains and queries an IRB database of approved amendment descriptions Maintains records of the current protocol(s) version, current Informed Consent document(s), FDA Safe to Proceed designation, etc. for each IND Provides expertise in data management including data collection and analysis Develops procedural manuals for clinical trials protocols Participates in quality improvement and assurance involving International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines This position is located at the National Institutes of Health (NIH) in Bethesda, Maryland.

Protocol Coordinator | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases.  CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. The Clinical Monitoring Research Program (CMRP) provides comprehensive clinical and administrative support to the National Cancer Institute’s Center for Cancer Research’s (CCR), Office of Regulatory Affairs for protocol development review, regulatory review, and the implementation process as well as oversees medical writing/editing, regulatory/ compliance, and protocol coordination/navigation and administration. KEY ROLES/RESPONSIBILITIES - THIS POSITION IS CONTINGENT UPON FUNDING APPROVAL The Protocol Coordinator II: Provides programmatic and logistical support for the operations of clinical research for Phase I and Phase II clinical trials Provides deployment of clinical support services for clinical research Streamlines protocol development timeline Provides data and document collection and compilation for regulatory filing with the FDA and other regulatory authorities Provides administrative coordination and general logistical support for regulatory activities Ensures the provision of training for investigators and associate staff to reinforce and enhance a GCP culture Provides quality assurance and quality control oversight Performs regulatory review of clinical protocols, informed consent and other clinical documents Tracks and facilitates a portfolio of protocols through each process step (IRB, RAC, DSMB, Office of Protocol Services) Assists clinical investigators in preparing clinical research protocols, including writing and formatting protocol documents and consent forms Prepares protocol packages for review and ensures that protocol packages include all of the required material and comply with CCR, NCI and NIH policies Collaborates with investigators to resolve any protocol/data issues Coordinates submission of protocols for scientific and ethical review by the Branch scientific review committees, the NCI Institutional Review Board (IRB) and the clinical trial sponsor or the FDA Monitors the review process and maintains detailed, complete and accurate records for each protocol of the approvals at the various stages of the review process, including new protocol submissions, amendments to protocols, and continuing reviews, as well as other submissions such as adverse events Attends and prepares minutes for the Branch Protocol Review Committees For protocols that are performed with other research centers: contacts coordinators at other centers to obtain review committee approvals at these centers, maintains records of these approvals at the outside centers in the protocol files, and sends protocol amendments and other reports to the participating centers Maintains a schedule of all review committee submission deadline dates and meeting dates Assists clinical investigators in understanding and complying with the entire review process Works closely with the NCI Protocol Review Office in establishing and maintaining a paperless automated document management and tracking system for NCI protocols Converts protocols from Word format to PDF with bookmarks Maintains the PDF version of the most current approved version of each active clinical protocol on a central server    This position has the option to be located in Frederick or Rockville, Maryland.

40 CFR 82.20 - Availability of consumption allowances in addition to baseline consumption allowances for class...

Code of Federal Regulations, 2010 CFR

2010-07-01

... period some quantity of consumption that the nation is permitted under the Montreal Protocol. (2) Trade... Party to the Protocol as set forth in this paragraph (b). A person may only receive consumption from... maximum consumption that the nation is allowed under the Protocol minus the quantity (in kilograms) traded...

40 CFR 82.20 - Availability of consumption allowances in addition to baseline consumption allowances for class...

Code of Federal Regulations, 2011 CFR

2011-07-01

... period some quantity of consumption that the nation is permitted under the Montreal Protocol. (2) Trade... Party to the Protocol as set forth in this paragraph (b). A person may only receive consumption from... maximum consumption that the nation is allowed under the Protocol minus the quantity (in kilograms) traded...

40 CFR 82.20 - Availability of consumption allowances in addition to baseline consumption allowances for class...

Code of Federal Regulations, 2013 CFR

2013-07-01

... period some quantity of consumption that the nation is permitted under the Montreal Protocol. (2) Trade... Party to the Protocol as set forth in this paragraph (b). A person may only receive consumption from... maximum consumption that the nation is allowed under the Protocol minus the quantity (in kilograms) traded...

40 CFR 82.20 - Availability of consumption allowances in addition to baseline consumption allowances for class...

Code of Federal Regulations, 2012 CFR

2012-07-01

... period some quantity of consumption that the nation is permitted under the Montreal Protocol. (2) Trade... Party to the Protocol as set forth in this paragraph (b). A person may only receive consumption from... maximum consumption that the nation is allowed under the Protocol minus the quantity (in kilograms) traded...

40 CFR 82.20 - Availability of consumption allowances in addition to baseline consumption allowances for class...

Code of Federal Regulations, 2014 CFR

2014-07-01

... period some quantity of consumption that the nation is permitted under the Montreal Protocol. (2) Trade... Party to the Protocol as set forth in this paragraph (b). A person may only receive consumption from... maximum consumption that the nation is allowed under the Protocol minus the quantity (in kilograms) traded...

The Efficacy of Sheltered Instruction Observation Protocol (SIOP) in Mathematics Instruction on English Language Learner Students

ERIC Educational Resources Information Center

Vidot, Jose L.

2011-01-01

Studies by the National Association for Educational Progress found that English Language Learner (ELL) students perform poorly compared to other students on standardized mathematics exams. The research problem addressed how Sheltered Instruction Observation Protocol (SIOP) affected the instructional practices of high school mathematics teachers.…

Protocol Coordinator | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases. CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. The Clinical Monitoring Research Program (CMRP) provides comprehensive clinical and administrative support to the National Cancer Institute’s Center for Cancer Research’s (CCR) Protocol Support Office (PSO) for protocol development review, regulatory review, and the implementation process as well as oversees medical writing/editing, regulatory/ compliance, and protocol coordination/navigation and administration. KEY ROLES/RESPONSIBILITIES The Protocol Coordinator III: Provides programmatic and logistical support for the operations of clinical research for Phase I and Phase II clinical trials. Provides deployment of clinical support services for clinical research. Streamlines the protocol development timeline. Provides data and documents collection and compilation for regulatory filing with the U.S. Food and Drug Administration (FDA) and other regulatory authorities.. Provides technical review and report preparation. Provides administrative coordination and general logistical support for regulatory activities. Ensures the provision of training for investigators and associate staff to reinforce and enhance a Good Clinical Practices (GCP) culture. Oversees quality assurance and quality control, performs regulatory review of clinical protocols, informed consent and other clinical documents. Tracks and facilitates a portfolio of protocols through each process step (Institutional Review Board [IRB], Regulatory Affairs Compliance [RAC], Data Safety Monitoring Board [DSMB], Office of Protocol Services). Assists clinical investigators in preparing clinical research protocols, including writing and formatting consent forms. Prepares protocol packages for review and ensures that protocol packages include all of the required material and comply with CCR, NCI and NIH policies. Collaborates with investigators to resolve any protocol/data issues. Coordinates submission of protocols for scientific and ethical review by the Branch scientific review committees, the NCI IRB, and the clinical trial sponsor or the FDA. Monitors the review process and maintains detailed, complete and accurate records for each protocol of the approvals at the various stages of the review process, including new protocol submissions, amendments to protocols, and continuing reviews, as well as other submissions such as adverse events. Attends and prepares minutes for the Branch Protocol Review Committees. Contacts coordinators at other centers for protocols that are performed there to obtain review committee approvals at those centers, maintains records of these approvals and sends protocol amendments and other reports to the participating centers. Maintains a schedule of all review committee submission deadline dates and meeting dates. Assists clinical investigators in understanding and complying with the entire review process. Works closely with the NCI Protocol Review Office in establishing and maintaining a paperless automated document and tracking system for NCI protocols. Converts protocols from Word format to .pdf with bookmarks. Maintains the .pdf version of the most current approved version of each active clinical protocol on a central server. This position is located in Rockville, Maryland.

Chapter A10. Lakes and reservoirs: Guidelines for study design and sampling

USGS Publications Warehouse

Green, William R.; Robertson, Dale M.; Wilde, Franceska D.

2015-09-29

Within this chapter are references to other chapters of the NFM that provide more detailed guidelines related to specific topics and more detailed protocols for the quality assurance and assessment of the lake and reservoir data. Protocols and procedures to address and document the quality of lake and reservoir investigations are adapted from, or referenced to, the protocols and standard operating procedures contained in related chapters of this National Field Manual.

National and sub-national prevalence, trend, and burden of metabolic risk factors (MRFs) in Iran: 1990 - 2013, study protocol.

PubMed

Peykari, Niloofar; Sepanlou, Sadaf Ghajarieh; Djalalinia, Shirin; Kasaeian, Amir; Parsaeian, Mahboubeh; Ahmadvand, Alireza; Koohpayehzadeh, Jalil; Damari, Behzad; Jamshidi, Hamid Reza; Larijani, Bagher; Farzadfar, Farshad

2014-01-01

Non-communicable diseases (NCDs) and their risk factors are the major public health problems. There are some documented trend and point estimations of metabolic risk factors for Iranian population but there are little information about their exposure distribution at sub-national level and no information about their trends and their effects on the population health.  The present study protocol is aimed to provide the standard structure definitions, organization, data sources, methods of data gathering or generating, and data on trend analysis of the metabolic risk factors in NASBOD study. We will estimate 1990 to 2013 trends of prevalence, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) and disability-adjusted life years DALYs for MRFs by gender, age group, and province. We will also quantify the uncertainty interval for the estimates of interest. The findings of study could provide practical information regarding metabolic risk factors and their burden for better health policy to reduce the burden of diseases, and to plan cost-effective preventive strategies. The results also could be used for future complementary global, regional, national, and sub national studies.

The National Riparian Core Protocol: A riparian vegetation monitoring protocol for wadeable streams of the conterminous United States

Treesearch

David M. Merritt; Mary E. Manning; Nate Hough-Snee

2017-01-01

Riparian areas are hotspots of biological diversity that may serve as high quality habitat for fish and wildlife. The National Riparian Core Protocol (NRCP) provides tools and methods to assist natural resource professionals in sampling riparian vegetation and physical characteristics along wadeable streams. Guidance is provided for collecting basic information on...

Protocol for monitoring metals in Ozark National Scenic Riverways, Missouri: Version 1.0

USGS Publications Warehouse

Schmitt, Christopher J.; Brumbaugh, William G.; Besser, John M.; Hinck, Jo Ellen; Bowles, David E.; Morrison, Lloyd W.; Williams, Michael H.

2008-01-01

The National Park Service is developing a monitoring plan for the Ozark National Scenic Riverways in southeastern Missouri. Because of concerns about the release of lead, zinc, and other metals from lead-zinc mining to streams, the monitoring plan will include mining-related metals. After considering a variety of alternatives, the plan will consist of measuring the concentrations of cadmium, cobalt, lead, nickel, and zinc in composite samples of crayfish (Orconectes luteus or alternate species) and Asian clam (Corbicula fluminea) collected periodically from selected sites. This document, which comprises a protocol narrative and supporting standard operating procedures, describes the methods to be employed prior to, during, and after collection of the organisms, along with procedures for their chemical analysis and quality assurance; statistical analysis, interpretation, and reporting of the data; and for modifying the protocol narrative and supporting standard operating procedures. A list of supplies and equipment, data forms, and sample labels are also included. An example based on data from a pilot study is presented.

Implementation of the Spanish ERAS program in bariatric surgery.

PubMed

Ruiz-Tovar, Jaime; Muñoz, José Luis; Royo, Pablo; Duran, Manuel; Redondo, Elisabeth; Ramirez, Jose Manuel

2018-03-08

The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish Fast Track Group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery, comparing it with a historical cohort receiving standard care. A multi-centric prospective study was performed, including 233 consecutive patients undergoing bariatric surgery during 2015 and following ERAS protocol. It was compared with a historical cohort of 286 patients, who underwent bariatric surgery at the same institutions between 2013 and 2014 and following standard care. Compliance with the protocol, morbidity, mortality, hospital stay and readmission were evaluated. Bariatric techniques performed were Roux-en-Y gastric bypass and sleeve gastrectomy. There were no significant differences in complications, mortality and readmission. Postoperative pain and hospital stay were significantly lower in the ERAS group. The total compliance to protocol was 80%. The Spanish National ERAS protocol is a safe issue, obtaining similar results to standard care in terms of complications, reoperations, mortality and readmissions. It is associated with less postoperative pain and earlier hospital discharge.

Evaluation of Protocol Uniformity Concerning Laparoscopic Cholecystectomy in The Netherlands

PubMed Central

Goossens, Richard H. M.; van Eijk, Daan J.; Lange, Johan F.

2008-01-01

Background Iatrogenic bile duct injury remains a current complication of laparoscopic cholecystectomy. One uniform and standardized protocol, based on the “critical view of safety” concept of Strasberg, should reduce the incidence of this complication. Furthermore, owing to the rapid development of minimally invasive surgery, technicians are becoming more frequently involved. To improve communication between the operating team and technicians, standardized actions should also be defined. The aim of this study was to compare existing protocols for laparoscopic cholecystectomy from various Dutch hospitals. Methods Fifteen Dutch hospitals were contacted for evaluation of their protocols for laparoscopic cholecystectomy. All evaluated protocols were divided into six steps and were compared accordingly. Results In total, 13 hospitals responded—5 academic hospitals, 5 teaching hospitals, 3 community hospitals—of which 10 protocols were usable for comparison. Concerning the trocar positions, only minor differences were found. The concept of “critical view of safety” was represented in just one protocol. Furthermore, the order of clipping and cutting the cystic artery and duct differed. Descriptions of instruments and apparatus were also inconsistent. Conclusions Present protocols differ too much to define a universal procedure among surgeons in The Netherlands. The authors propose one (inter)national standardized protocol, including standardized actions. This uniform standardized protocol has to be officially released and recommended by national scientific associations (e.g., the Dutch Society of Surgery) or international societies (e.g., European Association for Endoscopic Surgery and Society of American Gastrointestinal and Endoscopic Surgeons). The aim is to improve patient safety and professional communication, which are necessary for new developments. PMID:18224485

National Airspace System (NAS) open system architecture and protocols

DOT National Transportation Integrated Search

2003-08-14

This standard establishes the open systems data communications architecture and authorized protocol standards for the National Airspace System (NAS). The NAS will consist of various types of processors and communications networks procured from a vari...

Shortcuts to Adiabaticity in Transport of a Single Trapped Ion

NASA Astrophysics Data System (ADS)

An, Shuoming; Lv, Dingshun; Campo, Adolfo Del; Kim, Kihwan

2015-05-01

We report an experimental study on shortcuts to adiabaticity in the transport of a single 171Yb+ ion trapped in a harmonic potential. In these driving schemes, the application of a force induces a nonadiabatic dynamics in which excitations are tailored so as to preserve the ion motional state in the ground state upon completion of the process. We experimentally apply the laser induced force and realize three different protocols: (1) a transitionless driving with a counterdiabatic term out of phase with the displacement force, (2) a classical protocol assisted by counterdiabatic fields in phase with the main force, (3) and an engineered transport protocol based on the Fourier transform of the trap acceleration. We experimentally compare and discuss the robustness of these protocols under given experimental limitations such as trap frequency drifts. This work was supported by the National Basic Research Program of China under Grants No. 2011CBA00300 (No. 2011CBA00301), the National Natural Science Foundation of China 11374178, and the University of Massachusetts Boston (No. P20150000029279).

Recommended features of protocols for long-term ecological monitoring

USGS Publications Warehouse

Oakley, Karen L.; Boudreau, Susan L.; Humphrey, Sioux-Z

2001-01-01

In 1991, the National Park Service (NPS) selected seven parks to serve as prototypes for development of a long-term ecological monitoring program. Denali National Park and Preserve was one of the prototype parks selected. The principal focus of this national program was to detect and document resource changes and to understand the forces driving those changes. One of the major tasks of each prototype park was to develop monitoring protocols. In this paper, we discuss some lessons learned and what we believe to be the most important features of protocols.One of the many lessons we have learned is that monitoring protocols vary greatly in content and format. This variation leads to confusion about what information protocols should contain and how they should be formatted. Problems we have observed in existing protocols include (1) not providing enough detail, (2) omitting critical topics (such as data management), and (3) mixing explanation with instructions. Once written, protocols often sit on the shelf to collect dust, allowing methods changes to occur without being adequately considered, tested, or documented. Because a lengthy and costly research effort is often needed to develop protocols, a vision of what the final product should look like is helpful. Based on our involvement with the prototype monitoring program for Denali (Oakley and Boudreau 2000), we recommend key features of protocols, including a scheme for linking protocols to data in the data management system and for tracking protocol revisions. A protocol system is crucial for producing long-term data sets of known quality that meet program objectives.

PROTOCOL FOR LABORATORY TESTING OF CRUDE-OIL BIOREMEDIATION PRODUCTS IN FRESHWATER CONDITIONS

EPA Science Inventory

In 1993, the Environmental Protection Agency, National Risk Management Research Laboratory (EPA, NRMRL), with the National Environmental Technology Application Center (NETAC), developed a protocol for evaluation of bioremediation products in marine environments. The marine proto...

Update of Ireland's national average indoor radon concentration - Application of a new survey protocol.

PubMed

Dowdall, A; Murphy, P; Pollard, D; Fenton, D

2017-04-01

In 2002, a National Radon Survey (NRS) in Ireland established that the geographically weighted national average indoor radon concentration was 89 Bq m -3 . Since then a number of developments have taken place which are likely to have impacted on the national average radon level. Key among these was the introduction of amending Building Regulations in 1998 requiring radon preventive measures in new buildings in High Radon Areas (HRAs). In 2014, the Irish Government adopted the National Radon Control Strategy (NRCS) for Ireland. A knowledge gap identified in the NRCS was to update the national average for Ireland given the developments since 2002. The updated national average would also be used as a baseline metric to assess the effectiveness of the NRCS over time. A new national survey protocol was required that would measure radon in a sample of homes representative of radon risk and geographical location. The design of the survey protocol took into account that it is not feasible to repeat the 11,319 measurements carried out for the 2002 NRS due to time and resource constraints. However, the existence of that comprehensive survey allowed for a new protocol to be developed, involving measurements carried out in unbiased randomly selected volunteer homes. This paper sets out the development and application of that survey protocol. The results of the 2015 survey showed that the current national average indoor radon concentration for homes in Ireland is 77 Bq m -3 , a decrease from the 89 Bq m -3 reported in the 2002 NRS. Analysis of the results by build date demonstrate that the introduction of the amending Building Regulations in 1998 have led to a reduction in the average indoor radon level in Ireland. Copyright © 2016 Elsevier Ltd. All rights reserved.

Estimating national crop yield potential and the relevance of weather data sources

NASA Astrophysics Data System (ADS)

Van Wart, Justin

2011-12-01

To determine where, when, and how to increase yields, researchers often analyze the yield gap (Yg), the difference between actual current farm yields and crop yield potential. Crop yield potential (Yp) is the yield of a crop cultivar grown under specific management limited only by temperature and solar radiation and also by precipitation for water limited yield potential (Yw). Yp and Yw are critical components of Yg estimations, but are very difficult to quantify, especially at larger scales because management data and especially daily weather data are scarce. A protocol was developed to estimate Yp and Yw at national scales using site-specific weather, soils and management data. Protocol procedures and inputs were evaluated to determine how to improve accuracy of Yp, Yw and Yg estimates. The protocol was also used to evaluate raw, site-specific and gridded weather database sources for use in simulations of Yp or Yw. The protocol was applied to estimate crop Yp in US irrigated maize and Chinese irrigated rice and Yw in US rainfed maize and German rainfed wheat. These crops and countries account for >20% of global cereal production. The results have significant implications for past and future studies of Yp, Yw and Yg. Accuracy of national long-term average Yp and Yw estimates was significantly improved if (i) > 7 years of simulations were performed for irrigated and > 15 years for rainfed sites, (ii) > 40% of nationally harvested area was within 100 km of all simulation sites, (iii) observed weather data coupled with satellite derived solar radiation data were used in simulations, and (iv) planting and harvesting dates were specified within +/- 7 days of farmers actual practices. These are much higher standards than have been applied in national estimates of Yp and Yw and this protocol is a substantial step in making such estimates more transparent, robust, and straightforward. Finally, this protocol may be a useful tool for understanding yield trends and directing research and development efforts aimed at providing for a secure and stable future food supply.

Investigating Linguistic Sources of Differential Item Functioning Using Expert Think-Aloud Protocols in Science Achievement Tests

NASA Astrophysics Data System (ADS)

Roth, Wolff-Michael; Oliveri, Maria Elena; Dallie Sandilands, Debra; Lyons-Thomas, Juliette; Ercikan, Kadriye

2013-03-01

Even if national and international assessments are designed to be comparable, subsequent psychometric analyses often reveal differential item functioning (DIF). Central to achieving comparability is to examine the presence of DIF, and if DIF is found, to investigate its sources to ensure differentially functioning items that do not lead to bias. In this study, sources of DIF were examined using think-aloud protocols. The think-aloud protocols of expert reviewers were conducted for comparing the English and French versions of 40 items previously identified as DIF (N = 20) and non-DIF (N = 20). Three highly trained and experienced experts in verifying and accepting/rejecting multi-lingual versions of curriculum and testing materials for government purposes participated in this study. Although there is a considerable amount of agreement in the identification of differentially functioning items, experts do not consistently identify and distinguish DIF and non-DIF items. Our analyses of the think-aloud protocols identified particular linguistic, general pedagogical, content-related, and cognitive factors related to sources of DIF. Implications are provided for the process of arriving at the identification of DIF, prior to the actual administration of tests at national and international levels.

The evaluation of complex clinical trial protocols: resources available to research ethics committees and the use of clinical trial registries--a case study.

PubMed

Homedes, Núria; Ugalde, Antonio

2015-06-01

To assess the potential role of clinical trial (CT) registries and other resources available to research ethics committees (RECs) in the evaluation of complex CT protocols in low-income and middle-income countries. Using a case study approach, the authors examined the decision-making process of a REC in Argentina and its efforts to use available resources to decide on a complex protocol. We also analysed the information in the USA and other CT registries and consulted 24 CT experts in seven countries. Information requested by the Argentinean REC from other national RECs and ethics' experts was not useful to verify the adequacy of the REC's decision whether or not to approve the CT. The responses from the national regulatory agency and the sponsor were not helpful either. The identification of international resources that could assist was beyond the REC's capability. The information in the USA and other CT registries is limited, and at times misleading; and its accuracy is not verified by register keepers. RECs have limited access to experts and institutions that could assist them in their deliberations. Sponsors do not always answer RECs' request for information to properly conduct the ethical and methodological assessment of CT protocols. The usefulness of the CT registries is curtailed by the lack of appropriate codes and by data errors. Information about reasons for rejection, withdrawal or suspension of the trial should be included in the registries. Establishing formal channels of communication among national and foreign RECs and with independent international reference centres could strengthen the ethical review of CT protocols. 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.

PROFILE: Environmental Impact Assessment Under the National Environmental Policy Act and the Protocol on Environmental Protection to the Antarctic Treaty.

PubMed

Ensminger; McCold; Webb

1999-07-01

/ Antarctica has been set aside by the international community for protection as a natural reserve and a place for scientific research. Through the Antarctic Treaty of 1961, the signing nations agreed to cooperate in protecting the antarctic environment, in conducting scientific studies, and in abstaining from the exercise of territorial claims. The 1991 signing of the Protocol on Environmental Protection to the Antarctic Treaty (Protocol) by representatives of the 26 nations comprising the Antarctic Treaty Consultative Parties (Parties) significantly strengthened environmental protection measures for the continent. The Protocol required ratification by each of the governments individually prior to official implementation. The US government ratified the Protocol by passage of the Antarctic Science, Tourism, and Conservation Act of 1997. Japan completed the process by ratifying the Protocol on December 15, 1997. US government actions undertaken in Antarctica are subject to the requirements of both the Protocol and the US National Environmental Policy Act (NEPA). There are differences in the scope and intent of the Protocol and NEPA; however, both require environmental impact assessment (EIA) as part of the planning process for proposed actions that have the potential for environmental impacts. In this paper we describe the two instruments and highlight key similarities and differences with particular attention to EIA. Through this comparison of the EIA requirements of NEPA and the Protocol, we show how the requirements of each can be used in concert to provide enhanced environmental protection for the antarctic environment. NEPA applies only to actions of the US government; therefore, because NEPA includes certain desirable attributes that have been refined and clarified through numerous court cases, and because the Protocol is just entering implementation internationally, some recommendations are made for strengthening the procedural requirements of the Protocol for activities undertaken by all Parties in Antarctica. The Protocol gives clear and strong guidance for protection of specific, valued antarctic environmental resources including intrinsic wilderness and aesthetic values, and the value of Antarctica as an area for scientific research. That guidance requires a higher standard of environmental protection for Antarctica than is required in other parts of the world. This paper shows that taken together NEPA and the Protocol call for closer examination of proposed actions and a more rigorous consideration of environmental impacts than either would alone. Three areas are identified where the EIA provisions of the Protocol could be strengthened to improve its effectiveness. First, the thresholds defined by the Protocol need to be clarified. Specifically, the meanings of the terms "minor" and "transitory" are not clear in the context of the Protocol. The use of "or" in the phrase "minor or transitory" further confuses the meaning. Second, cumulative impact assessment is called for by the Protocol but is not defined. A clear definition could reduce the chance that cumulative impacts would be given inadequate consideration. Finally, the public has limited opportunities to comment on or influence the preparation of initial or comprehensive environmental evaluations. Experience has shown that public input to environmental documents has a considerable influence on agency decision making and the quality of EIA that agencies perform.KEY WORDS: Environment; Impact assessment; Antarctica; NEPA; Protocol; Antarctic Treatyhttp://link.springer-ny.com/link/service/journals/00267/bibs/24n1p13.html

[Protocol of the animal assisted activity program at a university hospital].

PubMed

Silveira, Isa Rodrigues; Santos, Nanci Cristiano; Linhares, Daniela Ribeiro

2011-03-01

Animal-Assisted Activity (AAA) consists in visitation and recreation through contact with animals, aiming at entertainment and improving the interpersonal relationship between patients and staff. Permission for the animals to visit an Institution requires a protocol with rules and safety routines to avoid accidents and zoonoses. The objective of this study is to describe the important points of the protocol to implement the AAA program. The protocol includes: introduction, objectives, inclusion and exclusion criteria for animals, drivers and patients; recommendations to the handlers and the health team, responsibilities of the Nosocomial Infection Control Committee, zoonoses posters, vaccination schedule for dogs and cats, free-informed consent to take part in the program and records with behavioral analysis of the animals. We believe that disclosing the protocol, based on scientific studies, favors the implementation of new programs in institutions considering the lack of national publications.

Standard Operating Procedures (SOPs) for Evaluating the Heart in Preclinical Studies of Duchenne Muscular Dystrophy.

PubMed

Duan, Dongsheng; Rafael-Fortney, Jill A; Blain, Alison; Kass, David A; McNally, Elizabeth M; Metzger, Joseph M; Spurney, Christopher F; Kinnett, Kathi

2016-02-01

A recent working group meeting focused on contemporary cardiac issues in Duchenne muscular dystrophy (DMD) was hosted by the National Heart, Lung, and Blood Institute in collaboration with the Parent Project Muscular Dystrophy. An outcome of this meeting was to provide freely available detailed protocols for preclinical animal studies. The goal of these protocols is to improve the quality and reproducibility of cardiac preclinical studies aimed at developing new therapeutics for the prevention and treatment of DMD cardiomyopathy.

National Urea Cycle Disorders Foundation

MedlinePlus

... questions, NUCDF has collaborated with clinical investigators to design a patient-centered research study to gather evidence- ... UCDC). The UCDC will be assist in study design as well as protocol review. Pre-clinical research ...

A report on IPv6 deployment activities and issues at Sandia National Laboratories:FY2007.

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

Tolendino, Lawrence F.; Eldridge, John M.; Hu, Tan Chang

2007-06-01

Internet Protocol version 4 (IPv4) has been a mainstay of the both the Internet and corporate networks for delivering network packets to the desired destination. However, rapid proliferation of network appliances, evolution of corporate networks, and the expanding Internet has begun to stress the limitations of the protocol. Internet Protocol version 6 (IPv6) is the replacement protocol that overcomes the constraints of IPv4. As the emerging Internet network protocol, SNL needs to prepare for its eventual deployment in international, national, customer, and local networks. Additionally, the United States Office of Management and Budget has mandated that IPv6 deployment in governmentmore » network backbones occurs by 2008. This paper explores the readiness of the Sandia National Laboratories network backbone to support IPv6, the issues that must be addressed before a deployment begins, and recommends the next steps to take to comply with government mandates. The paper describes a joint work effort of the Sandia National Laboratories ASC WAN project team and members of the System Analysis & Trouble Resolution, the Communication & Network Systems, and Network System Design & Implementation Departments.« less

Results of the 2009 ASBVd survey of avocado accessions in the national germplasm collection in Florida

USDA-ARS?s Scientific Manuscript database

The presence of Avocado Sunblotch Viroid (ASBVd) infection among the avocado (Persea americana Mill.) accessions in the National Germplasm Repository at Miami (NGR-Mia) was established in previous studies. An ASBVd specific reverse transcription-polymerase chain reaction (RT-PCR) protocol was used t...

Treatment influencing down-staging in EORTC Melanoma Group sentinel node histological protocol compared with complete step-sectioning: a national multicentre study.

PubMed

Riber-Hansen, Rikke; Hastrup, Nina; Clemmensen, Ole; Behrendt, Nille; Klausen, Siri; Ramsing, Mette; Spaun, Eva; Hamilton-Dutoit, Stephen Jacques; Steiniche, Torben

2012-02-01

Metastasis size in melanoma sentinel lymph nodes (SLNs) is an emerging prognostic factor. Two European melanoma treatment trials include SLN metastasis diameters as inclusion criteria. Whilst diameter estimates are sensitive to the number of sections examined, the level of this bias is largely unknown. We performed a prospective multicentre study to compare the European Organisation for Research and Treatment of Cancer (EORTC) recommended protocol with a protocol of complete step-sectioning. One hundred and thirty-three consecutive SLNs from seven SLN centres were analysed by five central sections 50μm apart (EORTC Protocol) followed by complete 250μm step-sectioning. Overall, 29 patients (21.8%) were SLN-positive. The EORTC Protocol missed eight of these metastases (28%), one metastasis measuring less than 0.1mm in diameter, seven measuring between 0.1 and 1mm. Complete step-sectioning at 250μm intervals (Extensive Protocol) missed one metastasis (3%) that measured less than 0.1mm. Thirteen treatment courses (34%) performed if inclusion was based on the Combined Protocol would not be performed if assessed by the EORTC Protocol. Thus, 10 patients would be without completion lymph node dissection (EORTC MINITUB study), whilst three patients would not be eligible for anti-CTLA4 trial (EORTC protocol 18071). The corresponding number with the Extensive Protocol would be three; one patient for the MINITUB registration study and two patients for the anti-CTLA4 study. Examining SLNs by close central sectioning alone (EORTC Protocol) misses a substantial number of metastases and underestimates the maximum metastasis diameter, leading to important changes in patient eligibility for various treatment protocols. Copyright © 2011 Elsevier Ltd. All rights reserved.

Advances in radiation detection technologies for responders.

PubMed

Unterweger, Michael P; Pibida, Leticia S

2005-11-01

The Department of Homeland Security is supporting the development of a large number of standards for first responders. In the area of detection of radioactive and nuclear materials, four new standards (ANSI N42.32, N42.33, N42.34, and N42.35) and their corresponding test and evaluation protocols were developed to meet Department of Homeland Security needs. Testing of the standards and protocols was carried out at the National Institute of Standards and Technology, Oak Ridge National Laboratory, Pacific Northwest National Laboratory, Los Alamos National Laboratory, and Lawrence Livermore National Laboratory.

Evidence-based recommendations for bowel cleansing before colonoscopy in children: a report from a national working group.

PubMed

Turner, D; Levine, A; Weiss, B; Hirsh, A; Shamir, R; Shaoul, R; Berkowitz, D; Bujanover, Y; Cohen, S; Eshach-Adiv, O; Jamal, Gera; Kori, M; Lerner, A; On, A; Rachman, L; Rosenbach, Y; Shamaly, H; Shteyer, E; Silbermintz, A; Yerushalmi, B

2010-12-01

There are no current recommendations for bowel cleansing before colonoscopy in children. The Israeli Society of Pediatric Gastroenterology and Nutrition (ISPGAN) established an iterative working group to formulate evidence-based guidelines for bowel cleansing in children prior to colonoscopy. Data were collected by systematic review of the literature and via a national-based survey of all endoscopy units in Israel. Based on the strength of evidence, the Committee reached consensus on six recommended protocols in children. Guidelines were finalized after an open audit of ISPGAN members. Data on 900 colonoscopies per year were accrued, which represents all annual pediatric colonoscopies performed in Israel. Based on the literature review, the national survey, and the open audit, several age-stratified pediatric cleansing protocols were proposed: two PEG-ELS protocols (polyethylene-glycol with electrolyte solution); Picolax-based protocol (sodium picosulphate with magnesium citrate); sodium phosphate protocol (only in children over the age of 12 years who are at low risk for renal damage); stimulant laxative-based protocol (e. g. bisacodyl); and a PEG 3350-based protocol. A population-based analysis estimated that the acute toxicity rate of oral sodium phosphate is at most 3/7320 colonoscopies (0.041 %). Recommendations on diet and enema use are provided in relation to each proposed protocol. There is no ideal bowel cleansing regimen and, thus, various protocols are in use. We propose several evidence-based protocols to optimize bowel cleansing in children prior to colonoscopy and minimize adverse events. © Georg Thieme Verlag KG Stuttgart · New York.

Research ethics review at University Eduardo Mondlane (UEM)/Maputo Central Hospital, Mozambique (2013-2016): a descriptive analysis of the start-up of a new research ethics committee (REC).

PubMed

Sacarlal, Jahit; Muchanga, Vasco; Mabutana, Carlos; Mabui, Matilde; Mariamo, Arlete; Cuamba, Assa Júlio; Fumo, Leida Artur; Silveira, Jacinta; Heitman, Elizabeth; Moon, Troy D

2018-05-23

Mozambique has seen remarkable growth in biomedical research over the last decade. To meet a growing need, the National Committee for Bioethics in Health of Mozambique (CNBS) encouraged the development of ethical review processes at institutions that regularly conduct medical and social science research. In 2012, the Faculty of Medicine (FM) of University Eduardo Mondlane (UEM) and the Maputo Central Hospital (MCH) established a joint Institutional Committee on Bioethics for Health (CIBS FM & MCH). This study examines the experience of the first 4 years of the CIBS FM & MCH. This study provides a descriptive, retrospective analysis of research protocols submitted to and approved by the CIBS FM & MCH between March 1, 2013 and December 31, 2016, together with an analysis of the Committee's respective reviews and actions. A total of 356 protocols were submitted for review during the period under analysis, with 309 protocols approved. Sixty-four percent were submitted by students, faculty, and researchers from UEM, mainly related to Master's degree research (42%). Descriptive cross-sectional studies were the most frequently reviewed research (61%). The majority were prospective (71%) and used quantitative methodologies (51%). The Departments of Internal Medicine at MCH and Community Health at the FM submitted the most protocols from their respective institutions, with 38 and 53% respectively. The CIBS's average time to final approval for all protocols was 56 days, rising to 161 for the 40 protocols that required subsequent national-level review by the CNBS. Our results show that over its first 4 years, the CIBS FM & MCH has been successful in managing a constant demand for protocol review and that several broad quality improvement initiatives, such as investigator mentoring and an electronic protocol submission platform have improved efficiency in the review process and the overall quality of the protocols submitted. Beyond Maputo, long-term investments in training and ethical capacity building for CIBS across the country continue to be needed, as Mozambique develops greater capacity for research and makes progress toward improving the health of all its citizens.

Benchmarking pediatric cranial CT protocols using a dose tracking software system: a multicenter study.

PubMed

De Bondt, Timo; Mulkens, Tom; Zanca, Federica; Pyfferoen, Lotte; Casselman, Jan W; Parizel, Paul M

2017-02-01

To benchmark regional standard practice for paediatric cranial CT-procedures in terms of radiation dose and acquisition parameters. Paediatric cranial CT-data were retrospectively collected during a 1-year period, in 3 different hospitals of the same country. A dose tracking system was used to automatically gather information. Dose (CTDI and DLP), scan length, amount of retakes and demographic data were stratified by age and clinical indication; appropriate use of child-specific protocols was assessed. In total, 296 paediatric cranial CT-procedures were collected. Although the median dose of each hospital was below national and international diagnostic reference level (DRL) for all age categories, statistically significant (p-value < 0.001) dose differences among hospitals were observed. The hospital with lowest dose levels showed smallest dose variability and used age-stratified protocols for standardizing paediatric head exams. Erroneous selection of adult protocols for children still occurred, mostly in the oldest age-group. Even though all hospitals complied with national and international DRLs, dose tracking and benchmarking showed that further dose optimization and standardization is possible by using age-stratified protocols for paediatric cranial CT. Moreover, having a dose tracking system revealed that adult protocols are still applied for paediatric CT, a practice that must be avoided. • Significant differences were observed in the delivered dose between age-groups and hospitals. • Using age-adapted scanning protocols gives a nearly linear dose increase. • Sharing dose-data can be a trigger for hospitals to reduce dose levels.

Documentation of operational protocol for the use of MAMA software

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

Schwartz, Daniel S.

2016-01-21

Image analysis of Scanning Electron Microscope (SEM) micrographs is a complex process that can vary significantly between analysts. The factors causing the variation are numerous, and the purpose of Task 2b is to develop and test a set of protocols designed to minimize variation in image analysis between different analysts and laboratories, specifically using the MAMA software package, Version 2.1. The protocols were designed to be “minimally invasive”, so that expert SEM operators will not be overly constrained in the way they analyze particle samples. The protocols will be tested using a round-robin approach where results from expert SEM usersmore » at Los Alamos National Laboratory, Lawrence Livermore National Laboratory, Pacific Northwest National Laboratory, Savannah River National Laboratory, and the National Institute of Standards and Testing will be compared. The variation of the results will be used to quantify uncertainty in the particle image analysis process. The round-robin exercise will proceed with 3 levels of rigor, each with their own set of protocols, as described below in Tasks 2b.1, 2b.2, and 2b.3. The uncertainty will be developed using NIST standard reference material SRM 1984 “Thermal Spray Powder – Particle Size Distribution, Tungsten Carbide/Cobalt (Acicular)” [Reference 1]. Full details are available in the Certificate of Analysis, posted on the NIST website (http://www.nist.gov/srm/).« less

A Cost Analysis of a Pancreatic Cancer Screening Protocol in High-Risk Populations

PubMed Central

Bruenderman, Elizabeth; Martin, Robert CG

2016-01-01

Background Pancreatic cancer is the 4th leading cause of cancer death in the U.S. A screening protocol is needed to catch early stage, resectable disease. This study suggests a protocol for high-risk individuals and assesses the cost in the context of the Affordable Care Act. Methods Medicare and national average pricing were used for cost analysis of a protocol using MRI/MRCP biannually in high-risk groups. Results: ‘ Costs per year of life added’ based on Medicare and national average costs, respectively, are: $638.62 and $2542.37 for Peutz-Jehgers Syndrome, $945.33 and $3763.44 for Hereditary Pancreatitis, $1141.77 and $4545.45 for Familial Pancreatic Cancer and p16-Leiden mutations, and $356.42 and $1418.92 for new-onset diabetes over age 50 with weight loss or smoking. Conclusion A screening program using MRI/MRCP is affordable in high-risk populations. The U.S. Preventive Services Task Force must reevaluate its pancreatic cancer screening guidelines to make screening more cost-effective for the individual. PMID:26003200

Safety of a "drip and ship" intravenous thrombolysis protocol for patients with acute ischemic stroke.

PubMed

Mansoor, Simin; Zand, Ramin; Al-Wafai, Ameer; Wahba, Mervat N; Giraldo, Elias A

2013-10-01

The "drip and ship" approach for intravenous thrombolysis (IVT) is becoming the standard of care for patients with acute ischemic stroke (AIS) in communities without direct access to a stroke specialist. We aimed to demonstrate the safety of our "drip and ship" IVT protocol. This was a retrospective study of patients with AIS treated with IVT between January 2003 and January 2011. Information on patients' baseline characteristics, neuroimaging, symptomatic intracerebral hemorrhage (sICH), and mortality was obtained from our stroke registry. A group of patients were treated with IVT by an emergency physician in phone consultation with a board-certified vascular neurologist (BCVN) at 1 of our 3 stroke network-affiliated hospitals (SNAHs). These patients were subsequently transferred to our Joint Commission-certified primary stroke center (CPSC) after completion of IVT ("drip and ship" protocol). The other patients were treated directly by a BCVN at the CPSC. We studied 201 patients treated with IVT. Of them, 14% received IVT at a SNAH ("drip and ship" protocol) and 86% were treated at the CPSC. There were no significant differences between the 2 groups with regard to age, National Institutes of Health Stoke Scale score, stroke symptom onset-to-needle time, sICH, or in-hospital mortality. Our "drip and ship" protocol for IVT is safe. The protocol was not associated with an excess of sICH or in-hospital mortality compared with patients who received IVT at the CPSC. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

An Examination of Effective Practice: Moving Toward Elimination of Achievement Gaps in Science

NASA Astrophysics Data System (ADS)

Johnson, Carla C.

2009-06-01

This longitudinal study of middle school science teachers explored the relationship between effective science instruction, as defined by the National Science Education Standards (NRC in National science education standards. National Academy Press, Washington, DC, 1996), and student achievement in science. Eleven teachers participated in a three year study of teacher effectiveness, determined by the LSC Classroom Observation Protocol (Horizon Research, Inc. in Local Systemic Change Classroom Observation Protocol. May 1, 2002) and student achievement, which was assessed using the Discovery Inquiry Test in Science. Findings in this study revealed the positive impact that effective science teachers have on student learning, eliminating achievement gaps between White and Non-White students. Case studies of three teachers, both effective and ineffective explore the beliefs and experiences that influence teachers to change, or not to change practice. This study provides justification for teaching science effectively to narrow achievement gaps in science and provides insight to stakeholders in science education as to how to support teachers in becoming more effective, through addressing existing teacher beliefs and providing experiences that challenge those beliefs.

76 FR 54241 - Office of the Director, National Institutes of Health; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director... selected human gene transfer protocols, including a protocol that will use a recombinant Saccharomyces cerevisiae that expresses the human Brachyury protein in adults with metastatic carcinoma. The RAC will also...

The characteristics of national health initiatives promoting earlier cancer diagnosis among adult populations: a systematic review protocol

PubMed Central

Calanzani, Natalia; Weller, David; Campbell, Christine

2017-01-01

Introduction The increasing burden of cancer morbidity and mortality has led to the development of national health initiatives to promote earlier cancer diagnosis and improve cancer survival. This protocol describes a systematic review aiming to identify the evidence about such initiatives among the adult population. We will describe their components, stakeholders and target populations, and summarise their outcomes. Methods and analysis We will search databases and websites for peer-reviewed publications and grey literature on national health initiatives in high-income countries as defined by the World Bank. Quantitative, qualitative and mixed-methods studies will be included and assessed for their methodological quality. Study selection, quality assessment and data extraction will be carried out independently by two reviewers. Narrative synthesis will be used to analyse the findings. Ethics and dissemination This systematic review analyses secondary data and ethical approval is not required. Review findings will be helpful to researchers, policy makers, governments and other key stakeholders developing similar initiatives and assessing cancer outcomes. The results will be submitted to a peer-reviewed journal in order to reach a diverse group of healthcare professionals, researchers and policy makers. This systematic review protocol is registered at PROSPERO (CRD42016047233). PMID:28698336

Variability in usual care mechanical ventilation for pediatric acute lung injury: the potential benefit of a lung protective computer protocol.

PubMed

Khemani, Robinder G; Sward, Katherine; Morris, Alan; Dean, J Michael; Newth, Christopher J L

2011-11-01

Although pediatric intensivists claim to embrace lung protective ventilation for acute lung injury (ALI), ventilator management is variable. We describe ventilator changes clinicians made for children with hypoxemic respiratory failure, and evaluate the potential acceptability of a pediatric ventilation protocol. This was a retrospective cohort study performed in a tertiary care pediatric intensive care unit (PICU). The study period was from January 2000 to July 2007. We included mechanically ventilated children with PaO(2)/FiO(2) (P/F) ratio less than 300. We assessed variability in ventilator management by evaluating actual changes to ventilator settings after an arterial blood gas (ABG). We evaluated the potential acceptability of a pediatric mechanical ventilation protocol we adapted from National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI) Acute Respiratory Distress Syndrome (ARDS) Network protocols by comparing actual practice changes in ventilator settings to changes that would have been recommended by the protocol. A total of 2,719 ABGs from 402 patients were associated with 6,017 ventilator settings. Clinicians infrequently decreased FiO(2), even when the PaO(2) was high (>68 mmHg). The protocol would have recommended more positive end expiratory pressure (PEEP) than was used in actual practice 42% of the time in the mid PaO(2) range (55-68 mmHg) and 67% of the time in the low PaO(2) range (<55 mmHg). Clinicians often made no change to either peak inspiratory pressure (PIP) or ventilator rate (VR) when the protocol would have recommended a change, even when the pH was greater than 7.45 with PIP at least 35 cmH(2)O. There may be lost opportunities to minimize potentially injurious ventilator settings for children with ALI. A reproducible pediatric mechanical ventilation protocol could prompt clinicians to make ventilator changes that are consistent with lung protective ventilation.

The Interlibrary Loan Protocol: An OSI Solution to ILL Messaging.

ERIC Educational Resources Information Center

Turner, Fay

1990-01-01

Discusses the interlibrary loan (ILL) protocol, a standard based on the principles of the Open Systems Interconnection (OSI) Reference Model. Benefits derived from protocol use are described, the status of the protocol as an international standard is reviewed, and steps taken by the National Library of Canada to facilitate migration to an ILL…

Cross-national comparisons of complex problem-solving strategies in two microworlds.

PubMed

Güss, C Dominik; Tuason, Ma Teresa; Gerhard, Christiane

2010-04-01

Research in the fields of complex problem solving (CPS) and dynamic decision making using microworlds has been mainly conducted in Western industrialized countries. This study analyzes the CPS process by investigating thinking-aloud protocols in five countries. Participants were 511 students from Brazil, Germany, India, the Philippines, and the United States who worked on two microworlds. On the basis of cultural-psychological theories, specific cross-national differences in CPS strategies were hypothesized. Following theories of situatedness of cognition, hypotheses about the specific frequency of problem-solving strategies in the two microworlds were developed. Results of the verbal protocols showed (a) modification of the theoretical CPS model, (b) task dependence of CPS strategies, and (c) cross-national differences in CPS strategies. Participants' CPS processes were particularly influenced by country-specific problem-solving strategies. Copyright © 2009 Cognitive Science Society, Inc.

Spina Bifida

MedlinePlus

... of myelomeningocele through a National Institutes of Health experimental protocol (Management of Myelomeningocele Study, or MOMS). Fetal ... additional loss from occurring. The surgery is considered experimental and there are risks to the fetus as ...

Emission factors of fine particulate matter, organic and elemental carbon, carbon monoxide, and carbon dioxide for four solid fuels commonly used in residential heating by the U.S. Navajo Nation.

PubMed

Champion, Wyatt M; Connors, Lea; Montoya, Lupita D

2017-09-01

Most homes in the Navajo Nation use wood as their primary heating fuel, often in combination with locally mined coal. Previous studies observed health effects linked to this solid-fuel use in several Navajo communities. Emission factors (EFs) for common fuels used by the Navajo have not been reported using a relevant stove type. In this study, two softwoods (ponderosa pine and Utah juniper) and two high-volatile bituminous coals (Black Mesa and Fruitland) were tested with an in-use residential conventional wood stove (homestove) using a modified American Society for Testing and Materials/U.S. Environmental Protection Agency (ASTM/EPA) protocol. Filter sampling quantified PM 2.5 (particulate matter with an aerodynamic diameter ≤2.5 μm) and organic (OC) and elemental (EC) carbon in the emissions. Real-time monitoring quantified carbon monoxide (CO), carbon dioxide (CO 2 ), and total suspended particles (TSP). EFs for these air pollutants were developed and normalized to both fuel mass and energy consumed. In general, coal had significantly higher mass EFs than wood for all pollutants studied. In particular, coal emitted, on average, 10 times more PM 2.5 than wood on a mass basis, and 2.4 times more on an energy basis. The EFs developed here were based on fuel types, stove design, and operating protocols relevant to the Navajo Nation, but they could be useful to other Native Nations with similar practices, such as the nearby Hopi Nation. Indoor wood and coal combustion is an important contributor to public health burdens in the Navajo Nation. Currently, there exist no emission factors representative of Navajo homestoves, fuels, and practices. This study developed emission factors for PM 2.5 , OC, EC, CO, and CO 2 using a representative Navajo homestove. These emission factors may be utilized in regional-, national-, and global-scale health and environmental models. Additionally, the protocols developed and results presented here may inform on-going stove design of the first EPA-certified wood and coal combination stove.

Quality assurance of research protocols conducted in the community: the National Institute on Drug Abuse Clinical Trials Network experience.

PubMed

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-04-01

Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. : QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed.

Quality assurance of research protocols conducted in the community: The National Institute on Drug Abuse Clinical Trials Network Experience

PubMed Central

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-01-01

Background: Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. Purpose: This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. Methods: The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Results: Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. Limitations: QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. Conclusions: The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed. PMID:19342468

Patient doses from CT examinations in Turkey.

PubMed

Ataç, Gökçe Kaan; Parmaksız, Aydın; İnal, Tolga; Bulur, Emine; Bulgurlu, Figen; Öncü, Tolga; Gündoğdu, Sadi

2015-01-01

We aimed to establish the first diagnostic reference levels (DRLs) for computed tomography (CT) examinations in adult and pediatric patients in Turkey and compare these with international DRLs. CT performance information and examination parameters (for head, chest, high-resolution CT of the chest [HRCT-chest], abdominal, and pelvic protocols) from 1607 hospitals were collected via a survey. Dose length products and effective doses for standard patient sizes were calculated from the reported volume CT dose index (CTDIvol). The median number of protocols reported from the 167 responding hospitals (10% response rate) was 102 across five different age groups. Third quartile CTDIvol values for adult pelvic and all pediatric body protocols were higher than the European Commission standards but were comparable to studies conducted in other countries. The radiation dose indicators for adult patients were similar to those reported in the literature, except for those associated with head protocols. CT protocol optimization is necessary for adult head and pediatric chest, HRCT-chest, abdominal, and pelvic protocols. The findings from this study are recommended for use as national DRLs in Turkey.

Implementation of a protocol proposed by the Brazilian National Health Surveillance Agency for antibiotic use in very low birth weight infants.

PubMed

Pinto, Maria Cristina F Guedes; Bueno, Arnaldo C; Vieira, Alan A

2013-01-01

To analyze the implementation of a protocol proposed by the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) to improve sepsis diagnosis in very low birth weight newborns. This was a prospective study that evaluated the implementation of a protocol involving clinical and laboratory criteria (hematologic scoring system of Rodwell and C-reactive protein serial measurements), recommended by ANVISA, to improve the diagnosis of neonatal sepsis in very low birth weight newborns. The study included all patients who were born and remained in the neonatal intensive care unit until discharge or death, and excluded those with congenital diseases. The main outcomes measured in newborns before (2006-2007) and after implementation of the protocol (2008) were the rates of early and late-onset sepsis, use of antibiotics, and mortality. Means were compared by Student's t-test and categorical variables were compared by the chi-squared test; the significance level for all tests was set at 95%. The study included 136 newborns with very low birth weight. There was no difference between groups regarding general clinical characteristics in the studied periods. There was, however, a decrease in the number of diagnoses of probable early-onset sepsis (p<0.001), use of antimicrobial regimens (p<0.001), and overall mortality and infection-related mortality (p=0.009 and p=0.049, respectively). The implementation of the protocol allowed improvement of sepsis diagnosis by reducing the diagnosis of probable early-onset sepsis, thus promoting efficient antimicrobial use in this population. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Compliance with the national palestinian infection prevention and control protocol at governmental paediatric hospitals in gaza governorates.

PubMed

Eljedi, Ashraf; Dalo, Shareef

2014-08-01

Nosocomial infections are a significant burden for both patients and the healthcare system. For this reason, infection prevention and control (IPC) practices are extremely important. The Palestinian Ministry of Health adopted the national IPC Protocol in 2004. This study aimed to assess the compliance of healthcare providers (HCPs) with the Protocol in three governmental paediatric hospitals in Gaza governorates. This descriptive cross-sectional study was conducted from February to November 2010. Data were collected from a sample of doctors, nurses and physiotherapists (N = 334) using a self-administered questionnaire and observation checklists to record HCP practices and assess the hospital environment. The response rate was 92%. The most important reasons for non-compliance with the IPC Protocol were the absence of an education programme (61.5%), lack of knowledge (52.4%) and the scarcity of required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC Protocol, while 65.8% did not know of its existence. Only 16.9% had participated in training sessions regarding general IPC practices. The observation checklist regarding HCP practices revealed low levels of compliance in hand washing (45.9%), wearing gloves (40.7%) and using antiseptics/disinfectants (49.16%). The health facilities checklist indicated that there was a lack of certain essential equipment and materials, such as covered waste containers and heavy-duty gloves. Due to the lack of HPC knowledge, the authors recommend that the IPC Protocol be made available in all hospitals. In addition, a qualified team should implement intensive IPC education and training programmes and facilities should provide the required equipment and materials.

Including Children with Intellectual Disabilities/Special Educational Needs into National Child Health Surveys: A Pilot Study

ERIC Educational Resources Information Center

Scott, Judith; Wishart, Jennifer; Currie, Candace

2011-01-01

Background: The language, format and length of typical national health survey questionnaires may make them inaccessible to many school-aged children with an intellectual disability. Materials and Methods: Using the standard delivery protocol, the WHO Health Behaviour in School-aged Children (HBSC) Questionnaire, currently in use in 43 countries,…

Research protocols in National Park Service wilderness

Treesearch

Jim Walters

2000-01-01

While the National Park Service encourages the use of its wilderness resource for research, management policies require that all research apply “minimum requirement” protocols to determine: 1) if the research is needed to support the purposes of wilderness and, 2) if it is appropriate, determine the minimum tool needed to accomplish the work.

NGSI student activities in open source information analysis in support of the training program of the U.S. DOE laboratories for the entry into force of the additional protocol

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

Sandoval, M Analisa; Uribe, Eva C; Sandoval, Marisa N

2009-01-01

In 2008 a joint team from Los Alamos National Laboratory (LANL) and Brookhaven National Laboratory (BNL) consisting of specialists in training of IAEA inspectors in the use of complementary access activities formulated a training program to prepare the U.S. Doe laboratories for the entry into force of the Additional Protocol. As a major part of the support of the activity, LANL summer interns provided open source information analysis to the LANL-BNL mock inspection team. They were a part of the Next Generation Safeguards Initiative's (NGSI) summer intern program aimed at producing the next generation of safeguards specialists. This paper describesmore » how they used open source information to 'backstop' the LANL-BNL team's effort to construct meaningful Additional Protocol Complementary Access training scenarios for each of the three DOE laboratories, Lawrence Livermore National Laboratory, Idaho National Laboratory, and Oak Ridge National Laboratory.« less

Protocol and standard operating procedures for common use in a worldwide multicenter study on reference values.

PubMed

Ozarda, Yesim; Ichihara, Kiyoshi; Barth, Julian H; Klee, George

2013-05-01

The reference intervals (RIs) given in laboratory reports have an important role in aiding clinicians in interpreting test results in reference to values of healthy populations. In this report, we present a proposed protocol and standard operating procedures (SOPs) for common use in conducting multicenter RI studies on a national or international scale. The protocols and consensus on their contents were refined through discussions in recent C-RIDL meetings. The protocol describes in detail (1) the scheme and organization of the study, (2) the target population, inclusion/exclusion criteria, ethnicity, and sample size, (3) health status questionnaire, (4) target analytes, (5) blood collection, (6) sample processing and storage, (7) assays, (8) cross-check testing, (9) ethics, (10) data analyses, and (11) reporting of results. In addition, the protocol proposes the common measurement of a panel of sera when no standard materials exist for harmonization of test results. It also describes the requirements of the central laboratory, including the method of cross-check testing between the central laboratory of each country and local laboratories. This protocol and the SOPs remain largely exploratory and may require a reevaluation from the practical point of view after their implementation in the ongoing worldwide study. The paper is mainly intended to be a basis for discussion in the scientific community.

Protocols for pressure ulcer prevention: are they evidence-based?

PubMed

Chaves, Lidice M; Grypdonck, Mieke H F; Defloor, Tom

2010-03-01

This study is a report of a study to determine the quality of protocols for pressure ulcer prevention in home care in the Netherlands. If pressure ulcer prevention protocols are evidence-based and practitioners use them correctly in practice, this will result a reduction in pressure ulcers. Very little is known about the evidence-based content and quality of the pressure ulcer prevention protocols. In 2008, current pressure ulcer prevention protocols from 24 home-care agencies in the Netherlands were evaluated. A checklist developed and validated by two pressure ulcer prevention experts was used to assess the quality of the protocols, and weighted and unweighted quality scores were computed and analysed using descriptive statistics. The 24 pressure ulcer prevention protocols had a mean weighted quality score of 63.38 points out of a maximum of 100 (sd 5). The importance of observing the skin at the pressure points at least once a day was emphasized in 75% of the protocols. Only 42% correctly warned against the use of materials that were 'less effective or that could potentially cause harm'. Pressure ulcer prevention commands a reasonable amount of attention in home care, but the incidence of pressure ulcers and lack of a consistent, standardized document for use in actual practice indicate a need for systematic implementation of national pressure ulcer prevention standards in the Netherlands to ensure adherence to the established protocols.

50 CFR 600.757 - Operational protocols.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Operational protocols. 600.757 Section 600.757 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... Operational protocols. (a) Services of conveners and facilitators. A Council or NMFS may employ or enter into...

A report on FY06 IPv6 deployment activities and issues at Sandia National Laboratories.

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

Tolendino, Lawrence F.; Eldridge, John M.; Hu, Tan Chang

2006-06-01

Internet Protocol version 4 (IPv4) has been a mainstay of the both the Internet and corporate networks for delivering network packets to the desired destination. However, rapid proliferation of network appliances, evolution of corporate networks, and the expanding Internet has begun to stress the limitations of the protocol. Internet Protocol version 6 (IPv6) is the replacement protocol that overcomes the constraints of IPv4. IPv6 deployment in government network backbones has been mandated to occur by 2008. This paper explores the readiness of the Sandia National Laboratories' network backbone to support IPv6, the issues that must be addressed before a deploymentmore » begins, and recommends the next steps to take to comply with government mandates. The paper describes a joint, work effort of the Sandia National Laboratories ASC WAN project team and members of the System Analysis & Trouble Resolution and Network System Design & Implementation Departments.« less

[Objective functional compensation in NHIL: INAIL prosthesic protocol in Lombardy, 2007-2010].

