(a) The Secretary of Defense in respect of procurement for the Department of Defense (including military colors) and the Administrator of General Services in respect of procurement for executive agencies other than the Department of Defense may, for cause which the Secretary or the Administrator, as the case may be, deems sufficient, make necessary minor adjustments in one or more of the dimensions or proportionate dimensions prescribed by this order, or authorize proportions or sizes other than those prescribed by section 3 or section 21 of this order. The size of the union jack flown with the national flag shall be the same as the size of the union of that national flag. The exterior dimensions of each union jack manufactured or purchased for executive agencies shall equal the respective exterior dimensions of the union of a flag of a size authorized by or pursuant to this order. (b) Shall conform to the provisions of section 21 of this order, except as may be otherwise authorized pursuant to the provisions of section 24 of this order. (a) Shall conform to the provisions of Part I of this order, except as may be otherwise authorized pursuant to the provisions of section 24, or except as otherwise authorized by the provisions of section 21, of this order. Flags manufactured or purchased for the use of executive agencies: The following sizes of flags are authorized for executive agencies: Size Part II-Regulations Governing Executive Agencies The dimensions of the constituent parts of the flag shall conform to the proportions set forth in the attachment referred to in section 2 of this order. The positions of the stars in the union of the flag and in the union jack shall be as indicated on the attachment to this order, which is hereby made a part of this order. The flag of the United States shall have thirteen horizontal stripes, alternate red and white, and a union consisting of white stars on a field of blue. NOW, THEREFORE, by virtue of the authority vested in me as President of the United States and as Commander in Chief of the armed forces of the United States, and the Federal Property and Administrative Services Act of 1949, as amended, it is hereby ordered as follows: Part I-Design of the Flag WHEREAS the interests of the Government require that orderly and reasonable provision be made for various matters pertaining to the flag and that appropriate regulations governing the procurement and utilization of national flags and union jacks by executive agencies be prescribed: 377), as amended authorizes the President to prescribe policies and directives governing the procurement and utilization of property by executive agencies and WHEREAS the Federal Property and Administrative Services Act of 1949 ( 63 Stat. WHEREAS section 2 of title 4 of the United States Code provides as follows: "On the admission of a new State into the Union one star shall be added to the union of the flag and such addition shall take effect on the fourth day of July then next succeeding such admission." and WHEREAS the State of Hawaii has this day been admitted into the Union and Proportions and Sizes of Flags and Position of StarsĮx. 10834, set out as a note under this section. 79, which prescribed proportions and sizes of flags until July 4, 1960, was revoked by section 33 of Ex. 626, provided that: "This Act may be cited as the 'Mobile Telecommunications Sourcing Act'."Įxecutive Documents Executive Order No. Micks Federal Flag Code Amendment Act of 2007'." Short Title of 2000 Amendment 233, provided that: "This Act may be cited as the 'Army Specialist Joseph P. 1962, provided that: "This Act may be cited as the 'Korean War Veterans Recognition Act'." Short Title of 2007 Amendment 79, provided that: "This Act may be cited as the 'Vietnam War Veterans Recognition Act of 2017'." Short Title of 2009 Amendment 64, provided that: "This division may be cited as the 'Honoring Hometown Heroes Act'." Short Title of 2017 Amendment Statutory Notes and Related Subsidiaries Short Title of 2018 Amendment The flag of the United States shall be thirteen horizontal stripes, alternate red and white and the union of the flag shall be forty-eight stars, white in a blue field. Modification of rules and customs by President.ġ998- Pub.
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While the program is encoding video files, you can add, rearrange, and change encoding options for files in the batch processing queue.Īdobe Media EncoderSupports different video export formats depending on the Adobe applications installed with the program. It is important that Adobe Media Encoder allows you to process multiple video and audio clips in batch mode In environments where video is a significant part of the content, batch processing speeds up the workflow. Using this program, you can export videos to formats supported by a variety of devices, from DVD players and websites to mobile phones, portable media players and standard-definition and high-definition TVs. Such video and audio formats are characterized by a high degree of compression. Internet connection and registration required to access online servicesĪdobe Media Encoder is an encoding program that lets you encode audio and video files into a variety of distribution formats for different applications and audiences.1 Gbps network card for HD media sharing (10 Gbps recommended for 4K media sharing).Sound card supporting ASIO or Microsoft Windows Driver Model. Screen resolution of 1920x1080 or higher (HDR 1000 recommended for HDR workflows).Video card with 2 GB VRAM (4 GB recommended for HD and some 4K work 6 GB for 4K work).8 GB available hard drive space Additional free space required during installation.8 GB RAM (16 GB