Tendering assessment

A.P.C. Ltd., having initially declined to render for Dungeness B , at a late stage decided to make an offer with the result that in February, 1965 when the varions offers were received their offer was less comprehensive and detailed than normally is the case. The process of tender assessment and contract negotiation was carried out to programme and in the event A.P.C. were required to mount a considerable effort to overcome a programme of recruitment of additional staff to overcome some losses that had occurred during the mn-down of Trawsfynydd. ... 

In parallel with these events there was anxiety within UKAEA that AGR would not receive adequate representation at the Dungeness B tender assessments unless APC put in a tender because it was considered that TNPG and EE Co had already turned their major efforts towards light water reactors. UKAEA were prepared to... 

As quoted in TNA PRO AB 48/816. Second nuclear power programme tender assessment for Dungeness B. 

TNA PRO AB 48/816. Second nuclear power programme tender assessment for Dungeness B. Notes on Tender Offer Based on First Reading of the Summary (Unpriced) Volume A of the Tender Submissions , 2 February 1965. 

TNA PRO EG 1/363. Prototype Steam Generating Heavy Water Reactor (SGHWR). SGHWR for North of Scotland Hydro-Electricity Board. St. Clair C Hood, UKAEA, to G Hubbard, Ministry of Technology, 11 August 1967. TNA PRO AB 65/869. Stake Ness tender assessment. 

MONITORING DRUGS GIVEN INTRAVENOUSLY. For optimal results, die nurse inspects the needle site and die area around die needle every hour for signs of extravasation of die IV fluid. The nurse performs diese assessments more frequently if the patient is restiess or uncooperative It is important to check the rate of infusion every 15 minutes and adjust it as needed. The nurse should inspect die vein used for die IV infusion every 4 hours for signs of tenderness, pain, and redness (which may indicate phlebitis or thrombophlebitis). If tiiese are apparent, die nurse must restart the IV in another vein and bring the problem to the attention of the primary health care provider. 

Baseline CK should be obtained in all patients prior to starting statin therapy. Follow-up CK should only be obtained in patients complaining of muscle pain, weakness, tenderness, or brown urine. Routine monitoring of CK is of little value in the absence of clinical signs or symptoms. Patient assessment for symptoms of myopathy should be done 6 to 12 weeks after starting therapy... 

Evaluate effectiveness of diuretic therapy with regard to ascitic fluid accumulation and development of peripheral edema. Ask the patient directed questions about abdominal girth, fullness, tenderness, and pain. Weigh the patient at each visit, and ask the patient to keep a weight diary. Assess for peripheral edema at each visit. 

Before starting treatment for RA, assess the subjective and objective evidence of disease. For joint findings, this includes the number of tender and swollen joints, pain, limitations on use, duration of morning stiffness, and presence of joint erosions. Systemic findings may include fatigue and the presence of extraarticular manifestations. Obtain laboratory measurements of CRP and ESR. The impact of the disease on quality of life and functional status is also important. 

Patient reported outcomes (disability index, patient global assessment), physician assessments (tender/painful/swollen joints, physician s global assessment), objective measures (ESR, CRP) neutrophil counts baseline, q3mo, then quarterly qyr... 

The safety and efficacy of Remicade when given in conjunction with methotrexate (MTX) were assessed in a multicenter, randomized, double-blind, placebo-controlled study of 428 patients with active rheumatoid arthritis despite treatment with MTX. All patients were to have received MTX for >6 months and be on a stable dose >12.5mg/week for 4 weeks prior to study. All Remicade and placebo groups continued their stable dose of MTX and folic acid. In addition to MTX, patients received placebo or Remicade by intravenous infusion at weeks 0, 2, and 6 followed by additional infusions every 4 or 8 weeks thereafter. The primary end point was the proportion of patients at week 30 who attained an improvement in signs and symptoms as measured by the American College of Rheumatology criteria (ACR 20). An ACR 20 response is defined as at least a 20% improvement in both tender and swollen joint counts and in 3 of 5 clinical criteria. At week 30, 43/86 (50%) of patients treated every 8 weeks with 3 mg/kg of Remicade plus MTX attained an ACR 20 compared with 18/88 (20%) of patients treated with placebo plus MTX ip < 0.001). 

Voisey, P.W. 1976. Engineering assessment and critique of instruments used for meat tenderness evaluation. J. Texture Studies 7 11-48. 

Touching the skin, however, is essential in clinical practice in order to assess certain skin properties that the other senses cannot detect. In cosmetics, this corresponds to a very common gesture performed every day to evaluate the condition of our skin or to check the effect of a cream or shampoo or when applying perfume. In social life too, it is through touching the skin that we express our feelings to convey sympathy, love, and tenderness. 

Back Logroll as a unit to inspect back maintain spinal alignment during examination observe for bruising and open wounds palpate each vertebral body for fenderness, pain, deformity, and stability assess flank area for bruising and tenderness. 

The patient may report episodes of watering or tenderness. When reduced lOP is fc>imd by applanation tonometry, a careful examination of the woimd is necessary.This inspection is achieved by painting sodium fluorescein over the cataract incision to observe for Seidel s sign. Occasionally, the auxiliary incisions can leak, so they should also be examined. The clinician should note the appearance of the cornea, which often shows endothelial folds. After the instillation of sodium fluorescein, a waffled appearance of the cornea is generally apparent if the lOP is markedly reduced (Figure 30-3). In addition, the anterior chamber depth should be assessed as well as the presence of inflammation. The pupils should be dilated and a retinal examination should be performed to rule out serous or hemorrhagic choroidal separations or a retinal break or detachment. 

The INR (prothrombin time) is preferred to plasma bilirubin and hepatic enzymes as a monitor of liver damage, and renal impairment is better assessed by plasma creatinine than urea (which is metabolised by the liver). The clinical signs (jaundice, abdominal pain, hepatic tenderness) do not become apparent for 24-48 h and liver failure, when it occurs, does so between 2 and 7 days after the overdose. It is vital... 

In a crossover study, 66 patients took 50 mg doxycychne or placebo twice a day for 12, 24, or 36 weeks (23). Patients assessments, swollen and tender joint counts, duration of morning stiffness, erythrocyte sedimentation rate, and the so-called modified disease activity score (25)... 

Assess location of pain, joint tenderness, swelling, redness, and limitation of motion. 

The severity of ulcerative colitis may be assessed by factors such as stool frequency, presence of blood in stool, fever, pulse, hemoglobin, erythrocyte sedimentation rate, C-reactive protein, abdominal tenderness, and radiologic or endoscopic findings. The severity of Crohn s disease can be assessed by the Crohn s disease activity index, which includes stool frequency, presence of blood in stool, endoscopic appearance, and physician s global assessment. 

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