PubMed

Calcinoni, O; Polo, L

2011-01-01

Even if NHIL gives already right to economic compensation, our Insurance aimed to real functional compensation, to reduce handicap in everyday life. Together with Professor Giordano, Audioprosthesists' Association and Manufacturers' representatives, INAIL Medical Superintendence started in 2003 a study on this problem, involving some of his forensic physician and ENT staff; in 2007-2009 INAIL issued directives innovating and planning the rules in prosthesis provision, not only acoustical ones. In 2010 started an experimental protocol to rule hearing aid provision in all INAIL centers, throughout Italy. Authors present first results of this protocol in Lombardy, related to previous and national ones.

Switching From Age-Based Stimulus Dosing to Dose Titration Protocols in Electroconvulsive Therapy: Empirical Evidence for Better Patient Outcomes With Lower Peak and Cumulative Energy Doses.

PubMed

O'Neill-Kerr, Alex; Yassin, Anhar; Rogers, Stephen; Cornish, Janie

2017-09-01

The aim of this study was to test the proposition that adoption of a dose titration protocol may be associated with better patient outcomes, at lower treatment dose, and with comparable cumulative dose to that in patients treated using an age-based stimulus dosing protocol. This was an analysis of data assembled from archived records and based on cohorts of patients treated respectively on an age-based stimulus dosing protocol and on a dose titration protocol in the National Health Service in England. We demonstrated a significantly better response in the patient cohort treated with dose titration than with age-based stimulus dosing. Peak doses were less and the total cumulative dose was less in the dose titration group than in the age-based stimulus dosing group. Our findings are consistent with superior outcomes in patients treated using a dose titration protocol when compared with age-based stimulus dosing in a similar cohort of patients.

78 FR 49717 - Speech-to-Speech and Internet Protocol (IP) Speech-to-Speech Telecommunications Relay Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

...] Speech-to-Speech and Internet Protocol (IP) Speech-to-Speech Telecommunications Relay Services... Internet Protocol (IP) Speech-to-Speech Telecommunications Relay Services; Telecommunications Relay... (IP Relay) and video relay service (VRS), the Commission should bundle national STS outreach efforts...

Advanced Global Atmospheric Gases Experiment (AGAGE)

NASA Technical Reports Server (NTRS)

Prinn, Ronald G.; Kurylo, Michael (Technical Monitor)

2004-01-01

We seek funding from NASA for the third year (2005) of the four-year period January 1, 2003 - December 31, 2006 for continued support of the MIT contributions to the multi-national global atmospheric trace species measurement program entitled Advanced Global Atmospheric Gases Experiment (AGAGE). The case for real-time high-frequency measurement networks like AGAGE is very strong and the observations and their interpretation are widely recognized for their importance to ozone depletion and climate change studies and to verification issues arising from the Montreal Protocol (ozone) and Kyoto Protocol (climate). The proposed AGAGE program is distinguished by its capability to measure over the globe at high frequency almost all of the important species in the Montreal Protocol and almost all of the significant non-CO2 gases in the Kyoto Protocol.

Systematic Evaluation of the Patient-Reported Outcome (PRO) Content of Clinical Trial Protocols

PubMed Central

Kyte, Derek; Duffy, Helen; Fletcher, Benjamin; Gheorghe, Adrian; Mercieca-Bebber, Rebecca; King, Madeleine; Draper, Heather; Ives, Jonathan; Brundage, Michael; Blazeby, Jane; Calvert, Melanie

2014-01-01

Background Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme trial protocols. Methods and Findings We conducted an electronic search of the NIHR HTA programme database (inception to August 2013) for protocols describing a randomised controlled trial including a primary/secondary PRO. Two investigators independently reviewed the content of each protocol, using a specially constructed PRO-specific protocol checklist, alongside the ‘Standard Protocol Items: Recommendations for Interventional Trials’ (SPIRIT) checklist. Disagreements were resolved through discussion with a third investigator. 75 trial protocols were included in the analysis. Protocols included a mean of 32/51 (63%) SPIRIT recommendations (range 16–41, SD 5.62) and 11/33 (33%) PRO-specific items (range 4–18, SD 3.56). Over half (61%) of the PRO items were incomplete. Protocols containing a primary PRO included slightly more PRO checklist items (mean 14/33 (43%)). PRO protocol content was not associated with general protocol completeness; thus, protocols judged as relatively ‘complete’ using SPIRIT were still likely to have omitted a large proportion of PRO checklist items. Conclusions The PRO components of HTA clinical trial protocols require improvement. Information on the PRO rationale/hypothesis, data collection methods, training and management was often absent. This low compliance is unsurprising; evidence shows existing PRO guidance for protocol developers remains difficult to access and lacks consistency. Study findings suggest there are a number of PRO protocol checklist items that are not fully addressed by the current SPIRIT statement. We therefore advocate the development of consensus-based supplementary guidelines, aimed at improving the completeness and quality of PRO content in clinical trial protocols. PMID:25333349

NCI study shows feasibility of cancer screening protocol for high-risk population

Cancer.gov

In a new study from the National Cancer Institute, researchers found a high prevalence of cancer at baseline screening in individuals with Li-Fraumeni syndrome, a rare inherited disorder that leads to a higher risk of developing certain cancers.

15 CFR 781.2 - Purposes of the Additional Protocol and APR.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL... and less any information to which the U.S. Government applies the national security exclusion, is... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Purposes of the Additional Protocol...

28 CFR 115.221 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault... for investigating allegations of sexual abuse, the agency shall follow a uniform evidence protocol... developed after 2011. (c) The agency shall offer all victims of sexual abuse access to forensic medical...

28 CFR 115.121 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... sexual abuse in its lockups, the agency shall follow a uniform evidence protocol that maximizes the... lockup detainees shall receive basic training regarding how to detect and respond to victims of sexual...

28 CFR 115.121 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... sexual abuse in its lockups, the agency shall follow a uniform evidence protocol that maximizes the... lockup detainees shall receive basic training regarding how to detect and respond to victims of sexual...

28 CFR 115.321 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential... or otherwise based on the most recent edition of the U.S. Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic Examinations, Adults...

28 CFR 115.321 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential... or otherwise based on the most recent edition of the U.S. Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic Examinations, Adults...

28 CFR 115.21 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential.... (c) The agency shall offer all victims of sexual abuse access to forensic medical examinations...

28 CFR 115.221 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault... for investigating allegations of sexual abuse, the agency shall follow a uniform evidence protocol... developed after 2011. (c) The agency shall offer all victims of sexual abuse access to forensic medical...

28 CFR 115.221 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault... for investigating allegations of sexual abuse, the agency shall follow a uniform evidence protocol... developed after 2011. (c) The agency shall offer all victims of sexual abuse access to forensic medical...

28 CFR 115.21 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential.... (c) The agency shall offer all victims of sexual abuse access to forensic medical examinations...

28 CFR 115.121 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... sexual abuse in its lockups, the agency shall follow a uniform evidence protocol that maximizes the... lockup detainees shall receive basic training regarding how to detect and respond to victims of sexual...

28 CFR 115.321 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential... or otherwise based on the most recent edition of the U.S. Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic Examinations, Adults...

28 CFR 115.21 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential.... (c) The agency shall offer all victims of sexual abuse access to forensic medical examinations...

Forest bird monitoring protocol for strategic habitat conservation and endangered species management on O'ahu Forest National Wildlife Refuge, Island of O'ahu, Hawai'i

USGS Publications Warehouse

Camp, Richard J.; Gorresen, P. Marcos; Banko, Paul C.

2011-01-01

This report describes the results of a pilot forest bird survey and a consequent forest bird monitoring protocol that was developed for the O'ahu Forest National Wildlife Refuge, O'ahu Island, Hawai'i. The pilot survey was conducted to inform aspects of the monitoring protocol and to provide a baseline with which to compare future surveys on the Refuge. The protocol was developed in an adaptive management framework to track bird distribution and abundance and to meet the strategic habitat conservation requirements of the Refuge. Funding for this research was provided through a Science Support Partnership grant sponsored jointly by the U.S. Geological Survey (USGS) and the U.S. Fish and Wildlife Service (USFWS).

The NINDS-Canadian stroke network vascular cognitive impairment neuropsychology protocols in Chinese.

PubMed

Wong, Adrian; Xiong, Yun-yun; Wang, Defeng; Lin, Shi; Chu, Winnie W C; Kwan, Pauline W K; Nyenhuis, David; Black, Sandra E; Wong, Ka Sing Lawrence; Mok, Vincent

2013-05-01

Vascular cognitive impairment (VCI) affects up to half of stroke survivors and predicts poor outcomes. Valid and reliable assessement for VCI is lacking, especially for the Chinese population. In 2005, the National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) Harmonisation workshop proposed a set of three neuropsychology protocols for VCI evaluation. This paper is to introduce the protocol design and to report the psychometric properties of the Chinese NINDS-CSN VCI protocols. Fifty patients with mild stroke (mean National Institute of Health Stroke Scale 2.2 (SD=3.2)) and 50 controls were recruited. The NINDS-CSN VCI protocols were adapted into Chinese. We assessed protocols' (1) external validity, defined by how well the protocol summary scores differentiated patients from controls using receiver operating characteristics (ROC) curve analysis; (2) concurrent validity, by correlations with functional measures including Stroke Impact Scale memory score and Chinese Disability Assessment for Dementia; (3) internal consistency; and (4) ease of administration. All three protocols differentiated patients from controls (area under ROC for the three protocols between 0.77 to 0.79, p<0.001), and significantly correlated with the functional measures (Pearson r ranged from 0.37 to 0.51). A cut-off of 19/20 on MMSE identified only one-tenth of patients classified as impaired on the 5-min protocol. Cronbach's α across the four cognitive domains of the 60-min protocol was 0.78 for all subjects and 0.76 for stroke patients. The Chinese NINDS-CSN VCI protocols are valid and reliable for cognitive assessment in Chinese patients with mild stroke.

Does an oral care protocol reduce VAP in patients with a tracheostomy?

PubMed

Conley, Patricia; McKinsey, David; Graff, Jason; Ramsey, Anthony R

2013-07-01

Several studies have demonstrated that oral care with chlorhexidine gluconate (CHG) 0.12% solution reduces the incidence of ventilator-associated pneumonia (VAP) in mechanically ventilated patients with endotracheal tubes in the ICU. Minimal evidence shows the effectiveness of any oral care protocols in preventing VAP in mechanically ventilated patients with tracheostomies in a step-down or progressive care unit (PCU). To determine the effectiveness of an oral care protocol in reducing the VAP rate in mechanically ventilated patients with tracheostomies in the PCU. A 12-month prospective study was conducted on 75 mechanically ventilated patients who had tracheostomies. The oral care protocol consisted of tooth brushing with toothpaste and applying CHG 0.12% solution every 12 hours. At the conclusion of the study, the VAP rate in the study population was compared with the National Health and Safety Network (NHSN) report for 2009 benchmark of 1.5 per 1,000 ventilator days. After the oral care protocol was implemented in the PCU, the VAP rate was 1.1 per 1,000 ventilator days over 12 months, compared with the NHSN report for 2009 of 1.5 per 1,000 ventilator days. Tooth brushing with toothpaste and applying CHG 0.12% solution may be an effective oral care protocol to reduce the VAP rate in patients in PCUs with tracheostomies who are being mechanically ventilated.

A Feasibility Study on the Application of the ScriptGenE Framework as an Anomaly Detection System in Industrial Control Systems

DTIC Science & Technology

2015-09-17

network intrusion detection systems NIST National Institute of Standards and Technology p-tree protocol tree PI protocol informatics PLC programmable logic...electrical, water, oil , natural gas, manufacturing, and pharmaceutical industries, to name a few. The differences between SCADA and DCS systems are often... Oil Company, also known as Saudi Aramco, suffered huge data loss that resulted in the disruption of daily operations for nearly two weeks [BTR13]. As it

Outcomes of Patients With Revised Stage I Clear Cell Sarcoma of Kidney Treated in National Wilms Tumor Studies 1-5

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

Kalapurakal, John A., E-mail: j-kalapurakal@northwestern.edu; Perlman, Elizabeth J.; Seibel, Nita L.

Purpose: To report the clinical outcomes of children with revised stage I clear cell sarcoma of the kidney (CCSK) using the National Wilms Tumor Study Group (NWTS)-5 staging criteria after multimodality treatment on NWTS 1-5 protocols. Methods and Materials: All CCSK patients enrolled in the National Wilms Tumor Study Group protocols had their pathology slides reviewed, and only those determined to have revised stage I tumors according to the NWTS-5 staging criteria were included in the present analysis. All patients were treated with multimodality therapy according to the NWTS 1-5 protocols. Results: A total of 53 children were identified asmore » having stage I CCSK. All patients underwent primary surgery with radical nephrectomy. The chemotherapy regimens used were as follows: regimen A, C, F, or EE in 4 children (8%); regimen DD or DD4A in 33 children (62%); regimen J in 4 children (8%); and regimen I in 12 children (22%). Forty-six patients (87%) received flank radiation therapy (RT). Seven children (13%) did not receive flank RT. The median delay between surgery and the initiation of RT was 9 days (range, 3-61). The median RT dose was 10.8 Gy (range, 10-36). The flank RT doses were as follows: 10.5 or 10.8 Gy in 25 patients (47%), 11-19.9 Gy in 2 patients (4%), 20-29.9 Gy in 9 patients (17%), and 30-40 Gy in 10 patients (19%). The median follow-up for the entire group was 17 years (range, 2-36). The relapse-free and cancer-specific survival rate was 100% at the last follow-up examination. Conclusions: The present results have demonstrated that children with revised stage I CCSK using the NWTS-5 staging criteria have excellent survival rates despite the use of varying RT doses and chemotherapy regimens in the NWTS 1-5 protocols.« less

"We need a mechanism to report abuses of women's human rights".

PubMed

Facio, A

1996-01-01

This article discusses the Optional Protocol of the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). This convention is the only instrument protecting the human rights of women at the international level. However, even if the convention was the best possible women's human rights documentation, there was no mechanism for reporting the abuses. The women's movement has long been pressing for the approval of the mechanism like the Optional Protocol, because they believe that the Protocol would fulfill the need in allowing the individual and collective accusations of human rights abuses. It means that a woman or a group of women can go to the committee and denounce an action as discriminatory. The committee can only receive reports and make recommendations, whereas having a Protocol would allow the committee to direct complaints, be able to investigate them, and make more specific recommendations. Those countries ratifying the CEDAW don't automatically agree to the Protocol, thus it is the country's discretion to either comply with the Protocol or not. There are also those who are against the Protocol and claim ironically that an Optional Protocol for Political and Civil rights already exists. But such mechanisms do not work for women's rights. What is most needed now is to lobby all national delegations to push the 5th Commission of the United Nations' General Assembly to approve the budget for the protocol.

77 FR 5492 - Magnuson-Stevens Act Provisions; General Provisions for Domestic Fisheries; Application for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

... assess the performance of an approved sampling protocol and to allow for continued sample collection and... developmental sampling protocol. While this application was being reviewed and was available for public comment, the sampling protocol being tested was adopted into the National Shellfish Sanitation Program by the...

32 CFR Appendix A to Part 179 - Tables of the Munitions Response Site Prioritization Protocol

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Tables of the Munitions Response Site... OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE PRIORITIZATION PROTOCOL (MRSPP) Pt. 179, App. A Appendix A to Part 179—Tables of the Munitions Response Site Prioritization Protocol The tables...

32 CFR Appendix A to Part 179 - Tables of the Munitions Response Site Prioritization Protocol

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Tables of the Munitions Response Site... OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE PRIORITIZATION PROTOCOL (MRSPP) Pt. 179, App. A Appendix A to Part 179—Tables of the Munitions Response Site Prioritization Protocol The tables...

32 CFR Appendix A to Part 179 - Tables of the Munitions Response Site Prioritization Protocol

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Tables of the Munitions Response Site... OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE PRIORITIZATION PROTOCOL (MRSPP) Pt. 179, App. A Appendix A to Part 179—Tables of the Munitions Response Site Prioritization Protocol The tables...

32 CFR Appendix A to Part 179 - Tables of the Munitions Response Site Prioritization Protocol

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Tables of the Munitions Response Site... OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE PRIORITIZATION PROTOCOL (MRSPP) Pt. 179, App. A Appendix A to Part 179—Tables of the Munitions Response Site Prioritization Protocol The tables...

32 CFR Appendix A to Part 179 - Tables of the Munitions Response Site Prioritization Protocol

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Tables of the Munitions Response Site... OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE PRIORITIZATION PROTOCOL (MRSPP) Pt. 179, App. A Appendix A to Part 179—Tables of the Munitions Response Site Prioritization Protocol The tables...

National Intelligence: A Consumer’s Guide

DTIC Science & Technology

2009-01-01

execution of that budget. The National Intelligence Program (NIP), formerly known as the National Foreign Intelligence Program ( NFIP ), provides the...Clandestine Service NCTC: National Counterterrorism Center NDIC: National Defense Intelligence College (DIA – formerly JMIC) NFIP : National Foreign...Center (ODNI) NIE: National Intelligence Estimate NIP: National Intelligence Program (formerly NFIP ) NIPRNet: Non-Secure Internet Protocol Router

Introduction of the second-generation direct-acting antivirals (DAAs) in chronic hepatitis C: a register-based study in Sweden.

PubMed

Frisk, P; Aggefors, K; Cars, T; Feltelius, N; Loov, S A; Wettermark, B; Weiland, O

2018-07-01

Introduction of the direct-acting antivirals (DAAs) for treatment of chronic hepatitis C (CHC) infection has been challenging in all health systems. In Sweden, a national protocol for managed introduction was developed. It was optional, but all county councils agreed to implement and follow it. The purpose of this study was to study (a) cure rates among all patients initiated on treatment in 2014-2015, (b) prescribers' adherence to the drug recommendations and treatment eligibility criteria in the protocol, and (c) introduction rate in the six Swedish healthcare regions. A cross-sectional study where national data from the Prescribed Drug Register and the quality register InfCare Hepatitis defined the study population, and clinical data from the Patient Register and InfCare Hepatitis were used to monitor outcomes. Descriptive statistics were used. A total of 3447 patients were initiated on treatment during 2014-2015. The overall cure rate, based on data from 85% of the cohort, was 96%, with variation between genotypes. Adherence to drug recommendations increased over time and varied between 43.2 and 94.2%. Adherence to the treatment eligibility criteria was initially 80% and increased to 87% when treatment restrictions were widened. The introduction rate differed initially between the regions and reached stable levels 15-18 months after the launch of the first DAA. The estimated overall cure rate was 96%, with some variations between genotypes. A high level of adherence to the introduction protocol as well as similar introduction rates in the health care regions indicate that the introduction protocol, alongside with other measures taken, contributed considerably to a rapid uptake and equal distribution of DAAs in Sweden.

From Fob to Noc: A Pathway to a Cyber Career for Combat Veterans

DTIC Science & Technology

2014-06-01

Assurance Certifications GS general schedule HSAC Homeland Security Advisory Council IDS intrusion detection system IP internet protocol IPS...NIPRNET non-secure internet protocol router network NIST National Institute for Standards and Technology NOC network operations center NSA National...twice a day on an irregular schedule or during contact with the enemy to keep any observing enemy wary of the force protection 13 condition at any

A Research Communication Brief: Gluten Analysis in Beef Samples Collected Using a Rigorous, Nationally Representative Sampling Protocol Confirms That Grain-Finished Beef Is Naturally Gluten-Free.

PubMed

McNeill, Shalene H; Cifelli, Amy M; Roseland, Janet M; Belk, Keith E; Woerner, Dale R; Gehring, Kerri B; Savell, Jeffrey W; Brooks, J Chance; Thompson, Leslie D

2017-08-25

Knowing whether or not a food contains gluten is vital for the growing number of individuals with celiac disease and non-celiac gluten sensitivity. Questions have recently been raised about whether beef from conventionally-raised, grain-finished cattle may contain gluten. To date, basic principles of ruminant digestion have been cited in support of the prevailing expert opinion that beef is inherently gluten-free. For this study, gluten analysis was conducted in beef samples collected using a rigorous nationally representative sampling protocol to determine whether gluten was present. The findings of our research uphold the understanding of the principles of gluten digestion in beef cattle and corroborate recommendations that recognize beef as a naturally gluten-free food.

Enhanced recovery from surgery in the UK: an audit of the enhanced recovery partnership programme 2009-2012.

PubMed

Simpson, J C; Moonesinghe, S R; Grocott, M P W; Kuper, M; McMeeking, A; Oliver, C M; Galsworthy, M J; Mythen, M G

2015-10-01

The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data. The data regarding length of stay and compliance with each element of Enhanced Recovery protocols for colorectal, orthopaedic, urological and gynaecological surgery patients were analysed. The relationship between Enhanced Recovery protocol compliance and length of stay was measured. From 16 267 patients from 61 hospital trusts, three out of four surgical specialties showed Enhanced Recovery, compliance being weakly associated with shorter length of stay (correlation coefficients -0.18, -0.14, -0.25 in colorectal, orthopaedics and gynaecology respectively). At a cut-off of 80% compliance, good compliance was associated with two, one and three day reductions in median length of stay respectively in colorectal, orthopaedic and urological surgeries, with no saving in gynaecology. This study is the largest assessment of the relationship between Enhanced Recovery protocol compliance and outcome in four surgical specialties. The data suggest that higher compliance with an Enhanced Recovery protocol has a weak association with shorter length of stay. This suggests that changes in process, resulting from highly protocolised pathways, may be as important in reducing perioperative length of stay as any individual element of Enhanced Recovery protocols in isolation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cross-sectional study on awareness and knowledge of torture investigation and documentation among Greek doctors and senior medical students.

PubMed

Orfanou, Christina; Tsiamis, Costas; Karamagioli, Evika; Pikouli, Anastasia; Terzidis, Agis; Pikoulis, Emmanuel

2018-06-05

Doctors in Greece face the possibility of encountering a person that has suffered torture, especially since the high rates of refugees' and migrants' inflows that took place over the last years. In order to assess the awareness and the knowledge of doctors and senior medical students in Greece regarding a manual on effective investigation and documentation of torture such as Istanbul Protocol (official United Nation document since 1999), a cross-sectional study was conducted using a structured anonymous questionnaire. The sample was doctors practicing in public hospitals in Greece, doctors volunteering at a non-governmental organization (NGO) and undergraduate medical students in their final year of studies in the Medical School of National and Kapodistrian University of Athens. The data were analyzed using IBM SPSS version 23, using descriptive statistics and statistical significance tests.In a total of 289 participants, the mean total score of Istanbul Protocol knowledge was 4.43 ± 1.104 (the maximum possible score was 10) and the mean total score of Istanbul Protocol awareness was 2.04 ± 1.521 (the maximum possible score was 10). The most important conclusion was that among doctors and senior medical students, there seem to be knowledge, awareness, and information deficit about Istanbul Protocol and several issues relating to torture. The overall research outcome highlights the need for the development of a relevant informative/educational program, in order to cover the corresponding existing needs of the population of doctors in Greece.

[Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer].

PubMed

2018-04-01

Colorectal cancer is one of the most common malignant tumors in China. In 2012 one million thirty six thousand cases of colorectal cancer were diagnosed all over the world, two hundred fifty three thousand cases were diagnosed in China (accounted for 18.6%). China has the largest number of new cases of colorectal cancer in the world. Colorectal cancer has becoming a serious threat of Chinese residents' health. In 2010, the National Ministry of Health organized colorectal cancer expertise of the Chinese Medical Association to write the "Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer" (2010edition), and publish it publicly. In recent years, the National Health and Family Planning Commission has organized experts to revised the protocol 2 times: the first time in 2015, the second time in 2017. The revised part of "Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer" (2017 edition) involves new progress in the field of imaging examination, pathological evaluation, surgery, chemotherpy and radiotherapy. The 2017 edition of the protocol not only referred to the contents of the international guidelines, but also combined with the specific national conditions and clinical practice in China, and also included many evidence-based clinical data in China recently. The 2017 edition of the protocol would further promote the standardization of diagnosis and treatment of colorectal cancer in China, improve the survival and prognosis of patients, and benefit millions of patients with colorectal cancer and their families.

Minimizing variance in Care of Pediatric Blunt Solid Organ Injury through Utilization of a hemodynamic-driven protocol: a multi-institution study.

PubMed

Cunningham, Aaron J; Lofberg, Katrine M; Krishnaswami, Sanjay; Butler, Marilyn W; Azarow, Kenneth S; Hamilton, Nicholas A; Fialkowski, Elizabeth A; Bilyeu, Pamela; Ohm, Erika; Burns, Erin C; Hendrickson, Margo; Krishnan, Preetha; Gingalewski, Cynthia; Jafri, Mubeen A

2017-12-01

An expedited recovery protocol for management of pediatric blunt solid organ injury (spleen, liver, and kidney) was instituted across two Level 1 Trauma Centers, managed by nine pediatric surgeons within three hospital systems. Data were collected for 18months on consecutive patients after protocol implementation. Patient demographics (including grade of injury), surgeon compliance, National Surgical Quality Improvement Program (NSQIP) complications, direct hospital cost, length of stay, time in the ICU, phlebotomy, and re-admission were compared to an 18-month control period immediately preceding study initiation. A total of 106 patients were treated (control=55, protocol=51). Demographics were similar among groups, and compliance was 78%. Hospital stay (4.6 vs. 3.5days, p=0.04), ICU stay (1.9 vs. 1.0days, p=0.02), and total phlebotomy (7.7 vs. 5.3 draws, p=0.007) were significantly less in the protocol group. A decrease in direct hospital costs was also observed ($11,965 vs. $8795, p=0.09). Complication rates (1.8% vs. 3.9%, p=0.86, no deaths) were similar. An expedited, hemodynamic-driven, pediatric solid organ injury protocol is achievable across hospital systems and surgeons. Through implementation we maintained quality while impacting length of stay, ICU utilization, phlebotomy, and cost. Future protocols should work to further limit resource utilization. Retrospective cohort study. Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

It's Time to Develop a New "Draft Test Protocol" for a Mars Sample Return Mission (or Two…).

PubMed

Rummel, John D; Kminek, Gerhard

2018-04-01

The last time NASA envisioned a sample return mission from Mars, the development of a protocol to support the analysis of the samples in a containment facility resulted in a "Draft Test Protocol" that outlined required preparations "for the safe receiving, handling, testing, distributing, and archiving of martian materials here on Earth" (Rummel et al., 2002 ). This document comprised a specific protocol to be used to conduct a biohazard test for a returned martian sample, following the recommendations of the Space Studies Board of the US National Academy of Sciences. Given the planned launch of a sample-collecting and sample-caching rover (Mars 2020) in 2 years' time, and with a sample return planned for the end of the next decade, it is time to revisit the Draft Test Protocol to develop a sample analysis and biohazard test plan to meet the needs of these future missions. Key Words: Biohazard detection-Mars sample analysis-Sample receiving facility-Protocol-New analytical techniques-Robotic sample handling. Astrobiology 18, 377-380.

Development of Uniform Protocol for Alopecia Areata Clinical Trials.

PubMed

Solomon, James A

2015-11-01

Developing a successful treatment for alopecia areata (AA), clearly has not been at the forefront of the agenda for new drug/device development among the pharmaceutical and medical device industry. The National Alopecia Areata Foundation (NAAF), a patient advocacy group, initiated a plan to facilitate and drive clinical research toward finding safe and efficacious treatments for AA. As such, Alopecia Areata Uniform Protocols for clinical trials to test new treatments for AA were developed. The design of the uniform protocol is to accomplish the development of a plug-and-play template as well as to provide a framework wherein data from studies utilizing the uniform protocol can be compared through consistency of inclusions/exclusions, safety, and outcome assessment measures. A core uniform protocol for use by pharmaceutical companies in testing proof of concept for investigational products to treat AA. The core protocol includes standardized title, informed consent, inclusion/exclusion criteria, disease outcome assessments, and safety assessments. The statistical methodology to assess successful outcomes will also be standardized. The protocol as well as the informed consent form has been approved in concept by Liberty IRB and is ready to present to pharmaceutical companies.

U.S. Additional Protocol Outreach Program-Tabletop Exercises to Implement the AP.

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

Langner, D. C.; Thomas, K. E.; Smith, M. K.

2005-01-01

The Office of International Regimes and Agreement (NA-243) is the lead office in the Department of Energy (DOE) to assist DOE and National Nuclear Security Administration (NNSA) sites in the preparation of providing declarations on relevant civilian, nuclear fuel cycle-related research and development activities to the International Atomic Energy Agency (IAEA). This is in accordance to the implementation of the ''Protocol Additional to the AGreement between the United STates and the International Atomic Energy Agency for the Applications of Safeguards in the United States. In preparation for entry-into-force, NA-243 conducted two tabletop exercises under the Additional Protocol Outreach Program. Themore » first one, held in May 2004 at Los Alamos National Laboratory, focused on the factors important to protect national security assets and intellectual property. The other, held in August 2004 at the Idaho National Laboratory explored the level of detail or granularity for reporting declarable activities. Both tabletops invited participants from the national laboratories and DOE/NNSA organizations. Discussions were based around the process to identify potential declarable activities relating to the nuclear fuel cycle-related R and D projects from the Advanced Fuel Cycle Initiative program. The two tabletop exercises provided recommendations and conclusions that would be helpful to other DOE/NNSA locations for preparing for and reporting relevant and concise information to the IAEA under the Additional Protocol. This paper provides details on the events, discussions, observations, and lessons learned from both the LANL and INL tabletop exercises.« less

Estuarine water quality in parks of the Northeast Coastal and Barrier Network: Development and early implementation of vital signs estuarine nutrient-enrichment monitoring, 2003-06

USGS Publications Warehouse

Kopp, Blaine S.; Nielsen, Martha; Glisic, Dejan; Neckles, Hilary A.

2009-01-01

This report documents results of pilot tests of a protocol for monitoring estuarine nutrient enrichment for the Vital Signs Monitoring Program of the National Park Service Northeast Coastal and Barrier Network. Data collected from four parks during protocol development in 2003-06 are presented: Gateway National Recreation Area, Colonial National Historic Park, Fire Island National Seashore, and Assateague Island National Seashore. The monitoring approach incorporates several spatial and temporal designs to address questions at a hierarchy of scales. Indicators of estuarine response to nutrient enrichment were sampled using a probability design within park estuaries during a late-summer index period. Monitoring variables consisted of dissolved-oxygen concentration, chlorophyll a concentration, water temperature, salinity, attenuation of downwelling photosynthetically available radiation (PAR), and turbidity. The statistical sampling design allowed the condition of unsampled locations to be inferred from the distribution of data from a set of randomly positioned "probability" stations. A subset of sampling stations was sampled repeatedly during the index period, and stations were not rerandomized in subsequent years. These "trend stations" allowed us to examine temporal variability within the index period, and to improve the sensitivity of the monitoring protocol to detecting change through time. Additionally, one index site in each park was equipped for continuous monitoring throughout the index period. Thus, the protocol includes elements of probabilistic and targeted spatial sampling, and the temporal intensity ranges from snapshot assessments to continuous monitoring.

PILOT STUDY PROTOCOL: APPLICATION OF MEASURES OF SPONTANEOUS MOTOR ACTIVITY FOR BEHAVORIAL ASSESSMENT IN HUMAN INFANTS

EPA Science Inventory

As a participant in planning the National Childrens Study (NCS), EPA is interested in the investigation of key developmental disorders that may be associated with environmental exposures. This is particularly important in light of research that has established that prenatal and e...

New Regional and Global HFC Projections and Effects of National Regulations and Montreal Protocol Amendment Proposals

NASA Astrophysics Data System (ADS)

Velders, G. J. M.

2015-12-01

Hydrofluorocarbons (HFCs) are used as substitutes for ozone-depleting substances that are being phased out globally under Montreal Protocol regulations. New global scenarios of HFC emissions reach 4.0-5.3 GtCO2-eq yr-1 in 2050, which corresponds to a projected growth from 2015 to 2050 which is 9% to 29% of that for CO2 over the same time period. New baseline scenarios are formulated for 10 HFC compounds, 11 geographic regions, and 13 use categories. These projections are the first to comprehensively assess production and consumption of individual HFCs in multiple use sectors and geographic regions with emission estimates constrained by atmospheric observations. In 2050, in percent of global HFC emissions, China (~30%), India and the rest of Asia (~25%), Middle East and northern Africa (~10%), and USA (~10%) are the principal source regions; and refrigeration and stationary air conditioning are the major use sectors. National regulations to limit HFC use have been adopted recently in the European Union, Japan and USA, and four proposals have been submitted in 2015 to amend the Montreal Protocol to substantially reduce growth in HFC use. Calculated baseline emissions are reduced by 90% in 2050 by implementing the North America Montreal Protocol amendment proposal. Global adoption of technologies required to meet national regulations would be sufficient to reduce 2050 baseline HFC consumption by more than 50% of that achieved with the North America proposal for most developed and developing countries. The new HFC scenarios and effects of national regulations and Montreal Protocol amendment proposals will be presented.

Physician Assistant/Sr. Nurse Practitioner | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases. CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. The Clinical Monitoring Research Program (CMRP) provides quality Physician Assistant and/or Nurse Practitioner clinical research services in support of the Urologic Oncology Branch (UOB), National Cancer Institute’s (NCI’s), Center for Cancer Research (CCR). KEY ROLES/RESPONSIBILITIES - THIS POSITION IS CONTINGENT UPON FUNDING APPROVAL The Physician Extender: Provides clinical care in collaboration with physicians and health care professionals. Performs a comprehensive physical assessment and documents findings in the appropriate format following institutional and protocol standards. Assesses the patient's general health status through observation and the use of appropriate screening procedures. Acquires patient data through health history taking that includes family history and significant social information. Explains the care management/discharge plan to all members of the covering team (inpatient NPs, attendings) at sign-out. Provides teaching and guidance related to the patient's current state of health and understanding of his/her disease to promote optimal performance. Coordinates study enrollment, collaborates with nursing staff to provide protocol treatment, and provides follow-up care for patients participating in clinical trials. Assists the Principal Investigator (PI) in assuring informed consent forms have been signed, obtaining written consent for treatment, pharmacokinetics, and assessing patients on the study for complications. Calculates the dose of and prescribes chemotherapy, investigational agents, medications, intravenous fluids and blood products according to established protocol, institutional, and practice guidelines. Provides guidance in the management of specific problems for the patient resulting from chemotherapy, immunotherapy or other treatments. Manages appropriate referrals to other specialists as indicated. Screens new patient calls and provides phone triage for active patients. Orders radiological studies, following protocols and patient care guidelines. Orders and interprets lab studies. Attends new patient consultations with the patient and family for the purpose of explaining the diagnosis, protocol, and treatment program, and establishing a rapport. Completes initial and follow-up assessment(s), progress notes and written correspondence to multidisciplinary personnel. Serves as a clinical liaison to area hospices and/or home care agencies as needed or as appropriate. Acts as a clinical liaison between inpatient and outpatient nurses in order to provide continuity of care to the hospitalized patient. Maintains documented evidence of weekly case review with the collaborating physician. Attends and participates in multidisciplinary meetings. Practices within boundaries established by the Nurse Practice Act, State of Maryland and Medical Board of the Clinical Center. Liaises with Leidos Biomed and various NCI staff to initiate and complete tasks relating to medicine and clinical protocols, and all activities related to nursing. Performs clinical data recording and medical chart entries. Dictates admission and discharge summaries. This position is located in Bethesda, Maryland.

2009 National Intelligence: A Consumer’s Guide

DTIC Science & Technology

2009-04-01

Program (NIP), formerly known as the National Foreign Intelligence Program ( NFIP ), provides the resources needed to develop and maintain...Clandestine Service NCTC: National Counterterrorism Center NDIC: National Defense Intelligence College (DIA – formerly JMIC) NFIP : National Foreign...Coordination Center (ODNI) NIE: National Intelligence Estimate NIP: National Intelligence Program (formerly NFIP ) NIPRNet: Non-Secure Internet Protocol Router

A GIS-based protocol for the simulation and evaluation of realistic 3-D thinning scenarios in recreational forest management.

PubMed

Lin, Chinsu; Thomson, Gavin; Hung, Shih-Hsiang; Lin, Yu-Dung

2012-12-30

This study introduces a GIS-based protocol for the simulation and evaluation of thinning treatments in recreational forest management. The protocol was implemented in a research study based on an area of recreational forest in Alishan National Scenic Area, Taiwan. Ground survey data were mapped to a GIS database, to create a precise, yet flexible, GIS-based digital forest. The digital forest model was used to generate 18 different thinning scenario images and one image of the existing unthinned forest. A questionnaire was completed by 456 participants while simultaneously viewing the scenario images. The questionnaire was used to determine the scenic beauty preferences of the respondents. Statistical analysis of the data revealed that the respondents preferred low density, upper-storey thinning treatments and a dispersed retention pattern of the remaining trees. High density upper-storey treatments evoked a strongly negative reaction in the observers. The experiment demonstrated that the proposed protocol is suitable for selecting an appropriate thinning strategy for recreational forest and that the protocol has practical value in recreational forest management. Copyright © 2012 Elsevier Ltd. All rights reserved.

National and sub-national trend and burden of injuries in Iran, 1990 - 2013: a study protocol.

PubMed

Jamshidbeygi, Esmat; Rastad, Hadith; Qorbani, Mostafa; Saadat, Soheil; Sepidarkish, Mehdi; Asayesh, Hamid; Sepanlou, Sadaf Ghajarieh; Shokraneh, Farhad; Najafi, Fereshteh; Khoramdad, Malihe; Maghsodi, Ahmad; Farzadfar, Farahnaz; Jamshidi, Hamid Reza; Moradi-Lakeh, Maziar; Farzadfar, Farshad

2014-03-01

Worldwide, injuries are a major public health concern and make a considerable contribution to the disease burden. The present study is a component of the National and Subnational Burden of Diseases, Injuries, and Risk Factors from 1990 to 2013 (NASBOD) study in Iran, which was designed to investigate the burden of most important injuries (road traffic injuries, falls, burns, poisonings and drownings) at the national and sub-national levels in Iran. In this paper we explain definitions, organization, injuries selection process, data sources, data gathering methods, and data analyses of the national and sub-national burden of injuries study in Iran. The burden of most important injuries in current metric of DALYs at the national and sub-national levels in Iran over 1990-2013 will be estimated through comprehensive reviews of either published or national data sources. Statistical modeling will be used to impute the missing data on the burden of selected important injuries for each district-year. The results of present study can help health policy makers to plan more comprehensive and cost-effective strategies at national and sub-national level for prevention and control of burden caused by injuries.

40 CFR 82.18 - Availability of production in addition to baseline production allowances for class II controlled...

Code of Federal Regulations, 2011 CFR

2011-07-01

... quantity of production that the nation is permitted under the Montreal Protocol or to receive from the... Article 5 allowances, for a specified control period through trades with another Party to the Protocol as... this subpart that is also listed in Appendix C, Annex 1 of the Protocol as having ratified the Beijing...

40 CFR 82.18 - Availability of production in addition to baseline production allowances for class II controlled...

Code of Federal Regulations, 2012 CFR

2012-07-01

... quantity of production that the nation is permitted under the Montreal Protocol or to receive from the... Article 5 allowances, for a specified control period through trades with another Party to the Protocol as... this subpart that is also listed in Appendix C, Annex 1 of the Protocol as having ratified the Beijing...

40 CFR 82.10 - Availability of consumption allowances in addition to baseline consumption allowances for class I...

Code of Federal Regulations, 2010 CFR

2010-07-01

... this subpart (Parties to the Montreal Protocol) must agree to transfer to the person for the current control period some amount of production that the nation is permitted under the Montreal Protocol. If the... Protocol for class I, Group I through Group V and Group VII controlled substances until January 1, 1996 and...

40 CFR 82.10 - Availability of consumption allowances in addition to baseline consumption allowances for class I...

Code of Federal Regulations, 2011 CFR

2011-07-01

... this subpart (Parties to the Montreal Protocol) must agree to transfer to the person for the current control period some amount of production that the nation is permitted under the Montreal Protocol. If the... Protocol for class I, Group I through Group V and Group VII controlled substances until January 1, 1996 and...

40 CFR 82.18 - Availability of production in addition to baseline production allowances for class II controlled...

Code of Federal Regulations, 2013 CFR

2013-07-01

... quantity of production that the nation is permitted under the Montreal Protocol or to receive from the... Article 5 allowances, for a specified control period through trades with another Party to the Protocol as... this subpart that is also listed in Appendix C, Annex 1 of the Protocol as having ratified the Beijing...

40 CFR 82.10 - Availability of consumption allowances in addition to baseline consumption allowances for class I...

Code of Federal Regulations, 2014 CFR

2014-07-01

... this subpart (Parties to the Montreal Protocol) must agree to transfer to the person for the current control period some amount of production that the nation is permitted under the Montreal Protocol. If the... Protocol for class I, Group I through Group V and Group VII controlled substances until January 1, 1996 and...

40 CFR 82.10 - Availability of consumption allowances in addition to baseline consumption allowances for class I...

Code of Federal Regulations, 2013 CFR

2013-07-01

... this subpart (Parties to the Montreal Protocol) must agree to transfer to the person for the current control period some amount of production that the nation is permitted under the Montreal Protocol. If the... Protocol for class I, Group I through Group V and Group VII controlled substances until January 1, 1996 and...

40 CFR 82.18 - Availability of production in addition to baseline production allowances for class II controlled...

Code of Federal Regulations, 2010 CFR

2010-07-01

... quantity of production that the nation is permitted under the Montreal Protocol or to receive from the... Article 5 allowances, for a specified control period through trades with another Party to the Protocol as... this subpart that is also listed in Appendix C, Annex 1 of the Protocol as having ratified the Beijing...

40 CFR 82.10 - Availability of consumption allowances in addition to baseline consumption allowances for class I...

Code of Federal Regulations, 2012 CFR

2012-07-01

... this subpart (Parties to the Montreal Protocol) must agree to transfer to the person for the current control period some amount of production that the nation is permitted under the Montreal Protocol. If the... Protocol for class I, Group I through Group V and Group VII controlled substances until January 1, 1996 and...

Experience of implementing a National pre-hospital Code Red bleeding protocol in Scotland.

PubMed

Reed, Matthew J; Glover, Alison; Byrne, Lauren; Donald, Michael; McMahon, Niall; Hughes, Neil; Littlewood, Nicola K; Garrett, Justin; Innes, Catherine; McGarvey, Margaret; Hazra, Eleanor; Rawlinson, P Sam M

2017-01-01

The Scottish Transfusion and Laboratory Support in Trauma Group (TLSTG) have introduced a unified National pre-hospital Code Red protocol. This paper reports the results of a study aiming to establish whether current pre-hospital Code Red activation criteria for trauma patients successfully predict need for in hospital transfusion or haemorrhagic death, the current admission coagulation profile and Concentrated Red Cell (CRC): Fresh Frozen Plasma (FFP) ratio being used, and whether use of the protocol leads to increased blood component discards? Prospective cohort study. Clinical and transfusion leads for each of Scotland's pre-hospital services and their receiving hospitals agreed to enter data into the study for all trauma patients for whom a pre-hospital Code Red was activated. Outcome data collected included survival 24h after Code Red activation, survival to hospital discharge, death in the Emergency Department and death in hospital. Between June 1st 2013 and October 31st 2015 there were 53 pre-hospital Code Red activations. Median Injury Severity Score (ISS) was 24 (IQR 14-37) and mortality 38%. 16 patients received pre-hospital blood. The pre-hospital Code Red protocol was sensitive for predicting transfusion or haemorrhagic death (89%). Sensitivity, specificity, positive and negative predictive values of the pre-hospital SBP <90mmHg component were 63%, 33%, 86% and 12%. 19% had an admission prothrombin time >14s and 27% had a fibrinogen <1.5g/L. CRC: FFP ratios did not drop to below 2:1 until 150min after arrival in the ED. 16 red cell units, 33 FFP and 6 platelets were discarded. This was not significantly increased compared to historical data. A National pre-hospital Code Red protocol is sensitive for predicting transfusion requirement in bleeding trauma patients and does not lead to increased blood component discards. A significant number of patients are coagulopathic and there is a need to improve CRC: FFP ratios and time to transfusion support especially FFP provision. Training clinicians to activate pre-hospital Code Red earlier during the pre-hospital phase may give blood bank more time to thaw and prepare FFP and may improve FFP administration times and ratios so long as components are used upon their availability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Investigating the level of agreement of two positioning protocols when using dual energy X-ray absorptiometry in the assessment of body composition.

PubMed

Shiel, Flinn; Persson, Carl; Simas, Vini; Furness, James; Climstein, Mike; Schram, Ben

2017-01-01

Dual energy X-ray absorptiometry (DXA) is a commonly used instrument for analysing segmental body composition (BC). The information from the scan guides the clinician in the treatment of conditions such as obesity and can be used to monitor recovery of lean mass following injury. Two commonly used DXA positioning protocols have been identified-the Nana positioning protocol and the National Health and Nutrition Examination Survey (NHANES). Both protocols have been shown to be reliable. However, only one study has assessed the level of agreement between the protocols and ascertained the participants' preference of protocol based upon comfort. Given the paucity of research in the field and the growing use of DXA in both healthy and pathological populations further research determining the most appropriate positioning protocol is warranted. Therefore, the aims of this study were to assess the level of agreement between results from the NHANES protocol and Nana protocol, and the participants' preference of protocol based on comfort. Thirty healthy participants (15 males, 15 females, aged 23-59 years) volunteered to participate in this study. These participants underwent two whole body DXA scans in a single morning (Nana positioning protocol and NHANES positioning protocol), in a randomised order. Each participant attended for scanning wearing minimal clothing and having fasted overnight, refrained from exercise in the past 24 h and voided their bladders. Level of agreement, comparing NAHNES to Nana protocol was assessed using an intra-class correlation coefficient (ICC), concordance correlation coefficient (CCC) and percentage change in mean. Limit of agreement comparing the two protocols were assessed using plots, mean difference and confidence limits. Participants were asked to indicate the protocol they found most comfortable. When assessing level of agreement between protocols both the ICC and CCC scores were very high and ranged from 0.987 to 0.997 for whole body composition, indicating excellent agreement between the Nana and NHANES protocols. Regional analysis (arms, legs, trunk) ICC scores, ranged between 0.966 and 0.996, CCC ranged between 0.964 and 0.997, change in mean percentage ranged between -0.58% and 0.37% which indicated a very high level of agreement. Limit of agreement analysis using mean difference ranged between -0.223 and 0.686 kg and 95% CL produced results ranging between -1.262 kg and 1.630 kg. The majority (80%) of participants found the NHANES positioning protocol more comfortable. This study reveals a strong level of agreement as illustrated by high ICC's and CCC's between the positioning protocols, however systematic bias within limit of agreement plot and a large difference in 95% confidence limits indicates that the protocols should not be interchanged when assessing an individual. The NHANES protocol affords greater participant comfort.

Transitions of care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK Study): a study of protocols in Greater London.

PubMed

Singh, Swaran P; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim

2008-06-23

Although young people's transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. A questionnaire survey (Jan-April 2005) of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Forty two of the 65 teams contacted (65%) responded to the survey. Teams varied in type (generic/targeted/in-patient), catchment area (locality-based, wider or national) and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0-70, SD 14.5, n = 37) was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0-50, SD 9.5, n = 33). In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in protocol-sharing organisational units and transition process suggest that practice may vary. There is discontinuity of care provision for some patients who 'graduate' from CAMHS services but are not accepted by adult services.

Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK Study): A study of protocols in Greater London

PubMed Central

Singh, Swaran P; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim

2008-01-01

Background Although young people's transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods A questionnaire survey (Jan-April 2005) of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results Forty two of the 65 teams contacted (65%) responded to the survey. Teams varied in type (generic/targeted/in-patient), catchment area (locality-based, wider or national) and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37) was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33). In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in protocol-sharing organisational units and transition process suggest that practice may vary. There is discontinuity of care provision for some patients who 'graduate' from CAMHS services but are not accepted by adult services. PMID:18573214

A Research Communication Brief: Gluten Analysis in Beef Samples Collected Using a Rigorous, Nationally Representative Sampling Protocol Confirms That Grain-Finished Beef Is Naturally Gluten-Free

PubMed Central

McNeill, Shalene H.; Cifelli, Amy M.; Roseland, Janet M.; Belk, Keith E.; Gehring, Kerri B.; Brooks, J. Chance; Thompson, Leslie D.

2017-01-01

Knowing whether or not a food contains gluten is vital for the growing number of individuals with celiac disease and non-celiac gluten sensitivity. Questions have recently been raised about whether beef from conventionally-raised, grain-finished cattle may contain gluten. To date, basic principles of ruminant digestion have been cited in support of the prevailing expert opinion that beef is inherently gluten-free. For this study, gluten analysis was conducted in beef samples collected using a rigorous nationally representative sampling protocol to determine whether gluten was present. The findings of our research uphold the understanding of the principles of gluten digestion in beef cattle and corroborate recommendations that recognize beef as a naturally gluten-free food. PMID:28841165

Receptor binding assay for paralytic shellfish poisoning toxins: optimization and interlaboratory comparison.

PubMed

Ruberu, Shryamalie R; Liu, Yun-Gang; Wong, Carolyn T; Perera, S Kusum; Langlois, Gregg W; Doucette, Gregory J; Powell, Christine L

2003-01-01

A receptor binding assay (RBA) for detection of paralytic shellfish poisoning (PSP) toxins was formatted for use in a high throughput detection system using microplate scintillation counting. The RBA technology was transferred from the National Ocean Service, which uses a Wallac TriLux 1450 MicroBeta microplate scintillation counter, to the California Department of Health Services, which uses a Packard TopCount scintillation counter. Due to differences in the detector arrangement between these 2 counters, markedly different counting efficiencies were exhibited, requiring optimization of the RBA protocol for the TopCount instrument. Precision, accuracy, and sensitivity [limit of detection = 0.2 microg saxitoxin (STX) equiv/100 g shellfish tissue] of the modified protocol were equivalent to those of the original protocol. The RBA robustness and adaptability were demonstrated by an interlaboratory study, in which STX concentrations in shellfish generated by the TopCount were consistent with MicroBeta-derived values. Comparison of STX reference standards obtained from the U.S. Food and Drug Administration and the National Research Council, Canada, showed no observable differences. This study confirms the RBA's value as a rapid, high throughput screen prior to testing by the conventional mouse bioassay (MBA) and its suitability for providing an early warning of increasing PSP toxicity when toxin levels are below the MBA limit of detection.

Agreement protocol between the CNES (National French Space Study Center) and the Swedish Space Commission

NASA Technical Reports Server (NTRS)

1979-01-01

The detailed arrangements made between France and Sweden to develop a satellite (and the associated receiving stations) which will perform systematic, repetitive observations of land masses, with the purpose of terrestrial resource exploration are described.

76 FR 66683 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

...: National Oceanic and Atmospheric Administration (NOAA). Title: Protocol for Access to Tissue Specimen Samples from the National Marine Mammal Tissue Bank. OMB Control Number: 0648-0468. Form Number(s): NA..., the National Marine Mammal Tissue Bank (NMMTB) was established by the National Marine Fisheries...

Passenger vehicle driver cell phone use : results from the fall 2000 National Occupant Protection Use Survey

DOT National Transportation Integrated Search

2001-07-01

The National Highway Traffic Safety Administration's National Occupant Protection Use Survey (NOPUS) expanded its data collection protocols during October and November 2000 to obtain national estimates of driver cell phone use. The results of NOPUS f...

Validation of the Australian diagnostic reference levels for paediatric multi detector computed tomography: a comparison of RANZCR QUDI data and subsequent NDRLS data from 2012 to 2015.

PubMed

Anna, Hayton; Wallace, Anthony; Thomas, Peter

2017-03-01

The national diagnostic reference level service (NDRLS), was launched in 2011, however no paediatric data were submitted during the first calendar year of operation. As such, Australian national diagnostic reference levels (DRLs), for paediatric multi detector computed tomography (MDCT), were established using data obtained from a Royal Australian and New Zealand College of Radiologists (RANZCR), Quality Use of Diagnostic Imaging (QUDI), study. Paediatric data were submitted to the NDRLS in 2012 through 2015. An analysis has been made of the NDRLS paediatric data using the same method as was used to analyse the QUDI data to establish the Australian national paediatric DRLs for MDCT. An analysis of the paediatric NDRLS data has also been made using the method used to calculate the Australian national adult DRLs for MDCT. A comparison between the QUDI data and subsequent NDRLS data shows the NDRLS data to be lower on average for the Head and AbdoPelvis protocol and similar for the chest protocol. Using an average of NDRLS data submitted between 2012 and 2015 implications for updated paediatric DRLS are considered.

Acupuncture for patients with Alzheimer's disease: a systematic review protocol

PubMed Central

Zhou, Jing; Peng, Weina; Li, Wang; Liu, Zhishun

2014-01-01

Introduction The aim of this protocol is to provide the methods used to assess the effectiveness and safety of acupuncture for the treatment of patients with Alzheimer's disease. Methods and analysis We will search the following electronic databases: The Cochrane Library, PubMed, Medline, Embase, PsycINFO, Chinese Biomedical Literature Database, Chinese Medical Current Contents and China National Knowledge Infrastructure without restriction of language and publication status. Other sources such as Chinese acupuncture journals and the reference list of selected studies will also be searched. After screening the studies, a meta-analysis of randomised controlled trials will be conducted, if possible. Results expressed as risk ratios for dichotomous data and standardised or weighted mean differences for continuous data, will be used for data synthesis. Dissemination The protocol of this systematic review will be disseminated in a peer-reviewed journal and presented at a relevant conference. Trial registration number PROSPERO CRD42014009619 PMID:25142265

NASA's Plan for SDLS Testing

NASA Technical Reports Server (NTRS)

Bailey, Brandon

2015-01-01

The Space Data Link Security (SDLS) Protocol is a Consultative Committee for Space Data Systems (CCSDS) standard which extends the known Data Link protocols to secure data being sent over a space link by providing confidentiality and integrity services. This plan outlines the approach by National Aeronautics Space Administration (NASA) in performing testing of the SDLS protocol using a prototype based on an existing NASA missions simulator.

77 FR 7577 - Emergency Access Advisory Committee; Announcement of Date of Next Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

... nation's migration to a national Internet protocol-enabled emergency network, also known as the next... individuals with disabilities as part of our nation's migration to the NG 9-1-1 system. The EAAC...

Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey)

PubMed Central

Atijosan, Oluwarantimi; Kuper, Hannah; Rischewski, Dorothea; Simms, Victoria; Lavy, Christopher

2007-01-01

Background Musculoskeletal impairment (MSI) is an important cause of morbidity and mortality worldwide, especially in developing countries. Prevalence studies for MSI in the developing world have used varying methodologies and are seldom directly comparable. This study aimed to develop a new tool to screen for and diagnose MSI and to pilot test the methodology for a national survey in Rwanda. Methods A 7 question screening tool to identify cases of MSI was developed through literature review and discussions with healthcare professionals. To validate the tool, trained rehabilitation technicians screened 93 previously identified gold standard 'cases' and 86 'non cases'. Sensitivity, specificity and positive predictive value were calculated. A standardised examination protocol was developed to determine the aetiology and diagnosis of MSI for those who fail the screening test. For the national survey in Rwanda, multistage cluster random sampling, with probability proportional to size procedures will be used for selection of a cross-sectional, nationally representative sample of the population. Households to be surveyed will be chosen through compact segment sampling and all individuals within chosen households will be screened. A pilot survey of 680 individuals was conducted using the protocol. Results: The screening tool demonstrated 99% sensitivity and 97% specificity for MSI, and a positive predictive value of 98%. During the pilot study 468 out of 680 eligible subjects (69%) were screened. 45 diagnoses were identified in 38 persons who were cases of MSI. The subjects were grouped into categories based on diagnostic subgroups of congenital (1), traumatic (17), infective (2) neurological (6) and other acquired(19). They were also separated into mild (42.1%), moderate (42.1%) and severe (15.8%) cases, using an operational definition derived from the World Health Organisation's International Classification of Functioning, Disability and Health. Conclusion: The screening tool had good sensitivity and specificity and was appropriate for use in a national survey. The pilot study showed that the survey protocol was appropriate for measuring the prevalence of MSI in Rwanda. This survey is an important step to building a sound epidemiological understanding of MSI, to enable appropriate health service planning. PMID:17391509

National trends in pediatric blunt spleen and liver injury management and potential benefits of an abbreviated bed rest protocol.

PubMed

Dodgion, Christopher M; Gosain, Ankush; Rogers, Andrew; St Peter, Shawn D; Nichol, Peter F; Ostlie, Daniel J

2014-06-01

Recent reports suggest that an abbreviated bed rest protocol (ABRP) may safely reduce length of stay (LOS) and resource utilization in pediatric blunt spleen and liver injury (BSLI) patients. This study evaluates national temporal trends in BLSI management and estimates national reduction in LOS using an ABRP. Pediatric patients (<18 years old) sustaining BLSI were identified in the Kids' Inpatient Database from 2000 to 2009. Yearly rates of injury and operative intervention were examined and stratified by type of injury. APSA guidelines and the reported ABRP were applied based on abbreviated injury score (AIS) and compared with actual LOS. 22,153 patients were identified. Over the study period, operative rates for spleen and liver injuries and overall mortality significantly declined: LOS=3.1 days (±1.6) and 2.7 days (±1.9) for spleen and liver, respectively. If APSA guidelines were followed, the rates were LOS=3.7 days (±1.1) and 3.4 days (±0.7), respectively. Application of the ABRP would result in LOS=1.3 days (±0.5) for all BSLI patients. An ABRP could potentially save 1.7 hospital days/patient or 36,964 patient hospital days nationally. Our study confirms a significant national decrease in operative intervention and overall mortality in patients with BSLI. Additionally, it appears that a shorter observation period than the APSA guidelines is being utilized. The implementation of ABRP holds potential in further reducing LOS and resource utilization. Copyright © 2014 Elsevier Inc. All rights reserved.

Estimating dead wood during national forest inventories: a review of inventory methodologies and suggestions for harmonization.

PubMed

Woodall, Christopher W; Rondeux, Jacques; Verkerk, Pieter J; Ståhl, Göran

2009-10-01

Efforts to assess forest ecosystem carbon stocks, biodiversity, and fire hazards have spurred the need for comprehensive assessments of forest ecosystem dead wood (DW) components around the world. Currently, information regarding the prevalence, status, and methods of DW inventories occurring in the world's forested landscapes is scattered. The goal of this study is to describe the status, DW components measured, sample methods employed, and DW component thresholds used by national forest inventories that currently inventory DW around the world. Study results indicate that most countries do not inventory forest DW. Globally, we estimate that about 13% of countries inventory DW using a diversity of sample methods and DW component definitions. A common feature among DW inventories was that most countries had only just begun DW inventories and employ very low sample intensities. There are major hurdles to harmonizing national forest inventories of DW: differences in population definitions, lack of clarity on sample protocols/estimation procedures, and sparse availability of inventory data/reports. Increasing database/estimation flexibility, developing common dimensional thresholds of DW components, publishing inventory procedures/protocols, releasing inventory data/reports to international peer review, and increasing communication (e.g., workshops) among countries inventorying DW are suggestions forwarded by this study to increase DW inventory harmonization.