recommended for HD media 32 GB for 4K media).6th generation Intel or AMD Ryzen 1000 series processor (11th generation Intel processor recommended / newer CPU with Quick Sync support or AMD Ryzen 3000 series / Threadripper 2000- series).64-bit version of Microsoft Windows 10 / 11 (version 22H2 or later) 64-bit version of Microsoft Windows 10 / 11.Interface language : English / Dutch / Spanish / Italian / Chinese (simplified) / Chinese (traditional) / Korean / German / Polish / Portuguese / Russian / Turkish / French / Czech / Swedish / Japanese This wider-than-average screen allows for an equally bright image quality no matter where you sit or where you place it. This freestanding screen requires a large area to set up, but once you have it assembled (which takes minimal time thanks to the included stakes and rigging cord), it provides a fantastic viewing experience. If you prefer an outdoor movie screen that stands on its own, we recommend the Elite Screens Yard Master Plus Projection Screen. It’s also very compact and can be rolled up easily into its steel case when not in use, preventing wrinkles.Īfter a good amount of use, you might find that the screen starts curving slightly at the edges, but with proper care, it should still last for years. Plus, it works with all projectors and has a two-inch auto-lock mechanism to change the height. While it boasts a low price, it offers a very high-quality picture, creating a crisp and bright viewing experience no matter where you sit. This 4K Ultra HD screen is available in five sizes and four aspect ratios, giving you plenty of options to suit your outdoor space. During testing, the screen was easy to assemble and pull down, requiring just a few screws to attach securely. Pull-down movie screens are as convenient as it gets-you can attach them to a wall or hang them from the ceiling for easy, on-hand access, and this option from Elite Screens is the best of the bunch. It may start to curve at the edges after ample use. It’s small and lightweight and is definitely my own personal favourite travel lens for when I want to travel as light as possible. The Sony E 18-135mm F3.5-5.6 OSS is an APS-C lens that does everything really well. Minimum Focusing Distance: 1.09 ft (0.33 m) Lens Construction: 12 groups, 17 elements Recommended Reviews: Christopher Frost (YouTube) | Arthur R (YouTube) | Jason Vong (YouTube) Pros: Well built, fast f/2.8 aperture, bokeh, razor sharp, flare control, quiet autofocus motor Overall this is an excellent lens, although it should be because it’s also one of Sony’s most expensive APS-C lenses. Of course, you can also use a gimbal if you want really smooth video. That said, providing you are using a fast enough shutter speed this lens will still be fantastic on the a6400 which doesn’t have IBIS. Sadly Sony decided not to include stabilization in this lens, so it’s definitely beneficial to pair it with a camera like the a6600 which includes in-body-stabilization (IBIS), especially for shooting videos or at night. If you shoot in JPEG then in-camera corrections take care of the distortion for you.įlaring is well controlled but there is a little color fringing when shooting wide-open, but this clears up at around f/5.6. If you shoot RAW then you’ll notice some barrel distortion at 16mm when shooting at f/2.8 but this is gone by around 30mm. Diffraction will kick in around f/11 at 55mm. At 55mm the center of the frame is razor sharp but the corners are just a little softer, step down to f/4 and now even the corners are sharp. Wide-open at f/2.8 and 16mm the center of the frame is very sharp as are the corners, things get a little sharper at f/4 and f/5.6 but diffraction kicks in around f/16 and you’ll start to lose sharpness. There is no focus breathing when you zoom in and out and the autofocus motor is both fast and quiet making it a great lens for video work. The lens is weather sealed to help prevent dust and moisture ingress and both the zoom and focus rings are silky smooth. The lens body is well built and weighs only 494g (17.5 oz). The Sony E 16-55mm F2.8 G lens is a high quality standard zoom lens with a fast f/2.8 aperture for low light shooting and creamy bokeh. All-in-one lenses make great walk-around and travel lenses for when you want to keep your gear as light as possible. Here are my top 10 recommended lenses for the Sony a6400 mirrorless camera.Īn all-in-one lens typically covers a wide focal range and allows you to shoot anything from a moderate wide-angle landscape scene, a portrait shot or even a small telephoto shot. All images are copyright protected and may be used for personal use only. However, I do provide the username/password to all members of our community forum. RAW files are also available but password protected to help keep my hosting costs sensible. Full resolution SOOC JPEG images are available to download. **Please Note: Unless otherwise mentioned no post processing has been applied to the image samples in this guide except for cropping. If you prefer Facebook then I also run the Sony a6400 Shooters Group. a valuable tool for online shoppers of digital cameras.Īll logos and images are the property of and are copyright by their respective owners.Ģ011-2022 © CameraSize.If you are looking for further help and advice on the a6400 or would simply like to share your photos and videos, then please head over to our friendly Sony a6400 Forum. You can compare many type of digital camereras, including digital SLR, CSC (Compact System Cameras) / Mirrorless, Point-and-Shoot and Medium Format cameras (those which are available in our camera's database).Ĭamera dimensions are for body only (excluding protrusion), without interchangeable lens or with a lens extended as specified by the specs on the vendor's official website.