Informal and formal trail monitoring protocols and baseline conditions: Acadia National Park

USGS Publications Warehouse

Marion, Jeffrey L.; Wimpey, Jeremy F.; Park, L.

2011-01-01

At Acadia National Park, changing visitor use levels and patterns have contributed to an increasing degree of visitor use impacts to natural and cultural resources. To better understand the extent and severity of these resource impacts and identify effective management techniques, the park sponsored this research to develop monitoring protocols, collect baseline data, and identify suggestions for management strategies. Formal and informal trails were surveyed and their resource conditions were assessed and characterized to support park planning and management decision-making.

CURRENT STATUS OF THE EPA PROTOCOL GAS PROGRAM

EPA Science Inventory

Accurate compressed gas calibration standards are needed to calibrate continuous emission monitors (CEMs) and ambient air quality monitors that are being used for regulatory purposes. EPA has published a protocol to establish the traceability of these standards to national refer...

Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) using Currently Existing Flight Resources

NASA Technical Reports Server (NTRS)

Bingham, Gail; Bates, Scott; Bugbee, Bruce; Garland, Jay; Podolski, Igor; Levinskikh, Rita; Sychev, Vladimir; Gushin, Vadim

2009-01-01

Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) Using Currently Existing Flight Resources (Lada-VPU-P3R) is a study to advance the technology required for plant growth in microgravity and to research related food safety issues. Lada-VPU-P3R also investigates the non-nutritional value to the flight crew of developing plants on-orbit. The Lada-VPU-P3R uses the Lada hardware on the ISS and falls under a cooperative agreement between National Aeronautics and Space Administration (NASA) and the Russian Federal Space Association (FSA). Research Summary: Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) Using Currently Existing Flight Resources (Lada-VPU-P3R) will optimize hardware and

Concussion Incidence and Return-to-Play Time in National Basketball Association Players: Results From 2006 to 2014.

PubMed

Padaki, Ajay S; Cole, Brian J; Ahmad, Christopher S

2016-09-01

Various research efforts have studied concussions in the National Football League, Major League Baseball, and the National Hockey League. However, no study has investigated the incidence and return-to-play trends in the National Basketball Association (NBA), which this study aims to do. Increased media scrutiny and public awareness, in addition to the institution of a league-wide concussion protocol, may have resulted in more conservative return-to-play practices. Descriptive epidemiology study. All concussions to NBA players that were publicly reported in the media from the beginning of the 2006 NBA season to the end of the 2014 season were included. The incidence and return-to-play statistics were generated by synthesizing information from publicly available records. There were 134 publicly reported concussions to NBA players from the beginning of the 2006 season to the conclusion of the 2014 season, resulting in an average of 14.9 concussions per season. The incidence has not changed significantly during this time span. The average games missed after a concussion from 2006 to 2010 was 1.6, significantly less than the 5.0 games missed from 2011 to 2014, following the institution of the NBA concussion protocol (P = .023). Although the incidence of publicly reported concussions in the NBA has not changed appreciably over the past 9 seasons, the time missed after a concussion has. While players often returned in the same game in the 2006 season, the combination of implemented policy, national coverage, medical staff awareness, and player education may have contributed to players now missing an average of 4 to 6 games after a concussion. A multitude of factors has resulted in more conservative return-to-play practices for NBA players after concussions. © 2016 The Author(s).

NIDA’s Clinical Trials Network: An Opportunity for HIV Research in Community Substance Abuse Treatment Programs

PubMed Central

Tross, Susan; Campbell, Aimee N. C.; Calsyn, Donald A.; Metsch, Lisa R.; Sorensen, James L.; Shoptaw, Steven; Haynes, Louise; Woody, George E.; Malow, Robert M.; Brown, Lawrence S.; Feaster, Daniel J.; Booth, Robert E.; Mandler, Raul N.; Masson, Carmen; Holmes, Beverly W.; Colfax, Grant; Brooks, Audrey J.; Hien, Denise A.; Schackman, Bruce R.; Korthuis, P. Todd; Miele, Gloria M.

2012-01-01

Background/Objectives HIV continues to be a significant problem among substance users and their sexual partners in the United States. The National Drug Abuse Treatment Clinical Trials Network (CTN) offers a national platform for effectiveness trials of HIV interventions in community substance abuse treatment programs. This article presents the HIV activities of the CTN during its first 10 years. Results While emphasizing CTN HIV protocols, this article reviews the (1) HIV context for this work; (2) the collaborative process among providers, researchers, and National Institute on Drug Abuse CTN staff, on which CTN HIV work was based; (3) results of CTN HIV protocols and HIV secondary analyses in CTN non-HIV protocols; and (4) implications for future HIV intervention effectiveness research in community substance abuse treatment programs. Conclusion/Significance While the feasibility of engaging frontline providers in this research is highlighted, the limitations of small to medium effect sizes and weak adoption and sustainability in everyday practice are also discussed. PMID:21854270

NIDA's Clinical Trials Network: an opportunity for HIV research in community substance abuse treatment programs.

PubMed

Tross, Susan; Campbell, Aimee N C; Calsyn, Donald A; Metsch, Lisa R; Sorensen, James L; Shoptaw, Steven; Haynes, Louise; Woody, George E; Malow, Robert M; Brown, Lawrence S; Feaster, Daniel J; Booth, Robert E; Mandler, Raul N; Masson, Carmen; Holmes, Beverly W; Colfax, Grant; Brooks, Audrey J; Hien, Denise A; Schackman, Bruce R; Korthuis, P Todd; Miele, Gloria M

2011-09-01

HIV continues to be a significant problem among substance users and their sexual partners in the United States. The National Drug Abuse Treatment Clinical Trials Network (CTN) offers a national platform for effectiveness trials of HIV interventions in community substance abuse treatment programs. This article presents the HIV activities of the CTN during its first 10 years. While emphasizing CTN HIV protocols, this article reviews the (1) HIV context for this work; (2) the collaborative process among providers, researchers, and National Institute on Drug Abuse CTN staff, on which CTN HIV work was based; (3) results of CTN HIV protocols and HIV secondary analyses in CTN non-HIV protocols; and (4) implications for future HIV intervention effectiveness research in community substance abuse treatment programs. While the feasibility of engaging frontline providers in this research is highlighted, the limitations of small to medium effect sizes and weak adoption and sustainability in everyday practice are also discussed.

40 CFR 82.18 - Availability of production in addition to baseline production allowances for class II controlled...

Code of Federal Regulations, 2014 CFR

2014-07-01

... permitted under the Montreal Protocol or to receive from the person for the current control period some... production quantities: (A) The maximum production that the nation is allowed under the Protocol minus the...

Cost savings using a protocol approach to manage anemia in a hemodialysis unit.

PubMed

Charlesworth, Emily C; Richardson, Robert M; Battistella, Marisa

2014-01-01

National guidelines recommend using anemia management protocols to guide treatment. The objective of this study was to determine if an anemia management protocol would improve hemoglobin (Hgb) indices in hemodialysis patients and to measure whether the protocol would reduce the use and cost of darbepoetin alfa (DBO) and intravenous (IV) iron in hemodialysis patients. An anemia management protocol was created and implemented for hemodialysis patients at our institution. A retrospective observational review of the use of DBO and IV iron as well as changes in Hgb, transferrin saturation and ferritin in 174 patients was conducted 6 months before and after implementation of the anemia protocol. The number of Hgb measurements in the target range increased from 44.3 to 46.0% (p = 0.48) after protocol implementation. The mean weekly dose of DBO was reduced from 34.56 ± 31.12 to 31.11 ± 28.64 μg post-protocol implementation (p = 0.011), which translated to a cost savings of USD 41,649 over 6 months. The mean monthly IV iron dose also decreased from 139.56 ± 98.83 to 97.65 ± 79.05 mg (p < 0.005), a cost savings of USD 18,594 over the same time period. The use of an anemia management protocol resulted in the deprescribing of DBO and iron agents while increasing the number of patients in the target Hgb range, which led to significant cost savings in the treatment of anemia.

Variability in donation after cardiac death protocols: a national survey.

PubMed

Fugate, Jennifer E; Stadtler, Maria; Rabinstein, Alejandro A; Wijdicks, Eelco F M

2011-02-27

As donation after cardiac death practices expand, the number of institutional policies is increasing. We contacted organ procurement organizations throughout the United States and requested protocols in hospitals in their donor service areas. Sixty-four protocols were obtained with representation from 16 different states. The terminology and recommended practices varied substantially. The methods for death determination were not specified in 28 (44%) protocols. Most adhered to a 2- to 5-min observation time between circulatory arrest and organ procurement, but 10 (16%) provided no information. This variability reveals a need to define a uniform standard in donation after cardiac death protocols and death determination practices.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR STANDARD PROTOCOL FOR CLEANING LABORATORY AND FIELD SAMPLING APPARATUS (UA-L-5.1)

EPA Science Inventory

The purpose of this SOP is to describe the standard approach used for cleaning glassware and plasticware during the Arizona NHEXAS project and the "Border" study. Keywords: lab; equipment; cleaning.

The National Human Exposure Assessment Survey (NHEXAS) is a federal interagency...

Issues in the Multi-Cultural Assessment of Parent-Child Interaction: An Exploratory Study from the Starting Early Starting Smart Collaboration

ERIC Educational Resources Information Center

Bernstein, V.J.; Harris, E.J.; Long, C.W.; Iida, E.; Hans, S.L.

2005-01-01

A national, multi-site study of behavioral health services integration developed a parent-child interaction assessment tool and culturally anchored videotape protocol. Representatives from programs serving Chinese, Native American, Latin-American, African-American, and Anglo-American families discussed cross-cultural issues in parenting and…

The Effect of Multipart Prompts on Children's Testimonies in Sexual Abuse Investigations

ERIC Educational Resources Information Center

Katz, Carmit; Hershkowitz, Irit

2012-01-01

Objective: The current study aimed to explore the frequency and effects of multipart prompts on the testimonies of children who were alleged victims of sexual abuse and were interviewed using the National Institute of Child Health and Human Development (NICHD) Investigative Protocol. The effects of the multipart prompts were studied by considering…

Meta Salud Diabetes study protocol: a cluster-randomised trial to reduce cardiovascular risk among a diabetic population of Mexico

PubMed Central

Cornejo Vucovich, Elsa; Ingram, Maia; Valenica, Celina; Castro Vasquez, Maria del Carmen; Gonzalez-Fagoaga, Eduardo; Geurnsey de Zapien, Jill

2018-01-01

Introduction Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. Methods and analysis The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomised clinical behavioural trial based in 22 (n=22) health centres in Sonora, Mexico. MSD aims to evaluate the effectiveness of the MSD intervention for the secondary prevention of CVD risk factors among a diabetic population (n=320) compared with the study control of usual care. The MSD intervention consists of 2-hour class sessions delivered over a 13-week period providing educational information to encourage sustainable behavioural change to prevent disease complications including the adoption of physical activity. MSD is delivered within the context of Mexico’s national primary care health centre system by health professionals, including nurses, physicians and community health workers via existing social support groups for individuals diagnosed with chronic disease. Mixed models are used to estimate the effect of MSD by comparing cardiovascular risk, as measured by the Framingham Risk Score, between the trial arms. Secondary outcomes include hypertension, behavioural risk factors and psychosocial factors. Ethics and dissemination This work is supported by the National Institutes of Health, National Heart Lung and Blood Institute (1R01HL125996-01) and approved by the University of Arizona Research Institutional Review Board (Protocol 1508040144) and the Research Bioethics Committee at the University of Sonora. The first Internal Review Board approval date was 31 August 2015 with five subsequent approved amendments. This article refers to protocol V.0.2, dated 30 January 2017. Results will be disseminated via peer-reviewed publication and presentation at international conferences and will be shared through meetings with health systems officials. Trial registration number NCT0280469; Pre-results. PMID:29530914

Oncosurgical Management of Liver Limited Stage IV Colorectal Cancer: Preliminary Data and Protocol for a Randomized Controlled Trial.

PubMed

Sutton, Paul; Vimalachandran, Dale; Poston, Graeme; Fenwick, Stephen; Malik, Hassan

2018-05-09

Colorectal cancer is the fourth commonest cancer and second commonest cause of cancer-related death in the United Kingdom. Almost 15% of patients have metastases on presentation. An increasing number of surgical strategies and better neoadjuvant treatment options are responsible for more patients undergoing resection of liver metastases, with prolonged survival in a select group of patients who present with synchronous disease. It is clear that the optimal strategy for the management of these patients remains unclear, and there is certainly a complete absence of Level 1 evidence in the literature. The objective of this study is to undertake preliminary work and devise an outline trial protocol to inform the future development of clinical studies to investigate the management of patients with liver limited stage IV colorectal cancer. We have undertaken some preliminary work and begun the process of designing a randomized controlled trial and present a draft trial protocol here. This study is at the protocol development stage only, and as such no results are available. There is no funding in place for this study, and no anticipated start date. We have presented preliminary work and an outline trial protocol which we anticipate will inform the future development of clinical studies to investigate the management of patients with liver limited stage IV colorectal cancer. We do not believe that the trial we have designed will answer the most significant clinical questions, nor that it is feasible to be delivered within the United Kingdom's National Health Service at this current time. ©Paul Sutton, Dale Vimalachandran, Graeme Poston, Stephen Fenwick, Hassan Malik. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 09.05.2018.

Data on Mercury in Water, Bed Sediment, and Fish from Streams Across the United States, 1998-2005

USGS Publications Warehouse

Bauch, Nancy J.; Chasar, Lia C.; Scudder, Barbara C.; Moran, Patrick W.; Hitt, Kerie J.; Brigham, Mark E.; Lutz, Michelle A.; Wentz, Dennis A.

2009-01-01

The U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) and Toxic Substances Hydrology Programs conducted the National Mercury Pilot Study in 1998 to examine relations of mercury (Hg) in water, bed sediment and fish in streams across the United States, including Alaska and Hawaii. Water and bed-sediment samples were analyzed for total Hg (THg), methylmercury (MeHg), and other constituents; fish were analyzed for THg. Similar sampling was conducted at additional streams across the country in 2002 and 2004-05. This report summarizes sample collection and processing protocols, analytical methods, environmental data, and quality-assurance data for stream water, bed sediment, and fish for these national studies. To extend the geographic coverage of the data, this report also includes four regional USGS Hg studies conducted during 1998-2001 and 2004. The environmental data for these national and regional Hg studies are provided in an electronic format.

SU-G-IeP2-10: Lens Dose Reduction by Patient Position Modification During Neck CT Exams

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

Mosher, E; Lee, C; Butman, J

Purpose: Irradiation of the lens during a neck CT may increase a patient’s risk of developing cataracts later in life. Radiologists and technologists at the National Institutes of Health Clinical Center (NIHCC) have developed new CT imaging protocols that include a reduction in scan range and modifying neck positioning using a head tilt. This study will evaluate the efficacy of this protocol in the reduction of lens dose. Methods: We retrieved CT images of five male patients who had two sets of CT images: before and after the implementation of the new protocol. The lens doses before the new protocolmore » were calculated using an in-house CT dose calculator, National Cancer Institute dosimetry system for CT (NCICT), where computational human phantoms with no head tilt are included. We also calculated the lens dose for the patient CT conducted after the new protocol by using an adult male computational phantom with the neck position deformed to match the angle of the head tilt. We also calculated the doses to other radiosensitive organs including the globes of the eye, brain, pituitary gland and salivary glands before and after head tilt. Results: Our dose calculations demonstrated that modifying neck position reduced dose to the lens by 89% on average (range: 86–96%). Globe, brain, pituitary and salivary gland doses also decreased by an average of 65% (51–95%), 38% (−8–66%), 34% (−43–84%) and 14% (13–14%), respectively. The new protocol resulted in a nearly ten-fold decrease in lens dose. Conclusion: The use of a head tilt and scan range reduction is an easy and effective method to reduce radiation exposure to the lens and other radiosensitive organs, while still allowing for the inclusion of critical neck structures in the CT image. We are expanding our study to a total of 10 males and 10 females.« less

Integration of the incident command system (ICS) protocol for effective coordination of multi-agency response to traffic incidents : final report.

DOT National Transportation Integrated Search

2017-06-13

In recent years, there has been an increased focus on Traffic Incident Management (TIM) and : incorporation of the Incident Command System (ICS) to reduce traffic congestion on the nation's : Interstates. In fact, studies show that for every minute a...

Transformational principles for NEON sampling of mammalian parasites and pathogens: a response to Springer et al. (2016)

USDA-ARS?s Scientific Manuscript database

The National Environmental Observatory Network (NEON) has recently released a series of protocols presented with apparently broad community support for studies of small mammals and parasites. Sampling designs were outlined outlined, collectively aimed at understanding how changing environmental cond...

Investigation of differences between field and laboratory pH measurements of national atmospheric deposition program/national trends network precipitation samples

USGS Publications Warehouse

Latysh, N.; Gordon, J.

2004-01-01

A study was undertaken to investigate differences between laboratory and field pH measurements for precipitation samples collected from 135 weekly precipitation-monitoring sites in the National Trends Network from 12/30/1986 to 12/28/1999. Differences in pH between field and laboratory measurements occurred for 96% of samples collected during this time period. Differences between the two measurements were evaluated for precipitation samples collected before and after January 1994, when modifications to sample-handling protocol and elimination of the contaminating bucket o-ring used in sample shipment occurred. Median hydrogen-ion and pH differences between field and laboratory measurements declined from 3.9 ??eq L-1 or 0.10 pH units before the 1994 protocol change to 1.4 ??eq L-1 or 0.04 pH units after the 1994 protocol change. Hydrogen-ion differences between field and laboratory measurements had a high correlation with the sample pH determined in the field. The largest pH differences between the two measurements occurred for high-pH samples (>5.6), typical of precipitation collected in Western United States; however low- pH samples (<5.0) displayed the highest variability in hydrogen-ion differences between field and laboratory analyses. Properly screened field pH measurements are a useful alternative to laboratory pH values for trend analysis, particularly before 1994 when laboratory pH values were influenced by sample-collection equipment.

Reference Dosimetry according to the New German Protocol DIN 6800-2 and Comparison with IAEA TRS 398 and AAPM TG 51*

PubMed Central

Zakaria, A; Schuette, W; Younan, C

2011-01-01

The preceding DIN 6800-2 (1997) protocol has been revised by a German task group and its latest version was published in March 2008 as the national standard dosimetry protocol DIN 6800-2 (2008 March). Since then, in Germany the determination of absorbed dose to water for high-energy photon and electron beams has to be performed according to this new German dosimetry protocol. The IAEA Code of Practice TRS 398 (2000) and the AAPM TG-51 are the two main protocols applied internationally. The new German version has widely adapted the methodology and dosimetric data of TRS-398. This paper investigates systematically the DIN 6800-2 protocol and compares it with the procedures and results obtained by using the international protocols. The investigation was performed with 6 MV and 18 MV photon beams as well as with electron beams from 5 MeV to 21 MeV. While only cylindrical chambers were used for photon beams, the measurements of electron beams were performed by using cylindrical and plane-parallel chambers. It was found that the discrepancies in the determination of absorbed dose to water among the three protocols were 0.23% for photon beams and 1.2% for electron beams. The determination of water absorbed dose was also checked by a national audit procedure using TLDs. The comparison between the measurements following the DIN 6800-2 protocol and the TLD audit-procedure confirmed a difference of less than 2%. The advantage of the new German protocol DIN 6800-2 lies in the renouncement on the cross calibration procedure as well as its clear presentation of formulas and parameters. In the past, the different protocols evoluted differently from time to time. Fortunately today, a good convergence has been obtained in concepts and methods. PMID:22287987

Reference Dosimetry according to the New German Protocol DIN 6800-2 and Comparison with IAEA TRS 398 and AAPM TG 51.

PubMed

Zakaria, A; Schuette, W; Younan, C

2011-04-01

The preceding DIN 6800-2 (1997) protocol has been revised by a German task group and its latest version was published in March 2008 as the national standard dosimetry protocol DIN 6800-2 (2008 March). Since then, in Germany the determination of absorbed dose to water for high-energy photon and electron beams has to be performed according to this new German dosimetry protocol. The IAEA Code of Practice TRS 398 (2000) and the AAPM TG-51 are the two main protocols applied internationally. The new German version has widely adapted the methodology and dosimetric data of TRS-398. This paper investigates systematically the DIN 6800-2 protocol and compares it with the procedures and results obtained by using the international protocols. The investigation was performed with 6 MV and 18 MV photon beams as well as with electron beams from 5 MeV to 21 MeV. While only cylindrical chambers were used for photon beams, the measurements of electron beams were performed by using cylindrical and plane-parallel chambers. It was found that the discrepancies in the determination of absorbed dose to water among the three protocols were 0.23% for photon beams and 1.2% for electron beams. The determination of water absorbed dose was also checked by a national audit procedure using TLDs. The comparison between the measurements following the DIN 6800-2 protocol and the TLD audit-procedure confirmed a difference of less than 2%. The advantage of the new German protocol DIN 6800-2 lies in the renouncement on the cross calibration procedure as well as its clear presentation of formulas and parameters. In the past, the different protocols evoluted differently from time to time. Fortunately today, a good convergence has been obtained in concepts and methods.

Coalition Logistics - The Multinational Force and Observers Model

DTIC Science & Technology

1986-05-19

MISSION The mission of the MFO, as specified by the protocol , is to supervise implemeutation of the peace treaty and to employ its best efforts to prevent ...result, a protocol was -- negotiated, calling for a multinational military force and civilian- ---- observer unit to serve in the Sinai--outside the...auspices of the United Nations.2 In this way, the protocol of 3 August 1981 created the Multinational Force and Observers and directed Lhat it be

Manuals Used in the National Aquatic Resource Surveys

EPA Pesticide Factsheets

Various manuals are used to communicate the methods and guidelines for the National Aquatic Resource Surveys. The Field Operations Manual: outlines the field protocols that crews will utilize to sample sites.

Instituting the Updated CPR Protocol: The Team Physician's Role.

ERIC Educational Resources Information Center

Araujo, David

1994-01-01

Summarizes recommendations from the 1992 National Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care. Because team physicians may have to provide basic life support for athletes or spectators, knowing current (CPR) protocol is essential in developing emergency response plans and training personnel. Practice removing…

Browsing for the Best Internet Access Provider?

ERIC Educational Resources Information Center

Weil, Marty

1996-01-01

Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

40 CFR 82.1 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... STRATOSPHERIC OZONE Production and Consumption Controls § 82.1 Purpose and scope. (a) The purpose of the regulations in this subpart is to implement the Montreal Protocol on Substances that Deplete the Ozone Layer... ozone-depleting substances, according to specified schedules. The Protocol also requires each nation...

40 CFR 82.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STRATOSPHERIC OZONE Production and Consumption Controls § 82.1 Purpose and scope. (a) The purpose of the regulations in this subpart is to implement the Montreal Protocol on Substances that Deplete the Ozone Layer... ozone-depleting substances, according to specified schedules. The Protocol also requires each nation...

40 CFR 82.1 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-07-01

... STRATOSPHERIC OZONE Production and Consumption Controls § 82.1 Purpose and scope. (a) The purpose of the regulations in this subpart is to implement the Montreal Protocol on Substances that Deplete the Ozone Layer... ozone-depleting substances, according to specified schedules. The Protocol also requires each nation...

40 CFR 82.1 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... STRATOSPHERIC OZONE Production and Consumption Controls § 82.1 Purpose and scope. (a) The purpose of the regulations in this subpart is to implement the Montreal Protocol on Substances that Deplete the Ozone Layer... ozone-depleting substances, according to specified schedules. The Protocol also requires each nation...

40 CFR 82.1 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-07-01

... STRATOSPHERIC OZONE Production and Consumption Controls § 82.1 Purpose and scope. (a) The purpose of the regulations in this subpart is to implement the Montreal Protocol on Substances that Deplete the Ozone Layer... ozone-depleting substances, according to specified schedules. The Protocol also requires each nation...

Using Forest Service multiple species inventory and monitoring protocols to count birds at forest inventory and analysis plots on the Caribbean landscape: results, observations, and challenges from year 1 of a 2-year study

Treesearch

Sonja N. Oswalt; Thomas J. Brandeis; David W. Steadman; Scott K. Robinson

2009-01-01

We conducted double-observer point counts of birds from December 3 to December 31, 2005, on preestablished permanent Forest Inventory and Analysis (FIA) plots and National Park Service System trails within the Virgin Islands National Park, St. John, U.S. Virgin Islands. We had three objectives: (1) to collect abundance and distribution data for wintering land birds,...

Preliminary monitoring protocol for the tidal freshwater wetland restoration herbivory study in national capital parks--east: Appendix B

USGS Publications Warehouse

Krafft, Cairn; Hatfield, Jeffrey S.

2014-01-01

Four tidal freshwater wetland restoration projects have been undertaken within Anacostia Park on lands managed by the National Park Service since 1993. Monitoring the impacts of Canada goose (Branta canadensis) herbivory on the wetland vegetation will play a key role in determining the long-term health of these tidal freshwater wetland restorations. This Implementation Plan lays out monitoring for impacts of herbivory on the vegetation in Kingman Area 1 and inferred to the other wetland areas.

The acute effects of manipulating volume and load of back squats on countermovement vertical jump performance.

PubMed

Moir, Gavin L; Mergy, David; Witmer, Ca; Davis, Shala E

2011-06-01

The acute effects of manipulating the volume and load of back squats on subsequent countermovement vertical jump performance were investigated in the present study. Eleven National Collegiate Athletic Association division II female volleyball players performed 10 countermovement vertical jumps (CMJs) on a force platform 2 minutes after the last squat repetition of a high-load (HL) or high-volume (HV) squat protocol. Two minutes of rest was provided between each CMJ. The HL protocol culminated in the subjects having to perform 3 repetitions with a load equivalent to 90% 1 repetition maximum (1RM) back squat, whereas 12 repetitions with a load equivalent to 37% 1RM were performed in the HV protocol. During an initial familiarization session, knee angles were recorded during a series of CMJs, and these angles were used to control the depth of descent during all subsequent back squats. Jump height (JH) and vertical stiffness (VStiff) were calculated during each of the 10 CMJ, and the change in these variables after the 2 squat protocols was assessed using an analysis of variance model with repeated measures on 2 factors (Protocol [2-levels]; Time [2-levels]). There was no significant difference in JH after the HL and HV protocols (p > 0.05). A significant Protocol × Time interaction for VStiff resulted from the increase after the HL protocol being greater than that after the HV protocol (p = 0.03). The knee angles before the HL and HV protocols were significantly greater than those measured during the initial familiarization session (p = 0.001). Although neither squat protocol provided any benefit in improving JH, the heavy squat protocol produced greater increases in VStiff during the CMJ. Because of the increased VStiff caused by the HL protocol, volleyball coaches may consider using such protocols with their players to improve performance in jumps performed from a run such as the spike and on-court agility.

Bridging the GAPS from Space: A Research/Educational Partnership in the Upper Delaware River Basin

NASA Astrophysics Data System (ADS)

Brown de Colstoun, E.; Robin, J.; Minelli, S.; Katsaros, M.; Peterec, I.; Sandt, K.

2006-05-01

The National Park Service (NPS) Inventory and Monitoring (I&M) Program is currently developing scientific protocols to inventory and monitor the natural resources of 270 park units at the national level. These are aimed at providing critical tools needed by park managers for effective decision-making regarding the management and stewardship of the resources they are charged with protecting. We are currently developing a satellite-based regional land cover and land use monitoring protocol that addresses the immediate needs of the NPS I&M. This is a pilot project that examines land cover/use changes in and around the Upper Delaware Scenic and Recreational River and Delaware Water Gap National Recreation Area national parks from Landsat data for the period 1984 to 2005, in one the fastest growing regions in the country. The products resulting from the application of the protocols are then used to guide the simulation of land cover/use changes within a simple Soil-Vegetation-Atmosphere-Transfer (SVAT) model called GAPS in order to better understand the consequences of the measured land cover/use change on the water and energy cycles of the parks and surrounding areas. The data needed for product validation and model parameterization are being acquired with the assistance of students and educators from area schools using protocols established through the GLOBE program. Through focused workshops organized in collaboration with NPS educational specialists and PA regional educational service agencies called Intermediate Units, and participation in hands-on field measurement campaigns, students and educators are learning about satellite remote sensing interpretation, land cover classification, and how to measure/monitor changes in land cover/use in their communities. Students will also assist in the model simulations using the data they acquire in the field. This partnership between the Principal Investigator, the NPS, Intermediate Units and area students and educators is one that clearly benefits the development and validation of the research but also provides the compelling story line for a variety of educational activities, all within the spectacular setting of our National Parks. We are building here on existing relationships between NASA, the NPS, and local governments and schools to strengthen the local curriculum in the natural sciences and to enhance the study and appreciation of the Earth as a system of interconnected parts.

Digital information management: a progress report on the National Digital Mammography Archive

NASA Astrophysics Data System (ADS)

Beckerman, Barbara G.; Schnall, Mitchell D.

2002-05-01

Digital mammography creates very large images, which require new approaches to storage, retrieval, management, and security. The National Digital Mammography Archive (NDMA) project, funded by the National Library of Medicine (NLM), is developing a limited testbed that demonstrates the feasibility of a national breast imaging archive, with access to prior exams; patient information; computer aids for image processing, teaching, and testing tools; and security components to ensure confidentiality of patient information. There will be significant benefits to patients and clinicians in terms of accessible data with which to make a diagnosis and to researchers performing studies on breast cancer. Mammography was chosen for the project, because standards were already available for digital images, report formats, and structures. New standards have been created for communications protocols between devices, front- end portal and archive. NDMA is a distributed computing concept that provides for sharing and access across corporate entities. Privacy, auditing, and patient consent are all integrated into the system. Five sites, Universities of Pennsylvania, Chicago, North Carolina and Toronto, and BWXT Y12, are connected through high-speed networks to demonstrate functionality. We will review progress, including technical challenges, innovative research and development activities, standards and protocols being implemented, and potential benefits to healthcare systems.

Governance and Trust in Higher Education

ERIC Educational Resources Information Center

Vidovich, Lesley; Currie, Jan

2011-01-01

The adoption of more corporate models of governance is a contemporary trend in higher education. In the early 2000s, the Australian Government legislated national governance protocols for universities, using the policy lever of financial sanctions. These more corporate-style governance protocols followed similar changes in the UK, consistent with…

National best management practices monitoring summary report, program phase-in period fiscal years 2013-2014

Treesearch

Joan Carlson; Pam Edwards; Todd Ellsworth; Michael Eberle

2015-01-01

The National BMP Program provides National Core BMPs, standardized monitoring protocols to evaluate implementation and effectiveness of the National Core BMPs, and a data management system to store and analyze the resulting monitoring data. BMP evaluations are completed by interdisciplinary teams of resource specialists and include assessments of whether BMP...

Gender research in the National Institute on Drug Abuse National Treatment Clinical Trials Network: a summary of findings.

PubMed

Greenfield, Shelly F; Rosa, Carmen; Putnins, Susan I; Green, Carla A; Brooks, Audrey J; Calsyn, Donald A; Cohen, Lisa R; Erickson, Sarah; Gordon, Susan M; Haynes, Louise; Killeen, Therese; Miele, Gloria; Tross, Susan; Winhusen, Theresa

2011-09-01

The National Institute of Drug Abuse's National Drug Abuse Treatment Clinical Trials Network (CTN) was established to foster translation of research into practice in substance abuse treatment settings. The CTN provides a unique opportunity to examine in multi-site, translational clinical trials, the outcomes of treatment interventions targeting vulnerable subgroups of women; the comparative effectiveness of gender-specific protocols to reduce risk behaviors; and gender differences in clinical outcomes. To review gender-related findings from published CTN clinical trials and related studies from January 2000 to March 2010. CTN studies were selected for review if they focused on treatment outcomes or services for special populations of women with substance use disorders (SUDs) including those with trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors; or implemented gender-specific protocols. The CTN has randomized 11,500 participants (41% women) across 200 clinics in 24 randomized controlled trials in community settings, of which 4 have been gender-specific. This article summarizes gender-related findings from CTN clinical trials and related studies, focusing on trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors. These published studies have expanded the evidence base regarding interventions for vulnerable groups of women with SUDs as well as gender-specific interventions to reduce HIV risk behaviors in substance-using men and women. The results also underscore the complexity of accounting for gender in the design of clinical trials and analysis of results. To fully understand the relevance of gender-specific moderators and mediators of outcome, it is essential that future translational studies adopt more sophisticated approaches to understanding and measuring gender-relevant factors and plan sample sizes that are adequate to support more nuanced analytic methods.

The Federal Government and Information Technology Standards: Building the National Information Infrastructure.

ERIC Educational Resources Information Center

Radack, Shirley M.

1994-01-01

Examines the role of the National Institute of Standards and Technology (NIST) in the development of the National Information Infrastructure (NII). Highlights include the standards process; voluntary standards; Open Systems Interconnection problems; Internet Protocol Suite; consortia; government's role; and network security. (16 references) (LRW)

A Practice-Based Evaluation of Distress Screening Protocol Adherence and Medical Service Utilization.

PubMed

Zebrack, Brad; Kayser, Karen; Bybee, Deborah; Padgett, Lynne; Sundstrom, Laura; Jobin, Chad; Oktay, Julianne

2017-07-01

Background: This study examined the extent to which cancer programs demonstrated adherence to their own prescribed screening protocol, and whether adherence to that protocol was associated with medical service utilization. The hypothesis is that higher rates of service utilization are associated with lower rates of adherence to screening protocols. Methods: Oncology social workers at Commission on Cancer-accredited cancer programs reviewed electronic health records (EHRs) in their respective cancer programs during a 2-month period in 2014. Rates of overall adherence to a prescribed distress screening protocol were calculated based on documentation in the EHR that screening adherence and an appropriate clinical response had occurred. We examined documentation of emergency department (ED) use and hospitalization within 2 months after the screening visit. Results: Review of 8,409 EHRs across 55 cancer centers indicated that the overall adherence rate to screening protocols was 62.7%. The highest rates of adherence were observed in Community Cancer Programs (76.3%) and the lowest rates were in NCI-designated Cancer Centers (43.3%). Rates of medical service utilization were significantly higher than expected when overall protocol adherence was lacking. After controlling for patient and institutional characteristics, risk ratios for ED use (0.82) and hospitalization (0.81) suggest that when overall protocol adherence was documented, 18% to 19% fewer patients used these medical services. Conclusions: The observed associations between a mandated psychosocial care protocol and medical service utilization suggest opportunities for operational efficiencies and costs savings. Further investigations of protocol integrity, as well as the clinical care models by which psychosocial care is delivered, are warranted. Copyright © 2017 by the National Comprehensive Cancer Network.

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

Vogt

This report describes a U.S. Department of Energy, (DOE) Chemical and Biological National Security Program project that sought to establish what is known about decontamination of structures, objects, and people following an exposure to chemical or biological materials. Specifically we sought to identify the procedures and protocols used to determine when and how people or buildings are considered ''clean'' following decontamination. To fulfill this objective, the study systematically examined reported decontamination experiences to determine what procedures and protocols are currently employed for decontamination, the timeframe involved to initiate and complete the decontamination process, how the contaminants were identified, the factorsmore » determining when people were (or were not) decontaminated, the problems encountered during the decontamination process, how response efforts of agencies were coordinated, and the perceived social psychological effects on people who were decontaminated or who participated in the decontamination process. Findings and recommendations from the study are intended to aid decision-making and to improve the basis for determining appropriate decontamination protocols for recovery planners and policy makers for responding to chemical and biological events.« less

Developing a service user informed intervention to improve participation and ability to perform daily activities in primary Sjögren's syndrome: a mixed-methods study protocol

PubMed Central

Hackett, Katie L; Newton, Julia L; Deane, Katherine H O; Rapley, Tim; Deary, Vincent; Kolehmainen, Niina; Lendrem, Dennis; Ng, Wan-Fai

2014-01-01

Introduction A significant proportion of patients with primary Sjögren's syndrome (PSS) is functionally impaired and experience difficulties participating in various aspects of everyday life. There is currently no evidence of efficacy for non-pharmacological interventions aimed specifically at supporting the patients with PSS to improve their participation and ability to perform daily activities. This paper describes a research protocol for a mixed-methods study to develop an intervention to improve these outcomes. The protocol follows the Medical Research Council framework for complex interventions. Methods and analysis We will use group concept mapping with the patients, adults who live with them and healthcare professionals to identify factors which prevent people with PSS from participating in daily life and performing daily activities. The factors will be prioritised by participants for importance and feasibility and will inform an intervention to be delivered within a National Health Service (NHS) setting. Evidence-based intervention techniques will be identified for the prioritised factors and combined into a deliverable intervention package. Key stakeholders will comment on the intervention content and mode of delivery through focus groups, and the data will be used to refine the intervention. The acceptability and feasibility of the refined intervention will be evaluated in a future study. Ethics and dissemination The study has been approved by an NHS Research Ethics Committee, REC Reference: 13/NI/0190. The findings of this study will be disseminated in peer-reviewed journals and through presentation at national and international conferences. Trial registration number UKCRN Study ID: 15939. PMID:25146718

Developing a service user informed intervention to improve participation and ability to perform daily activities in primary Sjögren's syndrome: a mixed-methods study protocol.

PubMed

Hackett, Katie L; Newton, Julia L; Deane, Katherine H O; Rapley, Tim; Deary, Vincent; Kolehmainen, Niina; Lendrem, Dennis; Ng, Wan-Fai

2014-08-21

A significant proportion of patients with primary Sjögren's syndrome (PSS) is functionally impaired and experience difficulties participating in various aspects of everyday life. There is currently no evidence of efficacy for non-pharmacological interventions aimed specifically at supporting the patients with PSS to improve their participation and ability to perform daily activities. This paper describes a research protocol for a mixed-methods study to develop an intervention to improve these outcomes. The protocol follows the Medical Research Council framework for complex interventions. We will use group concept mapping with the patients, adults who live with them and healthcare professionals to identify factors which prevent people with PSS from participating in daily life and performing daily activities. The factors will be prioritised by participants for importance and feasibility and will inform an intervention to be delivered within a National Health Service (NHS) setting. Evidence-based intervention techniques will be identified for the prioritised factors and combined into a deliverable intervention package. Key stakeholders will comment on the intervention content and mode of delivery through focus groups, and the data will be used to refine the intervention. The acceptability and feasibility of the refined intervention will be evaluated in a future study. The study has been approved by an NHS Research Ethics Committee, REC Reference: 13/NI/0190. The findings of this study will be disseminated in peer-reviewed journals and through presentation at national and international conferences. UKCRN Study ID: 15939. 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.

Sponsoring Organization | Division of Cancer Prevention

Cancer.gov

The National Cancer Institute (NCI) project officers are responsible for the design and oversight of all aspects of the PLCO trial. These NCI components work directly with the Coordinating Center which provides support for development and implementation of the study protocol; and with the Principal Investigators from each of the Screening Centers to ensure that the technical

Feasibility and Efficacy of Nurse-Driven Acute Stroke Care.

PubMed

Mainali, Shraddha; Stutzman, Sonja; Sengupta, Samarpita; Dirickson, Amanda; Riise, Laura; Jones, Donald; Yang, Julian; Olson, DaiWai M

2017-05-01

Acute stroke care requires rapid assessment and intervention. Replacing traditional sequential algorithms in stroke care with parallel processing using telestroke consultation could be useful in the management of acute stroke patients. The purpose of this study was to assess the feasibility of a nurse-driven acute stroke protocol using a parallel processing model. This is a prospective, nonrandomized, feasibility study of a quality improvement initiative. Stroke team members had a 1-month training phase, and then the protocol was implemented for 6 months and data were collected on a "run-sheet." The primary outcome of this study was to determine if a nurse-driven acute stroke protocol is feasible and assists in decreasing door to needle (intravenous tissue plasminogen activator [IV-tPA]) times. Of the 153 stroke patients seen during the protocol implementation phase, 57 were designated as "level 1" (symptom onset <4.5 hours) strokes requiring acute stroke management. Among these strokes, 78% were nurse-driven, and 75% of the telestroke encounters were also nurse-driven. The average door to computerized tomography time was significantly reduced in nurse-driven codes (38.9 minutes versus 24.4 minutes; P < .04). The use of a nurse-driven protocol is feasible and effective. When used in conjunction with a telestroke specialist, it may be of value in improving patient outcomes by decreasing the time for door to decision for IV-tPA. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Onboard screening dockside testing as a new means of managing paralytic shellfish poisoning risks in federally closed waters

NASA Astrophysics Data System (ADS)

DeGrasse, Stacey; Conrad, Stephen; DiStefano, Paul; Vanegas, Camilo; Wallace, David; Jensen, Pete; Hickey, J. Michael; Cenci, Florence; Pitt, Jaclyn; Deardorff, Dave; Rubio, Fernando; Easy, Dorothy; Donovan, Mary Anne; Laycock, Maurice; Rouse, Debbie; Mullen, John

2014-05-01

Paralytic shellfish poisoning (PSP) is the foodborne intoxication associated with the consumption of seafood contaminated with naturally occurring neurotoxins known as paralytic shellfish toxins. To protect public health from this potentially fatal syndrome, harvesting closures are implemented when toxins exceed the regulatory action level. Traditional monitoring programs established by state shellfish authorities allow for timely closures in state waters with minimal negative impacts on industry. However, such monitoring programs are not feasible in federal offshore waters given their distance from shore and the range of their spatial coverage. Thus innovative management strategies were investigated for these offshore resources. Georges Bank, an offshore resource with an estimated market value of more than 3 billion in Atlantic surfclams and ocean quahogs, has been closed to harvesting following a temporary ban in 1989 and a subsequent indefinite closure in 1990 due to the risk of PSP. As a means of managing this risk and allowing harvest of safe shellfish from this important resource, the Onboard Screening Dockside Testing Protocol (referred to as the Protocol) was developed by the US Food and Drug Administration (FDA), National Marine Fisheries Service (NMFS), state shellfish control authorities, and industry. The Protocol, which sets forth control measures to ensure product safety and public health protection, was endorsed by the Interstate Shellfish Sanitation Conference (ISSC) for pilot testing. Briefly, the pilot study Protocol required that (1) the fishing vessel receive a permit from NMFS to harvest in closed waters, (2) a miniμm of five shellfish samples per intended harvest lot be tested for PSP toxins onboard, and (3) harvesting only occur when the samples tested from the intended fishing area are negative using the Jellett Rapid Tests or Abraxis Shipboard ELISA kits. Finally, product landed under the Protocol was confirmed to be safe for consumption using the mouse bioassay (MBA) prior to its introduction into commerce. This paper presents data from the pilot study, with primary focus on the advantages and challenges of the field kits employed onboard compared to the dockside MBA, which has served as the longstanding regulatory method for PSP toxins. In 2010 alone, the successful pilot study resulted in the safe harvest of over 2.7 million worth of surfclams in an area that has otherwise been unavailable for decades. Due to the success of this pilot study, the Protocol was adopted into the National Shellfish Sanitation Program Model Ordinance as an approved marine biotoxin control strategy for use in federal waters at the 2011 ISSC Biennial Meeting. In January 2013 a portion of Georges Bank was reopened for the harvest of Atlantic surfclams and ocean quahogs to fishermen following the Protocol.

Report: Results of Technical Network Vulnerability Assessment: EPA’s Radiation and Indoor Environments National Laboratory

EPA Pesticide Factsheets

Report #09-P-0053, December 9, 2008. Vulnerability testing of EPA’s Radiation and Indoor Environments National Laboratory (R&IEN) network identified Internet Protocol addresses with medium-risk vulnerabilities.

Time to publication for publicly funded clinical trials in Australia: an observational study.

PubMed

Strand, Linn Beate; Clarke, Philip; Graves, Nicholas; Barnett, Adrian G

2017-03-22

To examine the length of time between receiving funding and publishing the protocol and main paper for randomised controlled trials. An observational study using survival analysis. Publicly funded health and medical research in Australia. Randomised controlled trials funded by the National Health and Medical Research Council of Australia between 2008 and 2010. Time from funding to the protocol paper and main results paper. Multiple variable survival models examining whether study characteristics predicted publication times. We found 77 studies with a total funding of $A59 million. The median time to publication of the protocol paper was 6.4 years after funding (95% CI 4.1 to 8.1). The proportion with a published protocol paper 8 years after funding was 0.61 (95% CI 0.48 to 0.74). The median time to publication of the main results paper was 7.1 years after funding (95% CI 6.3 to 7.6). The proportion with a published main results paper 8 years after funding was 0.72 (95% CI 0.56 to 0.87). The HRs for how study characteristics might influence timing were generally close to one with narrow CIs, the notable exception was that a longer study length lengthened the time to the main paper (HR=0.62 per extra study year, 95% CI 0.43 to 0.89). Despite the widespread registration of clinical trials, there remain serious concerns of trial results not being published or being published with a long delay. We have found that these same concerns apply to protocol papers, which should be publishable soon after funding. Funding agencies could set a target of publishing the protocol paper within 18 months of funding. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Technical Analysis of SSP-21 Protocol

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

Bromberger, S.

As part of the California Energy Systems for the Twenty-First Century (CES-21) program, in December 2016 San Diego Gas and Electric (SDG&E) contracted with Lawrence Livermore National Laboratory (LLNL) to perform an independent verification and validation (IV&V) of a white paper describing their Secure SCADA Protocol for the Twenty-First Century (SSP-21) in order to analyze the effectiveness and propriety of cryptographic protocol use within the SSP-21 specification. SSP-21 is designed to use cryptographic protocols to provide (optional) encryption, authentication, and nonrepudiation, among other capabilities. The cryptographic protocols to be used reflect current industry standards; future versions of SSP-21 will usemore » other advanced technologies to provide a subset of security services.« less

In Brief: Kyoto Protocol moves forward

NASA Astrophysics Data System (ADS)

Showstack, Randy

2004-10-01

The Russian cabinet's 30 September endorsement of the Kyoto Protocol to the United Nations Framework Convention on Climate Change (UNFCCC) likely clears the way for the treaty's ratification by that country's parliament and for its entry into force. The protocol enters into force when not less than 55 Parties to the Convention, including industrialized countries (so called ``Annex I Parties'') which accounted in total for at least 55 % of the total carbon dioxide emissions for 1990 from that group, officially have agreed to the treaty.

High-Dimensional Multi-particle Cat-Like State Teleportation

NASA Astrophysics Data System (ADS)

Zeng, Bei; Liu, Xiao-Shu; Li, Yan-Song; Long, Gui-Lu

2002-11-01

Two kinds of M-particle d-dimensional Schmidt-form entangled state teleportation protocols are presented. In the first protocol, the teleportation is achieved by d-dimensional Bell-basis measurements, while in the second protocol it is realized by d-dimensional GHZ-basis measurement. The project supported by the Major State Basic Research Development Program under Grant No. G200077400, National Natural Science Foundation of China under Grant No. 60073009, the Fok Ying Tung Education Foundation, and the Excellent Young University Teachers' Fund of Education Ministry of China

Cognitive Communications Protocols for SATCOM

DTIC Science & Technology

2017-10-20

both inadvertent Radio Frequency Interference (RFI) and deliberate jammers. Cognitive satellite and space communications strategies based on the... communications protocols for satellite and space communications with possible broad applications in defense, homeland-security as well as consumer...proposed WACR as the basis for future space communication systems that will offer significant benefits to national war‐fighting and peacekeeping

Provision of Auricular Acupuncture and Acupressure in a University Setting

ERIC Educational Resources Information Center

Oyola-Santiago, Tamara; Knopf, Rachel; Robin, Tracy; Harvey, Kristen

2013-01-01

Auricular acupuncture using the National Acupuncture Detoxification Association (NADA) protocol stimulates 5 points in each ear--the Shen Men, sympathetic nervous system, liver, kidney, and lung. This protocol is also known as Acu Detox, and has been used for recovery in community-based settings and drug use treatment programs. It has also been…

40 CFR 8.5 - Submission of environmental documents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... environmental documentation meets the requirements of Article 8 and Annex I of the Protocol and the provisions... Article 8 and Annex I of the Protocol and the provisions of this part, the operator will have no further... and with the concurrence of the National Science Foundation, will inform the operator that EPA finds...

40 CFR 8.8 - Comprehensive environmental evaluation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... evaluate the CEE to determine if the CEE meets the requirements under Article 8 and Annex I to the Protocol... operator, the EPA will inform the operator if EPA, with the concurrence of the National Science Foundation... Article 8 and Annex I of the Protocol and the provisions of this part. This notification will occur within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.5 - Submission of environmental documents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... environmental documentation meets the requirements of Article 8 and Annex I of the Protocol and the provisions... Article 8 and Annex I of the Protocol and the provisions of this part, the operator will have no further... and with the concurrence of the National Science Foundation, will inform the operator that EPA finds...

40 CFR 8.8 - Comprehensive environmental evaluation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... evaluate the CEE to determine if the CEE meets the requirements under Article 8 and Annex I to the Protocol... operator, the EPA will inform the operator if EPA, with the concurrence of the National Science Foundation... Article 8 and Annex I of the Protocol and the provisions of this part. This notification will occur within...

40 CFR 8.7 - Initial environmental evaluation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... documentation requirements under Article 8 and Annex I to the Protocol and the provisions of this part or a CEE... documentation submitted does not meet the requirements of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.5 - Submission of environmental documents.

Code of Federal Regulations, 2014 CFR

2014-07-01

... environmental documentation meets the requirements of Article 8 and Annex I of the Protocol and the provisions... Article 8 and Annex I of the Protocol and the provisions of this part, the operator will have no further... and with the concurrence of the National Science Foundation, will inform the operator that EPA finds...

40 CFR 8.7 - Initial environmental evaluation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... documentation requirements under Article 8 and Annex I to the Protocol and the provisions of this part or a CEE... documentation submitted does not meet the requirements of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation...

40 CFR 8.7 - Initial environmental evaluation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... documentation requirements under Article 8 and Annex I to the Protocol and the provisions of this part or a CEE... documentation submitted does not meet the requirements of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation...

40 CFR 8.5 - Submission of environmental documents.

Code of Federal Regulations, 2012 CFR

2012-07-01

... environmental documentation meets the requirements of Article 8 and Annex I of the Protocol and the provisions... Article 8 and Annex I of the Protocol and the provisions of this part, the operator will have no further... and with the concurrence of the National Science Foundation, will inform the operator that EPA finds...

40 CFR 8.7 - Initial environmental evaluation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... documentation requirements under Article 8 and Annex I to the Protocol and the provisions of this part or a CEE... documentation submitted does not meet the requirements of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation...

40 CFR 8.5 - Submission of environmental documents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... environmental documentation meets the requirements of Article 8 and Annex I of the Protocol and the provisions... Article 8 and Annex I of the Protocol and the provisions of this part, the operator will have no further... and with the concurrence of the National Science Foundation, will inform the operator that EPA finds...

40 CFR 8.7 - Initial environmental evaluation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... documentation requirements under Article 8 and Annex I to the Protocol and the provisions of this part or a CEE... documentation submitted does not meet the requirements of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation...

40 CFR 8.8 - Comprehensive environmental evaluation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... evaluate the CEE to determine if the CEE meets the requirements under Article 8 and Annex I to the Protocol... operator, the EPA will inform the operator if EPA, with the concurrence of the National Science Foundation... Article 8 and Annex I of the Protocol and the provisions of this part. This notification will occur within...

40 CFR 8.8 - Comprehensive environmental evaluation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... evaluate the CEE to determine if the CEE meets the requirements under Article 8 and Annex I to the Protocol... operator, the EPA will inform the operator if EPA, with the concurrence of the National Science Foundation... Article 8 and Annex I of the Protocol and the provisions of this part. This notification will occur within...

The Spanish Protocol for radiological surveillance of metal recycling: a collaboration of government and industry.

PubMed

Cadierno, Juan Pedro García; Renedo, J I Serrano; Lopez, E Gil

2006-11-01

The presence of radioactive materials in scrap metal has been detected relatively often in recent years. As a result of an accidental melting of a 137Cs source in a Spanish steel mill (Acerinox) in 1998, the national authorities, the involved private companies, and the main trade unions drafted a protocol for prevention of and responding to such events ("Spanish Protocol"). The Protocol was signed in 1999. The number of subscribing companies is 90. The Protocol is a voluntary agreement defining the radiological surveillance of scrap metal and its products and the duties and rights of the signatories. From the effective date of the Protocol to December 2004, 461 pieces of ferric scrap were detected including sources of radiation and contaminated metal. Four melting incidents have happened in different companies.

A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.

PubMed

Cohen, Deborah J; Balasubramanian, Bijal A; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I; Crabtree, Benjamin F; Stange, Kurt C; Davis, Melinda; Miller, William L; Damschroder, Laura J; McConnell, K John; Creswell, John

2016-06-29

The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. ESCALATES is a national evaluation of an ambitious large-scale dissemination and implementation effort focused on transforming smaller primary care practices. Insights will help to inform the design of national health care practice extension systems aimed at supporting practice transformation efforts in the USA. NCT02560428 (09/21/15).

Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

PubMed

Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

2016-03-01

This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P < 0.05) per TBSA burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P < 0.05). The authors report their promising experience with a newly implemented protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

The USA National Phenology Network: A national observatory for assessment of biotic response to environmental variation

NASA Astrophysics Data System (ADS)

Weltzin, J. F.; USA National Phenology Network National Coordinating Office

2011-12-01

The USA National Phenology Network (USA-NPN; www.usanpn.org), established in 2007, is a national science and monitoring initiative focused on phenology as a tool to understand how plants, animals and landscapes respond to climatic variability and change. Core functions of the National Coordinating Office (NCO) of USA-NPN are to provide a national information management system including databases, develop and implement internationally standardized phenology monitoring protocols, create partnerships with a variety of organizations including field stations for implementation, facilitate research and the development of decision support tools, and promote education and outreach activities related to phenology and climate change. This presentation will describe programs, tools and materials developed by USA-NPN to facilitate science, management and education related to phenology of plants, animals and landscapes within protected areas at local, regional and national scales. Particular emphasis will be placed on the on-line integrated animal and plant monitoring program, Nature's Notebook, which provides standardized protocols for phenological status monitoring and data management for over 500 animal and plant species. The monitoring system facilitates collection of sampling intensity, absence data, considerable metadata (from site to observation). We recently added functionality for recording estimates of animal abundance and plant canopy development. Real-time raw data for plants (from 2009 to present) and animals (from 2010 to present), including FGDC-compliant metadata and documented methodology, are now available for download from the website. A new data exploration tool premiered in spring 2010 allows sophisticated graphical visualization of integrated phenological and meteorological data. The network seeks to develop partnerships with other organizations interested in (1) implementing vetted, standardized protocols for phenological or ecological monitoring, and (2) using phenology data and information for a variety of modeling applications.

Standardized methods for Grand Canyon fisheries research 2015

USGS Publications Warehouse

Persons, William R.; Ward, David L.; Avery, Luke A.

2013-01-01

This document presents protocols and guidelines to persons sampling fishes in the Grand Canyon, to help ensure consistency in fish handling, fish tagging, and data collection among different projects and organizations. Most such research and monitoring projects are conducted under the general umbrella of the Glen Canyon Dam Adaptive Management Program and include studies by the U.S. Geological Survey (USGS), U.S. Fish and Wildlife Service (FWS), National Park Service (NPS), the Arizona Game and Fish Department (AGFD), various universities, and private contractors. This document is intended to provide guidance to fieldworkers regarding protocols that may vary from year to year depending on specific projects and objectives. We also provide herein documentation of standard methods used in the Grand Canyon that can be cited in scientific publications, as well as a summary of changes in protocols since the document was first created in 2002.

Wildlife feeding in parks: methods for monitoring the effectiveness of educational interventions and wildlife food attraction behaviors

USGS Publications Warehouse

Marion, Jeffrey L.; Dvorak, Robert G.; Manning, Robert E.

2008-01-01

Opportunities to view and interact with wildlife are often an important part of high quality recreational experiences. Such interactions frequently include wildlife feeding, resulting in food-conditioned behaviors that may cause harm to both wildlife and visitors. This study developed and applied efficient protocols for simultaneously evaluating wildlife feeding-related behaviors of visitors and related foraging behaviors of chipmunks along a trail in Zion National Park. Unobtrusive observation protocols permitted an evaluation of educational messages delivered, and documentation of wildlife success in obtaining human food and the strength of their food attraction behavior. Significant improvements were documented for some targeted visitor behaviors and human food available to chipmunks, with minor differences between treatments. Replication of these protocols as part of a long-term monitoring program can help protected area managers evaluate and improve the efficacy of their interventions and monitor the strength of food attraction behavior in wildlife.

How to design and write a clinical research protocol in Cosmetic Dermatology*

PubMed Central

Bagatin, Ediléia; Miot, Helio A.

2013-01-01

Cosmetic Dermatology is a growing subspecialty. High-quality basic science studies have been published; however, few double-blind, randomized controlled clinical trials, which are the major instrument for evidence-based medicine, have been conducted in this area. Clinical research is essential for the discovery of new knowledge, improvement of scientific basis, resolution of challenges, and good clinical practice. Some basic principles for a successful researcher include interest, availability, persistence, and honesty. It is essential to learn how to write a protocol research and to know the international and national regulatory rules. A complete clinical trial protocol should include question, background, objectives, methodology (design, variable description, sample size, randomization, inclusion and exclusion criteria, intervention, efficacy and safety measures, and statistical analysis), consent form, clinical research form, and references. Institutional ethical review board approval and financial support disclosure are necessary. Publication of positive or negative results should be an authors' commitment. PMID:23539006

The Impact of Afforestation on the Carbon Stocks of Mineral Soils Across the Republic of Ireland.

NASA Astrophysics Data System (ADS)

Wellock, M.; Laperle, C.; Kiely, G.; Reidy, B.; Duffy, C.; Tobin, B.

2009-04-01

At the beginning of the twentieth century forests accounted for only 1% of the total Irish land cover (Pilcher & Mac an tSaoir, 1995). However, due to the efforts of successive governments there has been rapid afforestation since the 1960s resulting in a 10.0% forest land cover as of 2007 (The Department of Agriculture, Fisheries, and Food, 2007). A large proportion of this afforestation took place after the mid-1980s and was fueled by government grant incentive schemes targeted at private landowners (Renou & Farrell 2005). Consequently, 54% of forests are less than 20 years old (Byrne, 2006). This specific land use change provides an opportunity for Ireland to meet international obligations set forth by the United Nations Framework Convention on Climate Change (UNFCCC, 1992). These obligations include the limitation of greenhouse gas emissions to 13% above 1990 levels. In order to promote accountability for these commitments, the UNFCCC treaty and the Kyoto Protocol (Kyoto Protocol, 1997) mandate signatories to publish greenhouse gas (GHG) emissions inventories for both greenhouse gas sources and removals by sinks. Article 3.3 of the Kyoto Protocol allows changes in C stocks due to afforestation, reforestation, and deforestation since 1990 to be used to offset inventory emissions. Therefore, due to the rapid rate of afforestation and its increased carbon sequestration since 1990, Ireland has the potential to significantly offset GHG emissions. There is little known as to the impacts of afforestation on the carbon stocks in soils over time, and even less known about the impact on Irish soils. The FORESTC project aims to analyse this impact by undertaking a nationwide study using a method similar to that of the paired plot method in Davis and Condron, 2002. The study will examine 42 forest sites across Ireland selected randomly from the National Forest Inventory (National Forest Inventory, 2007). These 42 sites will be grouped based on the forest type which includes conifer, broadleaf, and mixed (broadleaf and conifer) and soil type: brown earth, podzol, brown podzolic, gley and brown earth. The paired plot method involves selecting a second site that represents the same soil type and physical characteristics as the forest site. The only difference between the two sites should be the current land-use of the pair site, which should represent the pre-afforestation land-use of the forest site. Each forest site and its pair site will be sampled in the top 30 cm of soil for bulk density and organic carbon %, while litter and F/H layer samples will be taken and analysed for carbon. This data should provide an analysis of the carbon stocks of the soil and litter of both the forest site and its pair site allowing for comparison and thus the impact of afforestation on carbon stocks. References. Byrne, K.A., & Milne, R. (2006). Carbon stocks and sequestration in plantation forests in the Republic of Ireland. Forestry, 79, no. 4: 361. Davis, M.R., & Condron, L.M. (2002). Impact of grassland afforestation on soil carbon in New Zealand: a review of paired-site studies. Australian Journal of Soil Research, 40, no. 4: 675-690. Kyoto Protocol. 1997 Kyoto Protocol to the United Nations Framework Convention on Climate Change. FCCC/CP/1997/7/Add.1, Decision 1/CP.3, Annex 7. UN. National Forest Inventory: NFI Methodology. (2007). Forest Service, The Department of Agriculture, Fisheries, and Food, Wexford, Ireland. Pilcher, J.R. & Mac an tSaoir, S. (1995). Wood, Trees and Forests in Ireland. (Royal Irish Academy, Dublin. Renou, F. & Farrell, E.P. (2005). Reclaiming peatlands for forestry: the Irish experience. In: Stanturf, J.A. and Madsen, P.A. (eds.). Restoration of boreal and temperate forests. CRC Press, Boca Raton. p.541-557. UNFCCC. 1992 United Nations Framework Convention on Climate Change. Palais des Nations, Geneva. http://www.unfccc.de/index.html

Preventing Caries in Preschoolers: Successful Initiation of an Innovative Community-Based Clinical Trial in Navajo Nation Head Start

PubMed Central

Quissell, David O.; Bryant, Lucinda L.; Braun, Patricia A.; Cudeii, Diana; Johs, Nikolas; Smith, Vongphone L.; George, Carmen; Henderson, William G.; Albino, Judith

2014-01-01

Navajo Nation children have the greatest prevalence of early childhood caries in the United States. This protocol describes an innovative combination of community-based participatory research and clinical trial methods to rigorously test a lay native Community Oral Health Specialists-delivered oral health intervention, with the goal of reducing the progression of disease and improving family knowledge and behaviors. Methods/Design This cluster-randomized trial designed by researchers at the Center for Native Oral Health Research at the University of Colorado in conjunction with members of the Navajo Nation community compares outcomes between the manualized 2-year oral health fluoride varnish-oral health promotion intervention and usual care in the community (child-caregiver dyads from 26 Head Start classrooms in each study arm; total of 1016 dyads). Outcome assessment includes annual dental screening and an annual caregiver survey of knowledge, attitudes and behaviors; collection of cost data will support cost-benefit analyses. Discussion The study protocol meets all standards required of randomized clinical trials. Aligned with principles of community-based participatory research, extended interaction between members of the Navajo community and researchers preceded study initiation, and collaboration between project staff and a wide variety of community members informed the study design and implementation. We believe the benefits of adding CBPR methods to those of randomized clinical studies outweigh the barriers and constraints, especially in studies of health disparities and in challenging settings. When done well, this innovative mix of methods will increase the likelihood of valid results that communities can use. PMID:24469238

National ITS Architecture and Standards Resource Guide

DOT National Transportation Integrated Search

1998-09-01

The Transportation Equity Act for the 21st Century (TEA-21) encourages the use of the National ITS Architecture and the adoption of ITS standards and protocols. This guide provides field personnel with guidance and resources necessary for implementin...

Rationale, timeline, study design, and protocol overview of the therapeutic hypothermia after pediatric cardiac arrest trials.

PubMed

Moler, Frank W; Silverstein, Faye S; Meert, Kathleen L; Clark, Amy E; Holubkov, Richard; Browning, Brittan; Slomine, Beth S; Christensen, James R; Dean, J Michael

2013-09-01

To describe the rationale, timeline, study design, and protocol overview of the Therapeutic Hypothermia after Pediatric Cardiac Arrest trials. Multicenter randomized controlled trials. Pediatric intensive care and cardiac ICUs in the United States and Canada. Children from 48 hours to 18 years old, who have return of circulation after cardiac arrest, who meet trial eligibility criteria, and whose guardians provide written consent. Therapeutic hypothermia or therapeutic normothermia. From concept inception in 2002 until trial initiation in 2009, 7 years were required to plan and operationalize the Therapeutic Hypothermia after Pediatric Cardiac Arrest trials. Two National Institute of Child Health and Human Development clinical trial planning grants (R21 and R34) supported feasibility assessment and protocol development. Two clinical research networks, Pediatric Emergency Care Applied Research Network and Collaborative Pediatric Critical Care Research Network, provided infrastructure resources. Two National Heart Lung Blood Institute U01 awards provided funding to conduct separate trials of in-hospital and out-of-hospital cardiac arrest. A pilot vanguard phase that included half the clinical sites began on March 9, 2009, and this was followed by full trial funding through 2015. Over a decade will have been required to plan, design, operationalize, and conduct the Therapeutic Hypothermia after Pediatric Cardiac Arrest trials. Details described in this report, such as participation of clinical research networks and clinical trial planning grants utilization, may be of utility for individuals who are planning investigator-initiated, federally supported clinical trials.

Development of a Protocol for Epidemiologal Studies of Whole-Body Vibration and Musculoskeletal Disorders of the Lower Back

NASA Astrophysics Data System (ADS)

Magnusson, M. L.; Pope, M. H.; Hulshof, C. T. J.; Bovenzi, M.

1998-08-01

It seems evident from a large number of studies that there is a positive relationship between exposure to whole body vibration (WBV) and the occurrence of low back pain. There are existing standards for evaluating the human exposure to WBV, which are based on other factors than the effect of musculoskeletal disorders. Several national and international standards also exist for evaluating human exposure to WBV. The exposure limit values or health guidance caution zones included in some of these standards are not or only to a limited extent based on systematic epidemiological investigations. It has not yet been possible to establish a clear exposure-response relationship. There are many confounding or contributing factors which influence the hazards to workers caused by exposure to WBV. Reliable methods for the detection and prevention of injury due to vibration exposure at work, alone or in combination with other risk factors, need to be implemented. The aim of this paper was to design a protocol and a questionnaire for conducting collaborative studies of WBV and musculoskeletal back disorders. The protocol will be tested in a pilot study before it will be used in multi-center studies.

Report on July 2015 Additional Protocol Coordinators Best Practices Workshop

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

Gitau, Ernest T.N.; Burbank, Roberta L.; Finch, Valerie A.

After 10 years of implementation experience, the Office of Nonproliferation and Arms Control (NPAC) within the Department of Energy/National Nuclear Security Administration (DOE/NNSA) conducted the Additional Protocol (AP) Coordinators Best Practices Workshop at Oak Ridge National Laboratory from July 29-30, 2015. The goal of this workshop was to identify implementation best practices, lessons learned, and compliance challenges from the various Additional Protocol Coordinators (APCs) at each laboratory in the DOE/NNSA complex and associated sites. The workshop provided the opportunity for participants to share their insights and establish networks that APCs can utilize to continue to discuss challenges (new and old),more » identify best practices, and enhance communication and coordination for reporting multi-lab research projects during review activities. Workshop participants included DOE/NNSA HQ, laboratory and site APCs, seasoned experts, members of the original implementation outreach team, and Field Element and site security representatives.« less

Practices and Attitudes Regarding Women Undergoing Fertility Preservation: A Survey of the National Physicians Cooperative.

PubMed

Bortoletto, Pietro; Confino, Rafael; Smith, Brigid M; Woodruff, Teresa K; Pavone, Mary Ellen

2017-09-01

To describe physician attitudes and variations in oncofertility treatment strategies. An exploratory online survey administered between December 1, 2014 and January 27, 2015 to 185 members of the National Physicians Cooperative (NPC). Twenty-eight percent (52 of 185) of NPC members responded to the online survey. Fifty percent of respondents were obstetrician-gynecologists working largely in academic medical centers. Thirty-eight percent stated that 14 was the youngest age they felt comfortable performing oocyte retrievals with 35% stating that any age was acceptable as long as they were postpubertal. Short stimulation protocols, utilizing a gonadotropin-releasing hormone (GnRH) antagonist (86%), were more common than long stimulation or microdose Lupron flare protocols (23% and 18%), respectively, which utilize a GnRH agonist. Random start protocols were used by 77% and over 90% perform luteal phase starts. When using random start protocols, 64% use gonadotropins only and 32% start GnRH antagonists alone for several days before starting gonadotropins. Fifty-five percent of physicians were comfortable stimulating ovarian cancer patients only after clearance from an oncologist. Aromatase inhibitors (77%) were significantly more common than tamoxifen (24%) for stimulation in breast cancer patients (p = 0.0006). When considering ovarian stimulation after chemotherapy, 24% expressed comfort only if blood counts are normal, 38% tend to wait 3 months. Regarding experimental treatment, 83% report discussing the use of GnRH agonists alone and 64% of clinics offer ovarian tissue cryopreservation. This study underlines the wide variation that exists in stimulation and phase start techniques, patient selection, comfort levels, and cancer type-specific decision making.

Energy efficiency as a commodity: The emergence of a secondary market for efficiency savings in commercial buildings

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

Kats, G.H.; Rosenfield, A.H.; McIntosh, T.A.

1997-06-01

The energy efficiency industry is constrained by lack of financing. For example, in the United States, commercial and public buildings need an investment of $100 billion for cost-effective retrofits with an average payback of about four years. But the current level of financing is stagnant at only about 34% of this level per year. The U.S. Department of Energy (DOE) has led the development of the North American Energy Measurement and Verification Protocol (NEMVP). This Protocol will increase the reliability and quality of estimated efficiency savings and improve realized savings. A critical element in the development of low cost financingmore » and a secondary market--whether for homes or credit card debt--is the adoption of protocols to provide uniformity and reliability of the product. This is also true of energy efficiency installations, which have been characterized by inconsistency in the installation methodologies and, frequently, unreliability of savings. This Protocol, published in April 1996, is a DOE-led effort involving American Society of Heating, Refrigerating, and Air-Conditioning Engineers, Inc. ASHRAE, National Association of Energy Service Companies NAESCO, National Association of Regulatory Utility Commissioners NARUC, National Association of State Energy Officials NASEO, US Environmental Protection Agency EPA, Canada`s Canadian Association of Energy Service Companies CAESCO, and Mexico`s Comision Nacional Para El Ahorro De Energia CONAE and Fideicomiso De Apoyo Al Programa De Ahorro De Energia Del Sector Electrico FIDE. DOE has begun to build on this Protocol to develop new forms of lower-cost financing including, ultimately, development of a secondary market for energy efficiency. This could double financing for building energy efficiency within five years.« less

The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services.

PubMed

Brown, Kathleen M; Hirshon, Jon Mark; Alcorta, Richard; Weik, Tasmeen S; Lawner, Ben; Ho, Shiu; Wright, Joseph L

2014-01-01

In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidence-based prehospital pain management protocol developed using this model process. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review Committee (PRC) of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The PRC recommended revisions to the Maryland protocol that reflected recommendations in the EBG: weight-based dosing and repeat dosing of morphine. A training curriculum was developed and implemented using Maryland's online Learning Management System and successfully accessed by 3,941 paramedics and 15,969 BLS providers. Field providers submitted electronic patient care reports to the MIEMSS statewide prehospital database. Inclusion criteria were injured or burned patients transported by Maryland ambulances to Maryland hospitals whose electronic patient care records included data for level of EMS provider training during a 12-month preimplementation period and a 12-month postimplementation period from September 2010 through March 2012. We compared the percentage of patients receiving pain scale assessments and morphine, as well as the dose of morphine administered and the use of naloxone as a rescue medication for opiate use, before and after the protocol change. No differences were seen in the percentage of patients who had a pain score documented or the percent of patients receiving morphine before and after the protocol change, but there was a significant increase in the total dose and dose in mg/kg administered per patient. During the postintervention phase, patients received an 18% higher total morphine dose and a 14.9% greater mg/kg dose. We demonstrated that the implementation of a revised statewide prehospital pain management protocol based on an EBG developed using the National Prehospital Evidence-based Guideline Model Process was associated with an increase in dosing of narcotic pain medication consistent with that recommended by the EBG. No differences were seen in the percentage of patients receiving opiate analgesia or in the documentation of pain scores.

Hydrofluorocarbon (HFC) Scenarios, Climate Effects and the Montreal Protocol

NASA Astrophysics Data System (ADS)

Velders, G. J. M.; Fahey, D. W.; Daniel, J. S.

2016-12-01

The Montreal Protocol has reduced the use of ozone-depleting substances by more than 95% from its peak levels in the 1980s. As a direct result the use of hydrofluorocarbons (HFCs) as substitute compounds has increased significantly. National regulations to limit HFC use have been adopted recently in the European Union, Japan and USA, and four proposals have been submitted to amend the Montreal Protocol to substantially reduce growth in HFC use. The Parties of the Montreal Protocol have discussed these proposals during their meetings in 2016. The effects of the national regulations and Montreal Protocol amendment proposals on climate forcings and surface temperatures will be presented. Global scenarios of HFC emissions reach 4.0-5.3 GtCO2-eq yr-1 in 2050, which corresponds to a projected growth from 2015 to 2050 which is 9% to 29% of that for CO2 over the same time period. In 2050, in percent of global HFC emissions, China ( 30%), India and the rest of Asia ( 25%), Middle East and northern Africa ( 10%), and USA ( 10%) are the principal source regions; and refrigeration and stationary air conditioning are the major use sectors. Calculated baseline emissions are reduced by 90% in 2050 by implementing the North America Montreal Protocol amendment proposal. This corresponds to a reduction in surface temperature attributed to HFCs from 0.1 oC to 0.04 oC in 2050 and from 0.3-0.4 oC to 0.02 oC in 2100.

National Football League Head, Neck and Spine Committee's Concussion Diagnosis and Management Protocol: 2017-18 season.

PubMed

Ellenbogen, Richard G; Batjer, Hunt; Cardenas, Javier; Berger, Mitchel; Bailes, Julian; Pieroth, Elizabeth; Heyer, Robert; Theodore, Nicholas; Hsu, Wellington; Nabel, Elizabeth; Maroon, Joe; Cantu, Robert; Barnes, Ronnie; Collins, James; Putukian, Margot; Lonser, Russell; Solomon, Gary; Sills, Allen

2018-03-16

One of the National Football League's (NFL) Head, Neck and Spine Committee's principal goals is to create a 'best practice' protocol for concussion diagnosis and management for its players. The science related to concussion diagnosis and management continues to evolve, thus the protocol has evolved contemporaneously. The Fifth International Conference on Concussion in Sport was held in Berlin in 2016, and guidelines for sports concussion diagnosis and management were revised and refined. The NFL Head, Neck and Spine Committee has synthesised the most recent empirical evidence for sports concussion diagnosis and management including the Berlin consensus statement and tailored it to the game played in the NFL. One of the goals of the Committee is to provide a standardised, reliable, efficient and evidence-based protocol for concussion diagnosis and management that can be applied in this professional sport during practice and game day. In this article, the end-of-season version of the 2017-18 NFL Concussion Diagnosis and Management Protocol is described along with its clinical rationale. Immediate actions for concussion programme enhancement and research are reviewed. It is the Committee's expectation that the protocol will undergo refinement and revision over time as the science and clinical practice related to concussion in sports crystallise. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Standardizing data exchange for clinical research protocols and case report forms: An assessment of the suitability of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM).

PubMed

Huser, Vojtech; Sastry, Chandan; Breymaier, Matthew; Idriss, Asma; Cimino, James J

2015-10-01

Efficient communication of a clinical study protocol and case report forms during all stages of a human clinical study is important for many stakeholders. An electronic and structured study representation format that can be used throughout the whole study life-span can improve such communication and potentially lower total study costs. The most relevant standard for representing clinical study data, applicable to unregulated as well as regulated studies, is the Operational Data Model (ODM) in development since 1999 by the Clinical Data Interchange Standards Consortium (CDISC). ODM's initial objective was exchange of case report forms data but it is increasingly utilized in other contexts. An ODM extension called Study Design Model, introduced in 2011, provides additional protocol representation elements. Using a case study approach, we evaluated ODM's ability to capture all necessary protocol elements during a complete clinical study lifecycle in the Intramural Research Program of the National Institutes of Health. ODM offers the advantage of a single format for institutions that deal with hundreds or thousands of concurrent clinical studies and maintain a data warehouse for these studies. For each study stage, we present a list of gaps in the ODM standard and identify necessary vendor or institutional extensions that can compensate for such gaps. The current version of ODM (1.3.2) has only partial support for study protocol and study registration data mainly because it is outside the original development goal. ODM provides comprehensive support for representation of case report forms (in both the design stage and with patient level data). Inclusion of requirements of observational, non-regulated or investigator-initiated studies (outside Food and Drug Administration (FDA) regulation) can further improve future revisions of the standard. Published by Elsevier Inc.

Diagnostic reference levels of paediatric computed tomography examinations performed at a dedicated Australian paediatric hospital.

PubMed

Bibbo, Giovanni; Brown, Scott; Linke, Rebecca

2016-08-01

Diagnostic Reference Levels (DRL) of procedures involving ionizing radiation are important tools to optimizing radiation doses delivered to patients and in identifying cases where the levels of doses are unusually high. This is particularly important for paediatric patients undergoing computed tomography (CT) examinations as these examinations are associated with relatively high-dose. Paediatric CT studies, performed at our institution from January 2010 to March 2014, have been retrospectively analysed to determine the 75th and 95th percentiles of both the volume computed tomography dose index (CTDIvol ) and dose-length product (DLP) for the most commonly performed studies to: establish local diagnostic reference levels for paediatric computed tomography examinations performed at our institution, benchmark our DRL with national and international published paediatric values, and determine the compliance of CT radiographer with established protocols. The derived local 75th percentile DRL have been found to be acceptable when compared with those published by the Australian National Radiation Dose Register and two national children's hospitals, and at the international level with the National Reference Doses for the UK. The 95th percentiles of CTDIvol for the various CT examinations have been found to be acceptable values for the CT scanner Dose-Check Notification. Benchmarking CT radiographers shows that they follow the set protocols for the various examinations without significant variations in the machine setting factors. The derivation of DRL has given us the tool to evaluate and improve the performance of our CT service by improved compliance and a reduction in radiation dose to our paediatric patients. We have also been able to benchmark our performance with similar national and international institutions. © 2016 The Royal Australian and New Zealand College of Radiologists.

Identifying Evidence-Based Educational Practices: Which Research Designs Provide Findings That Can Influence Social Change?

ERIC Educational Resources Information Center

Schirmer, Barbara R.; Lockman, Alison S.; Schirmer, Todd N.

2016-01-01

We conducted this conceptual study to determine if the Institute of Education Sciences/National Science Foundation pipeline of evidence guidelines could be applied as a protocol that researchers could follow in establishing evidence of effective instructional practices. To do this, we compared these guidelines, new drug development process, and…

Family Carers' Experiences Using Support Services in Europe: Empirical Evidence from the EUROFAMCARE Study

ERIC Educational Resources Information Center

Lamura, Giovanni; Mnich, Eva; Nolan, Mike; Wojszel, Beata; Krevers, Barbro; Mestheneos, Liz; Dohner, Hanneli

2008-01-01

Purpose: This article explores the experiences of family carers of older people in using support services in six European countries: Germany, Greece, Italy, Poland, Sweden, and the UK. Design and Methods: Following a common protocol, data were collected from national samples of approximately 1,000 family carers per country and clustered into…

Repeated Interviews with Children Who Are the Alleged Victims of Sexual Abuse

ERIC Educational Resources Information Center

Katz, Carmit; Hershkowitz, Irit

2013-01-01

Objective: The present study was designed to test the effects of repeated retrievals in the course of forensic investigations with children who are the alleged victims of sexual abuse. Method: Using the National Institute of Child Health and Human Development protocol, 56 children participated in a first free-recall interview that was followed by…

Optimisation of pharmacy content in clinical cancer research protocols: Experience of the United Kingdom Chemotherapy and Pharmacy Advisory Service.

PubMed

Debruyne, Philip R; Johnson, Philip J; Pottel, Lies; Daniels, Susanna; Greer, Rachel; Hodgkinson, Elizabeth; Kelly, Stephen; Lycke, Michelle; Samol, Jens; Mason, Julie; Kimber, Donna; Loucaides, Eileen; Parmar, Mahesh Kb; Harvey, Sally

2015-06-01

Clarity and accuracy of the pharmacy aspects of cancer clinical trial protocols is essential. Inconsistencies and ambiguities in such protocols have the potential to delay research and jeopardise both patient safety and collection of credible data. The Chemotherapy and Pharmacy Advisory Service was established by the UK National Cancer Research Network, currently known as National Institute for Health Research Clinical Research Network, to improve the quality of pharmacy-related content in cancer clinical research protocols. This article reports the scope of Chemotherapy and Pharmacy Advisory Service, its methodology of mandated protocol review and pharmacy-related guidance initiatives and its current impact. Over a 6-year period (2008-2013) since the inception of Chemotherapy and Pharmacy Advisory Service, cancer clinical trial protocols were reviewed by the service, prior to implementation at clinical trial sites. A customised Review Checklist was developed and used by a panel of experts to standardise the review process and report back queries and inconsistencies to chief investigators. Based on common queries, a Standard Protocol Template comprising specific guidance on drug-related content and a Pharmacy Manual Template were developed. In addition, a guidance framework was established to address 'ad hoc' pharmacy-related queries. The most common remarks made at protocol review have been summarised and categorised through retrospective analysis. In order to evaluate the impact of the service, chief investigators were asked to respond to queries made at protocol review and make appropriate changes to their protocols. Responses from chief investigators have been collated and acceptance rates determined. A total of 176 protocols were reviewed. The median number of remarks per protocol was 26, of which 20 were deemed clinically relevant and mainly concerned the drug regimen, support medication, frequency and type of monitoring and drug supply aspects. Further analysis revealed that 62% of chief investigators responded to the review. All responses were positive with an overall acceptance rate of 89% of the proposed protocol changes. Review of pharmacy content of cancer clinical trial protocols is feasible and exposes many undetected clinically relevant issues that could hinder efficient trial conduct. Our service audit revealed that the majority of suggestions were effectively incorporated in the final protocols. The refinement of existing and development of new pharmacy-related guidance documents by Chemotherapy and Pharmacy Advisory Service might aid in better and safer clinical research. © The Author(s) 2015.

THE EFFECTS OF HEAT SHOCK PROTEIN 70 (HSP70) AND EXPOSURE PROTOCOL ON ARSENITE INDUCED GENOTOXICITY

EPA Science Inventory

The Effects of Heat Shock Protein 70 (Hsp70) and Exposure Protocol on Arsenite Induced Genotoxicity

Barnes, J.A.1,2, Collins, B.W.2, Dix, D.J.3 and Allen J.W2.
1National Research Council, 2Environmental Carcinogenesis Division, 3Reproductive Toxicology Division, Office...

Asserting National Sovereignty in Cyberspace: The Case for Internet Border Inspection

DTIC Science & Technology

2003-06-01

Influencing Foreign Policy. in Internet and International Systems: Information Technology and American Foreign Policy Decisionmaking Workshop. 1999...investigative Agencies that investigate violations of federal law IO Information Operations, military operations in information realm IP Internet ...Protocol, a specific format for Internet packet headers IW Information Warfare, part of information operations NCP Network Control Protocol NSA

An example problem illustrating the application of the national lime association mixture design and testing protocol (MDTP) to ascertain engineering properties of lime-treated subgrades for mechanistic pavement design/analysis.

DOT National Transportation Integrated Search

2001-09-01

This document presents an example of mechanistic design and analysis using a mix design and : testing protocol. More specifically, it addresses the structural properties of lime-treated subgrade, : subbase, and base layers through mechanistic design ...

OSI and TCP/IP

NASA Technical Reports Server (NTRS)

Randolph, Lynwood P.

1994-01-01

The Open Systems Interconnection Transmission Control Protocol/Internet Protocol (OSI TCP/IP) and the Government Open Systems Interconnection Profile (GOSIP) are compared and described in terms of Federal internetworking. The organization and functions of the Federal Internetworking Requirements Panel (FIRP) are discussed and the panel's conclusions and recommendations with respect to the standards and implementation of the National Information Infrastructure (NII) are presented.

Evidence supporting the need for a common soil monitoring protocol

Treesearch

Derrick A. Reeves; Mark D. Coleman; Deborah S. Page-Dumroese

2013-01-01

Many public land management agencies monitor forest soils for levels of disturbance related to management activities. Although several soil disturbance monitoring protocols based on visual observation have been developed to assess the amount and types of disturbance caused by forest management, no common method is currently used on National Forest lands in the United...

Impact of a pharmacist-driven warfarin management protocol on achieving therapeutic International Normalized Ratios.

PubMed

Downing, Amanda; Mortimer, Molly; Hiers, Jill

2016-03-01

Warfarin is a high alert medication and a challenge to dose and monitor. Pharmacist-driven warfarin management has been shown to decrease the time international normalized ratio (INR) is out of range, which may reduce undesired outcomes. The purpose of this study is to assess the effect of the implementation of a pharmacist-driven warfarin management protocol on the achievement of therapeutic INRs. A warfarin management protocol was developed using evidence based literature and similar protocols from other institutions. Pharmacists utilized the protocol to provide patient specific warfarin dosing upon provider referral. To evaluate the protocol's impact, a retrospective chart review pre- and post-implementation was completed for admitted patients receiving warfarin. Three hundred twenty-seven charts were reviewed for pre- and post-implementation data. INRs within therapeutic range increased from 27.8% before protocol implementation to 38.5% after implementation. There was also a reduction in subtherapeutic INRs (55.3% pre to 39% post) and supratherapeutic INRs 5 or above (3.7% pre to 2.6% post). Supratherapeutic INRs between 3 and 5 did increase from 13.2% before protocol implementation to 19.9% in the pharmacist managed group. In addition to reducing the time to achievement of therapeutic INRs by 0.5 days, implementation of the protocol resulted in an increased the number of patients with at least one therapeutic INR during admission (35% pre to 40% post). The implementation of a pharmacist-driven warfarin dosing protocol increased therapeutic INRs, and decreased the time to therapeutic range, as well as the proportion of subtherapeutic INRs and supratherapeutic INRs 5 or greater. Additional benefits of the protocol include documentation of Joint Commission National Patient Safety Goal compliance, promotion of interdisciplinary collaboration and increased continuity of care. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

An eight-year follow-up national study of medical school and general hospital ethics committees in Japan

PubMed Central

Akabayashi, Akira; Slingsby, Brian T; Nagao, Noriko; Kai, Ichiro; Sato, Hajime

2007-01-01

Background Ethics committees and their system of research protocol peer-review are currently used worldwide. To ensure an international standard for research ethics and safety, however, data is needed on the quality and function of each nation's ethics committees. The purpose of this study was to describe the characteristics and developments of ethics committees established at medical schools and general hospitals in Japan. Methods This study consisted of four national surveys sent twice over a period of eight years to two separate samples. The first target was the ethics committees of all 80 medical schools and the second target was all general hospitals with over 300 beds in Japan (n = 1457 in 1996 and n = 1491 in 2002). Instruments contained four sections: (1) committee structure, (2) frequency of annual meetings, (3) committee function, and (4) existence of a set of guidelines for the refusal of blood transfusion by Jehovah's Witnesses. Results Committee structure was overall interdisciplinary. Frequency of annual meetings increased significantly for both medical school and hospital ethics committees over the eight years. The primary activities for medical school and hospital ethics committees were research protocol reviews and policy making. Results also showed a significant increase in the use of ethical guidelines, particularly those related to the refusal of blood transfusion by Jehovah's Witnesses, among both medical school and hospital ethics committees. Conclusion Overall findings indicated a greater recognized degree of responsibilities and an increase in workload for Japanese ethics committees. PMID:17598923

The geographical distribution of underweight children in Africa.

PubMed Central

Nubé, Maarten; Sonneveld, Benjamin G. J. S.

2005-01-01

OBJECTIVE: To study geographical patterns of underweight children in Africa by combining information on prevalence with headcounts at a subnational level. METHODS: We used large-scale, nationally representative nutrition surveys, in particular the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys, which have been designed, analysed and presented according to largely similar protocols, and which report at the national and subnational levels. FINDINGS: We found distinct geographical patterns in the occurrence of underweight children, which could be linked to factors such as agronomic and climatic conditions, population density and economic integration. CONCLUSION: Patterns of underweight children cross national borders suggesting that regional characteristics and interactions need to be considered when addressing malnutrition. PMID:16283053

Meta Salud Diabetes study protocol: a cluster-randomised trial to reduce cardiovascular risk among a diabetic population of Mexico.

PubMed

Sabo, Samantha; Denman Champion, Catalina; Bell, Melanie L; Cornejo Vucovich, Elsa; Ingram, Maia; Valenica, Celina; Castro Vasquez, Maria Del Carmen; Gonzalez-Fagoaga, Eduardo; Geurnsey de Zapien, Jill; Rosales, Cecilia B

2018-03-12

Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomised clinical behavioural trial based in 22 (n=22) health centres in Sonora, Mexico. MSD aims to evaluate the effectiveness of the MSD intervention for the secondary prevention of CVD risk factors among a diabetic population (n=320) compared with the study control of usual care. The MSD intervention consists of 2-hour class sessions delivered over a 13-week period providing educational information to encourage sustainable behavioural change to prevent disease complications including the adoption of physical activity. MSD is delivered within the context of Mexico's national primary care health centre system by health professionals, including nurses, physicians and community health workers via existing social support groups for individuals diagnosed with chronic disease. Mixed models are used to estimate the effect of MSD by comparing cardiovascular risk, as measured by the Framingham Risk Score, between the trial arms. Secondary outcomes include hypertension, behavioural risk factors and psychosocial factors. This work is supported by the National Institutes of Health, National Heart Lung and Blood Institute (1R01HL125996-01) and approved by the University of Arizona Research Institutional Review Board (Protocol 1508040144) and the Research Bioethics Committee at the University of Sonora. The first Internal Review Board approval date was 31 August 2015 with five subsequent approved amendments. This article refers to protocol V.0.2, dated 30 January 2017. Results will be disseminated via peer-reviewed publication and presentation at international conferences and will be shared through meetings with health systems officials. NCT0280469; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

European emissions of the powerful greenhouse gases hydrofluorocarbons inferred from atmospheric measurements and their comparison with annual national reports to UNFCCC

NASA Astrophysics Data System (ADS)

Graziosi, F.; Arduini, J.; Furlani, F.; Giostra, U.; Cristofanelli, P.; Fang, X.; Hermanssen, O.; Lunder, C.; Maenhout, G.; O'Doherty, S.; Reimann, S.; Schmidbauer, N.; Vollmer, M. K.; Young, D.; Maione, M.

2017-06-01

Hydrofluorocarbons are powerful greenhouse gases developed by industry after the phase-out of the ozone depleting chlorofluorocarbons and hydrochlorofluorocarbons required by the Montreal Protocol. The climate benefit of reducing the emissions of hydrofluorocarbons has been widely recognised, leading to an amendment of the Montreal Protocol (Kigali Amendment) calling for developed countries to start to phase-down hydrofluorocarbons by 2019 and in developing countries to follow with a freeze between 2024 and 2028. In this way, nearly half a degree Celsius of warming would be avoided by the end of the century. Hydrofluorocarbons are also included in the basket of gases controlled under the Kyoto Protocol of the United Nations Framework Convention on Climate Change. Annex I parties to the Convention submit annual national greenhouse gas inventories based on a bottom-up approach, which relies on declared anthropogenic activities. Top-down methodologies, based on atmospheric measurements and modelling, can be used in support to the inventory compilation. In this study we used atmospheric data from four European sites combined with the FLEXPART dispersion model and a Bayesian inversion method, in order to derive emissions of nine individual hydrofluorocarbons from the whole European Geographic Domain and from twelve regions within it, then comparing our results with the annual emissions that the European countries submit every year to the United Nations Framework Convention on Climate Change, as well as with the bottom-up Emissions Database for Global Atmospheric Research. We found several discrepancies when considering the specific compounds and on the country level. However, an overall agreement is found when comparing European aggregated data, which between 2008 and 2014 are on average 84.2 ± 28.0 Tg-CO2-eq·yr-1 against the 95.1 Tg-CO2-eq·yr-1 reported by UNFCCC in the same period. Therefore, in agreement with other studies, the gap on the global level between bottom-up estimates of Annex I countries and total global top-down emissions should be essentially due to emissions from non-reporting countries (non-Annex I).

Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial.

PubMed

Wall, Peter Dh; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E

2016-10-01

Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12-26 weeks in 6-10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). ISRCTN 09754699. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Montreal Cognitive Assessment is superior to National Institute of Neurological Disease and Stroke-Canadian Stroke Network 5-minute protocol in predicting vascular cognitive impairment at 1 year.

PubMed

Dong, YanHong; Xu, Jing; Chan, Bernard Poon-Lap; Seet, Raymond Chee Seong; Venketasubramanian, Narayanaswamy; Teoh, Hock Luen; Sharma, Vijay Kumar; Chen, Christopher Li-Hsian

2016-04-12

The predictive ability of National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol and Montreal Cognitive Assessment (MoCA) administered sub-acutely and at the convalescent phase after stroke for significant vascular cognitive impairment (VCI) at 1 year is unknown. We compared prognostic values of these tests. Patients with ischemic stroke and transient ischemic attack (TIA) received MoCA sub-acutely (within 2 weeks) and 3-6 months after stroke followed by a formal neuropsychological evaluation at 1 year. The total score of NINDS-CSN 5-minutes protocol was derived from MoCA. Moderate-severe VCI was defined as neuropsychological impairment in ≥ 3 domains. Area under the receiver operating characteristic curve (AUC) analyses were conducted to establish the optimal cutoff points and discriminatory properties of the MoCA and NINDS-CSN 5-minute protocol in detecting moderate-severe VCI. Four hundre patients were recruited at baseline. Of these, 291 received a formal neuropsychological assessment 1 year after stroke. 19% patients had moderate-severe VCI. The MoCA was superior to the NINDS-CSN 5-minute protocol [sub-acute AUCs: 0.89 vs 0.80, p < 0.01; 3-6 months AUCs: 0.90 vs 0.83, p < 0.01] in predicting for moderate-severe VCI at 1 year. At respective cutoff points, MoCA had significantly higher sensitivity than the NINDS-CSN 5-minute protocol at baseline (p = 0.01) and 3-6 months (p = 0.04). MoCA administered sub-acutely and 3-6 months after stroke is superior to the NINDS-CSN 5-minute protocol in predicting moderate-severe VCI at 1 year.

Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial

PubMed Central

Wall, Peter DH; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E

2016-01-01

Introduction Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. Methods In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. Results The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12–26 weeks in 6–10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. Conclusion PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). Trial registration number ISRCTN 09754699. PMID:27629405

Accurate quantum Z rotations with less magic

NASA Astrophysics Data System (ADS)

Landahl, Andrew; Cesare, Chris

2013-03-01

We present quantum protocols for executing arbitrarily accurate π /2k rotations of a qubit about its Z axis. Unlike reduced instruction set computing (RISC) protocols which use a two-step process of synthesizing high-fidelity ``magic'' states from which T = Z (π / 4) gates can be teleported and then compiling a sequence of adaptive stabilizer operations and T gates to approximate Z (π /2k) , our complex instruction set computing (CISC) protocol distills magic states for the Z (π /2k) gates directly. Replacing this two-step process with a single step results in substantial reductions in the number of gates needed. The key to our construction is a family of shortened quantum Reed-Muller codes of length 2 k + 2 - 1 , whose distillation threshold shrinks with k but is greater than 0.85% for k <= 6 . AJL and CC were supported in part by the Laboratory Directed Research and Development program at Sandia National Laboratories. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

PCoD Lite - Using an Interim PCoD Protocol to Assess the Effects of Disturbance Associated with US Navy Exercises on Marine Mammal Populations

DTIC Science & Technology

2015-09-30

1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. PCoD Lite - Using an Interim PCoD Protocol to Assess...US National Research Council (NRC 2005). Here, we provide an insight into how the Interim PCoD approach (Harwood et al. 2014, King et al. 2015...illustrate how the interim PCoD protocol can be used to inform the process of determining whether or not Navy activities are likely to have an impact on

[Protocol for the treatment of severe acute pancreatitis with necrosis].

PubMed

Barreda, Luis; Targarona, Javier; Rodriguez, César

2005-01-01

The Severe Acute Pancreatic Unit of Edgardo Rebagliati Martins National Hospital was officially created in the year 2000. Up to date, we have cared for more than 195 patients with Pancreatic Necrosis. All of them have been treated under a management protocol presented by us. This has helped us to standardize treatment and also to compare results with work groups around the world. This Protocol comes from our own experience and that of our colleagues abroad with a wide knowledge in this kind of pathology abroad, with whom we maintain close ties.

COGNITIVE-HD study: protocol of an observational study of neurocognitive functioning and association with clinical outcomes in adults with end-stage kidney disease treated with haemodialysis.

PubMed

Palmer, Suetonia C; Ruospo, Marinella; Barulli, Maria Rosaria; Iurillo, Annalisa; Saglimbene, Valeria; Natale, Patrizia; Gargano, Letizia; Murgo, Angelo M; Loy, Clement; van Zwieten, Anita; Wong, Germaine; Tortelli, Rosanna; Craig, Jonathan C; Johnson, David W; Tonelli, Marcello; Hegbrant, Jörgen; Wollheim, Charlotta; Logroscino, Giancarlo; Strippoli, G F M

2015-12-09

The prevalence of cognitive impairment may be increased in adults with end-stage kidney disease compared with the general population. However, the specific patterns of cognitive impairment and association of cognitive dysfunction with activities of daily living and clinical outcomes (including withdrawal from treatment) among haemodialysis patients remain incompletely understood. The COGNITIVE impairment in adults with end-stage kidney disease treated with HemoDialysis (COGNITIVE-HD) study aims to characterise the age-adjusted and education-adjusted patterns of cognitive impairment (using comprehensive testing for executive function, perceptual-motor function, language, learning and memory, and complex attention) in patients on haemodialysis and association with clinical outcomes. A prospective, longitudinal, cohort study of 750 adults with end-stage kidney disease treated with long-term haemodialysis has been recruited within haemodialysis centres in Italy (July 2013 to April 2014). Testing for neurocognitive function was carried out by a trained psychologist at baseline to assess cognitive functioning. The primary study factor is cognitive impairment and secondary study factors will be specific domains of cognitive function. The primary outcome will be total mortality. Secondary outcomes will be cause-specific mortality, major cardiovascular events, fatal and non-fatal myocardial infarction and stroke, institutionalisation, and withdrawal from treatment at 12 months. This protocol was approved before study conduct by the following responsible ethics committees: Catania (approval reference 186/BE; 26/09/2013), Agrigento (protocol numbers 61-62; 28/6/2013), USL Roma C (CE 39217; 24/6/2013), USL Roma F (protocol number 0041708; 23/7/2013), USL Latina (protocol number 20090/A001/2011; 12/7/2013), Trapani (protocol number 3413; 16/7/2013) and Brindisi (protocol number 40259; 6/6/2013). All participants have provided written and informed consent and can withdraw from the study at any time. The findings of the study will be disseminated through peer-reviewed journals and national and international conference presentations and to the participants through communication within the dialysis network in which this study is conducted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Survey of Clostridium difficile infection surveillance systems in Europe, 2011.

PubMed

Kola, Axel; Wiuff, Camilla; Akerlund, Thomas; van Benthem, Birgit H; Coignard, Bruno; Lyytikäinen, Outi; Weitzel-Kage, Doris; Suetens, Carl; Wilcox, Mark H; Kuijper, Ed J; Gastmeier, Petra

2016-07-21

To develop a European surveillance protocol for Clostridium difficile infection (CDI), existing national CDI surveillance systems were assessed in 2011. A web-based electronic form was provided for all national coordinators of the European CDI Surveillance Network (ECDIS-Net). Of 35 national coordinators approached, 33 from 31 European countries replied. Surveillance of CDI was in place in 14 of the 31 countries, comprising 18 different nationwide systems. Three of 14 countries with CDI surveillance used public health notification of cases as the route of reporting, and in another three, reporting was limited to public health notification of cases of severe CDI. The CDI definitions published by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC) were widely used, but there were differing definitions to distinguish between community- and healthcare-associated cases. All CDI surveillance systems except one reported annual national CDI rates (calculated as number of cases per patient-days). Only four surveillance systems regularly integrated microbiological data (typing and susceptibility testing results). Surveillance methods varied considerably between countries, which emphasises the need for a harmonised European protocol to allow consistent monitoring of the CDI epidemiology at European level. The results of this survey were used to develop a harmonised EU-wide hospital-based CDI surveillance protocol. This article is copyright of The Authors, 2016.

National estimates of soil loss on rangelands

USDA-ARS?s Scientific Manuscript database

Since 1995, an interagency group composed of the Natural Resources Conservation Service, Agricultural Research Service, and U.S. Geological Survey have worked together to develop a robust field approach for National Resource Inventory (NRI) on rangeland. The new NRI protocols are designed to detect ...

Health Information National Trends Survey in American Sign Language (HINTS-ASL): Protocol for the Cultural Adaptation and Linguistic Validation of a National Survey.

PubMed

Kushalnagar, Poorna; Harris, Raychelle; Paludneviciene, Raylene; Hoglind, TraciAnn

2017-09-13

The Health Information National Trends Survey (HINTS) collects nationally representative data about the American's public use of health-related information. This survey is available in English and Spanish, but not in American Sign Language (ASL). Thus, the exclusion of ASL users from these national health information survey studies has led to a significant gap in knowledge of Internet usage for health information access in this underserved and understudied population. The objectives of this study are (1) to culturally adapt and linguistically translate the HINTS items to ASL (HINTS-ASL); and (2) to gather information about deaf people's health information seeking behaviors across technology-mediated platforms. We modified the standard procedures developed at the US National Center for Health Statistics Cognitive Survey Laboratory to culturally adapt and translate HINTS items to ASL. Cognitive interviews were conducted to assess clarity and delivery of these HINTS-ASL items. Final ASL video items were uploaded to a protected online survey website. The HINTS-ASL online survey has been administered to over 1350 deaf adults (ages 18 to 90 and up) who use ASL. Data collection is ongoing and includes deaf adult signers across the United States. Some items from HINTS item bank required cultural adaptation for use with deaf people who use accessible services or technology. A separate item bank for deaf-related experiences was created, reflecting deaf-specific technology such as sharing health-related ASL videos through social network sites and using video remote interpreting services in health settings. After data collection is complete, we will conduct a series of analyses on deaf people's health information seeking behaviors across technology-mediated platforms. HINTS-ASL is an accessible health information national trends survey, which includes a culturally appropriate set of items that are relevant to the experiences of deaf people who use ASL. The final HINTS-ASL product will be available for public use upon completion of this study. ©Poorna Kushalnagar. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 13.09.2017.

[Proposal of an Italian national protocol of health surveillance for former asbestos workers: an ongoing project].

PubMed

Marchiori, Luciano; Marangi, Gianluca; Ballarin, Nicoletta; Valentini, Flavio; D'Anna, Mauro; Barbina, Paolo; Franchi, Alberto; Mastrangelo, Giuseppe

2016-01-01

to define an Italian national protocol of post-occupational health surveillance for asbestos workers according to effectiveness, appropriateness, saving, and social utility. data for 1,071 former asbestos workers from several Italian Regions were collected and analysed. For these workers, a retrospective estimate of asbestos exposure was carried out. A cohort study of 1,588 asbestos workers recruited from 2000 onward during statutory health examinations in Veneto and followed-up for lung cancer mortality until December 2010 was executed. A literature search on methods of follow-up of asbestos workers (imaging, spirometry, and questionnaires) and diagnosis of non-malignant (asbestosis and pleural plaques) and malignant (lung cancer) asbestos disease was done. A consensus, i.e., a process of agreeing on one result among the participants, was made. 19 Italian Regions (North: Veneto, Emilia-Romagna, Lombardia, Piemonte, Valle d'Aosta, Autonomous Province of Trento, Autonomous Province of Bolzano, Friuli Venezia Giulia, Liguria; Centre:Toscana, Umbria; South and Islands: Calabria, Abruzzo, Puglia, Campania, Basilicata,Marche, Sicilia, Sardegna), Department of Occupational Medicine at Italian National Institute for Compensation ofWork-Related Diseases and Accidents (INAIL), and Department of Cardiac, Thoracic, and Vascular Sciences at University of Padova. analysis of current regional experiences on health surveillance; retrospective estimate of asbestos exposure; data collection and analysis of a cohort of asbestos workers; search of the relevant literature; final report with the consensus document. the results obtained in each of the above areas of research, along with the relevant findings of the literature, were presented and discussed among the participants. The several phases of expression and evaluation of the participants' opinions were conducted according to an iterative method of investigation (Delphi method), which allows a progressive converging of different views into one shared result. based on all the above, a consensus has been reached on a proposal for an Italian national protocol of health surveillance for asbestos workers.

Life-threatening asthma and anaphylaxis in schools: a treatment model for school-based programs.

PubMed

Murphy, Kevin R; Hopp, Russell J; Kittelson, Eleanor B; Hansen, Geri; Windle, Mary L; Walburn, John N

2006-03-01

Pediatric asthma is the No. 1 chronic disease in childhood and is responsible for significant morbidity and mortality. In Nebraska, the number of asthma-related deaths is greater than the national average, and in 1998, 2 students died of acute asthma attacks while attending school in the Omaha public schools (OPSs). In response, we designed and implemented a program to respond to this problem. To implement and study a school-based program for the treatment of life-threatening asthma and anaphylaxis in the OPSs. The Emergency Response to Life-Threatening Asthma or Systemic Allergic Reactions (Anaphylaxis) Protocol was designed and evaluated in 78 OPSs from 1998 to 2003. Nurses and school staff were trained in the protocol, which required the use of nebulized albuterol and/or intramuscular epinephrine in conjunction with an emergency response procedure. Outcomes were measured by improvement in acute care in schools and survival of students. In the 5 years of evaluation, 98 students were treated successfully. One student died. Of those treated with the protocol, equal numbers had at school both asthma action plans (AAPs) and metered-dose inhalers (MDIs), MDIs only, or neither AAPs nor MDIs. As a result of the program, there has been an increased awareness from parents, teachers, and physicians about the necessity of an emergency response program. In 2002, an outcome of the OPS program resulted in the formation of Attack on Asthma Nebraska to ensure that Nebraska schools have the education, training, and medications to respond to anyone experiencing a life-threatening asthma or anaphylaxis attack at school. The following year, a revised protocol was approved by the Nebraska State Board of Education for use in all Nebraska schools. Emergency response protocols provide protection for children while in school. This program should serve as a national model for other school-based programs for children and adolescents with asthma and anaphylaxis.

A national registry for juvenile dermatomyositis and other paediatric idiopathic inflammatory myopathies: 10 years' experience; the Juvenile Dermatomyositis National (UK and Ireland) Cohort Biomarker Study and Repository for Idiopathic Inflammatory Myopathies

PubMed Central

Martin, Neil; Krol, Petra; Smith, Sally; Murray, Kevin; Pilkington, Clarissa A.; Davidson, Joyce E.

2011-01-01

Objectives. The paediatric idiopathic inflammatory myopathies (IIMs) are a group of rare chronic inflammatory disorders of childhood, affecting muscle, skin and other organs. There is a severe lack of evidence base for current treatment protocols in juvenile myositis. The rarity of these conditions means that multicentre collaboration is vital to facilitate studies of pathogenesis, treatment and disease outcomes. We have established a national registry and repository for childhood IIM, which aims to improve knowledge, facilitate research and clinical trials, and ultimately to improve outcomes for these patients. Methods. A UK-wide network of centres and research group was established to contribute to the study. Standardized patient assessment, data collection forms and sample protocols were agreed. The Biobank includes collection of peripheral blood mononuclear cells, serum, genomic DNA and biopsy material. An independent steering committee was established to oversee the use of data/samples. Centre training was provided for patient assessment, data collection and entry. Results. Ten years after inception, the study has recruited 285 children, of which 258 have JDM or juvenile PM; 86% of the cases have contributed the biological samples. Serial sampling linked directly to the clinical database makes this a highly valuable resource. The study has been a platform for 20 sub-studies and attracted considerable funding support. Assessment of children with myositis in contributing centres has changed through participation in this study. Conclusions. This establishment of a multicentre registry and Biobank has facilitated research and contributed to progress in the management of a complex group of rare muscloskeletal conditions. PMID:20823094

Phenology monitoring protocol: Northeast Temperate Network

USGS Publications Warehouse

Tierney, Geri; Mitchell, Brian; Miller-Rushing, Abraham J.; Katz, Jonathan; Denny, Ellen; Brauer, Corinne; Donovan, Therese; Richardson, Andrew D.; Toomey, Michael; Kozlowski, Adam; Weltzin, Jake F.; Gerst, Kathy; Sharron, Ed; Sonnentag, Oliver; Dieffenbach, Fred

2013-01-01

historical parks and national historic sites in the northeastern US. This protocol was developed in collaboration with and relies upon the procedures and infrastructure of the USA National Phenology Network (USA-NPN), including Nature’s Notebook, USA-NPN’s online plant and animal phenology observation program (www.nn.usanpn.org). Organized in 2007, USA-NPN is a nation-wide partnership among federal agencies, schools and universities, citizen volunteers, and others to monitor and understand the influence of seasonal cycles on the nation’s biological resources. The overall goal of NETN’s phenology monitoring program is to determine trends in the phenology of key species in order to assist park managers with the detection and mitigation of the effects of climate change on park resources. An additional programmatic goal is to interest and educate park visitors and staff, as well as a cadre of volunteer monitors.

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.).

75 FR 56994 - Internet Protocol Version 6 (IPv6) Workshop: The Impact of the Uptake and Deployment of IPv6...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

...The National Telecommunications and Information Administration (NTIA), on behalf of the U.S. Department of Commerce (Department), will hold a workshop on September 28, 2010, on the importance of the adoption and deployment of Internet Protocol version six (IPv6) addresses for industry, the U.S. Government, and the Internet economy.

Progress toward developing field protocols for a North American marsh bird monitoring program

Treesearch

Courtney J. Conway; Steven T. A. Timmermans

2005-01-01

Populations of many marsh-dependent birds appear to be declining, but we currently lack a continental program that provides estimates of population trends for most secretive marshbirds. The survey protocol outlined here is a standardized survey methodology being used on a pilot basis at National Wildlife Refuges and other protected wetland areas across North America...

Sampling protocol, estimation, and analysis procedures for the down woody materials indicator of the FIA program

Treesearch

Christopher W. Woodall; Vicente J. Monleon

2008-01-01

The USDA Forest Service's Forest Inventory and Analysis program conducts an inventory of forests of the United States including down woody materials (DWM). In this report we provide the rationale and context for a national inventory of DWM, describe the components sampled, discuss the sampling protocol used and corresponding estimation procedures, and provide...

Inclusion of sex and gender in biomedical research: survey of clinical research proposed at the University of Pennsylvania.

PubMed

Freeman, Anne; Stanko, Patrick; Berkowitz, Lily N; Parnell, Neanta; Zuppe, Anastasia; Bale, Tracy L; Ziolek, Tracy; Epperson, C Neill

2017-01-01

The 2015 National Institutes of Health (NIH) policy that sex be considered as a biological variable (SABV) is now a critical part of the peer-review process for NIH funding as well as publication in several high-impact scientific journals. We sought to determine the degree to which biomedical researchers at the University of Pennsylvania already consider SABV or gender in their research. We reviewed 240 research protocols approved by the University of Pennsylvania Investigational Review Board (IRB) consecutively submitted between January and July 2016. Each protocol was searched for the terms sex, gender, male, female, man, and woman and justifications related to the population under study. A PubMed search was conducted to determine the current state of knowledge regarding potential sex and/or gender differences with respect to protocol topic. Data were summarized using descriptive statistics. Of the 165 (68.8%) protocols that included one of the search terms, only 24 (14.5%) provided justification for the choice of the sex/gender of the population studied. Sixty-three percent ( n  = 151) of the protocols focused on topics for which the extant literature supports at least a moderate degree of sex/gender differences in some aspect of the disorder/condition being studied. Of these, only three (2.0%) indicated that the investigator would consider sex or gender impact on their primary outcomes. Review of a subset of IRB protocols submitted at a major research institution suggests that very few investigators are considering sex or gender as important variables in their clinical research at the stage of protocol development. IRBs are in an excellent position to encourage investigators to consider SABV and gender in order to enhance the rigor of research design, maximize the importance of the resulting knowledge, and ensure that subject selection is equitable. These findings serve as the basis for developing an intervention at the level of IRB protocol development and submission that will promote consideration of SABV and/or gender, factors with critical import to patient safety and efficacy of interventions.

The OAuth 2.0 Web Authorization Protocol for the Internet Addiction Bioinformatics (IABio) Database.

PubMed

Choi, Jeongseok; Kim, Jaekwon; Lee, Dong Kyun; Jang, Kwang Soo; Kim, Dai-Jin; Choi, In Young

2016-03-01

Internet addiction (IA) has become a widespread and problematic phenomenon as smart devices pervade society. Moreover, internet gaming disorder leads to increases in social expenditures for both individuals and nations alike. Although the prevention and treatment of IA are getting more important, the diagnosis of IA remains problematic. Understanding the neurobiological mechanism of behavioral addictions is essential for the development of specific and effective treatments. Although there are many databases related to other addictions, a database for IA has not been developed yet. In addition, bioinformatics databases, especially genetic databases, require a high level of security and should be designed based on medical information standards. In this respect, our study proposes the OAuth standard protocol for database access authorization. The proposed IA Bioinformatics (IABio) database system is based on internet user authentication, which is a guideline for medical information standards, and uses OAuth 2.0 for access control technology. This study designed and developed the system requirements and configuration. The OAuth 2.0 protocol is expected to establish the security of personal medical information and be applied to genomic research on IA.

Evidence or eminence in abdominal surgery: Recent improvements in perioperative care

PubMed Central

Segelman, Josefin; Nygren, Jonas

2014-01-01

Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery (ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioperative management, the implementation of this complex protocol has been slow. Barriers to implementation involve both patient- and staff-related factors as well as practice-related issues and resources. To support efficient and successful implementation, further educational and structural measures have to be made on a national or regional level to improve the standard of general health care. Besides postoperative morbidity, biological and physiological variables have been quite commonly reported in previous ERAS studies. Little information, however, has been obtained on cost-effectiveness, long-term outcomes, quality of life and patient-related outcomes, and these issues remain important areas of research for future studies. PMID:25469030

Neck Cooling Improves Table Tennis Performance amongst Young National Level Players

PubMed Central

Desai, Terun; Bottoms, Lindsay

2017-01-01

This study aimed to examine the effects of neck cooling on table tennis performance. Eight young, National level, male table tennis players (age 16 ± 2 years, height 1.77 ± 0.08 m, body mass 67.54 ± 10.66 kg) were recruited. Participants attended four testing sessions separated by a week. Session one determined fitness levels, and session two was a familiarisation trial. The final two sessions involved completing the table tennis-specific protocol either with (ICE) or without (CON) neck cooling for 1 min before each exercise period (bout: 80–90 shots), which represented an individual game. The exercise protocol required completing three bouts to represent a match, each simulating a different skill (forehand, backhand, alternate forehand and backhand), against a mechanical ball thrower. Performance was measured by the number of balls hitting two pre-determined targets. Heart rate, ratings of perceived exertion (RPE), and thermal sensation (TS) were measured. Total performance scores (shots on target) were significantly greater during ICE (136 ± 26), compared to CON (120 ± 25; p = 0.006) with a 15 (±12)% improvement. Effects for time (p < 0.05) but not condition (p > 0.05) were found for RPE and all other physiological variables. TS significantly decreased with cooling throughout the protocol (p = 0.03). Neck cooling appears to be beneficial for table tennis performance by lowering thermal sensation. PMID:29910379

Impact of outpatient management following appendectomy for acute appendicitis: An ACS NSQIP-P analysis.

PubMed

Litz, Cristen N; Stone, Laurie; Alessi, Roberta; Walford, Nebbie E; Danielson, Paul D; Chandler, Nicole M

2018-04-01

In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes. There were 154 institutional patients and 4973 from NSQIP-P centers. Institutional rate of outpatient management was higher compared to NSQIP-P (84% vs 48%, p<0.0001). Surgical length of stay was shorter compared to national rates (0.3±0.7 vs 1.1±1.9days, p<0.0001). There was no significant difference in the incidence of superficial (1.9% vs 1.0%, p=0.2), deep (0.6% vs 0.1%, p=0.17) or organ/space surgical site infections (1.3% vs 0.7%, p=0.31). The incidences of other complications (1.3% vs 0.6%, p=0.26) and 30-day readmissions (3.2% vs 2.6%, p=0.61) were similar. Outpatient management following appendectomy in children is possible with low morbidity and readmission rates. Comparison with other NSQIP-Pediatric centers suggests an opportunity to generalize this practice with considerable savings to the health care system. Prognosis study, level II. Copyright © 2017 Elsevier Inc. All rights reserved.

Using the SIOP Model to Promote the Acquisition of Language and Science Concepts with English Learners

ERIC Educational Resources Information Center

Echevarria, Jana; Richards-Tutor, Catherine; Canges, Rebecca; Francis, David

2011-01-01

In this article we report findings from research through the Center for Research on the Educational Achievement and Teaching of English Language Learners (CREATE), a National Research and Development Center. In our study we examined the efficacy of a model of instruction for English learners, the Sheltered Instruction Observation Protocol (SIOP)…

Government agencies' need for data on ozone injury to western pines

Treesearch

Brent Takemoto; Trent Procter

1996-01-01

Since the 1970?s, researchers from the USDA Forest Service and USDI National Park Service have conducted field surveys to measure the presence or absence, amount, and changes of ozone-caused injury to ponderosa and Jeffrey pines (Pronos and others 1978, Pronos and Vogler 1981, Stolte and others 1992). However, differences in measurement protocols among studies and the...