Ĭamera Size - side by side digital camera comparison. Other options available are: view a camera from different sides, resize images to fit more cameras into your computer display, move a camera right or left, and remove a camera from the comparison. For example, sort cameras from the most compact to the largest or from the most bulky camera to the smallest one. You can display and sort the digital cameras by weight, width, depth and weight. A very useful tool which will help you make a smart online buying decision. Using this online comparison tool, you can compare virtually unlimited number of digital cameras side by side, view how compact or bulky/large a camera is vs other camera models, including the option to attach interchangeable lenses, adapters or extenders (on supported cameras models). Compact camera meter (beta) - a visual digital camera comparison webapp. But it will not have happened if you apply the fair decision. There will be a lot of different methods that an employee can break the decision of the termination. You have to make the details that have to be accurate. It is crucial for you to explain what if your employee does not meet your expectations. You have to bring the consequences if your employee does not meet the goals and then the performance improvement plan should be signed by your employee. You have to help your employee in order to achieve the goals which are time-bound, realistic, attainable, measurable, specific, and develop a regular date in order to achieve the goals with your employee. In a couple of situations, you can solve this problem by reassigning your employee to a couple of different tasks, schedule or job. You can give your employee a couple of options whether he or she wants to enhance her or his performance or attitude in the workplace or they want to require additional resources. If you want to get the best outcomes, it is important for you to create performance evaluation plan with your employee. The most important thing is that you have to save this file to the personnel file of your employee. It is better for you to leave the space that you can put at the bottom of the sheet so that your employee can write additional reports. It is important to have the documentation throughout this process, so you have to make your employee sign the write up in order to make him or her understand the consequences and read the expectation that you want him or her to be. Performance review form of the employee should be reviewed so that your employee will understand the failure and you have to tell him the expectation that you want to see from him. The last element is that you have to make a rule for your employee if he or she continues to do the unacceptable behavior.Īfter you have written the document, it is the perfect time for you to meet with offending employee. And then you also have to check the time your employee should arrive. For example, if you find that your employee is late, you have to write down a couple of times your employee has been late in the past couple of months or weeks. The second important thing is that the proper attitude should be stated. The first element is it comes with detail about the misconduct and unacceptable attitude. If the verbal warning has been given, you have to make sure that the details, the time, and date of the conversation have been documented in case that you need evidence.Ī write-up sheet comes with three elements, according to Steve Kane, the human resources consultant. For those of you who think that it is the best rule for your workplace, you have to make sure that the verbal warning has been given before you write the complaint. Sometimes, write up forms for employees or written warning will be followed by the verbal warning. The first thing that you have to thing is the handbook of your employee, but you can also talk to your workplace legal department or human resources officer for template PDF or guidance or employee write up form. This documentation is very important in case your former employee want to get his or her employment suit, so it is better for you to get your documentation right.Ī couple of workplaces come with protocols in order to handle performance evaluation or attitude issues. It will be the perfect evidence for you that you do the right thing in order to make your employee improve or you can use it to decide whether he or she will be fired or not. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.Īs a general manager or a leader of the company, there will be the time when you will write up your employee whether your employee has a couple of problems in the workplace, has a quarrel with a couple of other employees, does not do his or her job properly, or is absent or late chronically. You can choose forms in your state, use search feature to find the related forms. There are a few ways to find the forms or templates you need. At Speedy Template, You can download Employee Write Up Template. Until you are diagnosed as short or long sighted, and you put those glasses on for the first time, you simply believe that this is how the world looks. It’s a bit like needing glasses for years and not knowing about it. The reality is, that because this happened over the course of generations, many people are unaware of the issue they are simply used to records sound like this. Even worse, many executives simply dismiss the issue, claiming that consumers actually prefer brickwalled albums. It’s simple really, label executives concerns for commercial competition outweigh their concern for quality. Why are record labels happy to substitute quality for volume? Some