A prototype for forest health monitoring in Indiana state parks

Treesearch

Rachel Morse; KaDonna Randolph; John W., Jr. Moser

2000-01-01

In 1997, 25 Forest Health Monitoring (FHM) plots were established in two Indiana state parks and a nearby parcel of privately owned land using a new protocol that differs from the systematic grid of the national program. All plots were reassessed in 1998. Data analysis focuses upon establishing baseline conditions for the study sites and providing relevant information...

A comparison of two emergency medical dispatch protocols with respect to accuracy.

PubMed

Torlén, Klara; Kurland, Lisa; Castrén, Maaret; Olanders, Knut; Bohm, Katarina

2017-12-29

Emergency medical dispatching should be as accurate as possible in order to ensure patient safety and optimize the use of ambulance resources. This study aimed to compare the accuracy, measured as priority level, between two Swedish dispatch protocols - the three-graded priority protocol Medical Index and a newly developed prototype, the four-graded priority protocol, RETTS-A. A simulation study was carried out at the Emergency Medical Communication Centre (EMCC) in Stockholm, Sweden, between October and March 2016. Fifty-three voluntary telecommunicators working at SOS Alarm were recruited nationally. Each telecommunicator handled 26 emergency medical calls, simulated by experienced standard patients. Manuscripts for the scenarios were based on recorded real-life calls, representing the six most common complaints. A cross-over design with 13 + 13 calls was used. Priority level and medical condition for each scenario was set through expert consensus and used as gold standard in the study. A total of 1293 calls were included in the analysis. For priority level, n = 349 (54.0%) of the calls were assessed correctly with Medical Index and n = 309 (48.0%) with RETTS-A (p = 0.012). Sensitivity for the highest priority level was 82.6% (95% confidence interval: 76.6-87.3%) in the Medical Index and 54.0% (44.3-63.4%) in RETTS-A. Overtriage was 37.9% (34.2-41.7%) in the Medical Index and 28.6% (25.2-32.2%) in RETTS-A. The corresponding proportion of undertriage was 6.3% (4.7-8.5%) and 23.4% (20.3-26.9%) respectively. In this simulation study we demonstrate that Medical Index had a higher accuracy for priority level and less undertriage than the new prototype RETTS-A. The overall accuracy of both protocols is to be considered as low. Overtriage challenges resource utilization while undertriage threatens patient safety. The results suggest that in order to improve patient safety both protocols need revisions in order to guarantee safe emergency medical dispatching.

NADA Protocol for Behavioral Health. Putting Tools in the Hands of Behavioral Health Providers: The Case for Auricular Detoxification Specialists.

PubMed

Stuyt, Elizabeth B; Voyles, Claudia A; Bursac, Sara

2018-02-07

Background: The National Acupuncture Detoxification Association (NADA) protocol, a simple standardized auricular treatment has the potential to provide vast public health relief on issues currently challenging our world. This includes but is not limited to addiction, such as the opioid epidemic, but also encompasses mental health, trauma, PTSD, chronic stress, and the symptoms associated with these conditions. Simple accessible tools that improve outcomes can make profound differences. We assert that the NADA protocol can have greatest impact when broadly applied by behavioral health professionals, Auricular Detoxification Specialists (ADSes). Methods: The concept of ADS is described and how current laws vary from state to state. Using available national data, a survey of practitioners in three selected states with vastly different laws regarding ADSes, and interviews of publicly funded programs which are successfully incorporating the NADA protocol, we consider possible effects of ADS-friendly conditions. Results: Data presented supports the idea that conditions conducive to ADS practice lead to greater implementation. Program interviews reflect settings in which adding ADSes can in turn lead to improved outcomes. Discussion: The primary purpose of non-acupuncturist ADSes is to expand the access of this simple but effective treatment to all who are suffering from addictions, stress, or trauma and to allow programs to incorporate acupuncture in the form of the NADA protocol at minimal cost, when and where it is needed. States that have changed laws to allow ADS practice for this standardized ear acupuncture protocol have seen increased access to this treatment, benefiting both patients and the programs.

Lakes and reservoirs—Guidelines for study design and sampling

USGS Publications Warehouse

,

2015-09-29

The “National Field Manual for the Collection of Water-Quality Data” (NFM) is an online report with separately published chapters that provides the protocols and guidelines by which U.S. Geological Survey personnel obtain the data used to assess the quality of the Nation’s surface-water and groundwater resources. Chapter A10 reviews limnological principles, describes the characteristics that distinguish lakes from reservoirs, and provides guidance for developing temporal and spatial sampling strategies and data-collection approaches to be used in lake and reservoir environmental investigations.Within this chapter are references to other chapters of the NFM that provide more detailed guidelines related to specific topics and more detailed protocols for the quality assurance and assessment of the lake and reservoir data. Protocols and procedures to address and document the quality of lake and reservoir investigations are adapted from, or referenced to, the protocols and standard operating procedures contained in related chapters of this NFM.Before 2017, the U.S. Geological Survey (USGS) “National Field Manual for the Collection of Water-Quality Data” (NFM) chapters were released in the USGS Techniques of Water-Resources Investigations series. Effective in 2018, new and revised NFM chapters are being released in the USGS Techniques and Methods series; this series change does not affect the content and format of the NFM. More information is in the general introduction to the NFM (USGS Techniques and Methods, book 9, chapter A0, 2018) at https://doi.org/10.3133/tm9A0. The authoritative current versions of NFM chapters are available in the USGS Publications Warehouse at https://pubs.er.usgs.gov. Comments, questions, and suggestions related to the NFM can be addressed to nfm-owq@usgs.gov.

Quality control for quantitative multicenter whole-body PET/MR studies: A NEMA image quality phantom study with three current PET/MR systems

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

Boellaard, Ronald, E-mail: r.boellaard@vumc.nl; European Association of Nuclear Medicine Research Ltd., Vienna 1060; European Association of Nuclear Medicine Physics Committee, Vienna 1060

2015-10-15

Purpose: Integrated positron emission tomography/magnetic resonance (PET/MR) systems derive the PET attenuation correction (AC) from dedicated MR sequences. While MR-AC performs reasonably well in clinical patient imaging, it may fail for phantom-based quality control (QC). The authors assess the applicability of different protocols for PET QC in multicenter PET/MR imaging. Methods: The National Electrical Manufacturers Association NU 2 2007 image quality phantom was imaged on three combined PET/MR systems: a Philips Ingenuity TF PET/MR, a Siemens Biograph mMR, and a GE SIGNA PET/MR (prototype) system. The phantom was filled according to the EANM FDG-PET/CT guideline 1.0 and scanned for 5more » min over 1 bed. Two MR-AC imaging protocols were tested: standard clinical procedures and a dedicated protocol for phantom tests. Depending on the system, the dedicated phantom protocol employs a two-class (water and air) segmentation of the MR data or a CT-based template. Differences in attenuation- and SUV recovery coefficients (RC) are reported. PET/CT-based simulations were performed to simulate the various artifacts seen in the AC maps (μ-map) and their impact on the accuracy of phantom-based QC. Results: Clinical MR-AC protocols caused substantial errors and artifacts in the AC maps, resulting in underestimations of the reconstructed PET activity of up to 27%, depending on the PET/MR system. Using dedicated phantom MR-AC protocols, PET bias was reduced to −8%. Mean and max SUV RC met EARL multicenter PET performance specifications for most contrast objects, but only when using the dedicated phantom protocol. Simulations confirmed the bias in experimental data to be caused by incorrect AC maps resulting from the use of clinical MR-AC protocols. Conclusions: Phantom-based quality control of PET/MR systems in a multicenter, multivendor setting may be performed with sufficient accuracy, but only when dedicated phantom acquisition and processing protocols are used for attenuation correction.« less

Variability in Usual Care Mechanical Ventilation for Pediatric Acute Respiratory Distress Syndrome: Time for a Decision Support Protocol?

PubMed

Newth, Christopher J L; Sward, Katherine A; Khemani, Robinder G; Page, Kent; Meert, Kathleen L; Carcillo, Joseph A; Shanley, Thomas P; Moler, Frank W; Pollack, Murray M; Dalton, Heidi J; Wessel, David L; Berger, John T; Berg, Robert A; Harrison, Rick E; Holubkov, Richard; Doctor, Allan; Dean, J Michael; Jenkins, Tammara L; Nicholson, Carol E

2017-11-01

Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol. Prospective observational study. Eight tertiary care U.S. PICUs, October 2011 to April 2012. One hundred twenty patients (age range 17 d to 18 yr) with acute lung injury/acute respiratory distress syndrome. Two thousand hundred arterial and capillary blood gases, 3,964 oxygen saturation by pulse oximetry, and 2,757 end-tidal CO2 values were associated with 3,983 ventilator settings. Ventilation mode at study onset was pressure control 60%, volume control 19%, pressure-regulated volume control 18%, and high-frequency oscillatory ventilation 3%. Clinicians changed FIO2 by ±5 or ±10% increments every 8 hours. Positive end-expiratory pressure was limited at ~10 cm H2O as oxygenation worsened, lower than would have been recommended by the protocol. In the first 72 hours of mechanical ventilation, maximum tidal volume/kg using predicted versus actual body weight was 10.3 (8.5-12.9) (median [interquartile range]) versus 9.2 mL/kg (7.6-12.0) (p < 0.001). Intensivists made changes similar to protocol recommendations 29% of the time, opposite to the protocol's recommendation 12% of the time and no changes 56% of the time. Ventilator management varies substantially in children with acute respiratory distress syndrome. Opportunities exist to minimize variability and potentially injurious ventilator settings by using a pediatric mechanical ventilation protocol offering adequately explicit instructions for given clinical situations. An accepted protocol could also reduce confounding by mechanical ventilation management in a clinical trial.

Rationale, Timeline, Study Design, and Protocol Overview of the Therapeutic Hypothermia After Pediatric Cardiac Arrest Trials

PubMed Central

Moler, Frank W.; Silverstein, Faye S.; Meert, Kathleen L.; Clark, Amy E.; Holubkov, Richard; Browning, Brittan; Slomine, Beth S.; Christensen, James R.; Dean, Michael

2014-01-01

Objective To describe the rationale, timeline, study design, and protocol overview of the Therapeutic Hypothermia after Pediatric Cardiac Arrest trials. Design Multicenter randomized controlled trials. Setting Pediatric intensive care and cardiac ICUs in the United States and Canada. Patients Children from 48 hours to 18 years old, who have return of circulation after cardiac arrest, who meet trial eligibility criteria, and whose guardians provide written consent. Interventions Therapeutic hypothermia or therapeutic normothermia. Measurements and Main Results From concept inception in 2002 until trial initiation in 2009, 7 years were required to plan and operationalize the Therapeutic Hypothermia after Pediatric Cardiac Arrest trials. Two National Institute of Child Health and Human Development clinical trial planning grants (R21 and R34) supported feasibility assessment and protocol development. Two clinical research networks, Pediatric Emergency Care Applied Research Network and Collaborative Pediatric Critical Care Research Network, provided infrastructure resources. Two National Heart Lung Blood Institute U01 awards provided funding to conduct separate trials of in-hospital and out-of-hospital cardiac arrest. A pilot vanguard phase that included half the clinical sites began on March 9, 2009, and this was followed by full trial funding through 2015. Conclusions Over a decade will have been required to plan, design, operationalize, and conduct the Therapeutic Hypothermia after Pediatric Cardiac Arrest trials. Details described in this report, such as participation of clinical research networks and clinical trial planning grants utilization, may be of utility for individuals who are planning investigator-initiated, federally supported clinical trials. PMID:23842585

Protocol Coordinator | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious

32 CFR 179.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Purpose. 179.1 Section 179.1 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE... Munitions Response Site Prioritization Protocol (MRSPP) (hereinafter referred to as the “rule”) under the...

32 CFR 179.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Purpose. 179.1 Section 179.1 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE... Munitions Response Site Prioritization Protocol (MRSPP) (hereinafter referred to as the “rule”) under the...

32 CFR 179.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Purpose. 179.1 Section 179.1 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE... Munitions Response Site Prioritization Protocol (MRSPP) (hereinafter referred to as the “rule”) under the...

32 CFR 179.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Purpose. 179.1 Section 179.1 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE... Munitions Response Site Prioritization Protocol (MRSPP) (hereinafter referred to as the “rule”) under the...

32 CFR 179.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Purpose. 179.1 Section 179.1 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE CLOSURES AND REALIGNMENT MUNITIONS RESPONSE SITE... Munitions Response Site Prioritization Protocol (MRSPP) (hereinafter referred to as the “rule”) under the...

Using the ACR/NEMA standard with TCP/IP and Ethernet

NASA Astrophysics Data System (ADS)

Chimiak, William J.; Williams, Rodney C.

1991-07-01

There is a need for a consolidated picture archival and communications system (PACS) in hospitals. At the Bowman Gray School of Medicine of Wake Forest University (BGSM), the authors are enhancing the ACR/NEMA Version 2 protocol using UNIX sockets and TCP/IP to greatly improve connectivity. Initially, nuclear medicine studies using gamma cameras are to be sent to PACS. The ACR/NEMA Version 2 protocol provides the functionality of the upper three layers of the open system interconnection (OSI) model in this implementation. The images, imaging equipment information, and patient information are then sent in ACR/NEMA format to a software socket. From there it is handed to the TCP/IP protocol, which provides the transport and network service. TCP/IP, in turn, uses the services of IEEE 802.3 (Ethernet) to complete the connectivity. The advantage of this implementation is threefold: (1) Only one I/O port is consumed by numerous nuclear medicine cameras, instead of a physical port for each camera. (2) Standard protocols are used which maximize interoperability with ACR/NEMA compliant PACSs. (3) The use of sockets allows a migration path to the transport and networking services of OSIs TP4 and connectionless network service as well as the high-performance protocol being considered by the American National Standards Institute (ANSI) and the International Standards Organization (ISO) -- the Xpress Transfer Protocol (XTP). The use of sockets also gives access to ANSI's Fiber Distributed Data Interface (FDDI) as well as other high-speed network standards.

Anaplastic histology Wilms' tumors registered to the Japan Wilms' Tumor Study Group are less aggressive than that in the National Wilms' Tumor Study 5.

PubMed

Oue, Takaharu; Koshinaga, Tsugumichi; Takimoto, Tetsuya; Okita, Hajime; Tanaka, Yukichi; Nozaki, Miwako; Haruta, Masayuki; Kaneko, Yasuhiko; Fukuzawa, Masahiro

2016-09-01

To evaluate the clinical features and treatment results of anaplastic histology (AH) Wilms' tumor (WT) patients registered in the Japan Wilms' Tumor Study (JWiTS) group to elucidate the clinical characteristics of AH in the Japanese population. Of 344 WT patients who were enrolled in JWiTS between 1995 and 2013, 17 had AH. Treatment using the JWiTS protocols was similar to the fifth National Wilms' Tumor Study 5 (NWTS-5) protocols. Clinical characteristics and mutation status of TP53 gene were evaluated and compared with those in NWST-5 study. AH incidences in JWiTS were 4.9 %, lower than that in NWTS-5. Seven tumors had focal AH and 10 had diffuse AH. Clinical stages of AH patients were stage I in seven, stage II in three, stage III in five, stage IV in one and unknown in one. Four-year event-free survival and overall survival rates were 90.9 and 86.7 %, respectively. Two patients with diffuse AH and none with focal AH had TP53 mutation. Japanese patients presented with higher incidence, earlier stages and may have better outcomes than American patients, indicating a possible biological heterogeneity of AH WT. Further analysis is necessary to elucidate the different characteristic of AH WT between Japanese and American populations.

Informal trail monitoring protocols: Denali National Park and Preserve. Final Report, October 2011

USGS Publications Warehouse

Marion, Jeffrey L.; Wimpey, Jeremy F.

2011-01-01

Managers at Alaska?s Denali National Park and Preserve (DENA) sponsored this research to assess and monitor visitor-created informal trails (ITs). DENA is located in south-central Alaska and managed as a six million acre wilderness park. This program of research was guided by the following objectives: (1) Investigate alternative methods for monitoring the spatial distribution, aggregate lineal extent, and tread conditions of informal (visitor-created) trails within the park. (2) In consultation with park staff, develop, pilot test, and refine cost-effective and scientifically defensible trail monitoring procedures that are fully integrated with the park?s Geographic Information System. (3) Prepare a technical report that compiles and presents research results and their management implications. This report presents the protocol development and field testing process, illustrates the types of data produced by their application, and provides guidance for their application and use. The protocols described provide managers with an efficient means to document and monitor IT conditions in settings ranging from pristine to intensively visited.

40 CFR Appendix C to Subpart A of... - Parties to the Montreal Protocol, and Nations Complying With, But Not Parties to, the Protocol

Code of Federal Regulations, 2013 CFR

2013-07-01

... ✓ ✓ ✓ ✓ Slovakia ✓ ✓ ✓ ✓ ✓ Slovenia ✓ ✓ ✓ ✓ ✓ Solomon Island ✓ ✓ ✓ ✓ Somalia ✓ ✓ ✓ ✓ ✓ South Africa ✓ ✓ ✓ Spain... 118. Sierra Leone 119. Singapore 120. Solomon Islands 121. Somalia 122. South Africa 123. Sri Lanka...

40 CFR Appendix C to Subpart A of... - Parties to the Montreal Protocol, and Nations Complying With, But Not Parties to, the Protocol

Code of Federal Regulations, 2010 CFR

2010-07-01

... ✓ ✓ ✓ ✓ Slovakia ✓ ✓ ✓ ✓ ✓ Slovenia ✓ ✓ ✓ ✓ ✓ Solomon Island ✓ ✓ ✓ ✓ Somalia ✓ ✓ ✓ ✓ ✓ South Africa ✓ ✓ ✓ Spain... 118. Sierra Leone 119. Singapore 120. Solomon Islands 121. Somalia 122. South Africa 123. Sri Lanka...

40 CFR Appendix C to Subpart A of... - Parties to the Montreal Protocol, and Nations Complying With, But Not Parties to, the Protocol

Code of Federal Regulations, 2012 CFR

2012-07-01

... ✓ ✓ ✓ ✓ Slovakia ✓ ✓ ✓ ✓ ✓ Slovenia ✓ ✓ ✓ ✓ ✓ Solomon Island ✓ ✓ ✓ ✓ Somalia ✓ ✓ ✓ ✓ ✓ South Africa ✓ ✓ ✓ Spain... 118. Sierra Leone 119. Singapore 120. Solomon Islands 121. Somalia 122. South Africa 123. Sri Lanka...

40 CFR Appendix C to Subpart A of... - Parties to the Montreal Protocol, and Nations Complying With, But Not Parties to, the Protocol

Code of Federal Regulations, 2011 CFR

2011-07-01

... ✓ ✓ ✓ ✓ Slovakia ✓ ✓ ✓ ✓ ✓ Slovenia ✓ ✓ ✓ ✓ ✓ Solomon Island ✓ ✓ ✓ ✓ Somalia ✓ ✓ ✓ ✓ ✓ South Africa ✓ ✓ ✓ Spain... 118. Sierra Leone 119. Singapore 120. Solomon Islands 121. Somalia 122. South Africa 123. Sri Lanka...

Ocean fertilization, carbon credits and the Kyoto Protocol

NASA Astrophysics Data System (ADS)

Westley, M. B.; Gnanadesikan, A.

2008-12-01

Commercial interest in ocean fertilization as a carbon sequestration tool was excited by the December 1997 agreement of the Kyoto Protocol to the United Nations Convention on Climate Change. The Protocol commits industrialized countries to caps on net greenhouse gas emissions and allows for various flexible mechanisms to achieve these caps in the most economically efficient manner possible, including trade in carbon credits from projects that reduce emissions or enhance sinks. The carbon market was valued at 64 billion in 2007, with the bulk of the trading (50 billion) taking place in the highly regulated European Union Emission Trading Scheme, which deals primarily in emission allowances in the energy sector. A much smaller amount, worth $265 million, was traded in the largely unregulated "voluntary" market (Capoor and Ambrosi 2008). As the voluntary market grows, so do calls for its regulation, with several efforts underway to set rules and standards for the sale of voluntary carbon credits using the Kyoto Protocol as a starting point. Four US-based companies and an Australian company currently seek to develop ocean fertilization technologies for the generation of carbon credits. We review these plans through the lens of the Kyoto Protocol and its flexible mechanisms, and examine whether and how ocean fertilization could generate tradable carbon credits. We note that at present, ocean sinks are not included in the Kyoto Protocol, and that furthermore, the Kyoto Protocol only addresses sources and sinks of greenhouse gases within national boundaries, making open-ocean fertilization projects a jurisdictional challenge. We discuss the negotiating history behind the limited inclusion of land use, land use change and forestry in the Kyoto Protocol and the controversy and eventual compromise concerning methodologies for terrestrial carbon accounting. We conclude that current technologies for measuring and monitoring carbon sequestration following ocean fertilization are unlikely to meet the Kyoto Protocol's verification and accounting standards for trading carbon credits on the regulated market. The marketability of ocean fertilization in the voluntary carbon marketplace will likely depend on companies' efforts to minimize environmental risks and consumers' willingness to accept remaining risks.

Implementing the information prescription protocol in a family medicine practice: a case study*†‡

PubMed Central

Carey, Peggy; Haines, Laura; Lampson, Alan P; Pond, Fred

2010-01-01

Question: Can an information prescription protocol be successfully integrated into a family medicine practice seeking to enhance patient education and self-management? Setting: Milton Family Practice, an outpatient clinic and resident teaching site of the University of Vermont and Fletcher Allen Health Care, is located in a semirural area fifteen miles from main campus. Objectives: The objectives were to increase physicians' knowledge and use of information prescriptions, sustain integration of information prescription use, and increase physicians' ability to provide patient education information. Methods: Methods used were promotion of the National Library of Medicine's Information Rx, physician instruction, installation of patient and provider workstations, and a collaborative approach to practice integration. Main Results: A post-intervention survey showed increased physician knowledge and use of the Information Rx protocol. Support procedures were integrated at the practice. Conclusions: Sustainable integration of Information Rx in a primary care clinic requires not only promotion and education, but also attention to clinic organization and procedures. PMID:20648257

Fast formation cycling for lithium ion batteries

DOE PAGES

An, Seong Jin; Li, Jianlin; Du, Zhijia; ...

2017-01-09

The formation process for lithium ion batteries typically takes several days or more, and it is necessary for providing a stable solid electrolyte interphase on the anode (at low potentials vs. Li/Li +) for preventing irreversible consumption of electrolyte and lithium ions. An analogous layer known as the cathode electrolyte interphase layer forms at the cathode at high potentials vs. Li/Li +. However, several days, or even up to a week, of these processes result in either lower LIB production rates or a prohibitively large size of charging-discharging equipment and space (i.e. excessive capital cost). In this study, a fastmore » and effective electrolyte interphase formation protocol is proposed and compared with an Oak Ridge National Laboratory baseline protocol. Graphite, NMC 532, and 1.2 M LiPF 6 in ethylene carbonate: diethyl carbonate were used as anodes, cathodes, and electrolytes, respectively. Finally, results from electrochemical impedance spectroscopy show the new protocol reduced surface film (electrolyte interphase) resistances, and 1300 aging cycles show an improvement in capacity retention.« less

The Multiple Species Inventory and Monitoring Protocol: A Population, Community, and Biodiversity Monitoring Solution for National Forest System Lands

Treesearch

P. N. Manley; B. Van Horne

2006-01-01

The U.S. Forest Service manages approximately 76 million ha (191 million acres) of National Forest System (NFS) lands. The National Forest Management Act (1976) recognizes the importance of maintaining species and ecosystem diversity on NFS lands as a critical component of our ecological and cultural heritage. Information on the condition of populations and habitats of...

76 FR 28442 - Office of the Director, National Institutes of Health; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Director.... Agenda: The NIH Recombinant DNA Advisory Committee (RAC) will review and discuss selected human gene... Advisory Committee (RAC) will review and discuss selected human gene transfer protocols, including a...

75 FR 25866 - National Toxicology Program (NTP); NTP Interagency Center for the Evaluation of Alternative...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... Contact Dermatitis Potential of Chemicals and Products: Notice of Availability AGENCY: National Institute... contact dermatitis (ACD), are now available. ICCVAM recommended an updated LLNA test method protocol, a... Fewer Animals to Assess the Allergic Contact Dermatitis Potential of Chemicals and Products (NIH...

Assessing sediment quality in the Great Lakes Connecting Channels using National Coastal Condition Assessment protocol

EPA Science Inventory

The EPA Office of Water’s National Coastal Condition Assessment (NCCA) helps satisfy the assessment and antidegradation provisions of the Clean Water Actby estimating water, sediment, and benthic quality conditions in the Great Lakes nearshore on a five-year cycle starting ...

Assessing ecological conditions in the Great Lakes Connecting Channels using National Coastal Condition Assessment protocol

EPA Science Inventory

The EPA Office of Water’s National Coastal Condition Assessment (NCCA) helps satisfy the assessment and antidegradation provisions of the Clean Water Act by estimating water, sediment, and benthic quality conditions in the Great Lakes nearshore on a five-year cycle starting...

77 FR 15722 - Southern California Hook and Line Survey; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... meeting to evaluate the Southern California Shelf Rockfish Hook and Line Survey which was designed to... and Line survey design and protocols; (2) examine the analytical methods used to generate rockfish... California Hook and Line Survey; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National...

Thematic Accuracy Assessment of the 2011 National Land Cover Database (NLCD)

EPA Science Inventory

Accuracy assessment is a standard protocol of National Land Cover Database (NLCD) mapping. Here we report agreement statistics between map and reference labels for NLCD 2011, which includes land cover for ca. 2001, ca. 2006, and ca. 2011. The two main objectives were assessment o...

Z39.50 and the Scholar's Workstation Concept.

ERIC Educational Resources Information Center

Phillips, Gary Lee

1992-01-01

Examines the potential application of the American National Standards Institute (ANSI)/National Information Standards Organization (NISO) Z39.50 library networking protocol as a client/server environment for a scholar's workstation. Computer networking models are described, and linking the workstation to an online public access catalog (OPAC) is…

Australian Recognition Framework Arrangements. Australia's National Training Framework.

ERIC Educational Resources Information Center

Australian National Training Authority, Brisbane.

This document explains the objectives, principles, standards, and protocols of the Australian Recognition Framework (ARF), which is a comprehensive approach to national recognition of vocational education and training (VET) that is based on a quality-assured approach to the registration of training organizations seeking to deliver training, assess…

A Revised Marxist Political Economy of National Education Markets

ERIC Educational Resources Information Center

Marginson, Simon

2004-01-01

This article synthesises the social and economic dynamics of both non-market and market production in national education systems, drawing primarily on Marx's analysis of the commodity and Hirsch on positional competition. Market production has six principal aspects: a defined field of production, protocols governing entry/exit, the production of…

THE NEW ENGLAND AIR QUALITY FORECASTING PILOT PROGRAM: DEVELOPMENT OF AN EVALUATION PROTOCOL AND PERFORMANCE BENCHMARK

EPA Science Inventory

The National Oceanic and Atmospheric Administration recently sponsored the New England Forecasting Pilot Program to serve as a "test bed" for chemical forecasting by providing all of the elements of a National Air Quality Forecasting System, including the development and implemen...

Evaluation of a discharge education protocol for pediatric patients with gastrostomy tubes.

PubMed

Schweitzer, Michelle; Aucoin, Julia; Docherty, Sharron L; Rice, Henry E; Thompson, Julie; Sullivan, Dori Taylor

2014-01-01

To evaluate the impact of a preprocedure education protocol for children who receive a gastrostomy tube (GT). A preintervention-postintervention design, using surveys and comparison between preprotocol and postprotocol cohorts, was used to evaluate the effect of implementation of a standardized GT education protocol with 26 subjects on caregiver, patient, and provider outcomes. The use of a preprocedure education protocol resulted in improved patient outcomes and increased caregiver knowledge and confidence and was considered a positive change by the providers. Often education is a forgotten part of a medical procedure, and the importance of education is typically only recognized after an adverse event occurs. Establishing a standardized evidence-based education protocol for GT care improves overall care and satisfaction. Use of a systematic and family-centered interdisciplinary approach markedly improves patient care. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

General introduction for the “National Field Manual for the Collection of Water-Quality Data”

USGS Publications Warehouse

,

2018-02-28

BackgroundAs part of its mission, the U.S. Geological Survey (USGS) collects data to assess the quality of our Nation’s water resources. A high degree of reliability and standardization of these data are paramount to fulfilling this mission. Documentation of nationally accepted methods used by USGS personnel serves to maintain consistency and technical quality in data-collection activities. “The National Field Manual for the Collection of Water-Quality Data” (NFM) provides documented guidelines and protocols for USGS field personnel who collect water-quality data. The NFM provides detailed, comprehensive, and citable procedures for monitoring the quality of surface water and groundwater. Topics in the NFM include (1) methods and protocols for sampling water resources, (2) methods for processing samples for analysis of water quality, (3) methods for measuring field parameters, and (4) specialized procedures, such as sampling water for low levels of mercury and organic wastewater chemicals, measuring biological indicators, and sampling bottom sediment for chemistry. Personnel who collect water-quality data for national USGS programs and projects, including projects supported by USGS cooperative programs, are mandated to use protocols provided in the NFM per USGS Office of Water Quality Technical Memorandum 2002.13. Formal training, for example, as provided in the USGS class, “Field Water-Quality Methods for Groundwater and Surface Water,” and field apprenticeships supplement the guidance provided in the NFM and ensure that the data collected are high quality, accurate, and scientifically defensible.

Disentangling forest change from forest inventory change: A case study from the US Interior West

Treesearch

Sara A. Goeking

2015-01-01

Long-term trends in forest attributes are typically assessed using strategic inventories such as the US Department of Agriculture (USDA) Forest Service’s Forest Inventory and Analysis (FIA) program. The implicit assumption of any trend analysis is that data are comparable over time. The 1998 Farm Bill tasked FIA with implementing nationally consistent protocols,...

Approaching a Sacred Song: Toward a Respectful Presentation of the Discourse we Study

ERIC Educational Resources Information Center

Palmer, Andie Diane

2007-01-01

Educators who focus on American Indian or First Nations languages often have the privilege of bringing tape recordings of songs and stories to their students in the classroom. Learning the protocols for such sharing of the treasured gifts of ancestors is made easier by the good examples of teachers in and out of the classroom, who share such gifts…

Extending and Intensifying the FIA Inventory of Down Forest Fuels: Boundary Waters Canoe Area and Pictured Rocks National Lakeshore

Treesearch

Christopher W. Woodall; Bruce Leutscher

2005-01-01

The sampling design for the Forest Inventory and Analysis (FIA) program of the U.S. Department of Agriculture Forest Service allows intensification of fuel inventory sampling in areas of ?special interest? and implementation of fuel sampling protocol by non-FIA personnel. The objective of this study is to evaluate the contribution of sampling intensification/extension...

University of Washington/ Northwest National Marine Renewable Energy Center Tidal Current Technology Test Protocol, Instrumentation, Design Code, and Oceanographic Modeling Collaboration: Cooperative Research and Development Final Report, CRADA Number CRD-11-452

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

Driscoll, Frederick R.

The University of Washington (UW) - Northwest National Marine Renewable Energy Center (UW-NNMREC) and the National Renewable Energy Laboratory (NREL) will collaborate to advance research and development (R&D) of Marine Hydrokinetic (MHK) renewable energy technology, specifically renewable energy captured from ocean tidal currents. UW-NNMREC is endeavoring to establish infrastructure, capabilities and tools to support in-water testing of marine energy technology. NREL is leveraging its experience and capabilities in field testing of wind systems to develop protocols and instrumentation to advance field testing of MHK systems. Under this work, UW-NNMREC and NREL will work together to develop a common instrumentation systemmore » and testing methodologies, standards and protocols. UW-NNMREC is also establishing simulation capabilities for MHK turbine and turbine arrays. NREL has extensive experience in wind turbine array modeling and is developing several computer based numerical simulation capabilities for MHK systems. Under this CRADA, UW-NNMREC and NREL will work together to augment single device and array modeling codes. As part of this effort UW NNMREC will also work with NREL to run simulations on NREL's high performance computer system.« less

Multisite Semiautomated Clinical Data Repository for Duplication 15q Syndrome: Study Protocol and Early Uses.

PubMed

Ajayi, Oluwaseun Jessica; Smith, Ebony Jeannae; Viangteeravat, Teeradache; Huang, Eunice Y; Nagisetty, Naga Satya V Rao; Urraca, Nora; Lusk, Laina; Finucane, Brenda; Arkilo, Dimitrios; Young, Jennifer; Jeste, Shafali; Thibert, Ronald; Reiter, Lawrence T

2017-10-18

Chromosome 15q11.2-q13.1 duplication syndrome (Dup15q syndrome) is a rare disorder caused by duplications of chromosome 15q11.2-q13.1, resulting in a wide range of developmental disabilities in affected individuals. The Dup15q Alliance is an organization that provides family support and promotes research to improve the quality of life of patients living with Dup15q syndrome. Because of the low prevalence of this condition, the establishment of a single research repository would have been difficult and more time consuming without collaboration across multiple institutions. The goal of this project is to establish a national deidentified database with clinical and survey information on individuals diagnosed with Dup15q syndrome. The development of a multiclinic site repository for clinical and survey data on individuals with Dup15q syndrome was initiated and supported by the Dup15q Alliance. Using collaborative workflows, communication protocols, and stakeholder engagement tools, a comprehensive database of patient-centered information was built. We successfully established a self-report populating, centralized repository for Dup15q syndrome research. This repository also resulted in the development of standardized instruments that can be used for other studies relating to developmental disorders. By standardizing the data collection instruments, it allows us integrate our data with other national databases, such as the National Database for Autism Research. A substantial portion of the data collected from the questionnaires was facilitated through direct engagement of participants and their families. This allowed for a more complete set of information to be collected with a minimal turnaround time. We developed a repository that can efficiently be mined for shared clinical phenotypes observed at multiple clinic sites and used as a springboard for future clinical and basic research studies. ©Oluwaseun Jessica Ajayi, Ebony Jeannae Smith, Teeradache Viangteeravat, Eunice Y Huang, Naga Satya V Rao Nagisetty, Nora Urraca, Laina Lusk, Brenda Finucane, Dimitrios Arkilo, Jennifer Young, Shafali Jeste, Ronald Thibert, The Dup15q Alliance, Lawrence T Reiter. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.10.2017.

Validation of a novel protocol for calculating estimated energy requirements and average daily physical activity ratio for the US population: 2005-2006.

PubMed

Archer, Edward; Hand, Gregory A; Hébert, James R; Lau, Erica Y; Wang, Xuewen; Shook, Robin P; Fayad, Raja; Lavie, Carl J; Blair, Steven N

2013-12-01

To validate the PAR protocol, a novel method for calculating population-level estimated energy requirements (EERs) and average physical activity ratio (APAR), in a nationally representative sample of US adults. Estimates of EER and APAR values were calculated via a factorial equation from a nationally representative sample of 2597 adults aged 20 and 74 years (US National Health and Nutrition Examination Survey; data collected between January 1, 2005, and December 31, 2006). Validation of the PAR protocol-derived EER (EER(PAR)) values was performed via comparison with values from the Institute of Medicine EER equations (EER(IOM)). The correlation between EER(PAR) and EER(IOM) was high (0.98; P<.001). The difference between EER(PAR) and EER(IOM) values ranged from 40 kcal/d (1.2% higher than EER(IOM)) in obese (body mass index [BMI] ≥30) men to 148 kcal/d (5.7% higher) in obese women. The 2005-2006 EERs for the US population were 2940 kcal/d for men and 2275 kcal/d for women and ranged from 3230 kcal/d in obese (BMI ≥30) men to 2026 kcal/d in normal weight (BMI <25) women. There were significant inverse relationships between APAR and both obesity and age. For men and women, the APAR values were 1.53 and 1.52, respectively. Obese men and women had lower APAR values than normal weight individuals (P¼.023 and P¼.015, respectively) [corrected], and younger individuals had higher APAR values than older individuals (P<.001). The PAR protocol is an accurate method for deriving nationally representative estimates of EER and APAR values. These descriptive data provide novel quantitative baseline values for future investigations into associations of physical activity and health. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Stratospheric ozone, global warming, and the principle of unintended consequences--an ongoing science and policy success story.

PubMed

Andersen, Stephen O; Halberstadt, Marcel L; Borgford-Parnell, Nathan

2013-06-01

In 1974, Mario Molina and F. Sherwood Rowland warned that chlorofluorocarbons (CFCs) could destroy the stratospheric ozone layer that protects Earth from harmful ultraviolet radiation. In the decade after scientists documented the buildup and long lifetime of CFCs in the atmosphere; found the proof that CFCs chemically decomposed in the stratosphere and catalyzed the depletion of ozone; quantified the adverse effects; and motivated the public and policymakers to take action. In 1987, 24 nations plus the European Community signed the Montreal Protocol. Today, 25 years after the Montreal Protocol was agreed, every United Nations state is a party (universal ratification of 196 governments); all parties are in compliance with the stringent controls; 98% of almost 100 ozone-depleting chemicals have been phased out worldwide; and the stratospheric ozone layer is on its way to recovery by 2065. A growing coalition of nations supports using the Montreal Protocol to phase down hydrofluorocarbons, which are ozone safe but potent greenhouse gases. Without rigorous science and international consensus, emissions of CFCs and related ozone-depleting substances (ODSs) could have destroyed up to two-thirds of the ozone layer by 2065, increasing the risk of causing millions of cancer cases and the potential loss of half of global agricultural production. Furthermore, because most, ODSs are also greenhouse gases, CFCs and related ODSs could have had the effect of the equivalent of 24-76 gigatons per year of carbon dioxide. This critical review describes the history of the science of stratospheric ozone depletion, summarizes the evolution of control measures and compliance under the Montreal Protocol and national legislation, presents a review of six separate transformations over the last 100 years in refrigeration and air conditioning (A/C) technology, and illustrates government-industry cooperation in continually improving the environmental performance of motor vehicle A/C.

Stratospheric ozone, global warming, and the principle of unintended consequences-An ongoing science and policy success story.

PubMed

Andersen, Stephen O; Halberstadt, Marcel L; Borgford-Parnell, Nathan

2013-06-01

In 1974, Mario Molina and F. Sherwood Rowland warned that chlorofluorocarbons (CFCs) could destroy the stratospheric ozone layer that protects Earth from harmful ultraviolet radiation. In the decade after, scientists documented the buildup and long lifetime of CFCs in the atmosphere; found the proof that CFCs chemically decomposed in the stratosphere and catalyzed the depletion of ozone; quantified the adverse effects; and motivated the public and policymakers to take action. In 1987, 24 nations plus the European Community signed the Montreal Protocol. Today, 25 years after the Montreal Protocol was agreed, every United Nations state is a party (universal ratification of 196 governments); all parties are in compliance with the stringent controls; 98% of almost 100 ozone-depleting chemicals have been phased out worldwide; and the stratospheric ozone layer is on its way to recovery by 2065. A growing coalition of nations supports using the Montreal Protocol to phase down hydrofluorocarbons, which are ozone safe but potent greenhouse gases. Without rigorous science and international consensus, emissions of CFCs and related ozone-depleting substances (ODSs) could have destroyed up to two-thirds of the ozone layer by 2065, increasing the risk of causing millions of cancer cases and the potential loss of half of global agricultural production. Furthermore, because most ODSs are also greenhouse gases, CFCs and related ODSs could have had the effect of the equivalent of 24-76 gigatons per year of carbon dioxide. This critical review describes the history of the science of stratospheric ozone depletion, summarizes the evolution of control measures and compliance under the Montreal Protocol and national legislation, presents a review of six separate transformations over the last 100 years in refrigeration and air conditioning (A/C) technology, and illustrates government-industry cooperation in continually improving the environmental performance of motor vehicle A/C. [Box: see text].

Analysis of the pre-incident education and subsequent performance of emergency medical responders to the Volendam café fire.

PubMed

Welling, Lieke; Perez, Roberto S G M; van Harten, Sabine M; Patka, Peter; Mackie, Dave P; Kreis, Robert W; Bierens, Joost J L M

2005-12-01

At this moment, in the Netherlands, rescue workers are not given any specific standardized training in disaster response or disaster management. After the café fire in Volendam, the Netherlands, on New Year's Eve 2000, around 200 rescue workers were deployed on-site. The aim of this study is to investigate the rescue workers' experiences with regard to their level of preparation for the emergency response. In 2002, 30 members of the medical and paramedical personnel were requested to participate in a structured interview, focused on education, task perception, triage and registration. Twenty-seven participated. Twenty-two rescue workers received previous training in emergency medicine. During the alarm phase, 11 rescue workers had a clear perception of their tasks. Twenty-four were involved in triage and injury assessment. Three rescue workers used a protocol for triage and 15 for injury assessment. Twenty-five rescue workers gave on-scene treatment and 15 used a protocol. Eight registered their findings. Preparation for the emergency response lacked standardized procedures. The use of triage protocols was extremely poor, as was documentation of actions. Slightly more than half of the personnel followed treatment protocols. It is advisable that all rescue workers become familiar with the basic uniform principles and protocols regarding disaster management. A dedicated and standardized national disaster management course is needed for all rescue workers.

Comparison of IPSM 1990 photon dosimetry code of practice with IAEA TRS‐398 and AAPM TG‐51.

PubMed Central

Henríquez, Francisco Cutanda

2009-01-01

Several codes of practice for photon dosimetry are currently used around the world, supported by different organizations. A comparison of IPSM 1990 with both IAEA TRS‐398 and AAPM TG‐51 has been performed. All three protocols are based on the calibration of ionization chambers in terms of standards of absorbed dose to water, as it is the case with other modern codes of practice. This comparison has been carried out for photon beams of nominal energies: 4 MV, 6 MV, 8 MV, 10 MV and 18 MV. An NE 2571 graphite ionization chamber was used in this study, cross‐calibrated against an NE 2611A Secondary Standard, calibrated in the National Physical Laboratory (NPL). Absolute dose in reference conditions was obtained using each of these three protocols including: beam quality indices, beam quality conversion factors both theoretical and NPL experimental ones, correction factors for influence quantities and absolute dose measurements. Each protocol recommendations have been strictly followed. Uncertainties have been obtained according to the ISO Guide to the Expression of Uncertainty in Measurement. Absorbed dose obtained according to all three protocols agree within experimental uncertainty. The largest difference between absolute dose results for two protocols is obtained for the highest energy: 0.7% between IPSM 1990 and IAEA TRS‐398 using theoretical beam quality conversion factors. PACS number: 87.55.tm

Efficacy and cost effectiveness of telemedicine for improving access to care in the Paris region: study protocols for eight trials.

PubMed

Charrier, Nathanael; Zarca, Kevin; Durand-Zaleski, Isabelle; Calinaud, Christine

2016-02-08

With the development of information and communication technologies, telemedicine has been proposed as a way to improve patient management by facilitating access to appropriate diagnosis and treatment. The Paris Ile de France Regional Health Agency is currently funding a comprehensive program of telemedicine experiments. This article describes the protocols for the evaluation of the implementation of telemedicine in the Paris region. Over 2,500 patients have been included in eight studies addressing the use of telemedicine in the context of specific diseases or settings. Two projects are randomized controlled trials, while the six other projects are based on before-after designs (differences in differences studies). Based on the MAST model and the French national framework, we identified endpoints to assess the impact of telemedicine on five dimensions: clinical effectiveness, cost-effectiveness, security of the application, patient satisfaction and quality of life and perception of professionals. Telemedicine encompasses a wide range of services and stakeholders, and thus study protocols must be tailored to the specific constraints and interests of the users. NCT02110433 (03/07/2014), NCT02157740 (05/27/2014), NCT02374697 (02/05/2015), NCT02157727 (05/27/2014), NCT02229279 (08/28/2014), NCT02368769 (02/05/2015), NCT02164747 (NCT02164747), NCT02309905 (11/27/2014).

Metabolomics Workbench: An international repository for metabolomics data and metadata, metabolite standards, protocols, tutorials and training, and analysis tools

PubMed Central

Sud, Manish; Fahy, Eoin; Cotter, Dawn; Azam, Kenan; Vadivelu, Ilango; Burant, Charles; Edison, Arthur; Fiehn, Oliver; Higashi, Richard; Nair, K. Sreekumaran; Sumner, Susan; Subramaniam, Shankar

2016-01-01

The Metabolomics Workbench, available at www.metabolomicsworkbench.org, is a public repository for metabolomics metadata and experimental data spanning various species and experimental platforms, metabolite standards, metabolite structures, protocols, tutorials, and training material and other educational resources. It provides a computational platform to integrate, analyze, track, deposit and disseminate large volumes of heterogeneous data from a wide variety of metabolomics studies including mass spectrometry (MS) and nuclear magnetic resonance spectrometry (NMR) data spanning over 20 different species covering all the major taxonomic categories including humans and other mammals, plants, insects, invertebrates and microorganisms. Additionally, a number of protocols are provided for a range of metabolite classes, sample types, and both MS and NMR-based studies, along with a metabolite structure database. The metabolites characterized in the studies available on the Metabolomics Workbench are linked to chemical structures in the metabolite structure database to facilitate comparative analysis across studies. The Metabolomics Workbench, part of the data coordinating effort of the National Institute of Health (NIH) Common Fund's Metabolomics Program, provides data from the Common Fund's Metabolomics Resource Cores, metabolite standards, and analysis tools to the wider metabolomics community and seeks data depositions from metabolomics researchers across the world. PMID:26467476

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania.

PubMed

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki G M; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-12-30

A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.

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.

Simplified dispatch-assisted CPR instructions outperform standard protocol.

PubMed

Dias, J A; Brown, T B; Saini, D; Shah, R C; Cofield, S S; Waterbor, J W; Funkhouser, E; Terndrup, T E

2007-01-01

Dispatch-assisted chest compressions only CPR (CC-CPR) has gained widespread acceptance, and recent research suggests that increasing the proportion of compression time during CPR may increase survival from out-of-hospital cardiac arrest. We created a simplified CC-CPR protocol to reduce time to start chest compressions and to increase the proportion of time spent delivering chest compressions. This simplified protocol was compared to a published protocol, Medical Priority Dispatch System (MPDS) Version 11.2, recommended by the National Academies of Emergency Dispatch. Subjects were randomized to the MPDS v11.2 protocol or a simplified protocol. Data was recorded from a Laerdal Resusci Anne Skillreporter manikin. A simulated emergency medical dispatcher, contacted by cell phone, delivered standardized instructions for both protocols. Outcomes included chest compression rate, depth, hand position, full release, overall proportion of compressions without error, time to start of CPR and total hands-off chest time. Proportions were analyzed by Wilcoxon's Rank Sum tests and time variables with Welch ANOVA and Wilcoxon's Rank Sum test. All tests used a two-sided alpha-level of 0.05. One hundred and seventeen subjects were randomized prospectively, 58 to the standard protocol and 59 to the simplified protocol. The average age of subjects in both groups was 25 years old. For both groups, the compression rate was equivalent (104 simplified versus 94 MPDS, p = 0.13), as was the proportion with total release (1.0 simplified versus 1.0 MPDS, p = 0.09). The proportion to the correct depth was greater in the simplified protocol (0.31 versus 0.03, p < 0.01), as was the proportion of compressions done without error (0.05 versus 0.0, p = 0.16). Time to start of chest compressions and total hands-off chest time were better in the simplified protocol (start time 60.9s versus 78.6s, p < 0.0001; hands-off chest time 69 s versus 95 s, p < 0.0001). The proportion with correct hand position, however, was worse in the simplified protocol (0.35 versus 0.84, p < 0.01). The simplified protocol was as good as, or better than the MPDS v11.2 protocol in every aspect studied except hand position, and the simplified protocol resulted in significant time savings. The protocol may need modification to ensure correct hand position. Time savings and improved quality of CPR achieved by the new set of instructions could be important in strengthening critical links in the cardiac chain of survival.

National Survey of Environmental Cleaning and Disinfection in Hospitals in Thailand.

PubMed

Apisarnthanarak, Anucha; Weber, David J; Ratz, David; Saint, Sanjay; Khawcharoenporn, Thana; Greene, M Todd

2017-10-01

More than 90% of Thai hospitals surveyed reported implementing environmental cleaning and disinfection (ECD) protocols. Hospital epidemiologist presence was associated with the existence of an ECD checklist (P=.01) and of ECD auditing (P=.001), while good and excellent hospital administrative support were associated with better adherence to ECD protocols (P<.001) and ECD checklists (P=.005). Infect Control Hosp Epidemiol 2017;38:1250-1253.

The UAE healthy future study: a pilot for a prospective cohort study of 20,000 United Arab Emirates nationals.

PubMed

Abdulle, Abdishakur; Alnaeemi, Abdullah; Aljunaibi, Abdullah; Al Ali, Abdulrahman; Al Saedi, Khaled; Al Zaabi, Eiman; Oumeziane, Naima; Al Bastaki, Marina; Al-Houqani, Mohammed; Al Maskari, Fatma; Al Dhaheri, Ayesha; Shah, Syed M; Loney, Tom; El-Sadig, Mohamed; Oulhaj, Abderrahim; Wareth, Leila Abdel; Al Mahmeed, Wael; Alsafar, Habiba; Hirsch, Benjamin; Al Anouti, Fatme; Yaaqoub, Jamila; Inman, Claire K; Al Hamiz, Aisha; Al Hosani, Ayesha; Haji, Muna; Alsharid, Teeb; Al Zaabi, Thekra; Al Maisary, Fatima; Galani, Divya; Sprosen, Tim; El Shahawy, Omar; Ahn, Jiyoung; Kirchhoff, Tomas; Ramasamy, Ravichandran; Schmidt, Ann Marie; Hayes, Richard; Sherman, Scott; Ali, Raghib

2018-01-05

The United Arab Emirates (UAE) is faced with a rapidly increasing burden of non-communicable diseases including obesity, diabetes, and cardiovascular disease. The UAE Healthy Future study is a prospective cohort designed to identify associations between risk factors and these diseases amongst Emiratis. The study will enroll 20,000 UAE nationals aged ≥18 years. Environmental and genetic risk factors will be characterized and participants will be followed for future disease events. As this was the first time a prospective cohort study was being planned in the UAE, a pilot study was conducted in 2015 with the primary aim of establishing the feasibility of conducting the study. Other objectives were to evaluate the implementation of the main study protocols, and to build adequate capacity to conduct advanced clinical laboratory analyses. Seven hundred sixty nine UAE nationals aged ≥18 years were invited to participate voluntarily in the pilot study. Participants signed an informed consent, completed a detailed questionnaire, provided random blood, urine, and mouthwash samples and were assessed for a series of clinical measures. All specimens were transported to the New York University Abu Dhabi laboratories where samples were processed and analyzed for routine chemistry and hematology. Plasma, serum, and a small whole blood sample for DNA extraction were aliquoted and stored at -80 °C for future analyses. Overall, 517 Emirati men and women agreed to participate (68% response rate). Of the total participants, 495 (95.0%), 430 (82.2%), and 492 (94.4%), completed the questionnaire, physical measurements, and provided biological samples, respectively. The pilot study demonstrated the feasibility of recruitment and completion of the study protocols for the first large-scale cohort study designed to identify emerging risk factors for the major non-communicable diseases in the region.

Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.

PubMed

van der Roer, Nicole; van Tulder, Maurits; van Mechelen, Willem; de Vet, Henrica

2008-02-15

Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. To evaluate the cost effectiveness and cost utility of an intensive group training protocol compared with usual care physiotherapy in patients with nonspecific chronic low back pain. The intensive group training protocol combines exercise therapy, back school, and behavioral principles. Two studies found a significant reduction in absenteeism for a graded activity program in occupational health care. This program has not yet been evaluated in a primary care physiotherapy setting. Participating physical therapists in primary care recruited 114 patients with chronic nonspecific low back pain. Eligible patients were randomized to either the protocol group or the guideline group. Outcome measures included functional status (Roland Morris Disability Questionnaire), pain intensity (11-point numerical rating scale), general perceived effect and quality of life (EuroQol-5D). Cost data were measured with cost diaries and included direct and indirect costs related to low back pain. After 52 weeks, the direct health care costs were significantly higher for patients in the protocol group, largely due to the costs of the intervention. The mean difference in total costs amounted to [Euro sign] 233 (95% confidence interval: [Euro sign] -2.185; [Euro sign] 2.764). The cost-effectiveness planes indicated no significant differences in cost effectiveness between the 2 groups. The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.

Updated operational protocols for the U.S. Geological Survey Precipitation Chemistry Quality Assurance Project in support of the National Atmospheric Deposition Program

USGS Publications Warehouse

Wetherbee, Gregory A.; Martin, RoseAnn

2017-02-06

The U.S. Geological Survey Branch of Quality Systems operates the Precipitation Chemistry Quality Assurance Project (PCQA) for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN) and National Atmospheric Deposition Program/Mercury Deposition Network (NADP/MDN). Since 1978, various programs have been implemented by the PCQA to estimate data variability and bias contributed by changing protocols, equipment, and sample submission schemes within NADP networks. These programs independently measure the field and laboratory components which contribute to the overall variability of NADP wet-deposition chemistry and precipitation depth measurements. The PCQA evaluates the quality of analyte-specific chemical analyses from the two, currently (2016) contracted NADP laboratories, Central Analytical Laboratory and Mercury Analytical Laboratory, by comparing laboratory performance among participating national and international laboratories. Sample contamination and stability are evaluated for NTN and MDN by using externally field-processed blank samples provided by the Branch of Quality Systems. A colocated sampler program evaluates the overall variability of NTN measurements and bias between dissimilar precipitation gages and sample collectors.This report documents historical PCQA operations and general procedures for each of the external quality-assurance programs from 2007 to 2016.

Integrated Data Collection Analysis (IDCA) Program - RDX Type II Class 5 Standard, Data Set 1

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

Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

This document describes the results of the first reference sample material—RDX Type II Class 5—examined in the proficiency study for small-scale safety and thermal (SSST) testing of explosive materials for the Integrated Data Collection Analysis (IDCA) Program. The IDCA program is conducting proficiency testing on homemade explosives (HMEs). The reference sample materials are being studied to establish the accuracy of traditional explosives safety testing for each performing laboratory. These results will be used for comparison to results from testing HMEs. This effort, funded by the Department of Homeland Security (DHS), ultimately will put the issues of safe handling of thesemore » materials in perspective with standard military explosives. The results of the study will add SSST testing results for a broad suite of different HMEs to the literature, potentially suggest new guidelines and methods for HME testing, and possibly establish what are the needed accuracies in SSST testing to develop safe handling practices. Described here are the results for impact, friction, electrostatic discharge, and scanning calorimetry analysis of a reference sample of RDX Type II Class 5. The results from each participating testing laboratory are compared using identical test material and preparation methods wherever possible. Note, however, the test procedures differ among the laboratories. These results are then compared to historical data from various sources. The performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Air Force Research Laboratory/ RXQL (AFRL), Indian Head Division, Naval Surface Warfare Center, (IHD-NSWC), and Sandia National Laboratories (SNL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to understand how to compare results when test protocols are not identical.« less

Remote Sensing and the Kyoto Protocol: A Workshop Summary

NASA Technical Reports Server (NTRS)

Rosenqvist, Ake; Imhoff, Marc; Milne, Anthony; Dobson, Craig

2000-01-01

The Kyoto Protocol to the United Nations Framework Convention on Climate Change contains quantified, legally binding commitments to limit or reduce greenhouse gas emissions to 1990 levels and allows carbon emissions to be balanced by carbon sinks represented by vegetation. The issue of using vegetation cover as an emission offset raises a debate about the adequacy of current remote sensing systems and data archives to both assess carbon stocks/sinks at 1990 levels, and monitor the current and future global status of those stocks. These concerns and the potential ratification of the Protocol among participating countries is stimulating policy debates and underscoring a need for the exchange of information between the international legal community and the remote sensing community. On October 20-22 1999, two working groups of the International Society for Photogrammetry and Remote Sensing (ISPRS) joined with the University of Michigan (Michigan, USA) to convene discussions on how remote sensing technology could contribute to the information requirements raised by implementation of, and compliance with, the Kyoto Protocol. The meeting originated as a joint effort between the Global Monitoring Working Group and the Radar Applications Working Group in Commission VII of the ISPRS, co-sponsored by the University of Michigan. Tile meeting was attended by representatives from national government agencies and international organizations and academic institutions. Some of the key themes addressed were: (1) legal aspects of transnational remote sensing in the context of the Kyoto Protocol; (2) a review of the current and future and remote sensing technologies that could be applied to the Kyoto Protocol; (3) identification of areas where additional research is needed in order to advance and align remote sensing technology with the requirements and expectations of the Protocol; and 94) the bureaucratic and research management approaches needed to align the remote sensing community with both the science and policy communities.

Occupancy modeling of ruffed grouse in the Black Hills National Forest

Treesearch

Christopher Paul Hansen

2009-01-01

Ruffed grouse (Bonasa umbellus) are important game birds and the management indicator species for quaking aspen (Populus tremuloides) in the Black Hills National Forest (BHNF). As a result, a robust monitoring protocol which reflects the status, trends, and habitat associations of ruffed grouse in the BHNF is necessary. To evaluate...

Biosecurity protocols for heritage gardens

Treesearch

Ian Wright; David Slawson

2010-01-01

This project aims to protect The National Trust (NT) from the increasing number of harmful plant pests and diseases that slip though official controls and threaten our gardens, plant collections and landscapes. During 2008, the National Trust (NT) with the seconded help of Dr. David Slawson, Head of Pest and Disease Identification Programme, Food and Environment...

Vascular plant and vertebrate inventories in Sonoran Desert National Parks

Treesearch

Cecilia A. Schmidt; Eric W. Albrecht; Brian F. Powell; William L. Halvorson

2005-01-01

Biological inventories are important for natural resource management and interpretation, and can form a foundation for long-term monitoring programs. We inventoried vascular plants and vertebrates in nine National Parks in southern Arizona and western New Mexico from 2000 to 2004 using repeatable designs, commonly accepted methods, and standardized protocols. At...

78 FR 23539 - National Marine Fisheries Service, Pacific Fishery Management Council (Pacific Council); May 6...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... Pacific Council will host a meeting of the Council Coordination Committee (CCC) consisting of the eight..., including: budget issues, CCC meeting protocols, Managing Our Nation's Fisheries 3 (MONF3) conference...) of 2006 established the Council Coordination Committee (CCC) by amending section 302 (16 U.S.C. 1852...

Audit of HIV counselling and testing services among primary healthcare facilities in Cameroon: a protocol for a multicentre national cross-sectional study.

PubMed

Tianyi, Frank-Leonel; Tochie, Joel Noutakdie; Agbor, Valirie Ndip; Kadia, Benjamin Momo

2018-03-01

HIV testing is an invaluable entry point to prevention, care and treatment services for people living with HIV and AIDS. Poor adherence to recommended protocols and guidelines reduces the performance of rapid diagnostic tests, leading to misdiagnosis and poor estimation of HIV seroprevalence. This study seeks to evaluate the adherence of primary healthcare facilities in Cameroon to recommended HIV counselling and testing (HCT) procedures and the impact this may have on the reliability of HIV test results. This will be an analytical cross-sectional study involving primary healthcare facilities from all the 10 regions of Cameroon, selected by a multistaged random sampling of primary care facilities in each region. The study will last for 9 months. A structured questionnaire will be used to collect general information concerning the health facility, laboratory and other departments involved in the HCT process. The investigators will directly observe at least 10 HIV testing processes in each facility and fill out the checklist accordingly. Clearance has been obtained from the National Ethical Committee to carry out the study. Informed consent will be sought from the patients to observe the HIV testing process. The final study will be published in a peer-reviewed journal and the findings presented to health policy-makers and the general public. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Indicators and protocols for monitoring impacts of formal and informal trails in protected areas

USGS Publications Warehouse

Marion, Jeffrey L.; Leung, Yu-Fai

2011-01-01

Trails are a common recreation infrastructure in protected areas and their conditions affect the quality of natural resources and visitor experiences. Various trail impact indicators and assessment protocols have been developed in support of monitoring programs, which are often used for management decision-making or as part of visitor capacity management frameworks. This paper reviews common indicators and assessment protocols for three types of trails, surfaced formal trails, unsurfaced formal trails, and informal (visitor-created) trails. Monitoring methods and selected data from three U.S. National Park Service units are presented to illustrate some common trail impact indicators and assessment options.

U.S. National Academy panel reviews climate change science

NASA Astrophysics Data System (ADS)

Showstack, Randy

Could the administration of George W. Bush, which has rejected the Kyoto Protocol to reduce worldwide emissions of greenhouse gases—and which has reneged on a campaign pledge to regulate U.S. carbon dioxide emissions—sincerely be seeking the facts about climate change in time for the resumption of international negotiations on the issue in July?That is the hope of an 11-member committee of the U.S. National Academy of Sciences (NAS) that is working on an incredibly fast-tracked report “The Science of Climate Change,” at the request of the administration. The project largely will review and synthesize findings from a number of earlier studies.

Incorporating physical activity measures into environmental monitoring of national parks: an example from Yosemite.

PubMed

Walden-Schreiner, Chelsey; Leung, Yu-Fai; Floyd, Myron F

2014-09-01

To address increasing prevalence of obesity and associated chronic disease, recent national initiatives have called upon federal agencies to promote healthy lifestyles and provide opportunities for physical activity. In response, the U.S. National Park Service has developed strategies promoting health through physical activity in addition to its well-established biodiversity and landscape conservation mission. Incorporating physical activity measures with routine environmental monitoring would help identify areas where parks can promote active pursuits with minimal environmental impact. This study provides one example of how protocols developed for visitor and environmental monitoring can generate data to evaluate physical activity. Researchers implemented an observational study in high-use meadows of Yosemite National Park during the summer of 2011. Variables measured include the spatial location of visitors and activity type. Metabolic equivalents (METs) were assigned to activity categories and analyzed for average energy expenditure. Mean METs values indicated sedentary to light physical activity across the meadows, with greater means in areas with boardwalks or paved pathways. Data leveraged in this study provide park managers an example of adapting existing monitoring programs to incorporate indicators relevant to physical activity evaluation and how physical activity may impact resource conditions in national parks.

Recommended Protocol for Round Robin Studies in Additive Manufacturing

PubMed Central

Moylan, Shawn; Brown, Christopher U.; Slotwinski, John

2016-01-01

One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST’s experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed. PMID:27274602

Recommended Protocol for Round Robin Studies in Additive Manufacturing.

PubMed

Moylan, Shawn; Brown, Christopher U; Slotwinski, John

2016-03-01

One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST's experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed.

Targeted agents for patients with advanced/metastatic pancreatic cancer: A protocol for systematic review and network meta-analysis.

PubMed

Di, Baoshan; Pan, Bei; Ge, Long; Ma, Jichun; Wu, Yiting; Guo, Tiankang

2018-03-01

Pancreatic cancer (PC) is a devastating malignant tumor. Although surgical resection may offer a good prognosis and prolong survival, approximately 80% patients with PC are always diagnosed as unresectable tumor. National Comprehensive Cancer Network's (NCCN) recommended gemcitabine-based chemotherapy as efficient treatment. While, according to recent studies, targeted agents might be a better available option for advanced or metastatic pancreatic cancer patients. The aim of this systematic review and network meta-analysis will be to examine the differences of different targeted interventions for advanced/metastatic PC patients. We will conduct this systematic review and network meta-analysis using Bayesian method and according to Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. To identify relevant studies, 6 electronic databases including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of science, CNKI (Chinese National Knowledge Infrastructure), and CBM (Chinese Biological Medical Database) will be searched. The risk of bias in included randomized controlled trials (RCTs) will be assessed using the Cochrane Handbook version 5.1.0. And we will use GRADE approach to assess the quality of evidence from network meta-analysis. Data will be analyzed using R 3.4.1 software. To the best of our knowledge, this systematic review and network meta-analysis will firstly use both direct and indirect evidence to compare the differences of different targeted agents and targeted agents plus chemotherapy for advanced/metastatic pancreatic cancer patients. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required. We will disseminate the results of this review by submitting to a peer-reviewed journal.

Soil Science Education for Primary and Secondary Students

NASA Astrophysics Data System (ADS)

Sparrow, Elena; Yoshikawa, Kenji; Kopplin, Martha

2013-04-01

Soils is one of the science investigation areas in the Global learning and Observations to Benefit the Environment (GLOBE), an international science and education program (112 countries) that teaches primary and secondary students to learn science by doing science. For each area of investigation GLOBE provides background information, measurement protocols and learning activities compiled as a chapter in the GLOBE Teacher's Guide. Also provided are data sheets and field guides to assist in the accurate collection of data as well as suggestions of scientific instruments and calibration methods. Teachers learn GLOBE scientific measurement protocols at professional development workshops led by scientists and educators, who then engage their students in soil studies that also contribute to ongoing science investigations. Students enter their data on the GLOBE website and can access their data as well as other data contributed by students from other parts of the world. Soil characterization measurements carried out in the field include site description, horizon depths, soil structure, soil color, soil consistence, soil texture, roots, rocks and carbonates. Other field measurements are soil temperature and soil moisture monitoring while the following measurements are carried out in the classroom or laboratory: gravimetric soil moisture, bulk density, particle density, particle size distribution, pH and soil fertility (nitrogen, phosphorus and potassium). Learning activities provide support for preparing students to do the measurements and for better understanding of science concepts. Many countries in GLOBE have adopted standards for education including science education with commonalities among them. For the Teacher's Guide, the National Science Education Standards published by the US National Academy of Sciences, selected additional content standards that GLOBE scientists and educators feel are appropriate and the National Geography Standards prepared by the (US) National Education Standards Project, are being used. Educational objectives for students include gaining scientific inquiry abilities in addition to understanding scientific concepts. The Soils chapter also includes some suggestions for managing students in the field and classroom. A new protocol has also been developed by the Seasons and Biomes project, one of the GLOBE earth system science projects. Active Layer monitoring uses a Frost Tube that measures when and how deeply soil freezes and is currently being used in more than 200 sites in Alaska. Teachers have successfully implemented soil studies in their curriculum and have used it to teach about the science process.

Comparative Analysis of Two Inquiry Observational Protocols: Striving to Better Understand the Quality of Teacher-Facilitated Inquiry-Based Instruction

ERIC Educational Resources Information Center

Marshall, Jeff C.; Smart, Julie; Lotter, Christine; Sirbu, Cristina

2011-01-01

With inquiry being one of the central tenets of the national and most state standards, it is imperative that we have a solid means to measure the quality of inquiry-based instruction being led in classrooms. Many instruments are available and used for this purpose, but many are either invalid or too global. This study sought to compare two…

CareTrack Kids—part 1. Assessing the appropriateness of healthcare delivered to Australian children: study protocol for clinical indicator development

PubMed Central

Wiles, Louise K; Hooper, Tamara D; Hibbert, Peter D; White, Les; Mealing, Nicole; Jaffe, Adam; Cowell, Christopher T; Runciman, William B; Goldstein, Stan; Hallahan, Andrew R; Wakefield, John G; Murphy, Elisabeth; Lau, Annie; Wheaton, Gavin; Williams, Helena M; Hughes, Clifford; Braithwaite, Jeffrey

2015-01-01

Introduction Despite the widespread availability of clinical guidelines, considerable gaps remain between the care that is recommended (appropriate care) and the care provided. This protocol describes a research methodology to develop clinical indicators for appropriate care for common paediatric conditions. Methods and analysis We will identify conditions amenable to population-level appropriateness of care research and develop clinical indicators for each condition. Candidate conditions have been identified from published research; burden of disease, prevalence and frequency of presentation data; and quality of care priority lists. Clinical indicators will be developed through searches of national and international guidelines, and formatted with explicit criteria for inclusion, exclusion, time frame and setting. Experts will review the indicators using a wiki-based approach and modified Delphi process. A formative evaluation of the wiki process will be undertaken. Ethics and dissemination Human Research Ethics Committee approvals have been received from Sydney Children's Hospital Network, Children's Health Queensland Hospital and Health Service, and the Women's and Children's Health Network (South Australia). Applications are under review with Macquarie University and the Royal Australian College of General Practitioners. We will submit the results of the study to relevant journals and offer national and international presentations. PMID:25854976

2018 NDIA 33rd Annual National Test and Evaluation Conference

DTIC Science & Technology

2018-05-17

Breach IOC Delayed RDT&E Overrun MS B IOC First Flight CDR Wind Tunnel Campaign Flight Test Campaign $ Peak Burn Rate Occurs Around FF Wind Tunnel...Connectivity Team – Tier 2 network support, network characterization and analysis, walk-the- wire trouble resolution, assistance with new site Connection...File Transfer Protocol (SFTP) Server. The Test and Training Enabling Architecture (TENA) is used for over the wire simulation protocol via the DISGW

Study protocol for the recruitment of female sex workers and their non-commercial partners into couple-based HIV research.

PubMed

Syvertsen, Jennifer L; Robertson, Angela M; Abramovitz, Daniela; Rangel, M Gudelia; Martinez, Gustavo; Patterson, Thomas L; Ulibarri, Monica D; Vera, Alicia; El-Bassel, Nabila; Strathdee, Steffanie A

2012-02-20

Researchers are increasingly recognizing the importance of addressing sexual and drug-related HIV risk within the context of intimate relationships rather than solely focusing on individual behaviors. Practical and effective methods are needed to recruit, screen, and enroll the high risk and hard-to-reach couples who would most benefit from HIV interventions, such as drug-using female sex workers (FSWs) and their intimate, non-commercial partners. This paper outlines a bi-national, multidisciplinary effort to develop and implement a study protocol for research on the social context and epidemiology of HIV, sexually transmitted infections (STI), and high risk behaviors among FSWs and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico. We provide an overview of our study and specifically focus on the sampling, recruitment, screening, and successful enrollment of high risk couples into a public health study in this context. We used targeted and snowball sampling to recruit couples through the female partner first and administered a primary screener to check her initial eligibility. Willing and eligible females then invited their primary male partners for couple-based screening using a couple verification screening (CVS) instrument adapted from previous studies. The CVS rechecked eligibility and separately asked each partner the same questions about their relationship to "test" if the couple was legitimate. We adapted the original protocol to consider issues of gender and power within the local cultural and socioeconomic context and expanded the question pool to create multiple versions of the CVS that were randomly administered to potential couples to determine eligibility and facilitate study enrollment. The protocol successfully enrolled 214 high risk couples into a multi-site public health study. This work suggests the importance of collaborating to construct a study protocol, understanding the local population and context, and drawing on multiple sources of input to determine eligibility and verify the legitimacy of relationships. We provide a practical set of tools that other researchers should find helpful in the study of high risk couples in international settings, with particular relevance to studies of FSWs and their intimate partners.

Refining Ovarian Cancer Test accuracy Scores (ROCkeTS): protocol for a prospective longitudinal test accuracy study to validate new risk scores in women with symptoms of suspected ovarian cancer

PubMed Central

Sundar, Sudha; Rick, Caroline; Dowling, Francis; Au, Pui; Rai, Nirmala; Champaneria, Rita; Stobart, Hilary; Neal, Richard; Davenport, Clare; Mallett, Susan; Sutton, Andrew; Kehoe, Sean; Timmerman, Dirk; Bourne, Tom; Van Calster, Ben; Gentry-Maharaj, Aleksandra; Deeks, Jon

2016-01-01

Introduction Ovarian cancer (OC) is associated with non-specific symptoms such as bloating, making accurate diagnosis challenging: only 1 in 3 women with OC presents through primary care referral. National Institute for Health and Care Excellence guidelines recommends sequential testing with CA125 and routine ultrasound in primary care. However, these diagnostic tests have limited sensitivity or specificity. Improving accurate triage in women with vague symptoms is likely to improve mortality by streamlining referral and care pathways. The Refining Ovarian Cancer Test Accuracy Scores (ROCkeTS; HTA 13/13/01) project will derive and validate new tests/risk prediction models that estimate the probability of having OC in women with symptoms. This protocol refers to the prospective study only (phase III). Methods and analysis ROCkeTS comprises four parallel phases. The full ROCkeTS protocol can be found at http://www.birmingham.ac.uk/ROCKETS. Phase III is a prospective test accuracy study. The study will recruit 2450 patients from 15 UK sites. Recruited patients complete symptom and anxiety questionnaires, donate a serum sample and undergo ultrasound scored as per International Ovarian Tumour Analysis (IOTA) criteria. Recruitment is at rapid access clinics, emergency departments and elective clinics. Models to be evaluated include those based on ultrasound derived by the IOTA group and novel models derived from analysis of existing data sets. Estimates of sensitivity, specificity, c-statistic (area under receiver operating curve), positive predictive value and negative predictive value of diagnostic tests are evaluated and a calibration plot for models will be presented. ROCkeTS has received ethical approval from the NHS West Midlands REC (14/WM/1241) and is registered on the controlled trials website (ISRCTN17160843) and the National Institute of Health Research Cancer and Reproductive Health portfolios. PMID:27507231

Consensus Recommendations of the Multiple Sclerosis Study Group and Portuguese Neuroradiological Society for the Use of the Magnetic Resonance Imaging in Multiple Sclerosis in Clinical Practice: Part 1.

PubMed

Abreu, Pedro; Pedrosa, Rui; Sá, Maria José; Cerqueira, João; Sousa, Lívia; Da Silva, Ana Martins; Pinheiro, Joaquim; De Sá, João; Batista, Sónia; Simões, Rita Moiron; Pereira, Daniela Jardim; Vilela, Pedro; Vale, José

2018-05-30

Magnetic resonance imaging is established as a recognizable tool in the diagnosis and monitoring of multiple sclerosis patients. In the present, among multiple sclerosis centers, there are different magnetic resonance imaging sequences and protocols used to study multiple sclerosis that may hamper the optimal use of magnetic resonance imaging in multiple sclerosis. In this context, the Group of Studies of Multiple Sclerosis and the Portuguese Society of Neuroradiology, after a joint discussion, appointed a committee of experts to create recommendations adapted to the national reality on the use of magnetic resonance imaging in multiple sclerosis. The purpose of this document is to publish the first Portuguese consensus recommendations on the use of magnetic resonance imaging in multiple sclerosis in clinical practice. The Group of Studies of Multiple Sclerosis and the Portuguese Society of Neuroradiology, after discussion of the topic in national meetings and after a working group meeting held in Figueira da Foz on May 2017, have appointed a committee of experts that have developed by consensus several standard protocols on the use of magnetic resonance imaging in the diagnosis and follow-up of multiple sclerosis. The document obtained was based on the best scientific evidence and expert opinion. Subsequently, the majority of Portuguese multiple sclerosis consultants and departments of neuroradiology scrutinized and reviewed the consensus paper; comments and suggestions were considered. Technical magnetic resonance imaging protocols regarding diagnostic, monitoring and the recommended information to be included in the magnetic resonance imaging report will be published in a separate paper. We provide some practical guidelines to promote standardized strategies to be applied in the clinical practice setting of Portuguese healthcare professionals regarding the use of magnetic resonance imaging in multiple sclerosis. We hope that these first Portuguese magnetic resonance imaging guidelines, based in the best available clinical evidence and practices, will serve to optimize multiple sclerosis management and improve multiple sclerosis patient care across Portugal.

Study protocol for the recruitment of female sex workers and their non-commercial partners into couple-based HIV research

PubMed Central

2012-01-01

Background Researchers are increasingly recognizing the importance of addressing sexual and drug-related HIV risk within the context of intimate relationships rather than solely focusing on individual behaviors. Practical and effective methods are needed to recruit, screen, and enroll the high risk and hard-to-reach couples who would most benefit from HIV interventions, such as drug-using female sex workers (FSWs) and their intimate, non-commercial partners. This paper outlines a bi-national, multidisciplinary effort to develop and implement a study protocol for research on the social context and epidemiology of HIV, sexually transmitted infections (STI), and high risk behaviors among FSWs and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico. We provide an overview of our study and specifically focus on the sampling, recruitment, screening, and successful enrollment of high risk couples into a public health study in this context. Methods/Design We used targeted and snowball sampling to recruit couples through the female partner first and administered a primary screener to check her initial eligibility. Willing and eligible females then invited their primary male partners for couple-based screening using a couple verification screening (CVS) instrument adapted from previous studies. The CVS rechecked eligibility and separately asked each partner the same questions about their relationship to "test" if the couple was legitimate. We adapted the original protocol to consider issues of gender and power within the local cultural and socioeconomic context and expanded the question pool to create multiple versions of the CVS that were randomly administered to potential couples to determine eligibility and facilitate study enrollment. Discussion The protocol successfully enrolled 214 high risk couples into a multi-site public health study. This work suggests the importance of collaborating to construct a study protocol, understanding the local population and context, and drawing on multiple sources of input to determine eligibility and verify the legitimacy of relationships. We provide a practical set of tools that other researchers should find helpful in the study of high risk couples in international settings, with particular relevance to studies of FSWs and their intimate partners. PMID:22348625

Prebreathe Protocol for Extravehicular Activity Technical Consultation Report

NASA Technical Reports Server (NTRS)

Ross, Jerry; Duncan, Michael

2008-01-01

In the performance of EVA by that National Aeronautics and Space Administration (NASA) astronauts, there exists a risk of DCS as the suit pressure is reduced to 4.3 pounds per square inch, absolute (psia) from the International Space Station (ISS) pressure of 14.7 psia. Several DCS-preventive procedures have been developed and implemented. Each of these procedures involve the use of oxygen (O2) prebreathe to effectively washout tissue nitrogen (N2).The management of the ISS Programs convened an expert independent peer review Team to conduct a review of the Decompression Sickness (DCS) risks associated with the Extra Vehicular Activity (EVA) Campout Prebreathe (PB) protocol for its consideration for use on future missions. The major findings and recommendations of the expert panel are: There is no direct experimental data to confirm the potential DCS risks of the Campout PB protocol. However, based on model data, statistical probability, physiology, and information derived from similar PB protocols, there is no compelling evidence to suggest that the Campout PB protocol is less safe than the other NASA approved PB protocols.

Multi-Party Quantum Private Comparison Protocol Based on Entanglement Swapping of Bell Entangled States

NASA Astrophysics Data System (ADS)

Ye, Tian-Yu

2016-09-01

Recently, Liu et al. proposed a two-party quantum private comparison (QPC) protocol using entanglement swapping of Bell entangled state (Commun. Theor. Phys. 57 (2012) 583). Subsequently Liu et al. pointed out that in Liu et al.'s protocol, the TP can extract the two users' secret inputs without being detected by launching the Bell-basis measurement attack, and suggested the corresponding improvement to mend this loophole (Commun. Theor. Phys. 62 (2014) 210). In this paper, we first point out the information leakage problem toward TP existing in both of the above two protocols, and then suggest the corresponding improvement by using the one-way hash function to encrypt the two users' secret inputs. We further put forward the three-party QPC protocol also based on entanglement swapping of Bell entangled state, and then validate its output correctness and its security in detail. Finally, we generalize the three-party QPC protocol into the multi-party case, which can accomplish arbitrary pair's comparison of equality among K users within one execution. Supported by the National Natural Science Foundation of China under Grant No. 61402407

Global, regional and national levels and trends of preterm birth rates for 1990 to 2014: protocol for development of World Health Organization estimates.

PubMed

Vogel, Joshua P; Chawanpaiboon, Saifon; Watananirun, Kanokwaroon; Lumbiganon, Pisake; Petzold, Max; Moller, Ann-Beth; Thinkhamrop, Jadsada; Laopaiboon, Malinee; Seuc, Armando H; Hogan, Daniel; Tunçalp, Ozge; Allanson, Emma; Betrán, Ana Pilar; Bonet, Mercedes; Oladapo, Olufemi T; Gülmezoglu, A Metin

2016-06-17

The official WHO estimates of preterm birth are an essential global resource for assessing the burden of preterm birth and developing public health programmes and policies. This protocol describes the methods that will be used to identify, critically appraise and analyse all eligible preterm birth data, in order to develop global, regional and national level estimates of levels and trends in preterm birth rates for the period 1990 - 2014. We will conduct a systematic review of civil registration and vital statistics (CRVS) data on preterm birth for all WHO Member States, via national Ministries of Health and Statistics Offices. For Member States with absent, limited or lower-quality CRVS data, a systematic review of surveys and/or research studies will be conducted. Modelling will be used to develop country, regional and global rates for 2014, with time trends for Member States where sufficient data are available. Member States will be invited to review the methodology and provide additional eligible data via a country consultation before final estimates are developed and disseminated. This research will be used to generate estimates on the burden of preterm birth globally for 1990 to 2014. We invite feedback on the methodology described, and call on the public health community to submit pertinent data for consideration. Registered at PROSPERO CRD42015027439 CONTACT: pretermbirth@who.int.

A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT)

PubMed Central

Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

2016-01-01

Introduction Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. Methods and analysis A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver ‘active’ interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to ‘active’ intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. Ethics and dissemination The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the recommended SPIRIT Checklist. Amendments will be reported to relevant regulatory parties. Trial registration number ISRCTN 71002650; Pre-results. PMID:26781504

A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT).

PubMed

Bruce, Julie; Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

2016-01-18

Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver 'active' interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to 'active' intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the recommended SPIRIT Checklist. Amendments will be reported to relevant regulatory parties. ISRCTN 71002650; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

National protocol for quality assurance in DXA-bone densitometry

NASA Astrophysics Data System (ADS)

Slavchev, A.; Avramova-Cholakova, S.; Vassileva, J.

2008-01-01

Osteoporosis becomes largely one of the most important socially significant and costly diseases. Modern techniques (DXA, US) are applied for bone densitometry. The paper presents a protocol for quality assurance especially of DXA-bone densitometers including quality control made in compliance with international standards (ISCD, IOF). The methodology has been tested in practice by measurements on site-functional assessment, entrance dose, radiation protection, calibration, in-vitro precision. It is expected to raise the quality of the diagnostic process in concert with the EU Medical Directive 97/43 particularly for population screening and sensitive groups. The protocol is an essential part of the National Program for constraining osteoporosis which has been elaborated at the Ministry of Health and at present under implementation throughout the country. It aims at reducing the risk, factors spreading, at diminishing the fracture risk the morbidity and the mortality from osteoporosis. An integral multidisciplinary approach to the problem solving is applied as well as training on three levels — doctors, patients, population, which effectively will contribute for obtaining real results in preventing osteoporosis.

Review of the Medical Research Ethics Committee (MREC), National Research Center of Egypt, 2003-2011.

PubMed

Abdel-Aal, Wafaa; Ghaffar, Esmat Abdel; El Shabrawy, Osama

2013-10-01

Globally, ethical issues in research are becoming of major importance, being well established in developed countries with little information about research ethics committees (RECs) in Africa to assess whether these committees are actually improving the protection of human research participants. To describe the establishment, structure, function, operations and outcome of the Medical Research Ethics Committee (MREC) of the National Research Center (NRC) of Egypt from 2003 to 2011. The committee established its regulatory rules for human and animal research ethics based on the Declaration of Helsinki 2000-2008 and WHO regulations 2000-2011. There were 974 protocols revised in the 7 years (2005-2011). The outcome of the committee discussions was to clear 262 of the protocols without conditions. A full 556 were cleared conditionally upon completion of modifications. Another 118 were deferred pending action and further consideration at a subsequent meeting. And 16 researchers did not reply, while 22 protocols were rejected. Since 2005, the MREC in NRC Egypt has built up considerable experience of evaluating the ethical issues arising within the field of medical research.

Dealing with the long-term social implications of research.

PubMed

Fleischman, Alan; Levine, Carol; Eckenwiler, Lisa; Grady, Christine; Hammerschmidt, Dale E; Sugarman, Jeremy

2011-05-01

Biomedical and behavioral research may affect strongly held social values and thereby create significant controversy over whether such research should be permitted in the first place. Institutional review boards (IRBs) responsible for protecting the rights and welfare of participants in research are sometimes faced with review of protocols that have significant implications for social policy and the potential for negative social consequences. Although IRB members often raise concerns about potential long-term social implications in protocol review, federal regulations strongly discourage IRBs from considering them in their decisions. Yet IRBs often do consider the social implications of research protocols and sometimes create significant delays in initiating or even prevent such research. The social implications of research are important topics for public scrutiny and professional discussion. This article examines the reasons that the federal regulations preclude IRBs from assessing the social risks of research, and examines alternative approaches that have been used with varying success by national advisory groups to provide such guidance. The article concludes with recommendations for characteristics of a national advisory group that could successfully fulfill this need, including sustainability, independence, diverse and relevant expertise, and public transparency.

The emerging international regulatory framework for biotechnology.

PubMed

Komen, John

2012-01-01

Debate about the potential risks of genetically modified organisms (GMOs) to the environment or human health spurred attention to biosafety. Biosafety is associated with the safe use of GMOs and, more generally, with the introduction of non-indigenous species into natural or managed ecosystems. Biosafety regulation--the policies and procedures adopted to ensure the environmentally safe application of modern biotechnology--has been extensively discussed at various national and international forums. Much of the discussion has focused on developing guidelines, appropriate legal frameworks and, at the international level, a legally binding international biosafety protocol--the Cartagena Protocol on Biosafety. The Protocol is one among various international instruments and treaties that regulate specific aspects relevant to agricultural biotechnology. The present article presents the main international instruments relevant to biosafety regulation, and their key provisions. While international agreements and standards provide important guidance, they leave significant room for interpretation, and flexibility for countries implementing them. Implementation of biosafety at the national level has proven to be a major challenge, particularly in developing countries, and consequently the actual functioning of the international regulatory framework for biotechnology is still in a state of flux.

Monitoring the impact of trade agreements on national food environments: trade imports and population nutrition risks in Fiji.

PubMed

Ravuvu, Amerita; Friel, Sharon; Thow, Anne-Marie; Snowdon, Wendy; Wate, Jillian

2017-06-13

Trade agreements are increasingly recognised as playing an influential role in shaping national food environments and the availability and nutritional quality of the food supply. Global monitoring of food environments and trade policies can strengthen the evidence base for the impact of trade policy on nutrition, and support improved policy coherence. Using the INFORMAS trade monitoring protocol, we reviewed available food supply data to understand associations between Fiji's commitments under WTO trade agreements and food import volume trends. First, a desk review was conducted to map and record in one place Fiji's commitments to relevant existing trade agreements that have implications for Fiji's national food environment under the domains of the INFORMAS trade monitoring protocol. An excel database was developed to document the agreements and their provisions. The second aspect of the research focused on data extraction. We began with identifying food import volumes into Fiji by country of origin, with a particular focus on a select number of 'healthy and unhealthy' foods. We also developed a detailed listing of transnational food corporations currently operating in Fiji. The study suggests that Fiji's WTO membership, in conjunction with associated economic and agricultural policy changes have contributed to increased availability of both healthy and less healthy imported foods. In systematically monitoring the import volume trends of these two categories of food, the study highlights an increase in healthy foods such as fresh fruits and vegetables and whole-grain refined cereals. The study also shows that there has been an increase in less healthy foods including fats and oils; meat; processed dairy products; energy-dense beverages; and processed and packaged foods. By monitoring the trends of imported foods at country level from the perspective of trade agreements, we are able to develop appropriate and targeted interventions to improve diets and health. This would enable national health interventions to both identify areas of concern, and to ensure that interventions take into account the trade context.

Protocol for a national prevalence study of advance care planning documentation and self-reported uptake in Australia

PubMed Central

Ruseckaite, Rasa; Detering, Karen M; Perera, Veronica; Walker, Lynne; Sinclair, Craig; Clayton, Josephine M; Nolte, Linda

2017-01-01

Introduction Advance care planning (ACP) is a process between a person, their family/carer(s) and healthcare providers that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care. The Australian government funds a number of national initiatives aimed at increasing ACP uptake; however, there is currently no standardised Australian data on formal ACP documentation or self-reported uptake. This makes it difficult to evaluate the impact of ACP initiatives. This study aims to determine the Australian national prevalence of ACP and completion of Advance Care Directives (ACDs) in hospitals, aged care facilities and general practices. It will also explore people’s self-reported use of ACP and views about the process. Methods and analysis Researchers will conduct a national multicentre cross-sectional prevalence study, consisting of a record audit and surveys of people aged 65 years or more in three sectors. From 49 participating Australian organisations, 50 records will be audited (total of 2450 records). People whose records were audited, who speak English and have a decision-making capacity will also be invited to complete a survey. The primary outcome measure will be the number of people who have formal or informal ACP documentation that can be located in records within 15 min. Other outcomes will include demographics, measure of illness and functional capacity, details of ACP documentation (including type of document), location of documentation in the person’s records and whether current clinical care plans are consistent with ACP documentation. People will be surveyed, to measure self-reported interest, uptake and use of ACP/ACDs, and self-reported quality of life. Ethics and dissemination This protocol has been approved by the Austin Health Human Research Ethics Committee (reference HREC/17/Austin/83). Results will be submitted to international peer-reviewed journals and presented at international conferences. Trial registration number ACTRN12617000743369 PMID:29101142

Costing 'healthy' food baskets in Australia - a systematic review of food price and affordability monitoring tools, protocols and methods.

PubMed

Lewis, Meron; Lee, Amanda

2016-11-01

To undertake a systematic review to determine similarities and differences in metrics and results between recently and/or currently used tools, protocols and methods for monitoring Australian healthy food prices and affordability. Electronic databases of peer-reviewed literature and online grey literature were systematically searched using the PRISMA approach for articles and reports relating to healthy food and diet price assessment tools, protocols, methods and results that utilised retail pricing. National, state, regional and local areas of Australia from 1995 to 2015. Assessment tools, protocols and methods to measure the price of 'healthy' foods and diets. The search identified fifty-nine discrete surveys of 'healthy' food pricing incorporating six major food pricing tools (those used in multiple areas and time periods) and five minor food pricing tools (those used in a single survey area or time period). Analysis demonstrated methodological differences regarding: included foods; reference households; use of availability and/or quality measures; household income sources; store sampling methods; data collection protocols; analysis methods; and results. 'Healthy' food price assessment methods used in Australia lack comparability across all metrics and most do not fully align with a 'healthy' diet as recommended by the current Australian Dietary Guidelines. None have been applied nationally. Assessment of the price, price differential and affordability of healthy (recommended) and current (unhealthy) diets would provide more robust and meaningful data to inform health and fiscal policy in Australia. The INFORMAS 'optimal' approach provides a potential framework for development of these methods.

Combining accuracy assessment of land-cover maps with environmental monitoring programs

USGS Publications Warehouse

Stehman, S.V.; Czaplewski, R.L.; Nusser, S.M.; Yang, L.; Zhu, Z.

2000-01-01

A scientifically valid accuracy assessment of a large-area, land-cover map is expensive. Environmental monitoring programs offer a potential source of data to partially defray the cost of accuracy assessment while still maintaining the statistical validity. In this article, three general strategies for combining accuracy assessment and environmental monitoring protocols are described. These strategies range from a fully integrated accuracy assessment and environmental monitoring protocol, to one in which the protocols operate nearly independently. For all three strategies, features critical to using monitoring data for accuracy assessment include compatibility of the land-cover classification schemes, precisely co-registered sample data, and spatial and temporal compatibility of the map and reference data. Two monitoring programs, the National Resources Inventory (NRI) and the Forest Inventory and Monitoring (FIM), are used to illustrate important features for implementing a combined protocol.

Gender-Specific Combination HIV Prevention for Youth in High-Burden Settings: The MP3 Youth Observational Pilot Study Protocol

PubMed Central

Agot, Kawango

2017-01-01

Background Nearly three decades into the epidemic, sub-Saharan Africa (SSA) remains the region most heavily affected by human immunodeficiency virus (HIV), with nearly 70% of the 34 million people living with HIV globally residing in the region. In SSA, female and male youth (15 to 24 years) are at a disproportionately high risk of HIV infection compared to adults. As such, there is a need to target HIV prevention strategies to youth and to tailor them to a gender-specific context. This protocol describes the process for the multi-staged approach in the design of the MP3 Youth pilot study, a gender-specific, combination, HIV prevention intervention for youth in Kenya. Objective The objective of this multi-method protocol is to outline a rigorous and replicable methodology for a gender-specific combination HIV prevention pilot study for youth in high-burden settings, illustrating the triangulated methods undertaken to ensure that age, sex, and context are integral in the design of the intervention. Methods The mixed-methods, cross-sectional, longitudinal cohort pilot study protocol was developed by first conducting a systematic review of the literature, which shaped focus group discussions around prevention package and delivery options, and that also informed age- and sex- stratified mathematical modeling. The review, qualitative data, and mathematical modeling created a triangulated evidence base of interventions to be included in the pilot study protocol. To design the pilot study protocol, we convened an expert panel to select HIV prevention interventions effective for youth in SSA, which will be offered in a mobile health setting. The goal of the pilot study implementation and evaluation is to apply lessons learned to more effective HIV prevention evidence and programming. Results The combination HIV prevention package in this protocol includes (1) offering HIV testing and counseling for all youth; (2) voluntary medical circumcision and condoms for males; (3) pre-exposure prophylaxis (PrEP), conditional cash transfer (CCT), and contraceptives for females; and (4) referrals for HIV care among those identified as HIV-positive. The combination package platform selected is mobile health teams in an integrated services delivery model. A cross-sectional analysis will be conducted to determine the uptake of the interventions. To determine long-term impact, the protocol outlines enrolling selected participants in mutually exclusive longitudinal cohorts (HIV-positive, PrEP, CCT, and HIV-negative) followed by using mobile phone text messages (short message service, SMS) and in-person surveys to prospectively assess prevention method uptake, adherence, and risk compensation behaviors. Cross-sectional and sub-cohort analyses will be conducted to determine intervention packages uptake. Conclusions The literature review, focus groups, and modeling indicate that offering age- and gender- specific combination HIV prevention interventions that include biomedical, behavioral, and structural interventions can have an impact on HIV risk reduction. Implementing this protocol will show the feasibility of delivering these services at scale. The MP3 Youth study is one of the few combination HIV prevention intervention protocols incorporating youth- and gender-specific interventions in one delivery setting. Lessons learned from the design of the protocol can be incorporated into the national guidance for combination HIV prevention for youth in Kenya and other high-burden SSA settings. Trial Registration ClinicalTrials.gov NCT01571128; http://clinicaltrials.gov/ct2/show/NCT01571128?term=MP3+youth&rank=1 (Archived by WebCite at http://www.webcitation.org/6nmioPd54) PMID:28274904

A newly identified calculation discrepancy of the Sunset semi-continuous carbon analyzer

NASA Astrophysics Data System (ADS)

Zheng, G. J.; Cheng, Y.; He, K. B.; Duan, F. K.; Ma, Y. L.

2014-07-01

The Sunset semi-continuous carbon analyzer (SCCA) is an instrument widely used for carbonaceous aerosol measurement. Despite previous validation work, in this study we identified a new type of SCCA calculation discrepancy caused by the default multipoint baseline correction method. When exceeding a certain threshold carbon load, multipoint correction could cause significant total carbon (TC) underestimation. This calculation discrepancy was characterized for both sucrose and ambient samples, with two protocols based on IMPROVE (Interagency Monitoring of PROtected Visual Environments) (i.e., IMPshort and IMPlong) and one NIOSH (National Institute for Occupational Safety and Health)-like protocol (rtNIOSH). For ambient samples, the IMPshort, IMPlong and rtNIOSH protocol underestimated 22, 36 and 12% of TC, respectively, with the corresponding threshold being ~ 0, 20 and 25 μgC. For sucrose, however, such discrepancy was observed only with the IMPshort protocol, indicating the need of more refractory SCCA calibration substance. Although the calculation discrepancy could be largely reduced by the single-point baseline correction method, the instrumental blanks of single-point method were higher. The correction method proposed was to use multipoint-corrected data when below the determined threshold, and use single-point results when beyond that threshold. The effectiveness of this correction method was supported by correlation with optical data.

Climate Change Education as an Integral Part of the United Nations Framework Convention on Climate Change

ERIC Educational Resources Information Center

Journal of Education for Sustainable Development, 2012

2012-01-01

The United Nations Framework Convention on Climate Change (UNFCCC), through its Article 6, and the Convention's Kyoto Protocol, through its Article 10 (e), call on governments to develop and implement educational programmes on climate change and its effects. In particular, Article 6 of the Convention, which addresses the issue of climate…

Occupancy modeling of ruffed grouse in the Black Hills National Forest

Treesearch

Christopher P. Hansen; Joshua J. Millspaugh; Mark A. Rumble

2011-01-01

Ruffed grouse (Bonasa umbellus) are a popular game bird and the management indicator species for quaking aspen (Populus tremuloides) in the Black Hills National Forest (BHNF), which requires development of a robust monitoring protocol to evaluate trends in ruffed grouse populations. We used roadside drumming surveys in spring 2007 and 2008 to estimate ruffed grouse...

A Balanced Protocol for Return to School for Children and Youth Following Concussive Injury.

PubMed

DeMatteo, Carol; Stazyk, Kathy; Giglia, Lucy; Mahoney, William; Singh, Sheila K; Hollenberg, Robert; Harper, Jessica A; Missiuna, Cheryl; Law, Mary; McCauley, Dayle; Randall, Sarah

2015-07-01

Few protocols exist for returning children/youth to school after concussion. Childhood concussion can significantly affect school performance, which is vital to social development, academic learning, and preparation for future roles. The goal of this knowledge translation research was to develop evidence based materials to inform physicians about pediatric concussion. The Return to School (RTS) concussion protocol was developed following the National Institute for Health and Care Excellence procedures. Based on a scoping review, and stakeholder opinions, an RTS protocol was developed for children/youth. This unique protocol focuses on school adaptation in 4 main areas: (a) timetable/attendance, (b) curriculum, (c) environmental modifications, and (d) activity modifications. A balance of cognitive rest and timely return to school need to be considered for returning any student to school after a concussion. Implementation of these new recommendations may be an important tool in prevention of prolonged absence from school and academic failure while supporting brain recovery. © The Author(s) 2015.

National Collegiate Athletic Association Division I athletic trainers' concussion-management practice patterns.

PubMed

Kelly, Kassandra C; Jordan, Erin M; Joyner, A Barry; Burdette, G Trey; Buckley, Thomas A

2014-01-01

A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together. To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination. Cross-sectional study. Online survey. A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%. The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined. We identified high rates of multifaceted assessments (i.e., assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations. Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.

Treatment of antipsychotic-associated obesity with a GLP-1 receptor agonist--protocol for an investigator-initiated prospective, randomised, placebo-controlled, double-blinded intervention study: the TAO study protocol.

PubMed

Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V; Baandrup, Lone; Fagerlund, Birgitte; Jørgensen, Niklas R; Andersen, Ulrik B; Rostrup, Egill; Glenthøj, Birte Y; Ebdrup, Bjørn H

2014-01-08

Antipsychotic medication is widely associated with dysmetabolism including obesity and type 2 diabetes, cardiovascular-related diseases and early death. Obesity is considered the single most important risk factor for cardiovascular morbidity and mortality. Interventions against antipsychotic-associated obesity are limited and insufficient. Glucagon-like peptide-1 (GLP-1) receptor agonists are approved for the treatment of type 2 diabetes, but their bodyweight-lowering effects have also been recognised in patients with non-diabetes. The primary endpoint of this trial is weight loss after 3 months of treatment with a GLP-1 receptor agonist (exenatide once weekly) in patients with non-diabetic schizophrenia with antipsychotic-associated obesity. Secondary endpoints include physiological and metabolic measurements, various psychopathological and cognitive measures, and structural and functional brain MRI. 40 obese patients with schizophrenia or schizoaffective disorder treated with antipsychotic drugs will be randomised to subcutaneous injection of exenatide once weekly (2 mg) or placebo for 3 months, adjunctive to their antipsychotic treatment. The trial has been approved by the Danish Health and Medicines Authority, the National Committee on Health Research Ethics and the Danish Data Protection Agency. Trial participation presupposes theoral and written patient informed consent. An external, independent monitoring committee (Good Clinical Practice Unit at Copenhagen University Hospital) will monitor the study according to the GCP Guidelines. Trial data, including positive, negative and inconclusive results, will be presented at national and international scientific meetings and conferences. Papers will be submitted to peer-reviewed journals. ClinicalTrials.gov identifier: NCT01794429; National Committee on Health Research Ethics project number: 36378; EudraCT nr: 2012-005404-17; The Danish Data Protection Agency project number: RHP-2012-027.

Local network assessment

NASA Astrophysics Data System (ADS)

Glen, D. V.

1985-04-01

Local networks, related standards activities of the Institute of Electrical and Electronics Engineers the American National Standards Institute and other elements are presented. These elements include: (1) technology choices such as topology, transmission media, and access protocols; (2) descriptions of standards for the 802 local area networks (LAN's); high speed local networks (HSLN's) and military specification local networks; and (3) intra- and internetworking using bridges and gateways with protocols Interconnection (OSI) reference model. The convergence of LAN/PBX technology is also described.

The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use.

PubMed

Zarb, P; Coignard, B; Griskeviciene, J; Muller, A; Vankerckhoven, V; Weist, K; Goossens, Mm; Vaerenberg, S; Hopkins, S; Catry, B; Monnet, Dl; Goossens, H; Suetens, C

2012-11-15

A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals developed by the European Centre for Disease Prevention and Control was piloted across Europe. Variables were collected at national, hospital and patient level in 66 hospitals from 23 countries. A patient-based and a unit-based protocol were available. Feasibility was assessed via national and hospital questionnaires. Of 19,888 surveyed patients, 7.1% had an HAI and 34.6% were receiving at least one antimicrobial agent. Prevalence results were highest in intensive care units, with 28.1% patients with HAI, and 61.4% patients with antimicrobial use. Pneumonia and other lower respiratory tract infections (2.0% of patients; 95% confidence interval (CI): 1.8–2.2%) represented the most common type (25.7%) of HAI. Surgical prophylaxis was the indication for 17.3% of used antimicrobials and exceeded one day in 60.7% of cases. Risk factors in the patient-based protocol were provided for 98% or more of the included patients and all were independently associated with both presence of HAI and receiving an antimicrobial agent. The patient-based protocol required more work than the unit-based protocol, but allowed collecting detailed data and analysis of risk factors for HAI and antimicrobial use.

language and Adjustment Scales for the Thematic Apperception Test for Children 6-11 Years.

PubMed

Neman, R S; Brown, T S; Sells, S B

1973-12-01

This report summarizes research on the development of objectively scored language and emotionality scales for a five-card, orally administered and tape- reqorded version of the Thematic Apperception Test (TAT) used in the Health Examination Survey (HES) of children conducted by the National Center for Health Statistics in 1963-65. National norms for children ages 6-11 are presented for these scales. Two studies were carried out to develop the scales and national norms. Study I involved the development of scoring manuals, criterion measures, and TAT scales, as well as validation studies in which the TAT scales were treated as independent variables and the criteria as dependent variables. In that study major emphasis was placed on creation of usable scales. The sample of 1,224 cases employed was chosen on the basis of completeness and quality of TAT protocol from among the children examined in the first 19 of the 40 Iocations or "stands" in which examinations took place in the national survey. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Fluid management with a simplified conservative protocol for the acute respiratory distress syndrome*.

PubMed

Grissom, Colin K; Hirshberg, Eliotte L; Dickerson, Justin B; Brown, Samuel M; Lanspa, Michael J; Liu, Kathleen D; Schoenfeld, David; Tidswell, Mark; Hite, R Duncan; Rock, Peter; Miller, Russell R; Morris, Alan H

2015-02-01

In the Fluid and Catheter Treatment Trial (FACTT) of the National Institutes of Health Acute Respiratory Distress Syndrome Network, a conservative fluid protocol (FACTT Conservative) resulted in a lower cumulative fluid balance and better outcomes than a liberal fluid protocol (FACTT Liberal). Subsequent Acute Respiratory Distress Syndrome Network studies used a simplified conservative fluid protocol (FACTT Lite). The objective of this study was to compare the performance of FACTT Lite, FACTT Conservative, and FACTT Liberal protocols. Retrospective comparison of FACTT Lite, FACTT Conservative, and FACTT Liberal. Primary outcome was cumulative fluid balance over 7 days. Secondary outcomes were 60-day adjusted mortality and ventilator-free days through day 28. Safety outcomes were prevalence of acute kidney injury and new shock. ICUs of Acute Respiratory Distress Syndrome Network participating hospitals. Five hundred three subjects managed with FACTT Conservative, 497 subjects managed with FACTT Liberal, and 1,124 subjects managed with FACTT Lite. Fluid management by protocol. Cumulative fluid balance was 1,918 ± 323 mL in FACTT Lite, -136 ± 491 mL in FACTT Conservative, and 6,992 ± 502 mL in FACTT Liberal (p < 0.001). Mortality was not different between groups (24% in FACTT Lite, 25% in FACTT Conservative and Liberal, p = 0.84). Ventilator-free days in FACTT Lite (14.9 ± 0.3) were equivalent to FACTT Conservative (14.6 ± 0.5) (p = 0.61) and greater than in FACTT Liberal (12.1 ± 0.5, p < 0.001 vs Lite). Acute kidney injury prevalence was 58% in FACTT Lite and 57% in FACTT Conservative (p = 0.72). Prevalence of new shock in FACTT Lite (9%) was lower than in FACTT Conservative (13%) (p = 0.007 vs Lite) and similar to FACTT Liberal (11%) (p = 0.18 vs Lite). FACTT Lite had a greater cumulative fluid balance than FACTT Conservative but had equivalent clinical and safety outcomes. FACTT Lite is an alternative to FACTT Conservative for fluid management in Acute Respiratory Distress Syndrome.

Internet-Based Partner Services in US Sexually Transmitted Disease Prevention Programs: 2009-2013.

PubMed

Moody, Victoria; Hogben, Matthew; Kroeger, Karen; Johnson, James

2015-01-01

Social networking sites have become increasingly popular venues for meeting sex partners. Today, some sexually transmitted disease (STD) programs conduct Internet-based partner services (IPS). The purpose of the study was to explore how the Internet is being used by STD prevention programs to perform partner services. We assessed US STD prevention programs receiving funds through the 2008-2013 Comprehensive STD Prevention Systems cooperative agreement. We (1) reviewed 2009 IPS protocols in 57 funding applications against a benchmark of national guidelines and (2) surveyed persons who conducted IPS in jurisdictions conducting IPS in 2012. Of the 57 project areas receiving Comprehensive STD Prevention Systems funds, 74% provided an IPS protocol. States with IPS protocols had larger populations and more gonorrhea and syphilis cases (t = 2.2-2.6; all Ps < .05), although not higher rates of infection. Most protocols included staffing (92%) and IPS documentation (87%) requirements, but fewer had evaluation plans (29%) or social networking site engagement strategies (16%). Authority to perform a complete range of IPS activities (send e-mail, use social networking sites) was associated with contacting more partners via IPSs (P < .05). This study provides a snapshot of IPS activities in STD programs in the United States. Further research is needed to move from assessment to generating data that can assist training efforts and program action and, finally, to enable efficient IPS programs that are integrated into STD prevention and control efforts.

Sensitivity and Specificity of a Five-Minute Cognitive Screening Test in Patients With Heart Failure.

PubMed

Cameron, Janette D; Gallagher, Robyn; Pressler, Susan J; McLennan, Skye N; Ski, Chantal F; Tofler, Geoffrey; Thompson, David R

2016-02-01

Cognitive impairment occurs in up to 80% of patients with heart failure (HF). The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) recommend a 5-minute cognitive screening protocol that has yet to be psychometrically evaluated in HF populations. The aim of this study was to conduct a secondary analysis of the sensitivity and specificity of the NINDS-CSN brief cognitive screening protocol in HF patients. The Montreal Cognitive Assessment (MoCA) was administered to 221 HF patients. The NINDS-CSN screen comprises 3 MoCA items, with lower scores indicating poorer cognitive function. Receiver operator characteristic (ROC) curves were constructed, determining the sensitivity, specificity and appropriate cutoff scores of the NINDS-CSN screen. In an HF population aged 76 ± 12 years, 136 (62%) were characterized with cognitive impairment (MoCA <26). Scores on the NINDS-CSN screen ranged from 3-11. The area under the receiver operating characteristic curve indicated good accuracy in screening for cognitive impairment (0.88; P < .01; 95% CI 0.83-0.92). A cutoff score of ≤9 provided 89% sensitivity and 71% specificity. The NINDS-CSN protocol offers clinicians a feasible telephone method to screen for cognitive impairment in patients with HF. Future studies should include a neuropsychologic battery to more comprehensively examine the diagnostic accuracy of brief cognitive screening protocols. Copyright © 2016 Elsevier Inc. All rights reserved.

Interlaboratory comparison of real-time pcr protocols for quantification of general fecal indicator bacteria

USGS Publications Warehouse

Shanks, O.C.; Sivaganesan, M.; Peed, L.; Kelty, C.A.; Blackwood, A.D.; Greene, M.R.; Noble, R.T.; Bushon, R.N.; Stelzer, E.A.; Kinzelman, J.; Anan'Eva, T.; Sinigalliano, C.; Wanless, D.; Griffith, J.; Cao, Y.; Weisberg, S.; Harwood, V.J.; Staley, C.; Oshima, K.H.; Varma, M.; Haugland, R.A.

2012-01-01

The application of quantitative real-time PCR (qPCR) technologies for the rapid identification of fecal bacteria in environmental waters is being considered for use as a national water quality metric in the United States. The transition from research tool to a standardized protocol requires information on the reproducibility and sources of variation associated with qPCR methodology across laboratories. This study examines interlaboratory variability in the measurement of enterococci and Bacteroidales concentrations from standardized, spiked, and environmental sources of DNA using the Entero1a and GenBac3 qPCR methods, respectively. Comparisons are based on data generated from eight different research facilities. Special attention was placed on the influence of the DNA isolation step and effect of simplex and multiplex amplification approaches on interlaboratory variability. Results suggest that a crude lysate is sufficient for DNA isolation unless environmental samples contain substances that can inhibit qPCR amplification. No appreciable difference was observed between simplex and multiplex amplification approaches. Overall, interlaboratory variability levels remained low (<10% coefficient of variation) regardless of qPCR protocol. ?? 2011 American Chemical Society.

Spontaneous swallow frequency compared with clinical screening in the identification of dysphagia in acute stroke.

PubMed

Crary, Michael A; Carnaby, Giselle D; Sia, Isaac

2014-09-01

The aim of this study was to compare spontaneous swallow frequency analysis (SFA) with clinical screening protocols for identification of dysphagia in acute stroke. In all, 62 patients with acute stroke were evaluated for spontaneous swallow frequency rates using a validated acoustic analysis technique. Independent of SFA, these same patients received a routine nurse-administered clinical dysphagia screening as part of standard stroke care. Both screening tools were compared against a validated clinical assessment of dysphagia for acute stroke. In addition, psychometric properties of SFA were compared against published, validated clinical screening protocols. Spontaneous SFA differentiates patients with versus without dysphagia after acute stroke. Using a previously identified cut point based on swallows per minute, spontaneous SFA demonstrated superior ability to identify dysphagia cases compared with a nurse-administered clinical screening tool. In addition, spontaneous SFA demonstrated equal or superior psychometric properties to 4 validated, published clinical dysphagia screening tools. Spontaneous SFA has high potential to identify dysphagia in acute stroke with psychometric properties equal or superior to clinical screening protocols. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Metabolomics Workbench: An international repository for metabolomics data and metadata, metabolite standards, protocols, tutorials and training, and analysis tools.

PubMed

Sud, Manish; Fahy, Eoin; Cotter, Dawn; Azam, Kenan; Vadivelu, Ilango; Burant, Charles; Edison, Arthur; Fiehn, Oliver; Higashi, Richard; Nair, K Sreekumaran; Sumner, Susan; Subramaniam, Shankar

2016-01-04

The Metabolomics Workbench, available at www.metabolomicsworkbench.org, is a public repository for metabolomics metadata and experimental data spanning various species and experimental platforms, metabolite standards, metabolite structures, protocols, tutorials, and training material and other educational resources. It provides a computational platform to integrate, analyze, track, deposit and disseminate large volumes of heterogeneous data from a wide variety of metabolomics studies including mass spectrometry (MS) and nuclear magnetic resonance spectrometry (NMR) data spanning over 20 different species covering all the major taxonomic categories including humans and other mammals, plants, insects, invertebrates and microorganisms. Additionally, a number of protocols are provided for a range of metabolite classes, sample types, and both MS and NMR-based studies, along with a metabolite structure database. The metabolites characterized in the studies available on the Metabolomics Workbench are linked to chemical structures in the metabolite structure database to facilitate comparative analysis across studies. The Metabolomics Workbench, part of the data coordinating effort of the National Institute of Health (NIH) Common Fund's Metabolomics Program, provides data from the Common Fund's Metabolomics Resource Cores, metabolite standards, and analysis tools to the wider metabolomics community and seeks data depositions from metabolomics researchers across the world. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Results from the 2001 National Household Survey on Drug Abuse. Volume I: Summary of National Findings [and] Volume II: Technical Appendices and Selected Data Tables [and] Volume III: Detailed Tables.

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Office of Applied Studies.

This document presents the technical appendices and selected data tables from the 2001 National Household Survey on Drug Abuse. Included are a description of the survey; statistical methods and limitations of the data; effects of changes in survey protocol on trend measurement; key definitions for the 1999-2001 survey years; and other sources of…

Reestablishment of an Unknown State and Its Orthogonal Complement State with Assistance

NASA Astrophysics Data System (ADS)

Chen, Ai-Xi; Wu, Shu-Dong

2003-12-01

In this paper, we propose a protocol where one can realize reestablishment of an unknown state and its orthogonal complement state with a certain probability. In the first stage of the protocol, teleportation is performed between Alice (a sender) and Bob (a receiver) through a nonmaximally entangled quantum channel. In the process of teleportation, Alice performs nonmaximally entangled state measurement. In the second stage of the protocol, Victor (a state preparer) disentangles leftover nonmaximally entangled states by a single-particle measurement. With the assistance of Victor Alice can reestablish the original state or produce its orthogonal state. The project partially supported by National Natural Science Foundation of China under Grant Nos. 90103026 and 60078023

Wireless Communications in Space

NASA Technical Reports Server (NTRS)

2004-01-01

In 1992, NASA and the U.S. Department of Defense jointly commissioned the research and development of a technology solution to address the challenges and requirements of communicating with their spacecraft. The project yielded an international consortium composed of representatives from the space science community, industry, and academia. This group of experts developed a broad suite of protocols specifically designed for space-based communications, known today as Space Communications Protocol Standards (SCPS). Having been internationally standardized by the Consultative Committee on Space Data Systems and the International Standards Organization, SCPS is distributed as open source technology by NASA s Jet Propulsion Laboratory (JPL). The protocols are used for every national space mission that takes place today.

Idaho National Laboratory Supervisory Control and Data Acquisition Intrusion Detection System (SCADA IDS)

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

Jared Verba; Michael Milvich

2008-05-01

Current Intrusion Detection System (IDS) technology is not suited to be widely deployed inside a Supervisory, Control and Data Acquisition (SCADA) environment. Anomaly- and signature-based IDS technologies have developed methods to cover information technology-based networks activity and protocols effectively. However, these IDS technologies do not include the fine protocol granularity required to ensure network security inside an environment with weak protocols lacking authentication and encryption. By implementing a more specific and more intelligent packet inspection mechanism, tailored traffic flow analysis, and unique packet tampering detection, IDS technology developed specifically for SCADA environments can be deployed with confidence in detecting maliciousmore » activity.« less

Validation of drinking water disinfection by-product exposure assessment for rural areas in the National Children's Study.

PubMed

Binkley, Teresa L; Thiex, Natalie W; Specker, Bonny L

2015-05-01

The objective of this study was to provide evidence to evaluate the proposed National Children's Study (NCS) protocol for household water sampling in rural study areas. Day-to-day variability in total trihalomethane (TTHM) concentrations in community water supplies (CWS) in rural areas was determined, and the correlation between TTHM concentrations from household taps and CWS monitoring reports was evaluated. Daily water samples were collected from 7 households serviced by 7 different CWS for 15 days. Coefficients of variation for TTHM concentration over 15 days ranged from 8% to 20% depending on the household. Correlations were tested between TTHM household concentrations and the closest date- and location-matched CWS monitoring reports for the 15-day mean (R=0.85, P<0.01). To simulate the NCS-proposed protocol, correlations were tested for 30 additional NCS household samples (polynomial fit: R=0.74, P=0.04). CWS reported TTHM concentrations >50 μg/l corresponded to measured NCS household concentrations ranging from 2 to 60 μg/l. TTHM concentrations were higher in CWS than NCS samples (11.2±3.2 μg/l, mean difference±SE, P<0.01). These results show that in rural areas there is high variability within households and poor correlation at higher concentrations, suggesting that TTHM concentrations from CWS monitoring reports are not an accurate measure of exposure in the household.