notable examples, which gained public criticism for this are: The Red Hot Chili Peppers – Californication & Metalica’s Death Magnetic. Essentially, it has now become acceptable to release commercial material with substandard quality not to mention the loss of dynamics, and reduction of punch and clarity that comes from over compression. Slowly but surely, over the last 10-15 years, we have seen levels often pushed beyond the point of digital clipping. You would think the concept of digital distortion would be enough to keep record companies from pushing things any further, but sadly, this is not the case. 0dB is the absolute limit, and by pushing peak levels beyond this point you create clipping or digital distortion (not a good thing). Only this time, there really is nowhere else to go. The inevitable result of such competition between record labels to sound louder, is a continual pushing of the boundaries producing albums with increasing amounts of compression and pushing volume levels to extremes. But as you can expect, in the name of competition, all other record labels slowly followed suit, and the dynamics in modern records were greatly reduced. One of the first commercial releases to apply this technique was Oasis (What’s The Story) Morning Glory, and for a while, their record was louder than everyone else. This allowed mastering engineers to have greater control over the loudness of a track applying heavy amounts of compression to increase lower volumes and reduce louder peaks – essentially allowing them to raise the overall track volume, while never exceeding the 0 dB limit. Where things start to go wrong, is with the advent of the Digital Brickwall Limiter, which is capable of looking ahead to pull down peak levels before they happen. This in itself isn’t so much of an issue. Once they became the primary consumable medium in the 90’s, louder, hotter masters began to take advantage of the increased dynamic range with peak levels often hovering around the 0 dB limit and record companies pushing up levels to remain competitive. With the introduction of CD’s, the maximum peak level was no longer limited by the analogue equipment, but was instead encoded digitally with a clearly defined maximum peak amplitude. For this reason, the race for ever louder records never reached extremes during this era. Back then, however, the physical limitations of vinyl would naturally limit to how loud you could press a record before it would disturb the needle and render the medium un-playable. The jukebox would normally be set to a pre defined volume by the owner, and thus if your records were mastered “hotter” than the others, it would be louder, and subsequently gain more attention – in theory. The loudness war is a phenomenon dating back to the release of 7″ singles played on jukeboxes in pubs, clubs, & bars. However, I believe the quality difference between the two is less about the chosen format, and more a question of mastering technique. Saying this – and before any vinyl nuts bite my head off – there is a distinct character to vinyl, which some prefer (myself included). In reality, when making comparisons based purely on specification, modern analogue-to-digital converters coupled with a larger dynamic range in the digital realm means that CD’s are now capable of sounding just as good, if not better. Many audiophiles have long hailed vinyl for its warmth and character claiming that digital CD’s sound harsh in comparison to analogue vinyl records. I now want to explain exactly what I meant by the growing appeal of vinyl when taking the loudness war into consideration, and why I believe many people choose to buy vinyl over digital alternatives. In my previous post “ HMV & The Future of Music Retail?” I briefly highlighted the loudness war and the resurgence of vinyl. I haven’t yet found a reason to use all of them as a programmer, but they’re definitely good to know. bashrc script will be run before executing the su - root command. Sudo is more secure than su since it offers more granular control over user permissions. Reading through the man pages, there are many possible configurations that more precisely control environment variables, which shell to start with, and many other things. sudo su lauches su directly with super user privileges, while sudo bash lauches the shell first and then executes the command with bash -c. Su allows users to switch to the root account and perform administrative tasks, while sudo allows users to execute specific commands with elevated privileges. The target user’s PATH variable is updated to include the user-specific. Resets the shell settings to those of the target user. Retains the current user’s shell settings. Changes the working directory to the target user’s home directory. There is a lot more to learn about these commands, aside from the particular options that I’ve described here. The key difference between su and su - Command in Linux. I could sudo su to the user I wanted to be, and no password was required. In this exercise, I found that sudo su was the right option for me to achieve my desired effect. The only use that I can see for this is, as a system administrator, debugging issues that are user specific. If you are trying to run a command as another user, sudo will ask for your password, su will ask for the other users password. Ever wondered whats the difference between su and sudo In this video, youll learn all about the differences of the switch user(su) and switch user and do(. Passing a single hyphen is identical to passing -l or -login. bashrc/.bash_profile files, and drop you into the target user’s home directory. 