Adapting and enhancing PAX Good Behavior Game for First Nations communities: a mixed-methods study protocol developed with Swampy Cree Tribal Council communities in Manitoba

PubMed Central

Fortier, Janique; Chartier, Mariette; Turner, Sarah; Murdock, Nora; Turner, Frank; Sareen, Jitender; Afifi, Tracie O; Katz, Laurence Y; Brownell, Marni; Bolton, James; Elias, Brenda; Isaak, Corinne; Woodgate, Roberta; Jiang, Depeng

2018-01-01

Introduction High rates of mental health problems, such as suicidal behaviours, among First Nations youth in Canada are a major public health concern. The Good Behavior Game (GBG) is a school-based intervention that provides a nurturing environment for children and has been shown to promote positive outcomes. PAX Good Behavior Game (PAX GBG) is an adaptation and enhancement of the GBG. While PAX GBG has been implemented in Indigenous communities, little research exists examining the cultural and contextual appropriateness and effectiveness of the intervention in First Nations communities. Methods and analysis The present paper describes a protocol of the mixed-methods approach guided by an Indigenous ethical engagement model adopted to implement, adapt and evaluate PAX GBG in First Nations communities in Manitoba, Canada. First, implementation outcomes (eg, acceptability, adoption) of PAX GBG will be evaluated using qualitative interviews with teachers, principals and community members from Swampy Cree Tribal Council (SCTC) communities. Second, by linking administrative databases to programme data from schools in 38 First Nations communities, we will compare PAX GBG and control groups to evaluate whether PAX GBG is associated with improved mental health and academic outcomes. Third, the qualitative results will help inform a cultural and contextual adaptation of PAX GBG called First Nations PAX (FN PAX). Fourth, FN PAX will be implemented in a few SCTC communities and evaluated using surveys and qualitative interviews followed by the remaining communities the subsequent year. Ethics and dissemination Ethical approval was obtained from the University of Manitoba Health Research Ethics Board and will be obtained from the Health Information Privacy Committee and respective data providers for the administrative database linkages. Dissemination and knowledge translation will include community and stakeholder engagement throughout the research process, reports and presentations for policymakers and community members, presentations at scientific conferences and journal publications. PMID:29449291

Protocol for a single-centre, randomised controlled study of a preoperative rehabilitation bundle in the frail and elderly undergoing abdominal surgery

PubMed Central

Lien, Victoria Peixin; Ong, Hwee Kuan; Er, Pei Ling; Hao, Ying; Khan, Shariq Ali; Liu, Christopher Weiyang

2017-01-01

Introduction Frail patients have decreased physiological reserves and consequently, they are unable to recover as quickly from surgery. Frailty, as an entity, is a risk factor of increased morbidity and mortality. It is also associated with a longer time to discharge. This trial is undertaken to determine if a novel prehabilitation protocol (10-day bundle of interventions—physiotherapy, nutritional supplementation and cognitive training) can reduce the postoperative length of stay of frail patients who are undergoing elective abdominal surgery, compared with standard care. Methods and analysis This is a prospective, single-centre, randomised controlled trial with two parallel arms. 62 patients who are frail and undergoing elective abdominal surgery will be recruited and randomised to receive either a novel prehabilitation protocol or standard care. Participants will receive telephone reminders preoperatively to encourage protocol compliance. Data will be collected for up to 30 days postoperatively. The primary outcome of the trial will be the postoperative length of stay and the secondary outcomes are the postoperative complications and functional recovery during the hospital admission. Ethics and dissemination This study has been approved by the Singapore General Hospital Institutional Review Board (CIRB Ref: 2016/2584). The study is also listed on ClinicalTrials.gov (Trial number: NCT02921932). All participants will sign an informed consent form before randomisation and translators will be made available to non-English speaking patients. The results of this study will be published in peer-reviewed journals as well as national and international conferences. The data collected will also be made available in a public data repository. Trial registration number NCT02921932 (ClinicalTrials.gov) PMID:28778994

Protocol for a single-centre, randomised controlled study of a preoperative rehabilitation bundle in the frail and elderly undergoing abdominal surgery.

PubMed

Abdullah, Hairil Rizal; Lien, Victoria Peixin; Ong, Hwee Kuan; Er, Pei Ling; Hao, Ying; Khan, Shariq Ali; Liu, Christopher Weiyang

2017-08-04

Frail patients have decreased physiological reserves and consequently, they are unable to recover as quickly from surgery. Frailty, as an entity, is a risk factor of increased morbidity and mortality. It is also associated with a longer time to discharge. This trial is undertaken to determine if a novel prehabilitation protocol (10-day bundle of interventions-physiotherapy, nutritional supplementation and cognitive training) can reduce the postoperative length of stay of frail patients who are undergoing elective abdominal surgery, compared with standard care. This is a prospective, single-centre, randomised controlled trial with two parallel arms. 62 patients who are frail and undergoing elective abdominal surgery will be recruited and randomised to receive either a novel prehabilitation protocol or standard care. Participants will receive telephone reminders preoperatively to encourage protocol compliance. Data will be collected for up to 30 days postoperatively. The primary outcome of the trial will be the postoperative length of stay and the secondary outcomes are the postoperative complications and functional recovery during the hospital admission. This study has been approved by the Singapore General Hospital Institutional Review Board (CIRB Ref: 2016/2584). The study is also listed on ClinicalTrials.gov (Trial number: NCT02921932). All participants will sign an informed consent form before randomisation and translators will be made available to non-English speaking patients. The results of this study will be published in peer-reviewed journals as well as national and international conferences. The data collected will also be made available in a public data repository. NCT02921932 (ClinicalTrials.gov). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Weather and Climate Monitoring Protocol, Channel Islands National Park, California

USGS Publications Warehouse

McEachern, Kathryn; Power, Paula; Dye, Linda; Rudolph, Rocky

2008-01-01

Weather and climate are strong drivers of population dynamics, plant and animal spatial distributions, community interactions, and ecosystem states. Information on local weather and climate is crucial in interpreting trends and patterns in the natural environment for resource management, research, and visitor enjoyment. This document describes the weather and climate monitoring program at the Channel Islands National Park (fig. 1), initiated in the 1990s. Manual and automated stations, which continue to evolve as technology changes, are being used for this program. The document reviews the history of weather data collection on each of the five Channel Islands National Park islands, presents program administrative structure, and provides an overview of procedures for data collection, archival, retrieval, and reporting. This program overview is accompanied by the 'Channel Islands National Park Remote Automated Weather Station Field Handbook' and the 'Channel Islands National Park Ranger Weather Station Field Handbook'. These Handbooks are maintained separately at the Channel Island National Park as 'live documents' that are updated as needed to provide a current working manual of weather and climate monitoring procedures. They are available on request from the Weather Program Manager (Channel Islands National Park, 1901 Spinnaker Dr., Ventura, CA 93001; 805.658.5700). The two Field Handbooks describe in detail protocols for managing the four remote automated weather stations (RAWS) and the seven manual Ranger Weather Stations on the islands, including standard operating procedures for equipment maintenance and calibration; manufacturer operating manuals; data retrieval and archiving; metada collection and archival; and local, agency, and vendor contracts.

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania

PubMed Central

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki GM; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-01-01

Background A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey. PMID:19116022

Building a Protocol Expressway: The Case of Mayo Clinic Cancer Center

PubMed Central

McJoynt, Terre A.; Hirzallah, Muhanad A.; Satele, Daniel V.; Pitzen, Jason H.; Alberts, Steven R.; Rajkumar, S. Vincent

2009-01-01

Purpose Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. Methods A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Results Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P < .001) from 25.00 weeks (n = 41; range, 3.43 to 94.14 weeks) to 10.15 weeks (n = 14; range, 4.00 to 22.14 weeks). The mean turnaround time for externally authored protocols was improved (P < .001) from 20.61 weeks (n = 85; range, 3.29 to 108.57 weeks) to 7.79 weeks (n = 50; range, 2.00 to 20.86 weeks). Conclusion DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes. PMID:19564529

Building a protocol expressway: the case of Mayo Clinic Cancer Center.

PubMed

McJoynt, Terre A; Hirzallah, Muhanad A; Satele, Daniel V; Pitzen, Jason H; Alberts, Steven R; Rajkumar, S Vincent

2009-08-10

Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P < .001) from 25.00 weeks (n = 41; range, 3.43 to 94.14 weeks) to 10.15 weeks (n = 14; range, 4.00 to 22.14 weeks). The mean turnaround time for externally authored protocols was improved (P < .001) from 20.61 weeks (n = 85; range, 3.29 to 108.57 weeks) to 7.79 weeks (n = 50; range, 2.00 to 20.86 weeks). DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.

Are vaccine strain, type or administration protocol risk factors for canine parvovirus vaccine failure?

PubMed

Altman, K D; Kelman, M; Ward, M P

2017-10-01

Canine parvovirus (CPV) is a highly contagious and worldwide cause of serious and often fatal disease in dogs, despite the widespread availability of vaccines. Which vaccine-related factors are associated with vaccination failure is largely unknown, and there are no reports from Australia. In this study - the first national population-level CPV study of its kind ever conducted - we analysed data on 594 cases of apparent CPV vaccination failure reported from an Australian national surveillance system to determine whether vaccine strain, type or administration protocol are risk factors for vaccination failures. The strain of CPV used in vaccine manufacture was not significantly associated with vaccination failure in clinical practice. The vaccine type (killed versus attenuated vaccine) for puppies diagnosed with CPV was associated with a lower mean age at time of vaccination (P=0.0495). The age at administration of the last CPV vaccination a puppy received prior to presenting with disease was a significant (P=0.0334) risk factor for vaccination failure, irrespective of whether the vaccine was marketed for a 10-week or 12-week or greater vaccination finish protocol. There was also a strong negative correlation between age at last vaccination prior to disease and vaccination failure (P<0.0001): the later a puppy received this last vaccination, the lower the risk of vaccination failure. This supports the hypothesis that the use of final vaccination in puppies at less than 16 weeks of age predisposes to vaccination failure and warrants a final age for vaccination recommendation to be at least 16 weeks for all canine parvovirus vaccines, especially in outbreak situations. The large number of cases identified in this study confirms that CPV vaccination failure is occurring in Australia. Veterinarians should consider CPV as a differential diagnosis in cases with appropriate clinical presentation, regardless of the reported vaccination status of the dog. Copyright © 2017 Elsevier B.V. All rights reserved.

Mars Sample Handling Protocol Workshop Series: Workshop 2a (Sterilization)

NASA Technical Reports Server (NTRS)

Rummel, John D. (Editor); Brunch, Carl W. (Editor); Setlow, Richard B. (Editor); DeVincenzi, Donald L. (Technical Monitor)

2001-01-01

The Space Studies Board of the National Research Council provided a series of recommendations to NASA on planetary protection requirements for future Mars sample return missions. One of the Board's key findings suggested, although current evidence of the martian surface suggests that life as we know it would not tolerate the planet's harsh environment, there remain 'plausible scenarios for extant microbial life on Mars.' Based on this conclusion, all samples returned from Mars should be considered potentially hazardous until it has been demonstrated that they are not. In response to the National Research Council's findings and recommendations, NASA has undertaken a series of workshops to address issues regarding NASA's proposed sample return missions. Work was previously undertaken at the Mars Sample Handling and Protocol Workshop 1 (March 2000) to formulate recommendations on effective methods for life detection and/or biohazard testing on returned samples. The NASA Planetary Protection Officer convened the Mars Sample Sterilization Workshop, the third in the Mars Sample Handling Protocol Workshop Series, on November 28-30, 2000 at the Holiday Inn Rosslyn Westpark, Arlington, Virginia. Because of the short timeframe between this Workshop and the second Workshop in the Series, which was convened in October 2000 in Bethesda, Maryland, they were developed in parallel, so the Sterilization Workshop and its report have therefore been designated as '2a'). The focus of Workshop 2a was to make recommendations for effective sterilization procedures for all phases of Mars sample return missions, and to answer the question of whether we can sterilize samples in such a way that the geological characteristics of the samples are not significantly altered.

Chaotic maps and biometrics-based anonymous three-party authenticated key exchange protocol without using passwords

NASA Astrophysics Data System (ADS)

Xie, Qi; Hu, Bin; Chen, Ke-Fei; Liu, Wen-Hao; Tan, Xiao

2015-11-01

In three-party password authenticated key exchange (AKE) protocol, since two users use their passwords to establish a secure session key over an insecure communication channel with the help of the trusted server, such a protocol may suffer the password guessing attacks and the server has to maintain the password table. To eliminate the shortages of password-based AKE protocol, very recently, according to chaotic maps, Lee et al. [2015 Nonlinear Dyn. 79 2485] proposed a first three-party-authenticated key exchange scheme without using passwords, and claimed its security by providing a well-organized BAN logic test. Unfortunately, their protocol cannot resist impersonation attack, which is demonstrated in the present paper. To overcome their security weakness, by using chaotic maps, we propose a biometrics-based anonymous three-party AKE protocol with the same advantages. Further, we use the pi calculus-based formal verification tool ProVerif to show that our AKE protocol achieves authentication, security and anonymity, and an acceptable efficiency. Project supported by the Natural Science Foundation of Zhejiang Province, China (Grant No. LZ12F02005), the Major State Basic Research Development Program of China (Grant No. 2013CB834205), and the National Natural Science Foundation of China (Grant No. 61070153).

Italian National Forest Inventory: methods, state of the project, and future developments

Treesearch

Giovanni Tabacchi; Flora De Natale; Antonio Floris; Caterina Gagliano; Patrizia Gasparini; Gianfranco Scrinzi; Vittorio Tosi

2007-01-01

A primary objective of the Italian National Forest Inventory (NFI) is to provide information required by the Kyoto Protocol and the Ministerial Conference on the Protection of Forests in Europe in relation to sustainable forest management practices. For this reason, the second Italian NFI was aimed at providing data in a way that is consistent with the international...

Application of the biosafety RAM and eProtocol software programs to streamline institutional biosafety committee processes at the USDA-National Animal Disease Center

USDA-ARS?s Scientific Manuscript database

The National Animal Disease Center (NADC) conducts basic and applied research on endemic animal diseases of high priority that adversely affect U.S. livestock production or trade. Experiments conducted at this Center vary in range and scope, with a subset involving synthetic or recombinant nucleic a...

Evaluating plant biodiversity measurements and exotic species detection in National Resources Inventory Sampling protocols using examples from the Northern Great Plains of the USA

USDA-ARS?s Scientific Manuscript database

Native plant biodiversity loss and exotic species invasions are threatening the ability of many ecosystems to maintain key functions and processes. We currently lack detailed plant biodiversity data at a national scale with which to make management decisions and recommendations based on current cons...

SURVIVAL OF CAPTIVE-REARED PUERTO RICAN PARROTS RELEASED IN THE CARIBBEAN NATIONAL FOREST

Treesearch

THOMAS H. WHITE; JAIME A. COLLAZO; FRANCISCO J. VILELLA

2005-01-01

We report first-year survival for 34 captive-reared Puerto Rican Parrots (Amazona vittata) released in the Caribbean National Forest, Puerto Rico between 2000 and 2002. The purpose of the releases were to increase population size and the potential number of breeding individuals of the sole extant wild population, and to refine release protocols for eventual...

The NTCIP guide : updated version 3

DOT National Transportation Integrated Search

2002-10-01

The transportation community has long needed transportation systems that could be built using devices and components that were interchangeable and interoperable. The National Transportation Communications for ITS Protocol (NTCIP) family of standards ...

Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

PubMed

Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

2016-01-01

To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

Protocol for Monitoring Fish Assemblages in Pacific Northwest National Parks

USGS Publications Warehouse

Brenkman, Samuel J.; Connolly, Patrick J.

2008-01-01

Rivers and streams that drain from Olympic, Mount Rainier, and North Cascades National Parks are among the most protected corridors in the lower 48 States, and represent some of the largest tracts of contiguous, undisturbed habitat throughout the range of several key fish species of the Pacific Northwest. These watersheds are of high regional importance as freshwater habitat sanctuaries for native fish, where habitat conditions are characterized as having little to no disturbance from development, channelization, impervious surfaces, roads, diversions, or hydroelectric projects. Fishery resources are of high ecological and cultural importance in Pacific Northwest National Parks, and significantly contribute to economically important recreational, commercial, and tribal fisheries. This protocol describes procedures to monitor trends in fish assemblages, fish abundance, and water temperature in eight rivers and five wadeable streams in Olympic National Park during summer months, and is based on 4 years of field testing. Fish assemblages link freshwater, marine, and terrestrial ecosystems. They also serve as focal resources of national parks and are excellent indicators of ecological conditions of rivers and streams. Despite the vital importance of native anadromous and resident fish populations, there is no existing monitoring program for fish assemblages in the North Coast and Cascades Network. Specific monitoring objectives of this protocol are to determine seasonal and annual trends in: (1) fish species composition, (2) timing of migration of adult fish, (3) relative abundance, (4) age and size structure, (5) extent of non-native and hatchery fish, and (6) water temperature. To detect seasonal and annual trends in fish assemblages in reference sites, we rely on repeated and consistent annual sampling at each monitoring site. The general rationale for the repeated sampling of reference sites is to ensure that we account for the high interannual variability in fish movements and abundances in rivers. One underlying assumption is that the monitoring program is designed in perpetuity, and consequently our capability to detect trends substantially increases with time. The protocol describes sampling designs, methods, training procedures, safety considerations, data management, data analysis, and reporting. The allocation of sampling effort represents a balance between ecological considerations, a sound monitoring approach, and practical limitations caused by logistical constraints and a limited annual budget of $55,000. The widespread declines of native fish species in western North America highlights the importance and urgency of understanding trends in fish assemblages from undisturbed habitats. Seasonal and annual trends in fish assemblages will provide insights at the individual, population, and assemblage level. This protocol will allow managers to detect increases and decreases in abundance of priority management species, and occurrence of non-native, hatchery, and federally listed fish. The detection of trends in fish assemblages will allow for specific management actions that may include: implementation of more appropriate fishing regulations, evaluation of existing hatchery releases, control of non-native fish species, and prioritization of habitat restoration projects. Dissemination and communication of scientific findings on North Coast and Cascades Network fish assemblages will be a core product of this protocol, which will have much relevance to decision makers, park visitors, researchers, and educators.

Improving the Sandia Test Protocols with Advanced Inverter Functionality Testing of INV3, VV11, FW21, and L/HVRT

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

Johnson, Jay Dean

2013-11-01

Sandia National Laboratories has created a test protocol for IEC TR 61850-90-7 advanced distributed energy resource (DER) functions, titled "Test Protocols for Advanced Inverter Interoperability Functions," often referred to as the Sandia Test Protocols. This document is currently in draft form, but has been shared with stakeholders around the world with the ultimate goal of collaborating to create a consensus set of test protocols which can be then incorporated into an International Electrotechnical Commission (IEC) and/or Underwriters Laboratories (UL) certification standard. The protocols are designed to ensure functional interoperability of DER (primarily photovoltaic (PV) inverters and energy storage systems) asmore » specified by the IEC technical report through communication and electrical tests. In this report, Sandia exercises the electrical characterization portion of the test protocols for four functions: constant power factor (INV3), volt-var (VV11), frequency-watt (FW21), and Low and High Voltage Ride Through (L/HVRT). The goal of the tests reported here was not to characterize the performance of the equipment under test (EUT), but rather to (a) exercise the draft Sandia Test Protocols in order to identify any revisions needed in test procedures, conditions, or equipment and (b) gain experience with state-of-the-art DER equipment to determine if the tests put unrealistic or overly aggressive requirements on EUT operation. In performing the work according to the current versions of the protocols, Sandia was able to identify weaknesses in the current versions and suggest improvements to the test protocols.« less

The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): design and methods.

PubMed

Katzmarzyk, Peter T; Barreira, Tiago V; Broyles, Stephanie T; Champagne, Catherine M; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Johnson, William D; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V; Maher, Carol; Maia, José; Matsudo, Victor; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tremblay, Mark S; Tudor-Locke, Catrine; Zhao, Pei; Church, Timothy S

2013-09-30

The primary aim of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was to determine the relationships between lifestyle behaviours and obesity in a multi-national study of children, and to investigate the influence of higher-order characteristics such as behavioural settings, and the physical, social and policy environments, on the observed relationships within and between countries. The targeted sample included 6000 10-year old children from 12 countries in five major geographic regions of the world (Europe, Africa, the Americas, South-East Asia, and the Western Pacific). The protocol included procedures to collect data at the individual level (lifestyle, diet and physical activity questionnaires, accelerometry), family and neighborhood level (parental questionnaires), and the school environment (school administrator questionnaire and school audit tool). A standard study protocol was developed for implementation in all regions of the world. A rigorous system of training and certification of study personnel was developed and implemented, including web-based training modules and regional in-person training meetings. The results of this study will provide a robust examination of the correlates of adiposity and obesity in children, focusing on both sides of the energy balance equation. The results will also provide important new information that will inform the development of lifestyle, environmental, and policy interventions to address and prevent childhood obesity that may be culturally adapted for implementation around the world. ISCOLE represents a multi-national collaboration among all world regions, and represents a global effort to increase research understanding, capacity and infrastructure in childhood obesity.

Impact of intrapatient variability (IPV) in tacrolimus trough levels on long-term renal transplant function: multicentre collaborative retrospective cohort study protocol

PubMed Central

Goldsmith, Petra M; Bottomley, Matthew J; Okechukwu, Okidi; Ross, Victoria C; Ghita, Ryan; Wandless, David; Falconer, Stuart J; Papachristos, Stavros; Nash, Philip; Androshchuk, Vitaliy; Clancy, Marc

2017-01-01

Introduction High intrapatient variability (IPV) in tacrolimus trough levels has been shown to be associated with higher rates of renal transplant failure. There is no consensus on what level of IPV constitutes a risk of graft loss. The establishment of such a threshold could help to guide clinicians in identifying at-risk patients to receive targeted interventions to improve IPV and thus outcomes. Methods and analysis A multicentre Transplant Audit Collaborative has been established to conduct a retrospective study examining tacrolimus IPV and renal transplant outcomes. Patients in receipt of a renal transplant at participating centres between 2009 and 2014 and fulfilling the inclusion criteria will be included in the study. The aim is to recruit a minimum of 1600 patients with follow-up spanning at least 2 years in order to determine a threshold IPV above which a renal transplant recipient would be considered at increased risk of graft loss. The study also aims to determine any national or regional trends in IPV and any demographic associations. Ethics and dissemination Consent will not be sought from patients whose data are used in this study as no additional procedures or information will be required from participants beyond that which would normally take place as part of clinical care. The study will be registered locally in each participating centre in line with local research and development protocols. It is anticipated that the results of this audit will be disseminated locally, in participating NHS Trusts, through national and international meetings and publications in peer-reviewed journals. PMID:28756385

A watershed approach to ecosystem monitoring in Denali National Park and preserve, Alaska

USGS Publications Warehouse

Thorsteinson, L.K.; Taylor, D.L.

1997-01-01

The National Park Service and the National Biological Service initiated research in Denali National Park and Preserve, a 2.4 million-hectare park in southcentral Alaska, to develop ecological monitoring protocols for national parks in the Arctic/Subarctic biogeographic area. We are focusing pilot studies on design questions, on scaling issues and regionalization, ecosystem structure and function, indicator selection and evaluation, and monitoring technologies. Rock Creek, a headwater stream near Denali headquarters, is the ecological scale for initial testing of a watershed ecosystem approach. Our conceptual model embraces principles of the hydrological cycle, hypotheses of global climate change, and biological interactions of organisms occupying intermediate, but poorly studied, positions in Alaskan food webs. The field approach includes hydrological and depositional considerations and a suite of integrated measures linking key aquatic and terrestrial biota, environmental variables, or defined ecological processes, in order to establish ecological conditions and detect, track, and understand mechanisms of environmental change. Our sampling activities include corresponding measures of physical, chemical, and biological attributes in four Rock Creek habitats believed characteristic of the greater system diversity of Denali. This paper gives examples of data sets, program integration and scaling, and research needs.

National and sub-national prevalence, trend, and burden of asthma in Iran from 1990 to 2013; the study protocol.

PubMed

Varmaghani, Mehdi; Rashidian, Arash; Kebriaeezadeh, Abbas; Moradi-Lakeh, Maziar; Moin, Mostafa; Ghasemian, Anoosheh; Rezaei-Darzi, Ehsan; Sepanlou, Sadaf Ghajarieh; Peykari, Niloofar; Rezaei, Nazila; Parsaeian, Mahboubeh; Farzadfar, Farshad

2014-12-01

Asthma is a chronic inflammatory airway disease caused or worsened by environmental factors in genetically vulnerable people. The study of national and sub-national burden of asthma aims to provide a quantitative method and valid estimates for the prevalence, incidence, and economic burden of asthma disease in Iran from 1990 to 2013 and this papers explains measures, data sources, methods, and challenges that we will use in the study. In order to conduct this study, we will use all available unpublished data sources, including claim databases and data collected by the food and drug organization (FDO). Moreover, we will devise and run a systematic review of all studies and literature published about asthma epidemiology in Iran, which includes all cross-sectional, cohort and case-control studies with asthma epidemiology focus that are population based. In this study, we will use two statistical models, including spatio-temporal and multilevel autoregressive models to estimate mean and uncertainty intervals for the parameters under study by gender, age, year, and province. All programs will be written in R statistical packages (version 3.0.1). This study helps to obtain information concerning the variation among regions and provinces, and in general among sub-national divisions. Our study can be contribute to better allocation of resources, since it helps policymakers to recognize inequalities between regions and provinces and consequently help them to allocate resources more efficiently.

Elementary teachers' ideas about, planning for and implementation of learner-directed and teacher-directed inquiry: A mixed methods study

NASA Astrophysics Data System (ADS)

Biggers, Mandy Sue

Using a framework for variations of classroom inquiry (National Research Council [NRC], 2000, p. 29), this study explored 40 inservice elementary teachers' planning, modification, and enactment of kit-based science curriculum materials. As part of the study, a new observation protocol was modified from an existing protocol (Practices of Science Observation Protocol [P-SOP]) to measure the amount of teacher direction in science inquiry lessons (Practices of Science Observation Protocol + Directedness [P-SOPd]). An embedded mixed methods design was employed to investigate four questions: 1. How valid and reliable is the P-SOPd? 2. In what ways do inservice elementary teachers adapt existing elementary science curriculum materials across the inquiry continuum? 3. What is the relationship between the overall quality of inquiry and variations of inquiry in elementary teachers' enacted science instruction? 4. How do inservice elementary teachers' ideas about the inquiry continuum influence their adaptation of elementary science curriculum materials? Each teacher chose three lessons from a science unit for video-recorded observation, and submitted lesson plans for the three lessons. Lesson plans and videos were scored using the P-SOPd. The scores were also compared between the two protocols to determine if a correlation existed between the level of inquiry (measured on the P-SOP) and the amount of teacher direction (measured on the P-SOPd). Findings indicated no significant differences between planned and enacted lessons for the amount of teacher direction, but a correlation existed between the level of inquiry and the amount of teacher direction. In effect, the elementary teachers taught their science curriculum materials with a high level of fidelity for both the features of inquiry and the amount of teacher direction. A smaller group of three case study teachers were followed for the school year to give a more in-depth explanation of the quantitative findings. Case study findings revealed that the teachers' science instruction was teacher-directed while their conceptions of inquiry were student-directed. This study contributes to existing research on preservice teachers' learning about the continuum (Biggers & Forbes, 2012) and inservice teachers' ideas about the five features of inquiry (Biggers & Forbes, in press).

The Space Communications Protocol Standards Program

NASA Technical Reports Server (NTRS)

Jeffries, Alan; Hooke, Adrian J.

1994-01-01

In the fall of 1992 NASA and the Department of Defense chartered a technical team to explore the possibility of developing a common set of space data communications standards for potential dual-use across the U.S. national space mission support infrastructure. The team focused on the data communications needs of those activities associated with on-lined control of civil and military aircraft. A two-pronged approach was adopted: a top-down survey of representative civil and military space data communications requirements was conducted; and a bottom-up analysis of available standard data communications protocols was performed. A striking intersection of civil and military space mission requirements emerged, and an equally striking consensus on the approach towards joint civil and military space protocol development was reached. The team concluded that wide segments of the U.S. civil and military space communities have common needs for: (1) an efficient file transfer protocol; (2) various flavors of underlying data transport service; (3) an optional data protection mechanism to assure end-to-end security of message exchange; and (4) an efficient internetworking protocol. These recommendations led to initiating a program to develop a suite of protocols based on these findings. This paper describes the current status of this program.

Impact of targeted scanning protocols on perinatal outcomes in pregnancies at risk of placenta accreta spectrum or vasa previa.

PubMed

Melcer, Yaakov; Jauniaux, Eric; Maymon, Shlomit; Tsviban, Anna; Pekar-Zlotin, Marina; Betser, Moshe; Maymon, Ron

2018-04-01

Placenta accreta spectrum and vasa previa (VP) are congenital disorders of placentation associated with high morbidity and mortality for both mothers and newborns when undiagnosed before delivery. Prenatal diagnosis of these conditions is essential to allow multidisciplinary management and thus improve perinatal outcomes. The objective of the study was to compare perinatal outcome in women with placenta accreta spectrum or vasa previa before and after implementation of targeted scanning protocols. This retrospective study included 2 nonconcurrent cohorts for each condition before and after implementation of the corresponding protocols (2004-1012 vs 2013-2016 for placenta accreta spectrum and 1988-2007 vs 2008-2016 for vasa previa). Clinical reports of women diagnosed with placenta accreta spectrum and vasa previa during the study periods were reviewed and outcomes were compared. In total, there were 97 cases of placenta accreta spectrum and 51 cases with vasa previa, all confirmed at delivery. In both cohorts, the prenatal detection rate increased after implementation of the scanning protocols (28 of 65 cases [43.1%] vs 31 of 32 cases [96.9%], P < .001, for placenta accreta spectrum and 9 of 18 cases [50%] vs 29 of 33 cases [87.9%], 87.9%, P < .01 for vasa previa). The perinatal outcome improved also significantly in both cohorts after implementation of the protocols. In the placenta accreta spectrum cohort, the estimated blood loss and the postoperative hospitalization stay decreased between periods (1520 ± 845 vs 1168 ± 707 mL, P < .01, and 10.9 ± 14.1 vs 5.7 ± 2.2 days, P < .05, respectively). In the vasa previa cohort, the number of 5 minute Apgar score ≤5 and umbilical cord pH <7 decreased between periods (5 of 18 cases [27.8%] vs 1 of 33 cases [3%]; P < .05, and 4 of 18 cases [22.2%] vs 1 of 33 cases [3%], P < .05, respectively). The implementation of standardized prenatal targeted scanning protocols for pregnant women with risk factors for placenta accreta spectrum and vasa previa was associated with improved maternal and neonatal outcomes. The continuous increases in the rates of caesarean deliveries and use of assisted reproductive technology highlights the need to develop training programs and introduce targeted scanning protocols at the national and international levels. Copyright © 2018 Elsevier Inc. All rights reserved.

Transit signal priority research tools

DOT National Transportation Integrated Search

2008-05-01

This report presents the results of a research project that addresses Transit Signal Priority (TSP) deployment issues. The report reviews National Transportation Communications for ITS Protocol (NTCIP) 1211 Signal Control and Prioritization (SCP) sta...

Meet EPA's Dan Nelson

EPA Pesticide Factsheets

EPA’s Dan Nelson is the Director of the Human Research Protocol Office at the National Health and Environmental Effect Research Laboratory, Dan works to protect the rights and welfare of EPA’s research participants.

Implementation of National Science Education Standards in suburban elementary schools: Teachers' perceptions and classroom practices

NASA Astrophysics Data System (ADS)

Khan, Rubina Samer

2005-07-01

This was an interpretive qualitative study that focused on how three elementary school science teachers from three different public schools perceived and implemented the National Science Education Standards based on the Reformed Teaching Observation Protocol and individual interviews with the teachers. This study provided an understanding of the standards movement and teacher change in the process. Science teachers who were experienced with the National Science Education Standards were selected as the subjects of the study. Grounded in the theory of teacher change, this study's phenomenological premise was that the extent to which a new reform has an effect on students' learning and achievement on standardized tests depends on the content a teacher teaches as well as the style of teaching. It was therefore necessary to explore how teachers understand and implement the standards in the classrooms. The surveys, interviews and observations provided rich data from teachers' intentions, reflections and actions on the lessons that were observed while also providing the broader contextual framework for the understanding of the teachers' perspectives.

An Improved Quantum Information Hiding Protocol Based on Entanglement Swapping of χ-type Quantum States

NASA Astrophysics Data System (ADS)

Xu, Shu-Jiang; Chen, Xiu-Bo; Wang, Lian-Hai; Ding, Qing-Yan; Zhang, Shu-Hui

2016-06-01

In 2011, Qu et al. proposed a quantum information hiding protocol based on the entanglement swapping of χ-type quantum states. Because a χ-type state can be described by the 4-particle cat states which have good symmetry, the possible output results of the entanglement swapping between a given χ-type state and all of the 16 χ-type states are divided into 8 groups instead of 16 groups of different results when the global phase is not considered. So it is difficult to read out the secret messages since each result occurs twice in each line (column) of the secret messages encoding rule for the original protocol. In fact, a 3-bit instead of a 4-bit secret message can be encoded by performing two unitary transformations on 2 particles of a χ-type quantum state in the original protocol. To overcome this defect, we propose an improved quantum information hiding protocol based on the general term formulas of the entanglement swapping among χ-type states. Supported by the National Natural Science Foundation of China under Grant Nos. 61572297, 61303199, 61272514, and 61373131, the Shandong Provincial Natural Science Foundation of China under Grant Nos. ZR2013FM025, ZR2013FQ001, ZR2014FM003, and ZY2015YL018, the Shandong Provincial Outstanding Research Award Fund for Young Scientists of China under Grant Nos. BS2015DX006 and BS2014DX007, the National Development Foundation for Cryptological Research, China under Grant No. MMJJ201401012, the Priority Academic Program Development of Jiangsu Higher Education Institutions and Jiangsu Collaborative Innovation Center on Atmospheric Environment and Equipment Technology Funds, and the Shandong Academy of Sciences Youth Fund Project, China under Grant Nos. 2015QN003 and 2013QN007

Understanding healthcare practices in superdiverse neighbourhoods and developing the concept of welfare bricolage: Protocol of a cross-national mixed-methods study.

PubMed

Phillimore, Jenny; Bradby, Hannah; Knecht, Michi; Padilla, Beatriz; Brand, Tilman; Cheung, Sin Yi; Pemberton, Simon; Zeeb, Hajo

2015-06-28

Diversity in Europe has both increased and become more complex posing challenges to both national and local welfare state regimes. Evidence indicates specific barriers for migrant, faith and minority ethnic groups when accessing healthcare. However, previous studies of health in diverse cities in European countries have mainly adopted an ethno-national focus. Taking into account the new complexity of diversity within cities, a deeper and multi-faceted understanding of everyday health practices in superdiverse contexts is needed to support appropriate healthcare provision. This protocol describes a mixed method study investigating how residents in superdiverse neighbourhoods access healthcare. The study will include participant observation and qualitative interviewing as well as a standardised health survey and will be carried out in eight superdiverse neighbourhoods - with varying deprivations levels and trajectories of change - in four European countries (Germany, Portugal, Sweden and UK). In each neighbourhood, trained polylingual community researchers together with university researchers will map formal and informal provision and infrastructures supportive to health and healthcare. In-depth interviews with residents and healthcare providers in each country will investigate local health-supportive practices. Thematic analysis will be used to identify different types of help-seeking behaviours and support structures across neighbourhoods and countries. Using categories identified from analyses of interview material, a health survey will be set up investigating determinants of access to healthcare. Complex models, such as structural equation modelling, will be applied to analyse commonalities and differences between population groups, neighbourhoods and countries. This study offers the potential to contribute to a deeper understanding of how residents in superdiverse neighbourhoods deal with health and healthcare in everyday practices. The findings will inform governmental authorities, formal and informal healthcare providers how to further refine health services and how to achieve equitable access in diverse population groups.

Gender Research in the National Institute on Drug Abuse National Treatment Clinical Trials Network: A Summary of Findings

PubMed Central

Greenfield, Shelly F.; Rosa, Carmen; Putnins, Susan I.; Green, Carla A.; Brooks, Audrey J.; Calsyn, Donald A.; Cohen, Lisa R.; Erickson, Sarah; Gordon, Susan M.; Haynes, Louise; Killeen, Therese; Miele, Gloria; Tross, Susan; Winhusen, Theresa

2011-01-01

Background The NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) was established to foster translation of research into practice in substance abuse treatment settings. The CTN provides a unique opportunity to examine in multi-site, translational clinical trials, the outcomes of treatment interventions targeting vulnerable sub-groups of women; the comparative effectiveness of gender-specific protocols to reduce risk behaviors; and gender differences in clinical outcomes. Objectives To review gender-related findings from published CTN clinical trials and related studies from January, 2000 through March, 2010. Methods CTN studies were selected for review if they focused on treatment outcomes or services for special populations of women with substance use disorders (SUDs) including those with trauma histories, pregnancy, co-occurring eating and other psychiatric disorders and HIV risk behaviors; or implemented gender-specific protocols. Results The CTN has randomized 11,500 participants (41% women) across 200 clinics in 24 randomized clinical trials in community settings, of which 4 have been gender-specific. This paper summarizes gender-related findings from CTN clinical trials and related studies, focusing on trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors. Conclusions These published studies have expanded the evidence base regarding interventions for vulnerable groups of women with SUDs as well as gender-specific interventions to reduce HIV risk behaviors in substance using men and women. The results also underscore the complexity of accounting for gender in the design of clinical trials and analysis of results. Scientific Relevance To fully understand the relevance of gender-specific moderators and mediators of outcome, it is essential that future translational studies adopt more sophisticated approaches to understanding and measuring gender-relevant factors and plan sample sizes that are adequate to support more nuanced analytic methods. PMID:21854272

Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts.

PubMed

Madsen, Ida E H; Hannerz, Harald; Nyberg, Solja T; Magnusson Hanson, Linda L; Ahola, Kirsi; Alfredsson, Lars; Batty, G David; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Dragano, Nico; Ferrie, Jane E; Hamer, Mark; Jokela, Markus; Knutsson, Anders; Koskenvuo, Markku; Koskinen, Aki; Leineweber, Constanze; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Salo, Paula; Singh-Manoux, Archana; Suominen, Sakari; Theorell, Töres; Toppinen-Tanner, Salla; Vahtera, Jussi; Väänänen, Ari; Westerholm, Peter J M; Westerlund, Hugo; Fransson, Eleonor; Heikkilä, Katriina; Virtanen, Marianna; Rugulies, Reiner; Kivimäki, Mika

2013-01-01

Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

LANES - LOCAL AREA NETWORK EXTENSIBLE SIMULATOR

NASA Technical Reports Server (NTRS)

Gibson, J.

1994-01-01

The Local Area Network Extensible Simulator (LANES) provides a method for simulating the performance of high speed local area network (LAN) technology. LANES was developed as a design and analysis tool for networking on board the Space Station. The load, network, link and physical layers of a layered network architecture are all modeled. LANES models to different lower-layer protocols, the Fiber Distributed Data Interface (FDDI) and the Star*Bus. The load and network layers are included in the model as a means of introducing upper-layer processing delays associated with message transmission; they do not model any particular protocols. FDDI is an American National Standard and an International Organization for Standardization (ISO) draft standard for a 100 megabit-per-second fiber-optic token ring. Specifications for the LANES model of FDDI are taken from the Draft Proposed American National Standard FDDI Token Ring Media Access Control (MAC), document number X3T9.5/83-16 Rev. 10, February 28, 1986. This is a mature document describing the FDDI media-access-control protocol. Star*Bus, also known as the Fiber Optic Demonstration System, is a protocol for a 100 megabit-per-second fiber-optic star-topology LAN. This protocol, along with a hardware prototype, was developed by Sperry Corporation under contract to NASA Goddard Space Flight Center as a candidate LAN protocol for the Space Station. LANES can be used to analyze performance of a networking system based on either FDDI or Star*Bus under a variety of loading conditions. Delays due to upper-layer processing can easily be nullified, allowing analysis of FDDI or Star*Bus as stand-alone protocols. LANES is a parameter-driven simulation; it provides considerable flexibility in specifying both protocol an run-time parameters. Code has been optimized for fast execution and detailed tracing facilities have been included. LANES was written in FORTRAN 77 for implementation on a DEC VAX under VMS 4.6. It consists of two programs, a simulation program and a user-interface program. The simulation program requires the SLAM II simulation library from Pritsker and Associates, W. Lafayette IN; the user interface is implemented using the Ingres database manager from Relational Technology, Inc. Information about running the simulation program without the user-interface program is contained in the documentation. The memory requirement is 129,024 bytes. LANES was developed in 1988.

New developments in water efficiency

NASA Astrophysics Data System (ADS)

Gregg, Tony T.; Dewees, Amanda; Gross, Drema; Hoffman, Bill; Strub, Dan; Watson, Matt

2006-10-01

An overview of significant new developments in water efficiency is presented in this paper. The areas covered will be legislative, regulatory, new programs or program wrinkles, new products, and new studies on the effectiveness of conservation programs. Examples include state and local level efficiency regulations in Texas; the final results of the national submetering study for apartments in the US; the US effort to adopt the IWA protocols for leak detection; new water efficient commercial products such as ET irrigation controllers, new models of efficient clothes washers, and innovative toilet designs.

Common Operating Picture: UAV Security Study

NASA Technical Reports Server (NTRS)

2004-01-01

This initial communication security study is a top-level assessment of basic security issues related to the operation of Unmanned Aerial Vehicles (UAVs) in the National Airspace System (NAS). Security considerations will include information relating to the use of International Civil Aviation Organization (ICAO) Aeronautical Telecommunications Network (ATN) protocols and applications identifying their maturity, as well as the use of IPV4 and a version of mobile IPV6. The purpose of this assessment is to provide an initial analysis of the security implications of introducing UAVs into the NAS.

Peritonitis in peritoneal dialysis patients in Uruguay.

PubMed

Gadola, Liliana; Orihuela, Lucía; Pérez, Daniel; Gómez, Teresa; Solá, Laura; Chifflet, Liliana; Mautone, Mariela; Torres, Eugenia; Rodriguez, Grisel

2008-01-01

Uruguay is a South American country (3241003 inhabitants) where renal replacement treatment is universally available. The aim of this study was to analyze the incidence and outcome of peritonitis, and the causative organisms and their sensitivity, in order to recommend an empiric initial antibiotic treatment. A retrospective descriptive study of all peritonitis during the period 2004-2005 was performed (144 peritonitis, 44% due to gram-positive bacteria). We conclude that the high prevalence of methicillin-resistant coagulase-negative staphylococci justifies the use of vancomycin in the national empiric initial antibiotic protocols.

Assessing five field sampling methods to monitor Yellowstone National Park's northern ungulate winter range: the advantages and disadvantages of implementing a new sampling protocol

Treesearch

Pamela G. Sikkink; Roy Renkin; Geneva Chong; Art Sikkink

2013-01-01

The five field sampling methods tested for this study differed in richness and Simpson's Index values calculated from the raw data. How much the methods differed, and which ones were most similar to each other, depended on which diversity measure and which type of data were used for comparisons. When the number of species (richness) was used as a measure of...

Assuring bridge safety and serviceability in Europe

DOT National Transportation Integrated Search

2010-08-01

U.S. engineers need advanced tools and protocols to better assess and assure safety and serviceability of bridges. The Federal Highway Administration, American Association of State Highway and Transportation Officials, and National Cooperative Highwa...

Four studies on effects of environmental factors on the quality of National Atmospheric Deposition Program measurements

USGS Publications Warehouse

Wetherbee, Gregory A.; Latysh, Natalie E.; Lehmann, Christopher M.B.; Rhodes, Mark F.

2011-01-01

Selected aspects of National Atmospheric Deposition Program / National Trends Network (NADP/NTN) protocols are evaluated in four studies. Meteorological conditions have minor impacts on the error in NADP/NTN sampling. Efficiency of frozen precipitation sample collection is lower than for liquid precipitation samples. Variability of NTN measurements is higher for relatively low-intensity deposition of frozen precipitation than for higher-intensity deposition of liquid precipitation. Urbanization of the landscape surrounding NADP/NTN sites is not affecting trends in wet-deposition chemistry data to a measureable degree. Five NADP siting criteria intended to preserve wet-deposition sample integrity have varying degrees of effectiveness. NADP siting criteria for objects within the 90 degrees cones and trees within the 120 degrees cones projected from the collector bucket to sky are important for protecting sample integrity. Tall vegetation, fences, and other objects located within 5 meters of the collectors are related to the frequency of visible sample contamination, indicating the importance of these factors in NADP siting criteria.

Gender-Specific Combination HIV Prevention for Youth in High-Burden Settings: The MP3 Youth Observational Pilot Study Protocol.

PubMed

Buttolph, Jasmine; Inwani, Irene; Agot, Kawango; Cleland, Charles M; Cherutich, Peter; Kiarie, James N; Osoti, Alfred; Celum, Connie L; Baeten, Jared M; Nduati, Ruth; Kinuthia, John; Hallett, Timothy B; Alsallaq, Ramzi; Kurth, Ann E

2017-03-08

Nearly three decades into the epidemic, sub-Saharan Africa (SSA) remains the region most heavily affected by human immunodeficiency virus (HIV), with nearly 70% of the 34 million people living with HIV globally residing in the region. In SSA, female and male youth (15 to 24 years) are at a disproportionately high risk of HIV infection compared to adults. As such, there is a need to target HIV prevention strategies to youth and to tailor them to a gender-specific context. This protocol describes the process for the multi-staged approach in the design of the MP3 Youth pilot study, a gender-specific, combination, HIV prevention intervention for youth in Kenya. The objective of this multi-method protocol is to outline a rigorous and replicable methodology for a gender-specific combination HIV prevention pilot study for youth in high-burden settings, illustrating the triangulated methods undertaken to ensure that age, sex, and context are integral in the design of the intervention. The mixed-methods, cross-sectional, longitudinal cohort pilot study protocol was developed by first conducting a systematic review of the literature, which shaped focus group discussions around prevention package and delivery options, and that also informed age- and sex- stratified mathematical modeling. The review, qualitative data, and mathematical modeling created a triangulated evidence base of interventions to be included in the pilot study protocol. To design the pilot study protocol, we convened an expert panel to select HIV prevention interventions effective for youth in SSA, which will be offered in a mobile health setting. The goal of the pilot study implementation and evaluation is to apply lessons learned to more effective HIV prevention evidence and programming. The combination HIV prevention package in this protocol includes (1) offering HIV testing and counseling for all youth; (2) voluntary medical circumcision and condoms for males; (3) pre-exposure prophylaxis (PrEP), conditional cash transfer (CCT), and contraceptives for females; and (4) referrals for HIV care among those identified as HIV-positive. The combination package platform selected is mobile health teams in an integrated services delivery model. A cross-sectional analysis will be conducted to determine the uptake of the interventions. To determine long-term impact, the protocol outlines enrolling selected participants in mutually exclusive longitudinal cohorts (HIV-positive, PrEP, CCT, and HIV-negative) followed by using mobile phone text messages (short message service, SMS) and in-person surveys to prospectively assess prevention method uptake, adherence, and risk compensation behaviors. Cross-sectional and sub-cohort analyses will be conducted to determine intervention packages uptake. The literature review, focus groups, and modeling indicate that offering age- and gender- specific combination HIV prevention interventions that include biomedical, behavioral, and structural interventions can have an impact on HIV risk reduction. Implementing this protocol will show the feasibility of delivering these services at scale. The MP3 Youth study is one of the few combination HIV prevention intervention protocols incorporating youth- and gender-specific interventions in one delivery setting. Lessons learned from the design of the protocol can be incorporated into the national guidance for combination HIV prevention for youth in Kenya and other high-burden SSA settings. ClinicalTrials.gov NCT01571128; http://clinicaltrials.gov/ct2/show/NCT01571128?term=MP3+youth&rank=1 (Archived by WebCite at http://www.webcitation.org/6nmioPd54). ©Jasmine Buttolph, Irene Inwani, Kawango Agot, Charles M Cleland, Peter Cherutich, James N Kiarie, Alfred Osoti, Connie L Celum, Jared M Baeten, Ruth Nduati, John Kinuthia, Timothy B Hallett, Ramzi Alsallaq, Ann E Kurth. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.03.2017.

Dealing With the Long-Term Social Implications of Research

PubMed Central

Fleischman, Alan; Levine, Carol; Eckenwiler, Lisa; Grady, Christine; Hammerschmidt, Dale E.; Sugarman, Jeremy

2016-01-01

Biomedical and behavioral research may affect strongly held social values and thereby create significant controversy over whether such research should be permitted in the first place. Institutional review boards (IRBs) responsible for protecting the rights and welfare of participants in research are sometimes faced with review of protocols that have significant implications for social policy and the potential for negative social consequences. Although IRB members often raise concerns about potential long-term social implications in protocol review, federal regulations strongly discourage IRBs from considering them in their decisions. Yet IRBs often do consider the social implications of research protocols and sometimes create significant delays in initiating or even prevent such research. The social implications of research are important topics for public scrutiny and professional discussion. This article examines the reasons that the federal regulations preclude IRBs from assessing the social risks of research, and examines alternative approaches that have been used with varying success by national advisory groups to provide such guidance. The article concludes with recommendations for characteristics of a national advisory group that could successfully fulfill this need, including sustainability, independence, diverse and relevant expertise, and public transparency. PMID:21534138

Development of the Commonwealth of Puerto Rico National Protocol for the Management of Victims of Sexual Violence: Adults/Adolescents.

PubMed

Méndez, Rose Marie; Kulbok, Pamela; Lawson, Sarah; Matos, Abigail

2013-01-01

Sexual violence is a public health problem in Puerto Rico (PR), with an incidence of 7.4 cases for every 10,000 people during 2005-2006 (Departamento de Salud Secretaría Auxiliar de Salud Familiar y Servicios Integrados, 2007). Findings from the literature review indicated that the traditional model of care provided to the victims of sexual violence in the Emergency Department is incomplete; furthermore, it may cause revictimization because of the attitudes, behaviors, and practices of the community service providers, resulting in additional trauma. Emerging evidence demonstrates that Sexual Assault Nurse Examiner (SANE) programs are providing effective quality care. In PR, SANEs do not intervene in sexual assault cases; nevertheless, the Department of Health of PR has recognized the importance of SANE intervention. Consequently, there is a need for current evidence-based protocols and standards of care to describe the procedures, roles, and responsibilities for the provision of quality care to victims. This project involves the implementation of the Stufflebeam's Context-Input-Process-Product Model in the creation of the Commonwealth of Puerto Rico National Protocol for the Management of Victims of Sexual Violence: Adults/Adolescents.

TH-C-18A-08: A Management Tool for CT Dose Monitoring, Analysis, and Protocol Review

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

Wang, J; Chan, F; Newman, B

2014-06-15

Purpose: To develop a customizable tool for enterprise-wide managing of CT protocols and analyzing radiation dose information of CT exams for a variety of quality control applications Methods: All clinical CT protocols implemented on the 11 CT scanners at our institution were extracted in digital format. The original protocols had been preset by our CT management team. A commercial CT dose tracking software (DoseWatch,GE healthcare,WI) was used to collect exam information (exam date, patient age etc.), scanning parameters, and radiation doses for all CT exams. We developed a Matlab-based program (MathWorks,MA) with graphic user interface which allows to analyze themore » scanning protocols with the actual dose estimates, and compare the data to national (ACR,AAPM) and internal reference values for CT quality control. Results: The CT protocol review portion of our tool allows the user to look up the scanning and image reconstruction parameters of any protocol on any of the installed CT systems among about 120 protocols per scanner. In the dose analysis tool, dose information of all CT exams (from 05/2013 to 02/2014) was stratified on a protocol level, and within a protocol down to series level, i.e. each individual exposure event. This allows numerical and graphical review of dose information of any combination of scanner models, protocols and series. The key functions of the tool include: statistics of CTDI, DLP and SSDE, dose monitoring using user-set CTDI/DLP/SSDE thresholds, look-up of any CT exam dose data, and CT protocol review. Conclusion: our inhouse CT management tool provides radiologists, technologists and administration a first-hand near real-time enterprise-wide knowledge on CT dose levels of different exam types. Medical physicists use this tool to manage CT protocols, compare and optimize dose levels across different scanner models. It provides technologists feedback on CT scanning operation, and knowledge on important dose baselines and thresholds.« less

Services, architectures, and protocols for space data systems

NASA Technical Reports Server (NTRS)

Helgert, Hermann J.

1991-01-01

The author presents a comprehensive discussion of three major aspects of the work of the Consultative Committee for Space Data Systems (CCSDS), a worldwide cooperative effort of national space agencies. The author examines the CCSDS space data communications network concept on which the data communications facilities of future advanced orbiting systems will be based. He derives the specifications of an open communications architecture as a reference model for the development of services and protocols that support the transfer of information over space data communications networks. Detailed specifications of the communication services and information transfer protocols that have reached a high degree of maturity and stability are offered. The author also includes a complete list of currently available CCSDS standards and supporting documentation.

Probabilistic direct counterfactual quantum communication

NASA Astrophysics Data System (ADS)

Zhang, Sheng

2017-02-01

It is striking that the quantum Zeno effect can be used to launch a direct counterfactual communication between two spatially separated parties, Alice and Bob. So far, existing protocols of this type only provide a deterministic counterfactual communication service. However, this counterfactuality should be payed at a price. Firstly, the transmission time is much longer than a classical transmission costs. Secondly, the chained-cycle structure makes them more sensitive to channel noises. Here, we extend the idea of counterfactual communication, and present a probabilistic-counterfactual quantum communication protocol, which is proved to have advantages over the deterministic ones. Moreover, the presented protocol could evolve to a deterministic one solely by adjusting the parameters of the beam splitters. Project supported by the National Natural Science Foundation of China (Grant No. 61300203).

Free-space quantum key distribution at night

NASA Astrophysics Data System (ADS)

Buttler, William T.; Hughes, Richard J.; Kwiat, Paul G.; Lamoreaux, Steve K.; Luther, Gabriel G.; Morgan, George L.; Nordholt, Jane E.; Peterson, C. Glen; Simmons, Charles M.

1998-07-01

An experimental free-space quantum key distribution (QKD) system has been tested over an outdoor optical path of approximately 1 km under nighttime conditions at Los Alamos National Laboratory. This system employs the Bennett 92 protocol; here we give a brief overview of this protocol, and describe our experimental implementation of it. An analysis of the system efficiency is presented as well as a description of our error detection protocol, which employs a 2D parity check scheme. Finally, the susceptibility of this system to eavesdropping by various techniques is determined, and the effectiveness of privacy amplification procedures is discussed. Our conclusions are that free-space QKD is both effective and secure; possible applications include the rekeying of satellites in low earth orbit.

Enhancing the interpretation of stated choice analysis through the application of a verbal protocol assessment

USGS Publications Warehouse

Cahill, K.L.; Marion, J.L.; Lawson, S.R.

2007-01-01

A stated choice survey was employed to evaluate the relative importance of resource, social, and management attributes by asking visitors to select preferred configurations of these attributes. A verbal protocol assessment was added to consider how respondents interpret and respond to stated choice questions applied to hikers of a popular trail at Acadia National Park. Results suggest that visitors are sensitive to changes in public access to the trail and its ecological conditions, with level of encounters least important. Verbal protocol results identified considnations made by respondents that provide insight to their evaluations of alternative recreation setting configurations. These insights help clarify issues important to visitors that stated choice results on their own do not provide.

Protocol for Detection of Yersinia pestis in Environmental ...

EPA Pesticide Factsheets

Methods Report This is the first ever open-access and detailed protocol available to all government departments and agencies, and their contractors to detect Yersinia pestis, the pathogen that causes plague, from multiple environmental sample types including water. Each analytical method includes sample processing procedure for each sample type in a step-by-step manner. It includes real-time PCR, traditional microbiological culture, and the Rapid Viability PCR (RV-PCR) analytical methods. For large volume water samples it also includes an ultra-filtration-based sample concentration procedure. Because of such a non-restrictive availability of this protocol to all government departments and agencies, and their contractors, the nation will now have increased laboratory capacity to analyze large number of samples during a wide-area plague incident.

Epinephrine Policies and Protocols Guidance for Schools: Equipping School Nurses to Save Lives.

PubMed

Tanner, Andrea; Clarke, Carrie

2016-01-01

In response to limited direction given by legislative bodies to school nurses about how to implement state-mandated or recommended stock epinephrine programs in their schools, NASN convened a workgroup of invested stakeholders. This workgroup was challenged to equip school nurses with the necessary tools to develop policies and protocols regarding stock epinephrine in their school districts. The dynamic workgroup subcommittees focused on policies, procedures, and reporting tools. This article reviews the results of the subcommittees' work and the overall collaboration within the workgroup. This article provides clear, nationally recognized guidance on the best practice for establishing stock epinephrine policies and protocols with reporting tools at the local school district level. © 2015 The Author(s).

FIRST-line support for Assistance in Breathing in Children (FIRST-ABC): protocol for a multicentre randomised feasibility trial of non-invasive respiratory support in critically ill children.

PubMed

Ramnarayan, Padmanabhan; Lister, Paula; Dominguez, Troy; Habibi, Parviz; Edmonds, Naomi; Canter, Ruth; Mouncey, Paul; Peters, Mark J

2017-06-12

Over 18 000 children are admitted annually to UK paediatric intensive care units (PICUs), of whom nearly 75% receive respiratory support (invasive and/or non-invasive). Continuous positive airway pressure (CPAP) has traditionally been used to provide first-line non-invasive respiratory support (NRS) in PICUs; however, high-flow nasal cannula therapy (HFNC), a novel mode of NRS, has recently gained popularity despite the lack of high-quality trial evidence to support its effectiveness. This feasibility study aims to inform the design and conduct of a future definitive randomised clinical trial (RCT) comparing the two modes of respiratory support. We will conduct a three-centre randomised feasibility study over 12 months. Patients admitted to participating PICUs who satisfy eligibility criteria will be recruited to either group A (primary respiratory failure) or group B (postextubation). Consent will be obtained from parents/guardians prior to randomisation in 'planned' group B, and deferred in emergency situations (group A and 'rescue' group B). Participants will be randomised (1:1) to either CPAP or HFNC using sealed, opaque envelopes, from a computer-generated randomisation sequence with variable block sizes. The study protocol specifies algorithms for the initiation, maintenance and weaning of HFNC and CPAP. The primary outcomes are related to feasibility, including the number of eligible patients in each group, feasibility of randomising >50% of eligible patients and measures of adherence to the treatment protocols. Data will also be collected on patient outcomes (eg, mortality and length of PICU stay) to inform the selection of an appropriate outcome measure in a future RCT. We aim to recruit 120 patients to the study. Ethical approval was granted by the National Research Ethics Service Committee North East-Tyne&Wear South (15/NE/0296). Study findings will be disseminated through peer-reviewed journals, national and international conferences. NCT02612415; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

FIRST-line support for Assistance in Breathing in Children (FIRST-ABC): protocol for a multicentre randomised feasibility trial of non-invasive respiratory support in critically ill children

PubMed Central

Ramnarayan, Padmanabhan; Lister, Paula; Dominguez, Troy; Habibi, Parviz; Edmonds, Naomi; Canter, Ruth; Mouncey, Paul; Peters, Mark J

2017-01-01

Introduction Over 18 000 children are admitted annually to UK paediatric intensive care units (PICUs), of whom nearly 75% receive respiratory support (invasive and/or non-invasive). Continuous positive airway pressure (CPAP) has traditionally been used to provide first-line non-invasive respiratory support (NRS) in PICUs; however, high-flow nasal cannula therapy (HFNC), a novel mode of NRS, has recently gained popularity despite the lack of high-quality trial evidence to support its effectiveness. This feasibility study aims to inform the design and conduct of a future definitive randomised clinical trial (RCT) comparing the two modes of respiratory support. Methods and analysis We will conduct a three-centre randomised feasibility study over 12 months. Patients admitted to participating PICUs who satisfy eligibility criteria will be recruited to either group A (primary respiratory failure) or group B (postextubation). Consent will be obtained from parents/guardians prior to randomisation in ‘planned’ group B, and deferred in emergency situations (group A and ‘rescue’ group B). Participants will be randomised (1:1) to either CPAP or HFNC using sealed, opaque envelopes, from a computer-generated randomisation sequence with variable block sizes. The study protocol specifies algorithms for the initiation, maintenance and weaning of HFNC and CPAP. The primary outcomes are related to feasibility, including the number of eligible patients in each group, feasibility of randomising >50% of eligible patients and measures of adherence to the treatment protocols. Data will also be collected on patient outcomes (eg, mortality and length of PICU stay) to inform the selection of an appropriate outcome measure in a future RCT. We aim to recruit 120 patients to the study. Ethics and dissemination Ethical approval was granted by the National Research Ethics Service Committee North East—Tyne&Wear South (15/NE/0296). Study findings will be disseminated through peer-reviewed journals, national and international conferences. Trials registration number NCT02612415; pre-results. PMID:28606907

Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda.