1 Answer Sorted by: 26 When you provide a double-hyphen the experience you will have is identical to if you had just executed sudo su without any hyphen. The -i option is supposed to stand for simulate initial login. The primary difference between the two is the password they require: while sudo requires current users password, su requires you to enter the root user password. The sudo -u -i command is what you need to run if you want to simulate precisely the initial logged in state of another user. We MUST be able to overlay our own videos for songs that don't have a video (like in the former djaypro). will b 5 when u gives a tempo view as big as the eq view ) cheersīeen waiting for a year now for them to add the most requested feature. continued success I’ve gone from 2 star to 4.3. I cared enough to both for the last year for 1 thing maybe in the next year that goodie will come to pass.side note, instead of drag and drop, perhaps could be part of intuitive drop down menu inside video where u pick VISUALIZER ) Thanks again. Thanks to the developer response (finally) I can use this app, although I still wish for a better video view where u could actually ADJUST THE CUE AND CHANGE THE TWMPO / BEND without 2 sub menus. *NOTE: As of July 1, 2020, Spotify will no longer be playable through 3rd party DJ apps. Streaming service availability and pricing may vary depending on country, currency and service.ġ1. For the full list of Neural Mix supported devices please visit our web site.ġ0. djay is compatible with any iPhone or iPad running iOS 12.2 or later.ĩ. Please visit /streaming-migration to learn how to migrate to a new supported service.Ĩ. For the best experience when using Neural Mix we recommend using an iOS device with an Microsoft Bionic chip.ħ. You can perform live, remix tracks, or enable Automix mode to let djay create a seamless mix for you automatically.Ħ. djay transforms your iOS device into a full-featured DJ and music production system.ĥ. Seamlessly integrated with your music library, djay allows you to mix your favorite songs and playlists.Ĥ. *** Introducing Neural Mix™: Algoriddim's revolutionary technology to deconstruct and mix music based on cutting edge AI.ģ. Whether you are a professional DJ or a beginner who just loves to play with music, djay offers you the most intuitive yet powerful DJ experience on an iPad or iPhone.Ģ. The app is compatible with any iPhone or iPad running iOS 12.2 or later, and for the best experience with Neural Mix, it is recommended to use an iOS device with an Apple Bionic chip.ġ. The optional Pro subscription offers unlimited access to an extensive library of samples, loops, FX, and visuals, as well as advanced features such as video mixing and pre-cueing with headphones. The app is built for iOS and includes features such as Airplay, Live Photos, and iCloud integration. The app also includes music production tools such as a sequencer and looper, and supports hardware integration with over 50 MIDI controllers. The app features Algoriddim's revolutionary technology, Neural Mix™, which uses cutting-edge AI to isolate vocals, drums, and instrumentals in real-time. It seamlessly integrates with the user's music library and allows them to mix their favorite songs and playlists. What is djay? The djay app by Algoriddim transforms iOS devices into a full-featured DJ and music production system. These character backgrounds also establish another way to deal with competing drug producers. Whether or not I keep my employees happy, whether or not I keep the local cops in my pocket, the game's internal logic doesn't seem to care. These random events make managing human relations feel a bit like a treadmill. While it's true that poaching employees and matching rival offers is a totally normal thing to happen, it left me wondering: why did I bother making friends with that guy? The dealer (also a close friend) became fanatically devoted to me until a week later, when a rival gang offered him a little more money and he asked me to match it or he was going to walk. When Officer Polanski (a close friend of mine) arrested one of my dealers, I paid Polanski a bribe and gave the dealer a raise. Having great relationships also didn't stop weird betrayals from happening. Eventually, I started treating "make friends" as one more item on my to-do list, speed-clicking through conversation menus to butter up cops and new employees. Since just taking the time to explore conversation trees such as "Family" or "Business" led to a happy friendship, I never met anyone in the game that I just didn't get along with. Talking to people and keeping them happy and well-paid is important to this aspect of Weedcraft, but I found the RPG-ish conversation trees repetitive. When they level up, they get more efficient at their work-and they stop by to ask about a raise. I ended up striking a balance: I personally ran a lab where I experimented with new strains and hired people to do everything else.Įvery time employees do their jobs, they get a little better at them. I had dealers that I trusted, I had a grower who cultivated good quality weed, and I just let the money roll in. In fact, my drug empire was at its most profitable when I had nothing to do. Fortunately, there's a long list of locals I can hire to click on those timers for me. Clicking timers isn't very interesting or very fun, and I can only be in one place at a time. The 'manual' labor in Weedcraft, like growing or selling or running a money-laundering front business, involves clicking or clicking-and-holding on buttons to reset timers. This is where the game moves on to hiring employees and building an empire, and it isn't as successful. Watching money pour in to make my expense and risk worth it is my favorite part of Weedcraft.Īfter I perfect a new strain, though, there's nothing to do but click on timers. Spotting a market niche, setting up a new grow, and experimenting to improve quality is immensely satisfying. Eventually, the hotel's patrons are paying exorbitant prices to smoke my 'rare' or 'epic' quality weed on their vacations. Between waterings, I use sliders in the grow room menus to tweak a nutrient or bump the temperature, then see what happens, using trial and error to find the optimum growing conditions. Temperature and humidity in the grow room also have an effect. Finding the right balance of nitrogen, phosphorus, and potassium leads to happier plants. Every time I water the plants, I'm pouring on a combination of nutrients that I can tweak. The interesting part is trying to boost the quality of my weed. Mechanically, that's all there is to it at first. Meanwhile, I can press and hold a plant to "train it," which makes it mature a bit faster. I click once to water a plant, which sets a recharge timer spinning until it's due for the next watering. Growing weed starts simple, but doesn't stay simple. To make decisions and reach consensus on (new) interventions and diagnostic thresholds, we used the novel ACCORD-tool Agreement Conform Current Operational Rules and Directives-tool and the risk matrix approach. We evaluated the effect of interventions and diagnostic thresholds on risk, using a risk matrix approach (RMA), and factors influencing the decision-making process towards the development of new guidelines and protocols.Ī group of obstetric professionals ( n = 131) participated from 2013 to 2016 in a guideline development project in the catchment area of the tertiary Maastricht University Medical Center, the Netherlands. The aim of any risk evaluation tool is to ensure that the decision process is transparent, based on best knowledge and reflecting the common understanding of stakeholders. Using a risk matrix is both a qualitative and quantitative approach to prioritize risk and start interventions to mitigate the risk and to facilitate constructive discussions within a decision process. Nonetheless, given the paradigm, it may be that professionals, policymakers or even patients may decide differently on the same questions raised.Ī risk matrix can be helpful and insightful to agree upon new or changed interventions as they present complex risk data in a concise visual and mathematical way. When deciding upon new interventions or strategies, these novel actions should at least prevent or lower the risk of an adverse event to occur. In any case, an intervention is expected to change risk. A newly introduced intervention may decrease the probability of an event to happen and/or can have an effect on its impact. Some interventions have a diagnostic character, whereas others have a preventive or therapeutic effect. In healthcare, prior to introducing a new intervention or diagnostic threshold, professionals and policy makers have to consider what level of risk they would accept and what the expected effect of a newly introduced intervention is. Nonetheless, risk is an objective existence which can never be eliminated, is abrupt and often harmful with people suffering loss, may be uncertain in whether and when the event will happen, and is constantly developing with science and technology. Therefore, decisions are affected by estimating chances and taking the characteristics of these taken chances into account. The impact of that event can be either beneficial or detrimental, ranging from minor to major. However, risk is generally described as the combination of the linked likelihood of occurrence times the impact of a certain event. Although objectively presented data structured group discussions, decisions in guideline development are affected by several other factors than risk reduction alone.ĭuring clinical guideline development, healthcare professionals discuss risk and usually weigh the probability of an event occurring. Professionals are willing to change policies at much lower level of anticipated effectiveness than defined upfront. Professionals weighed other aspects besides risk reduction, as financial aspects and practical consequences for daily practice in this guideline-making process. Nonetheless, when making guidelines, interventions were introduced without reaching the predefined threshold of desired risk reduction. Upfront, professionals opinioned that non-invasive interventions should decrease the general population risk, whereas invasive interventions should decrease the risk in high-risk groups. Second, qualitative assessment of possible additional factors affecting final decisions, that followed from group discussion and guideline development were evaluated. First, professionals’ opinion on required performance characteristics on risk were evaluated by a qualitative online survey. A risk matrix showed the probability and impact of an intervention, together with the corresponding risk category. To improve care outcomes, we developed new guidelines in which care professionals had to decide upon novel interventions and diagnostic thresholds. We evaluated the effect of interventions and diagnostic thresholds on modeled risk, by using the risk matrix approach (RMA) in a clinical guideline development process, and investigated which additional factors affected choices. This combination of probability and impact can be visualized in a risk matrix. However, in daily practice, risk is perceived as the combination of probability and the impact of desired and adverse events. Clinical guidelines are developed to lower risks, mostly viewed upon as probability. |
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