PubMed

Igras, Susan; Sinai, Irit; Mukabatsinda, Marie; Ngabo, Fidele; Jennings, Victoria; Lundgren, Rebecka

2014-05-01

There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the Standard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda. Much of the success of the scale-up effort was due to systematic use of monitoring and evaluation (M&E) data from several sources to make midcourse corrections. Four lessons learned illustrate this crucially important approach. First, ongoing M&E data showed that provider training protocols and client materials that worked in the pilot phase did not work at scale; therefore, we simplified these materials to support integration into the national program. Second, triangulation of ongoing monitoring data with national health facility and population-based surveys revealed serious problems in supply chain mechanisms that affected SDM (and the accompanying CycleBeads client tool) availability and use; new procedures for ordering supplies and monitoring stockouts were instituted at the facility level. Third, supervision reports and special studies revealed that providers were imposing unnecessary medical barriers to SDM use; refresher training and revised supervision protocols improved provider practices. Finally, informal environmental scans, stakeholder interviews, and key events timelines identified shifting political and health policy environments that influenced scale-up outcomes; ongoing advocacy efforts are addressing these issues. The SDM scale-up experience in Rwanda confirms the importance of monitoring and evaluating programmatic efforts continuously, using a variety of data sources, to improve program outcomes.

Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda

PubMed Central

Igras, Susan; Sinai, Irit; Mukabatsinda, Marie; Ngabo, Fidele; Jennings, Victoria; Lundgren, Rebecka

2014-01-01

There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the Standard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda. Much of the success of the scale-up effort was due to systematic use of monitoring and evaluation (M&E) data from several sources to make midcourse corrections. Four lessons learned illustrate this crucially important approach. First, ongoing M&E data showed that provider training protocols and client materials that worked in the pilot phase did not work at scale; therefore, we simplified these materials to support integration into the national program. Second, triangulation of ongoing monitoring data with national health facility and population-based surveys revealed serious problems in supply chain mechanisms that affected SDM (and the accompanying CycleBeads client tool) availability and use; new procedures for ordering supplies and monitoring stockouts were instituted at the facility level. Third, supervision reports and special studies revealed that providers were imposing unnecessary medical barriers to SDM use; refresher training and revised supervision protocols improved provider practices. Finally, informal environmental scans, stakeholder interviews, and key events timelines identified shifting political and health policy environments that influenced scale-up outcomes; ongoing advocacy efforts are addressing these issues. The SDM scale-up experience in Rwanda confirms the importance of monitoring and evaluating programmatic efforts continuously, using a variety of data sources, to improve program outcomes. PMID:25276581

Cardiac events in football and strategies for first-responder treatment on the field.

PubMed

Schmied, Christian; Drezner, Jonathan; Kramer, Efraim; Dvorak, Jiri

2013-12-01

The incidence and outcomes of sudden cardiac arrest (SCA) and global strategies for prevention of sudden cardiac death (SCD) in football are not known. The aim of this study was to estimate the occurrence of cardiac events in football and to investigate the preventive measures taken among the Fédération International de Football Association (FIFA) member associations internationally. A questionnaire was sent to the member associations of FIFA. The first section addressed the previous events of SCA, SCD or unexplained sports-related sudden death within the last 10 years. Further questions focused on football player medical screening strategies and SCA resuscitation response protocols on the field. 126 of 170 questionnaires were returned (response rate 74.1%), and 103 questionnaires (60.6%) were completed sufficiently to include in further analysis. Overall, 107 cases of SCA/SCD and 5 unexplained football-associated sudden deaths were reported. These events occurred in 52 of 103 responding associations (50.5%). 23 of 112 (20.5%) footballers survived. 12 of 22 (54.5%) players treated with an available automated external defibrillators (AED) on the pitch survived. A national registry to monitor cardiac events was established in only 18.4% of the associations. Most associations (85.4%) provide regular cardiac screening for their national teams while 75% screen teams of the national leagues. An AED is available at all official matches in 68% of associations. National registries to accurately measure SCA/SCD in football are rare and greatly needed. Deficiencies in emergency preparations, undersupply of AEDs on the field during matches, and variability in resuscitation response protocols and training of team-staff members should be addressed to effectively prevent SCD in football.

WE-E-304-00: Implementing SBRT Protocols

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

NONE

2015-06-15

SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. A number of national protocols have been and are being developed to assess the clinical efficacy of SBRT for various anatomical sites, such as lung and spine. Physics credentialing for participating and implementation of trial protocols involve a broad spectrum of requirements from image guidance, motion management, to planning technology and dosimetric constrains. For radiation facilities that do not have extensive experiences in SBRT treatment and protocol credentialing, these complex processes of credentialing and implementation could be very challenging and, sometimes, may lead to ineffective evenmore » unsuccessful execution of these processes. In this proposal, we will provide comprehensive review of some current SBRT protocols, explain the requirements and their underline rationales, illustrate representative failed and successful experiences, related to SBRT credentialing, and discuss strategies for effective SBRT credentialing and implementation. Learning Objectives: Understand requirements and challenges of SBRT credentailing and implentation Discuss processes and strategies of effective SBRT credentailing Discuss practical considerations, potential pitfalls and solutions of SBRT implentation.« less

WE-E-304-02: Implementing SBRT Protocols: A NRG CIRO Perspective

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

Xiao, Y.

2015-06-15

SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. A number of national protocols have been and are being developed to assess the clinical efficacy of SBRT for various anatomical sites, such as lung and spine. Physics credentialing for participating and implementation of trial protocols involve a broad spectrum of requirements from image guidance, motion management, to planning technology and dosimetric constrains. For radiation facilities that do not have extensive experiences in SBRT treatment and protocol credentialing, these complex processes of credentialing and implementation could be very challenging and, sometimes, may lead to ineffective evenmore » unsuccessful execution of these processes. In this proposal, we will provide comprehensive review of some current SBRT protocols, explain the requirements and their underline rationales, illustrate representative failed and successful experiences, related to SBRT credentialing, and discuss strategies for effective SBRT credentialing and implementation. Learning Objectives: Understand requirements and challenges of SBRT credentailing and implentation Discuss processes and strategies of effective SBRT credentailing Discuss practical considerations, potential pitfalls and solutions of SBRT implentation.« less

Evaluation of Discrimination Technologies and Classification Results Live Site Demonstration: Former Waikoloa Maneuver Area

DTIC Science & Technology

2015-06-01

National Instruments. The National Instruments DAQ is a full-featured PC running Windows 7. The DAQ, electromagnetic transmitter , and batteries for the... electromagnetic induction Environet Environet, Inc. ESTCP Environmental Security Technology Certification Program ftp file transfer protocol FUDS formerly used...capabilities of a currently available advanced electromagnetic induction sensor developed specifically for discrimination on real sites under operational

Student Behaviour Problems: Context, Initiatives and Programs. Selected Papers from the National Conference on Student Behaviour Problems: Context, Initiatives and Programs (3rd, Brisbane, Queensland, Australia, October 1991).

ERIC Educational Resources Information Center

Elkins, John, Ed.; Izard, John, Ed.

The conference papers in this collection are grouped under the following topics: behavior problems in context; interpersonal relationships; initiatives by systems and schools; and programs in special settings. Papers included are: (1) National Trends in Discipline Policy Development (Roger Slee); (2) Balancing: The Protocols of Discipline (William…

Networking and Information Technology Research and Development. Supplement to the President’s Budget for FY 2002

DTIC Science & Technology

2001-07-01

Web-based applications to improve health data systems and quality of care; innovative strategies for data collection in clinical settings; approaches...research to increase interoperability and integration of software in distributed systems ; protocols and tools for data annotation and management; and...Generation National Defense and National Security Systems .......................... 27 Improved Health Care Systems for All Citizens

The management of Convulsive Refractory Status Epilepticus in adults in the UK: No consistency in practice and little access to continuous EEG monitoring.

PubMed

Patel, Mitesh; Bagary, Manny; McCorry, Dougall

2015-01-01

Convulsive Status Epilepticus (CSE) is a common neurological emergency with patients presenting with prolonged epileptic activity. Sub-optimal management is coupled with high morbidity and mortality. Continuous electroencephalogram (EEG) monitoring is considered essential by the National Institute for Health and Care Excellence (NICE) in the management of Convulsive Refractory Status Epilepticus (CRSE). The aim of this research was to determine current clinical practice in the management of CRSE amongst adults in intensive care units (ICU) in the UK and establish if the use of a standardised protocol requires re-enforcement within trusts. 75 randomly selected UK NHS Trusts were contacted and asked to complete a questionnaire in addition to providing their protocol for CRSE management in ICU. 55 (73%) trusts responded. While 31 (56% of responders) had a protocol available in ICU for early stages of CSE, just 21 (38%) trusts had specific guidelines if CRSE occurred. Only 23 (42%) trusts involved neurologists at any stage of management and just 18 (33%) have access to continuous EEG monitoring. This study identifies significant inconsistency in the management of CSE in ICU's across the UK. A minority of ICU units have a protocol for CRSE or access to continuous EEG monitoring despite it being considered fundamental for management and supported by NICE guidance. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

The Achilles' heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability.

PubMed

Rodriguez, Violeta J; LaCabe, Richard P; Privette, C Kyle; Douglass, K Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo Willy; Horigian, Viviana; Weiss, Stephen M; Jones, Deborah L

2017-12-01

The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff-patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention.

Derivation and Implementation of a Protocol in Israel for Organ Donation after Cardio-Circulatory Death.

PubMed

Cohen, Jonathan; Rahamimov, Ruth; Hoffman, Aaron; Katvan, Eyal; Grozovski, Kyril; Ashkenazi, Tamar

2017-09-01

Strategies aimed at expanding the organ donor pool have been sought, which has resulted in renewed interest in donation after cardio-circulatory death (DCCD), also known as non-heart beating donors (NHBDs). To describe the derivation and implementation of a protocol for DCCD in Israel and report on the results with the first six cases. After receiving approval from an extraordinary ethics committee, Ministry of Health, the steering committee of the National Transplant Center defined and reached consensus on the unique challenges presented by a DCCD program. These protocol included medical aspects (construction of a clinical pathway), social and ethical aspects (presentation of the protocol at a public gathering(, legal/ethical aspects (consent for organ preservation procedures being either implied if the donor had signed an organ donor card or received directly from a surrogate decision maker), and logistical aspects (pilot study confined to kidney retrieval and to four medical centers). Data regarding organ donors and recipients were recorded. The protocol was implemented at four medical centers. Consent for organ donation was received from four of the six potential donors meeting criteria for inclusion, in all cases, from a surrogate decision maker. Of the eight kidneys retrieved, only four were suitable for transplantation, which was carried out successfully for four recipients. Graft function remained normal in all cases in 6-12 months follow-up. The DCCD program was successfully implemented and initial results are encouraging, suggesting that expansion of the program might further aid in decreasing the gap between needs and availability of organs.

A protocol proposition of cell therapy for the treatment of chronic obstructive pulmonary disease.

PubMed

Ribeiro-Paes, J T; Stessuk, T; Marcelino, M; Faria, C; Marinelli, T; Ribeiro-Paes, M J

2014-01-01

The main feature of pulmonary emphysema is airflow obstruction resulting from the destruction of the alveolar walls distal to the terminal bronchioles. Existing clinical approaches have improved and extended the quality of life of emphysema patients. However, no treatment currently exists that can change the disease course and cure the patient. The different therapeutic approaches that are available aim to increase survival and/or enhance the quality of life of emphysema patients. In this context, cell therapy is a promising therapeutic approach with great potential for degenerative pulmonary diseases. In this protocol proposition, all patients will be submitted to laboratory tests, such as evaluation of heart and lung function and routine examinations. Stem cells will be harvested by means of 10 punctures on each anterior iliac crest, collecting a total volume of 200mL bone marrow. After preparation, separation, counting and labeling (optional) of the mononuclear cells, the patients will receive an intravenous infusion from the pool of Bone Marrow Mononuclear Cells (BMMC). This article proposes a rational and safe clinical cellular therapy protocol which has the potential for developing new projects and can serve as a methodological reference for formulating clinical application protocols related to the use of cellular therapy in COPD. This study protocol was submitted and approved by the Brazilian National Committee of Ethics in Research (CONEP - Brazil) registration number 14764. It is also registered in ClinicalTrials.gov (NCT01110252). Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability

PubMed Central

Rodriguez, Violeta J.; LaCabe, Richard P.; Privette, C. Kyle; Douglass, K. Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo “Willy”; Horigian, Viviana; Weiss, Stephen M.; Jones, Deborah L.

2017-01-01

Abstract The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff–patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention. PMID:28922974

Research ethics board approval for an international thromboprophylaxis trial.

PubMed

Lutz, Kristina; Wilton, Kelly; Zytaruk, Nicole; Julien, Lisa; Hall, Richard; Harvey, Johanne; Skrobik, Yoanna; Vlahakis, Nicholas; Meade, Laurie; Matte, Andrea; Meade, Maureen; Burns, Karen; Albert, Martin; Cash, Bronwyn Barlow; Vallance, Shirley; Klinger, James; Heels-Ansdell, Diane; Cook, Deborah

2012-06-01

Research ethics board (REB) review of scientific protocols is essential, ensuring participants' dignity, safety, and rights. The objectives of this study were to examine the time from submission to approval, to analyze predictors of approval time, and to describe the scope of conditions from REBs evaluating an international thromboprophylaxis trial. We generated survey items through literature review and investigators' discussions, creating 4 domains: respondent and institutional demographics, the REB application process, and alternate consent models. We conducted a document analysis that involved duplicate assessment of themes from REB critique of the protocol and informed consent forms (ICF). Approval was granted from 65 REB institutions, requiring 58 unique applications. We analyzed 44 (75.9%) of 58 documents and surveys. Survey respondents completing the applications had 8 (5-12) years of experience; 77% completed 4 or more REB applications in previous 5 years. Critical care personnel were represented on 54% of REBs. The time to approval was a median (interquartile range) of 75 (42, 150) days, taking longer for sites with national research consortium membership (89.1 vs 31.0 days, P = .03). Document analysis of the application process and ICF yielded 5 themes: methodology, data management, consent procedures, cataloguing, and miscellaneous. Protocol-specific themes focused on trial implementation, external critiques, and budget. The only theme specific to the ICF was risks and benefits. The most frequent comments on the protocol and ICF were about methodology and miscellaneous issues; ICF comments also addressed study risks and benefits. More studies on methods to enhance efficiency and consistency of the REB approval processes for clinical trials are needed while still maintaining high ethical standards. Copyright © 2012 Elsevier Inc. All rights reserved.

A protocol for coordinating post-tsunami field reconnaissance efforts in the USA

USGS Publications Warehouse

Wilson, Rick I.; Wood, Nathan J.; Kong, Laura; Shulters, Michael V.; Richards, Kevin D.; Dunbar, Paula; Tamura, Gen; Young, Edward J.

2015-01-01

In the aftermath of a catastrophic tsunami, much is to be learned about tsunami generation and propagation, landscape and ecological changes, and the response and recovery of those affected by the disaster. Knowledge of the impacted area directly helps response and relief personnel in their efforts to reach and care for survivors and for re-establishing community services. First-hand accounts of tsunami-related impacts and consequences also help researchers, practitioners, and policy makers in other parts of the world that lack recent events to better understand and manage their own societal risks posed by tsunami threats. Conducting post-tsunami surveys and disseminating useful results to decision makers in an effective, efficient, and timely manner is difficult given the logistical issues and competing demands in a post-disaster environment. To facilitate better coordination of field-data collection and dissemination of results, a protocol for coordinating post-tsunami science surveys was developed by a multi-disciplinary group of representatives from state and federal agencies in the USA. This protocol is being incorporated into local, state, and federal post-tsunami response planning through the efforts of the Pacific Risk Management ‘Ohana, the U.S. National Tsunami Hazard Mitigation Program, and the U.S. National Plan for Disaster Impact Assessments. Although the protocol was designed to support a coordinated US post-tsunami response, we believe it could help inform post-disaster science surveys conducted elsewhere and further the discussion on how hazard researchers can most effectively operate in disaster environments.

JAXA-NASA Interoperability Demonstration for Application of DTN Under Simulated Rain Attenuation

NASA Technical Reports Server (NTRS)

Suzuki, Kiyoshisa; Inagawa, Shinichi; Lippincott, Jeff; Cecil, Andrew J.

2014-01-01

As is well known, K-band or higher band communications in space link segment often experience intermittent disruptions caused by heavy rainfall. In view of keeping data integrity and establishing autonomous operations under such situation, it is important to consider introducing a tolerance mechanism such as Delay/Disruption Tolerant Networking (DTN). The Consultative Committee for Space Data Systems (CCSDS) is studying DTN as part of the standardization activities for space data systems. As a contribution to CCSDS and a feasibility study for future utilization of DTN, Japan Aerospace Exploration Agency (JAXA) and National Aeronautics and Space Administration (NASA) conducted an interoperability demonstration for confirming its tolerance mechanism and capability of automatic operation using Data Relay Test Satellite (DRTS) space link and its ground terminals. Both parties used the Interplanetary Overlay Network (ION) open source software, including the Bundle Protocol, the Licklider Transmission Protocol, and Contact Graph Routing. This paper introduces the contents of the interoperability demonstration and its results.

The expansion and performance of national newborn screening programmes for cystic fibrosis in Europe.

PubMed

Barben, Jürg; Castellani, Carlo; Dankert-Roelse, Jeannette; Gartner, Silvia; Kashirskaya, Nataliya; Linnane, Barry; Mayell, Sarah; Munck, Anne; Sands, Dorota; Sommerburg, Olaf; Pybus, Simon; Winters, Victoria; Southern, Kevin W

2017-03-01

Newborn screening (NBS) for cystic fibrosis (CF) is a well-established public health strategy with international standards. The aim of this study was to provide an update on NBS for CF in Europe and assess performance against the standards. Questionnaires were sent to key workers in each European country. In 2016, there were 17 national programmes, 4 countries with regional programmes and 25 countries not screening in Europe. All national programmes employed different protocols, with IRT-DNA the most common strategy. Five countries were not using DNA analysis. In addition, the processing and structure of programmes varied considerably. Most programmes were achieving the ECFS standards with respect to timeliness, but were less successful with respect to sensitivity and specificity. There has been a steady increase in national CF NBS programmes across Europe with variable strategies and outcomes that reflect the different approaches. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Medicoeconomic analysis of lobectomy using thoracoscopy versus thoracotomy for lung cancer: a study protocol for a multicentre randomised controlled trial (Lungsco01)

PubMed Central

Pagès, Pierre-Benoit; Abou Hanna, Halim; Bertaux, Anne-Claire; Serge Aho, Ludwig Serge; Magdaleinat, Pierre; Baste, Jean-Marc; Filaire, Marc; de Latour, Richard; Assouad, Jalal; Tronc, François; Jayle, Christophe; Mouroux, Jérome; Thomas, Pascal-Alexandre; Falcoz, Pierre-Emmanuel; Marty-Ané, Charles-Henri; Bernard, Alain

2017-01-01

Introduction In the last decade, video-assisted thoracoscopic surgery (VATS) lobectomy for non-small cell lung cancer (NSCLC) has had a major effect on thoracic surgery. Retrospective series have reported benefits of VATS when compared with open thoracotomy in terms of postoperative pain, postoperative complications and length of hospital stay. However, no large randomised control trial has been conducted to assess the reality of the potential benefits of VATS lobectomy or its medicoeconomic impact. Methods and analysis The French National Institute of Health funded Lungsco01 to determine whether VATS for lobectomy is superior to open thoracotomy for the treatment of NSCLC in terms of economic cost to society. This trial will also include an analysis of postoperative outcomes, the length of hospital stay, the quality of life, long-term survival and locoregional recurrence. The study design is a two-arm parallel randomised controlled trial comparing VATS lobectomy with lobectomy using thoracotomy for the treatment of NSCLC. Patients will be eligible if they have proven or suspected lung cancer which could be treated by lobectomy. Patients will be randomised via an independent service. All patients will be monitored according to standard thoracic surgical practices. All patients will be evaluated at day 1, day 30, month 3, month 6, month 12 and then every year for 2 years thereafter. The recruitment target is 600 patients. Ethics and dissemination The protocol has been approved by the French National Research Ethics Committee (CPP Est I: 09/06/2015) and the French Medicines Agency (09/06/2015). Results will be presented at national and international meetings and conferences and published in peer-reviewed journals. Trial registration number NCT02502318. PMID:28619764

Luba-Kasai Men and the Prevention of Mother to Child Transmission (PMTCT) of HIV program in Lusaka.

PubMed

Auvinen, Jaana; Kylmä, Jari; Välimäki, Maritta; Bweupe, Max; Suominen, Tarja

2015-09-01

Male participation in the prevention of mother-to-child transmission (PMTCT) of HIV has been determined as one of the key factors in sub-Saharan African countries, but its realization is challenging because of male-related and institutional factors. The purpose of this study is two-fold: first, we explored the views of Luba-Kasai men, living in Zambia in the Lusaka Province, on the factors that encourage, inconvenience or inhibit them in accompanying their wives to the antenatal clinic and their ideas to improve their experience. Secondly, the study considered their knowledge of the PMTCT program and how such knowledge conformed to the Zambian National Protocol Guidelines Integrated PMTCT of HIV /: AIDS. Twenty-one interviews were analyzed using qualitative inductive content analysis. The National Protocol Guidelines Integrated PMTCT of HIV/AIDS were analyzed using the deductive content analysis. The encouraging factors that emerged were involvement in the program, the time of delivery, love and care, and also the suspicion of corruption. The inconveniencing factors were the arrangements and working culture of the clinic, together with stigma and guilt. A lack of motivation, fear of death, socioeconomic circumstances and again the arrangements and working culture at the clinic were held as inhibiting factors. The ideas to remove inconvenient factors were maintaining a spiritual outlook on life, education, interaction, a good mood and a sense of meaningfulness. Considering such male views and paying attention to minorities in the development of national PMTCT of HIV Programs may enhance male participation in the process. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Factors and motivations associated with use of e-cigarette among primary care patients in a prospective cohort study: e-TAC study protocol.

PubMed

Kinouani, Shérazade; Castéra, Philippe; Laporte, Catherine; Pétrègne, François; Gay, Bernard

2016-06-15

While the relationship between electronic cigarette use and smoking has often been studied, the association between electronic cigarette use and socioeconomic factors has received less attention. This is a study protocol aiming to describe the relationship between the consumption of psychoactive products (in particular: smoking) or some socioeconomic factors and the evolution of the use of electronic cigarette in primary healthcare over 1 year. Electronic cigarette, Tobacco, Alcohol and Cannabis (e-TAC) is a prospective multisite cohort study, including 473 patients at baseline and carrying out in general practices in the Aquitaine area (France). The volunteer patients participated in the study regardless of their initial reason for consultation. They filled out a self-administered questionnaire at baseline and will also do so after 12 months by phone, email or letter. The study will focus on the factors that explain the experimentation with or the current use of the electronic cigarette, as well as factors associated with their evolutions over time using multivariate logistic regression modelling or Cox regression modelling. This study received ethical approval from the University of Bordeaux Committee for the protection of persons. It was also approved by the National Commission for Data Processing and Freedoms. Findings will be submitted for publication in peer-reviewed journals and we will disseminate them by presentations at national or international conferences. RCB: 2015-A00778-41; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Beam quality corrections for parallel-plate ion chambers in electron reference dosimetry

NASA Astrophysics Data System (ADS)

Zink, K.; Wulff, J.

2012-04-01

Current dosimetry protocols (AAPM, IAEA, IPEM, DIN) recommend parallel-plate ionization chambers for dose measurements in clinical electron beams. This study presents detailed Monte Carlo simulations of beam quality correction factors for four different types of parallel-plate chambers: NACP-02, Markus, Advanced Markus and Roos. These chambers differ in constructive details which should have notable impact on the resulting perturbation corrections, hence on the beam quality corrections. The results reveal deviations to the recommended beam quality corrections given in the IAEA TRS-398 protocol in the range of 0%-2% depending on energy and chamber type. For well-guarded chambers, these deviations could be traced back to a non-unity and energy-dependent wall perturbation correction. In the case of the guardless Markus chamber, a nearly energy-independent beam quality correction is resulting as the effects of wall and cavity perturbation compensate each other. For this chamber, the deviations to the recommended values are the largest and may exceed 2%. From calculations of type-B uncertainties including effects due to uncertainties of the underlying cross-sectional data as well as uncertainties due to the chamber material composition and chamber geometry, the overall uncertainty of calculated beam quality correction factors was estimated to be <0.7%. Due to different chamber positioning recommendations given in the national and international dosimetry protocols, an additional uncertainty in the range of 0.2%-0.6% is present. According to the IAEA TRS-398 protocol, the uncertainty in clinical electron dosimetry using parallel-plate ion chambers is 1.7%. This study may help to reduce this uncertainty significantly.

[Aseptic non-touch technique in the operating room: keep it simple].

PubMed

Pans, Solange J A; Molmans, Eva; Marczinski, Susanne C; Bijker, Jilles B; Snijdelaar, Dik G

2015-01-01

The Dutch national patient safety platform developed a protocol for the preparation of intravenous medication; the Aseptic Non-Touch Technique (ANTT). Use of ANTT on nursing wards has shown to reduce contamination of intravenous medication. Therefore it is dictated by the Dutch Healthcare Inspectorate that this technique has to be used at all departments in the hospital, including the operating theatre. However, because of the use of air treatment and operating theatre uniforms, the operating theatre cannot be compared with a nursing ward. In this study, the bacterial contamination of syringes prepared in the operating theatre by anesthesia nurses was determined. Simulation study 45 anesthesia nurses prepared 1000 syringes of 10 ml bacterial culture medium, using their routine method of drawing up iv medication from vials. Turbidity in a syringe after culturing for 14 days at 30° C was used as evidence for bacterial contamination. Using questionnaires, nurses were interviewed in what degree their working method equals ANTT-protocol. We calculated how much extra time must be invested when using the strict ANTT-protocol in the operating theatre. Six syringes (0,6%) were contaminated. Normal dermal bacteria were identified in all syringes. The nurses who prepared the contaminated syringes worked similar manner as their colleagues. It takes an additional 54 minutes per day per operating theatre to work strictly using the ANTT technique. Contamination rates of aseptic preparations in the OR are very low, and are as low as ANTT preparations in a GMP-certified hospital pharmacy. Therefore it is legitimate to develop a modified ANTT-protocol for use in the operating theatre.

“We as Drug Addicts Need that Program”: Insight from Rural African American Cocaine Users on Designing a Sexual Risk Reduction Intervention for Their Community

PubMed Central

Montgomery, Brooke E. E.; Stewart, Katharine E.; Wright, Patricia B.; McSweeney, Jean; Booth, Brenda M.

2013-01-01

This focused ethnographic study examines data collected in 2007 from four gender- and age-specific focus groups (FGs) (N = 31) to inform the development of a sexual risk reduction intervention for African American cocaine users in rural Arkansas. A semi-structured protocol was used to guide audio-recorded FGs. Data were entered into Ethnograph and analyzed using constant comparison and content analysis. Four codes with accompanying factors emerged from the data and revealed recommendations for sexual risk reduction interventions with similar populations. Intervention design implications and challenges, study limitations, and future research are discussed. The study was supported by funds from the National Institute of Nursing Research (P20 NR009006-01) and the National Institute on Drug Abuse (1R01DA024575-01 and F31 DA026286-01). PMID:22216991

Changes of catecholamine excretion during long-duration confinement.

PubMed

Kraft, N; Inoue, N; Ohshima, H; Sekiguchi, C

2002-06-01

Simulation studies have become the main source of data about small group interactions during prolonged isolation, from which it should be possible to anticipate crew problems during actual space missions. International Space Station (ISS) astronauts and cosmonauts will form one international crew, although living in different national modules. They will have joint flight protocols, and at the same time, fulfill a number of different tasks in accord with their national flight programs. Consistent with these concepts, we studied two simultaneously functioning groups in a simulation of ISS flight. The objective of this study was to investigate physiological parameters (such as catecholamine excretions) related to long-duration confinement in the hermetic chamber, simulating International Space Station flight conditions. We also planned to evaluate the relationship between epinephrine/norepinephrine with group dynamics and social events to predict unfavorable changes in health and work capability of the subjects related to psychological interaction in the isolation chamber.

Innovating for Transformation in First Nations Health Using Community-Based Participatory Research.

PubMed

Kyoon-Achan, Grace; Lavoie, Josée; Avery Kinew, Kathi; Phillips-Beck, Wanda; Ibrahim, Naser; Sinclair, Stephanie; Katz, Alan

2018-06-01

Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.

Comments from the Behavioral Teratology Committee of the Japanese Teratology Society on OECD guideline for the testing of chemicals, proposal for a new guideline 426, developmental neurotoxicity study, draft document (September 2003).

PubMed

Fukui, Yoshihiro; Ema, Makoto; Fujiwara, Michio; Higuchi, Hashihiro; Inouye, Minoru; Iwase, Takayuki; Kihara, Takahide; Nishimura, Tatsuya; Oi, Akihide; Ooshima, Yojiro; Otani, Hiroki; Shinomiya, Mitsuhiro; Sugioka, Kozo; Yamano, Tsunekazu; Yamashita, Keisuke H; Tanimura, Takashi

2004-09-01

In September 2003, a new revision of the draft guideline (Organization for Economic Co-operation and Development [OECD] Guideline for the Testing of Chemicals, Proposal for a New Guideline 426, Developmental Neurotoxicity Study) was distributed. The draft guideline consists of 51 paragraphs and an appendix. The National Coordinators were requested to arrange national expert reviews of the guideline proposal in their member countries. The member of the Behavioral Teratology (BT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed and commented on the draft Test Guideline proposal. The BT Committee of the JTS also commented that the International Collaborative Study to validate this protocol should be definitely performed. These comments were sent to the OECD Secretariat. The BT Committee of the JTS expects that the comments are useful for further discussion.

Support Documents for EPA’s Second Review of Existing Drinking Water Standards

EPA Pesticide Factsheets

The support documents for the Six-Year Review 2 of existing National Primary Drinking Water Standards contain extensive information including protocol for the review, and chemical contaminant health effects among others

Support Documents for EPA’s Third Review of Existing Drinking Water Standards

EPA Pesticide Factsheets

The support documents for the Six-Year Review 3 of existing National Primary Drinking Water Standards contain extensive information including protocol for the review, and chemical contaminant health effects among others

Extremity war injuries: collaborative efforts in research, host nation care, and disaster preparedness.

PubMed

Pollak, Andrew N; Ficke, Col James R

2010-01-01

The fourth annual Extremity War Injuries (EWI) Symposium addressed ongoing challenges and opportunities in the management of combat-related musculoskeletal injury. The symposium, which also examined host-nation care and disaster preparedness and response, defined opportunities for synergy between several organizations with similar missions and goals. Within the Department of Defense, the Orthopaedic Extremity Trauma Research Program (OETRP) has funded basic research related to a series of protocols first identified and validated at prior EWI symposia. A well-funded clinical research arm of OETRP has been developed to help translate and validate research advances from each of the protocols. The Armed Forces Institute for Regenerative Medicine, a consortium of academic research institutions, employs a tissue-engineering approach to EWI challenges, particularly with regard to tissue loss. Programs within the National Institute of Arthritis and Musculoskeletal and Skin Diseases and throughout the National Institutes of Health have also expanded tissue-engineering efforts by emphasizing robust mechanistic basic science programs. Much of the clinical care delivered by US military medical personnel and nongovernmental agencies has been to host-nation populations; coordinating delivery to maximize the number of injured who receive care requires understanding of the breadth and scope of resources available within the war zone. Similarly, providing the most comprehensive care to the greatest number of injured in the context of domestic mass casualty requires discussion and planning by all groups involved.

Mount Rainier National Park and Olympic National Park elk monitoring program annual report 2011

USGS Publications Warehouse

Happe, Patricia J.; Reid, Mason; Griffin, Paul C.; Jenkins, Kurt J.; Vales, David J.; Moeller, Barbara J.; Tirhi, Michelle; McCorquodale, Scott

2013-01-01

Fiscal year 2011 was the first year of implementing an approved elk monitoring protocol in Mount Rainier (MORA) and Olympic (OLYM) National Parks in the North Coast and Cascades Network (NCCN) (Griffin et al. 2012). However, it was the fourth and second year of gathering data according to protocol in MORA and OLYM respectively; data gathered during the protocol development phase followed procedures that are laid out in the protocol. Elk monitoring in these large wilderness parks relies on aerial surveys from a helicopter. Summer surveys are intended to provide quantitative estimates of abundance, sex and age composition, and distribution of migratory elk in high elevation trend count areas. An unknown number of elk is not detected during surveys; however the protocol estimates the number of missed elk by applying a model that accounts for detection bias. Detection bias in elk surveys in MORA is estimated using a double-observer sightability model that was developed using survey data from 2008-2010 (Griffin et al. 2012). That model was developed using elk that were previously equipped with radio collars by cooperating tribes. At the onset of protocol development in OLYM there were no existing radio-collars on elk. Consequently the majority of the effort in OLYM in the past 4 years has been focused on capturing and radio-collaring elk and conducting sightability trials needed to develop a double-observer sightability model in OLYM. In this annual report we provide estimates of abundance and composition for MORA elk, raw counts of elk made in OLYM, and describe sightability trials conducted in OLYM. At MORA the North trend count area was surveyed twice and the South once (North Rainier herd, and South Rainier herd). We counted 373 and 267 elk during two replicate surveys of the North Rainier herd, and 535 elk in the South Rainier herd. Using the model, we estimated that 413 and 320 elk were in the North and 652 elk were in the South trend count areas during the time of the respective surveys. At OLYM, the Core and Northwest trend count areas were completely surveyed, as were portions of the Quinault. In addition, we surveyed 10 survey units specifically to get resight data. Two-hundred and forty eight elk were counted in the Core, 19 in the Northwest, and 169 in the Quinault. We conducted double-observer sightability trials associated with 14 collared elk groups for use in developing the double-observer sightability model for OLYM.

Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage.

PubMed

Rockall, T A; Logan, R F; Devlin, H B; Northfield, T C

1997-11-01

To assess changes in practice and outcome in acute upper gastrointestinal haemorrhage following the feedback of data, the reemphasis of national guidelines, and specific recommendations following an initial survey. A prospective, multicentre, audit cycle. Forty five hospitals from three health regions participated in two phases of the audit cycle. Phase I: 2332 patients with acute upper gastrointestinal haemorrhage; phase II: 1625 patients with upper gastrointestinal haemorrhage. Patients were evaluated with respect to management (with reference to the recommendations in the national guidelines), mortality, and length of hospital stay. Following the distribution of data from the first phase of the National Audit and the formulation of specific recommendations for improving practice, the proportion of hospitals with local guidelines or protocols for the management of upper gastrointestinal haemorrhage rose from 71% (32/45) to 91% (41/45); 12 of the 32 hospitals with guidelines during the first phase revised their guidelines following the initial survey. There was a small but significant increase in the proportion of all patients who underwent endoscopy (from 81% to 86%), the proportion who underwent endoscopy within 24 hours of admission (from 50% to 56%), and the use of central venous pressure monitoring in patients with organ failure requiring blood transfusion or those with profound shock (from 30% to 43%). There was, however, no change in the use of high dependency beds or joint medical/surgical management in high risk cases. There was no significant change in crude or risk standardised mortality (13.4% in the first phase and 14.4% in the second phase). Although many of the participating hospitals have made efforts to improve practice by producing or updating guidelines or protocols, there has been only a small demonstrable change in some areas of practice during the National Audit. The failure to detect any improvement in mortality may reflect this lack of change of practice, but may also reflect the fact that a large proportion of the deaths in this unselected study are not preventable; only a very large study could hope to demonstrate a significant change out of the context of a clinical trial.

Integrated Data Collection Analysis (IDCA) Program - AN and Bullseye Smokeless Powder

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

Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the results for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis of ammonium nitrate (AN) mixed with Bullseye® smokeless powder (Gunpowder). The participants found the AN/Gunpowder to: 1) have a range of sensitivity to impact, comparable to or less than RDX, 2) be fairly insensitive to friction as measured by BAM and ABL, 3) have a range for ESD, from insensitive to more sensitive than PETN, and 4) have thermal sensitivity aboutmore » the same as PETN and Gunpowder. This effort, funded by the Department of Homeland Security (DHS), is putting the issues of safe handling of these materials in perspective with standard military explosives. The study is adding SSST testing results for a broad suite of different HMEs to the literature. Ultimately the study has the potential to suggest new guidelines and methods and possibly establish the SSST testing accuracies needed when developing safe handling practices for HMEs. Each participating testing laboratory uses identical test materials and preparation methods. Note, however, the test procedures differ among the laboratories. The testing performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Indian Head Division, Naval Surface Warfare Center, (NSWC IHD), Sandia National Laboratories (SNL), and Air Force Research Laboratory (AFRL/RXQL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to compare results when these testing variables cannot be made consistent. Keywords: Small-scale safety testing, proficiency test, impact-, friction-, spark discharge-, thermal testing, round-robin test, safety testing protocols, HME, RDX, potassium perchlorate, potassium chlorate, sodium chlorate, sugar, dodecane, PETN, carbon, ammonium nitrate, Gunpowder, Bullseye® smokeless powder.« less

Electroacupuncture as a complement to usual care for patients with non-acute pain after back surgery: a study protocol for a pilot randomised controlled trial.

PubMed

Hwang, Man-Suk; Heo, Kwang-Ho; Cho, Hyun-Woo; Shin, Byung-Cheul; Lee, Hyeon-Yeop; Heo, In; Kim, Nam-Kwen; Choi, Byung-Kwan; Son, Dong-Wuk; Hwang, Eui-Hyoung

2015-02-04

Recurrent or persistent low back pain is common after back surgery but is typically not well controlled. Previous randomised controlled trials on non-acute pain after back surgery were flawed. In this article, the design and protocol of a randomised controlled trial to treat pain and improve function after back surgery are described. This study is a pilot randomised, active-controlled, assessor-blinded trial. Patients with recurring or persistent low back pain after back surgery, defined as a visual analogue scale value of ≥50 mm, with or without leg pain, will be randomly assigned to an electroacupuncture-plus-usual-care group or to a usual-care-only group. Patients assigned to both groups will have usual care management, including physical therapy and patient education, twice a week during a 4-week treatment period that would begin at randomisation. Patients assigned to the electroacupuncture-plus-usual-care group will also have electroacupuncture twice a week during the 4-week treatment period. The primary outcome will be measured with the 100 mm pain visual analogue scale of low back pain by a blinded evaluator. Secondary outcomes will be measured with the EuroQol 5-Dimension and the Oswestry Disability Index. The primary and secondary outcomes will be measured at 4 and 8 weeks after treatment. Written informed consent will be obtained from all participants. This study was approved by the Institutional Review Board (IRB) of Pusan National University Korean Hospital in September 2013 (IRB approval number 2013012). The study findings will be published in peer-reviewed journals and presented at national and international conferences. This trial was registered with the US National Institutes of Health Clinical Trials Registry: NCT01966250. 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.

Oral intradialytic nutritional supplement use and mortality in hemodialysis patients.

PubMed

Weiner, Daniel E; Tighiouart, Hocine; Ladik, Vladimir; Meyer, Klemens B; Zager, Philip G; Johnson, Douglas S

2014-02-01

Hemodialysis patients have high mortality rates, potentially reflecting underlying comorbid conditions and ongoing catabolism. Intradialytic oral nutritional supplements may reduce this risk. Retrospective propensity-matched cohort. Maintenance hemodialysis patients treated at Dialysis Clinic Inc facilities who were initiated on a nutritional supplement protocol in September to October 2010 were matched using a propensity score to patients at facilities at which the protocol was not used. Prescription of the protocol, whereby hemodialysis patients with serum albumin levels ≤3.5g/dL would initiate oral protein supplementation during the dialysis procedure. Sensitivity analyses matched on actual supplement intake during the first 3 study months. Covariates included patient and facility characteristics, which were used to develop the propensity scores and adjust multivariable models. All-cause mortality, ascertained though March 2012. Of 6,453 eligible patients in 101 eligible hemodialysis facilities, the protocol was prescribed to 2,700, and 1,278 of these were propensity matched to controls. Mean age was 61 ± 15 (SD) years and median dialysis vintage was 34 months. There were 258 deaths among protocol assignees versus 310 among matched controls during a mean follow-up of 14 months. In matched analyses, protocol prescription was associated with a 29% reduction in the hazard of all-cause mortality (HR, 0.71; 95% CI, 0.58-0.86); adjustment had minimal impact on models. In time-dependent models incorporating change in albumin level, protocol status remained significant but was attenuated in models incorporating a 30-day lag. Similar results were seen in sensitivity analyses of 439 patients receiving supplements who were propensity-matched to controls, with 116 deaths among supplement users versus 140 among controls (HR, 0.79; 95% CI, 0.60-1.05), achieving statistical significance in adjusted models. Observational design, potential residual confounding. Prescription of an oral nutritional supplement protocol and use of oral protein nutritional supplements during hemodialysis are associated with reduced mortality among in-center maintenance hemodialysis patients, an effect likely not mediated by change in serum albumin levels. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Association of physical activity with cognition, metacognition and academic performance in children and adolescents: a protocol for systematic review and meta-analysis.

PubMed

Álvarez-Bueno, Celia; Pesce, Caterina; Cavero-Redondo, Iván; Sánchez-López, Mairena; Pardo-Guijarro, María Jesús; Martínez-Vizcaíno, Vicente

2016-06-28

Schools provide a relevant context for improving children's and adolescents' physical and mental health by increasing physical activity during school hours and/or beyond. The interest in the relationship between physical activity programmes and cognition during development has recently increased, with evidence suggesting a positive association. We present a protocol of systematic reviews and meta-analysis of intervention studies that, by determining the effects of chronic physical exercise on children's and adolescents' cognitive and metacognitive functions, cognitive life skills, academic behaviours and achievement, aims to ensure procedural objectivity and transparency, and maximise the extraction of relevant information to inform policy development. This protocol is guided by Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. Databases to be utilised for a thorough selection of the pertinent literature are MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, PsycINFO and ERIC. Selection is proposed to encompass an international and a national publication level, with inclusion of experimental studies written in English or in Spanish, respectively. Also, relevant references included in the selected studies will be considered suitable for review as supplemental sources.We present an integrated approach to the methodological quality assessment of the selected studies, including the Jadad Scale for the assessment of the quality of randomised controlled trials and the Quality Assessment Tool for Quantitative Studies for pre-post studies and non-randomised controlled trials. The pre-post interventions mean differences will be the primary indicator of the intervention outcome. A subgroup analysis is proposed based on cognitive functions and their neural correlates, metacognitive functions and cognitive life skills, academic achievement areas and academic behaviours. PROSPERO CRD42015029913. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Experiences from a pilot study on how to conduct a qualitative multi-country research project regarding use of antibiotics in Southeast Europe.

PubMed

Kaae, Susanne; Sporrong, Sofia Kälvemark; Traulsen, Janine Morgall; Wallach Kildemoes, Helle; Nørgaard, Lotte Stig; Jakupi, Arianit; Raka, Denis; Gürpinar, Emre Umut; Alkan, Ali; Hoxha, Iris; Malaj, Admir; Cantarero, Lourdes Arevalo

2016-01-01

In 2014, a qualitative multi-country research project was launched to study the reasons behind the high use of antibiotics in regions of Southeast Europe by using previously untrained national interviewers (who were engaged in other antibiotic microbial resistance-related investigations) to conduct qualitative interviews with local patients, physicians and pharmacists. Little knowledge exists about how to implement qualitative multi-country research collaborations involving previously untrained local data collectors. The aim of this paper was therefore to contribute to the knowledge regarding how to conduct these types of research projects by evaluating a pilot study of the project. Local data collectors conducted the study according to a developed protocol and evaluated the study with the responsible researcher-team from University of Copenhagen. The pilot study focused on 'local ownership', 'research quality' and 'feasibility' with regard to successful implementation and evaluation. The evaluation was achieved by interpreting 'Skype' and 'face to face' meetings and email correspondence by applying 'critical common sense'. Local data collectors achieved a sense of joint ownership. Overall, the protocol worked well. Several minor challenges pertaining to research quality and feasibility were identified, in particular obtaining narratives when conducting interviews and recruiting patients for the study. Furthermore, local data collectors found it difficult to allocate sufficient time to the project. Solutions were discussed and added to the protocol. Despite the challenges, it was possible to achieve an acceptable scientific level of research when conducting qualitative multi-country research collaboration under the given circumstances. Specific recommendations to achieve this are provided by the authors.

Sampling protocol for post-landfall Deepwater Horizon oil release, Gulf of Mexico, 2010

USGS Publications Warehouse

Wilde, F.D.; Skrobialowski, S.C.; Hart, J.S.

2010-01-01

The protocols and procedures described in this report are designed to be used by U.S. Geological Survey (USGS) field teams for the collection of environmental data and samples in coastal areas affected by the 2010 Deepwater Horizon oil spill in the Gulf of Mexico. This sampling protocol focuses specifically on sampling for water, sediments, benthic invertebrates, and microorganisms (ambient bacterial populations) after shoreline arrival of petroleum-associated product on beach, barrier island, and wetland environments of the Gulf of Mexico coastal states. Deployment to sampling sites, site setup, and sample collection in these environments necessitates modifications to standard USGS sampling procedures in order to address the regulatory, logistical, and legal requirements associated with samples collected in oil-impacted coastal areas. This document, therefore, has been written as an addendum to the USGS National Field Manual for the Collection of Water-Quality Data (NFM) (http://pubs.water.usgs.gov/twri9A/), which provides the basis for training personnel in the use of standard USGS sampling protocols. The topics covered in this Gulf of Mexico oil-spill sampling protocol augment NFM protocols for field-deployment preparations, health and safety precautions, sampling and quality-assurance procedures, and decontamination requirements under potentially hazardous environmental conditions. Documentation procedures and maintenance of sample integrity by use of chain-of-custody procedures also are described in this protocol.

Screening Protocol for Early Identification of Brazilian Children at Risk for Dyslexia

PubMed Central

Germano, Giseli D.; César, Alexandra B. P. de C.; Capellini, Simone A.

2017-01-01

Early identification of students at risk of dyslexia has been an educational challenge in the past years. This research had two main goals. First, we aimed to develop a screening protocol for early identification of Brazilian children at risk for dyslexia; second, we aimed to identify the predictive variables of this protocol using Principal Component Analysis. The major step involved in developing this protocol was the selection of variables, which were chosen based on the literature review and linguistic criteria. The screening protocol was composed of seven cognitive-linguistic skills: Letter naming; Phonological Awareness (which comprises the following subtests: Rhyme production, Rhyme identification, Syllabic segmentation, Production of words from a given phoneme, Phonemic Synthesis, and Phonemic analysis); Phonological Working memory, Rapid naming Speed; Silent reading; Reading of words and non-words; and Auditory Comprehension of sentences from pictures. A total of 149 children, aged from 6 years to 6 and 11, of both genders who were enrolled in the 1st grade of elementary public schools were submitted to the screening protocol. Principal Component Analysis revealed four factors, accounting for 64.45% of the variance of the Protocol variables: first factor (“pre-reading”), second factor (“decoding”), third factor (“Reading”), and fourth factor “Auditory processing.” The factors found corroborate those reported in the National and International literature and have been described as early signs of dyslexia and reading problems. PMID:29163246

Evaluating newly acquired authority of nurse practitioners and physician assistants for reserved medical procedures in the Netherlands: a study protocol

PubMed Central

De Bruijn-Geraets, Daisy P; Van Eijk-Hustings, Yvonne JL; Vrijhoef, Hubertus JM

2014-01-01

Aim The study protocol is designed to evaluate the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Background Recent (temporarily) enacted legislation in Dutch health care authorizes nurse practitioners and physician assistants to indicate and perform specified medical procedures, i.e. catheterization, cardioversion, defibrillation, endoscopy, injection, puncture, prescribing and simple surgical procedures, independently. Formerly, these procedures were exclusively reserved to physicians, dentists and midwives. Design A triangulation mixed method design is used to collect quantitative (surveys) and qualitative (interviews) data. Methods Outcomes are selected from evidence-based frameworks and models for assessing the impact of advanced nursing on quality of health care. Data are collected in various manners. Surveys are structured around the domains: (i) quality of care; (ii) costs; (iii) healthcare resource use; and (iv) patient centredness. Focus group and expert interviews aim to ascertain facilitators and barriers to the implementation process. Data are collected before the amendment of the law, 1 and 2·5 years thereafter. Groups of patients, nurse practitioners, physician assistants, supervising physicians and policy makers all participate in this national study. The study is supported by a grant from the Dutch Ministry of Health, Welfare and Sport in March 2011. Research Ethics Committee approval was obtained in July 2011. Conclusion This study will provide information about the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Study findings aim to support policy makers and other stakeholders in making related decisions. The study design enables a cross-national comparative analysis. PMID:24684631

Study of participating and nonparticipating states' telemedicine Medicaid reimbursement status: Its impact on Idaho's policymaking process.

PubMed

Gray, Gayle A; Stamm, B Hudnall; Toevs, Sarah; Reischl, Uwe; Yarrington, Diane

2006-12-01

Although Medicare currently reimburses for telemedicine services, advocates are struggling to increase state Medicaid reimbursement. This study provides data from a national study of Medicaid telemedicine reimbursement policies and examines Idaho as a case study for developing telemedicine reimbursement policies. Idahoans have actively advocated for Medicaid telemedicine reimbursement by forming a statewide network. Working with policymakers, Idaho Medicaid and telemedicine advocates established interpersonal connections, providing policymakers information and support. With developing academic, private, and legislative interest, a window of opportunity opened to allow for positive, albeit minimal, movement. To establish protocols for Idaho's use of telemedicine, a national electronic policy survey was conducted to evaluate the direction of telemedicine policy in state Medicaid agencies. Surveys to explore Medicaid reimbursement status were sent to states that were both participating and non-participating in telemedicine. Responses were received from 10 of the 25 states providing Medicaid telemedicine reimbursement and 17 of the 25 states and one U.S. territory not providing reimbursement. Issues common among participating states included provider and reimbursement complications, allowable services, and modification of reimbursement codes. Nonparticipating states indicated an interest in reimbursing for telemedicine and a need to enhance advocate and state Medicaid agency relationships. In addition, the survey results demonstrated the need to provide cost-benefit analysis on the viability of Medicaid reimbursement for telemedicine. Research outcomes were used to develop Idaho's Interactive Video Telemedicine Protocols. These address identified barriers and fears regarding Medicare reimbursement and state budgetary concerns--the additional major issue identified for state Medicaid agencies.

Ethical Issues Surrounding the Use of Modern Human Remains for Research in South Africa.

PubMed

Briers, N; Dempers, J J

2017-02-01

Chapter 8 of the South African National Health Act 61 of 2003 (NHA) that deals with the donation of human tissue was promulgated in 2012. The new Act is perceived to impose restrictions on low-risk research involving human remains. This study aimed to identify the issues raised by a research ethics committee (REC) when reviewing protocols where human remains are used as data source. REC minutes from 2009 to 2014 were reviewed, and issues raised by the committee were categorized. In total, 127 protocols submitted to the committee over 6 years involved human remains. Queries relating to science (22.2%) and administration (18.9%) were the most common, whereas queries relating to legal issues constituted only 10.2%. Ethical issues centered on informed consent regarding sensitive topics such as HIV, DNA, and deceased children. The change in legislation did not change the number or type of legal issues identified by the REC.

Formative research in a school-based obesity prevention program for Native American school children (Pathways)

PubMed Central

Gittelsohn, Joel; Evans, Marguerite; Helitzer, Deborah; Anliker, Jean; Story, Mary; Metcalfe, Lauve; Davis, Sally; Cloud, Patty Iron

2016-01-01

This paper describes how formative research was developed and implemented to produce obesity prevention interventions among school children in six different Native American nations that are part of the Pathways study. The formative assessment work presented here was unique in several ways: (1) it represents the first time formative research methods have been applied across multiple Native American tribes; (2) it is holistic, including data collection from parents, children, teachers, administrators and community leaders; and (3) it was developed by a multi-disciplinary group, including substantial input from Native American collaborators. The paper describes the process of developing the different units of the protocol, how data collection was implemented and how analyses were structured around the identification of risk behaviors. An emphasis is placed on describing which units of the formative assessment protocol were most effective and which were less effective. PMID:10181023

Catalyzing Transdisciplinarity: A Systems Ethnography of Cancer-Obesity Comorbidity and Risk Coincidence.

PubMed

Graham, S Scott; Harley, Amy; Kessler, Molly M; Roberts, Laura; DeVasto, Dannielle; Card, Daniel J; Neuner, Joan M; Kim, Sang-Yeon

2017-05-01

Effectively addressing wicked health problems, that is, those arising from complex multifactorial biological and socio-economic causes, requires transdisciplinary action. However, a significant body of research points toward substantial difficulties in cultivating transdisciplinary collaboration. Accordingly, this article presents the results of a study that adapts Systems Ethnography and Qualitative Modeling (SEQM) in response to wicked health problems. SEQM protocols were designed to catalyze transdisciplinary responses to national defense concerns. We adapted these protocols to address cancer-obesity comorbidity and risk coincidence. In so doing, we conducted participant-observations and interviews with a diverse range of health care providers, community health educators, and health advocacy professionals who target either cancer or obesity. We then convened a transdisciplinary conference designed to catalyze a coordinated response. The findings offer productive insights into effective ways of catalyzing transdisciplinarity in addressing wicked health problems action and demonstrate the promise of SEQM for continued use in health care contexts.

Environmental effects of the US Antarctic Program`s use of balloons in Antarctica

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

McCold, L.N.; Eddlemon, G.K.; Blasing, T.J.

1995-06-01

The USAP uses balloons in Antarctica to conduct scientific research, to facilitate safe air transport, and to provide data for global weather predictions. However, there is the possibility that balloons or their payloads may adversely affect Antarctic fauna or flora. The purpose of this study is to provide background information upon which the USAP may draw when complying with its responsibilities under the National Environmental Policy Act of 1969, the Antarctic Treaty, and the Madrid Protocol.

Agricultural Meteorology in China.

NASA Astrophysics Data System (ADS)

Rosenberg, Norman J.

1982-03-01

During nearly five weeks in China (May-June 1981), the author visited scientific institutions and experiment stations engaged in agricultural meterology and climatology research and teaching. The facilities, studies, and research programs at each institution are described and the scientific work in these fields is evaluated. Agricultural meteorology and climatology are faced with some unique problems and opportunities in China and progress in these fields may be of critical importance to that nation in coming years. The author includes culinary notes and comments on protocol in China.

Refinement of the use of food and fluid control as motivational tools for macaques used in behavioural neuroscience research: report of a Working Group of the NC3Rs.

PubMed

Prescott, Mark J; Brown, Verity J; Flecknell, Paul A; Gaffan, David; Garrod, Kate; Lemon, Roger N; Parker, Andrew J; Ryder, Kathy; Schultz, Wolfram; Scott, Leah; Watson, Jayne; Whitfield, Lucy

2010-11-30

This report provides practical guidance on refinement of the use of food and fluid control as motivational tools for macaques used in behavioural neuroscience research. The guidance is based on consideration of the scientific literature and, where data are lacking, expert opinion and professional experience, including that of the members of a Working Group convened by the United Kingdom National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs). The report should be useful to researchers, veterinarians and animal care staff responsible for the welfare of macaques used in food and fluid control protocols, as well as those involved with designing, performing and analysing studies that use these protocols. It should also assist regulatory authorities and members of local ethical review processes or institutional animal care and use committees concerned with evaluating such protocols. The report provides a framework for refinement that can be tailored to meet local requirements. It also identifies data gaps and areas for future research and sets out the Working Group's recommendations on contemporary best practice. Copyright © 2010 Elsevier B.V. All rights reserved.

Refining Ovarian Cancer Test accuracy Scores (ROCkeTS): protocol for a prospective longitudinal test accuracy study to validate new risk scores in women with symptoms of suspected ovarian cancer.

PubMed

Sundar, Sudha; Rick, Caroline; Dowling, Francis; Au, Pui; Snell, Kym; Rai, Nirmala; Champaneria, Rita; Stobart, Hilary; Neal, Richard; Davenport, Clare; Mallett, Susan; Sutton, Andrew; Kehoe, Sean; Timmerman, Dirk; Bourne, Tom; Van Calster, Ben; Gentry-Maharaj, Aleksandra; Menon, Usha; Deeks, Jon

2016-08-09

Ovarian cancer (OC) is associated with non-specific symptoms such as bloating, making accurate diagnosis challenging: only 1 in 3 women with OC presents through primary care referral. National Institute for Health and Care Excellence guidelines recommends sequential testing with CA125 and routine ultrasound in primary care. However, these diagnostic tests have limited sensitivity or specificity. Improving accurate triage in women with vague symptoms is likely to improve mortality by streamlining referral and care pathways. The Refining Ovarian Cancer Test Accuracy Scores (ROCkeTS; HTA 13/13/01) project will derive and validate new tests/risk prediction models that estimate the probability of having OC in women with symptoms. This protocol refers to the prospective study only (phase III). ROCkeTS comprises four parallel phases. The full ROCkeTS protocol can be found at http://www.birmingham.ac.uk/ROCKETS. Phase III is a prospective test accuracy study. The study will recruit 2450 patients from 15 UK sites. Recruited patients complete symptom and anxiety questionnaires, donate a serum sample and undergo ultrasound scored as per International Ovarian Tumour Analysis (IOTA) criteria. Recruitment is at rapid access clinics, emergency departments and elective clinics. Models to be evaluated include those based on ultrasound derived by the IOTA group and novel models derived from analysis of existing data sets. Estimates of sensitivity, specificity, c-statistic (area under receiver operating curve), positive predictive value and negative predictive value of diagnostic tests are evaluated and a calibration plot for models will be presented. ROCkeTS has received ethical approval from the NHS West Midlands REC (14/WM/1241) and is registered on the controlled trials website (ISRCTN17160843) and the National Institute of Health Research Cancer and Reproductive Health portfolios. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/