Degree Of Urgency Research Articles

Survey of health education in a certain air force troop in the northwest

Objective To understand the current situation and demand of health education in the northwest army pilot, which will lay the foundation to construct a new health management model for the northwest army pilot. Methods A survey was conducted among a northwest pilot troop, in which 223 pilots were included. Self-designed questionnaires were used which was demonstrated by the Delphi method. Results The satisfaction degree of current health education was 39.2%. The health practice and the practice guidance can not meet their actual need, and the urgency degree they thought that the situation should be improved was 54.45% and 37.70%. There was a gape between the knowledge and skills, and the content of health education that they need most was the method to relieve fatigue (40.70%); As for the health education, they had demand of acquiring specialized knowledge, but the source and their self-learning ability were not enough, and they lack of professional guidance. Different content of different aspects of health education needs showed the characteristics of modular. Conclusions It is very necessary to apply modular health management into the northwest army pilot, and combined with different task situations, to divide modules with different emphasis into information module, management module, practice module, update module and series of modules. It is of great significance for guidance of the medical practice. Key words: Pilot; Health education; Status survey; The northwest area

Parental Decision-Making Preferences in Neonatal Intensive Care

To explore how characteristics of medical decisions influence parents' preferences for control over decisions for their seriously ill infants. In qualitative interviews, parents of infants in the neonatal intensive care unit (NICU) were asked to consider all medical decisions they could recall, and were prompted with decisions commonly encountered in the NICU. For each decision, parents were asked detailed questions about who made each decision, whom they would have preferred to make the decision, and why. Using standard qualitative methods, responses were coded and organized such that decision-level characteristics could be analyzed according to preferred decision-making role. Parents identified 2 factors that were associated with a preference to delegate decisions to the medical team (high degree of urgency, high level of required medical expertise) and 4 factors associated with a preference to retain parental control (high perceived risk, high personal experience with the decision, involvement of foreign bodily fluids, and similarity to decisions that they perceived as part of the normal parental role). Characteristics of decisions influence preferences for control over medical decisions among parents of patients in the NICU. These insights may guide improvements in physician-parent communication and consent.

La paupière malformative chez l’enfant

Palpebral malformations can be isolated or associated with a craniofacial disorder. Their assessment is based on clinical examination; additional investigations are mainly done to characterize craniofacial syndromes. In case of extrapalpebral lesions or complex craniofacial pathology, genetic testing must be performed. Some isolated malformations will only need a simple follow-up; others must have specific treatment, undertaken following a precise timing, taking into account child and anatomical structures' growth and the possible consequences of the malformation on the eye and child's sight (degree of urgency). When dealing with these malformations, there are two main risks to be taken into consideration: corneal irritation due to lagophtalmos and amblyopia owing to visual axis obstruction, anisometropia or strabismus.

The impact of telephone crisis services on suicidal users: a systematic review of the past 45 years

Purpose– Telephone crisis services are increasingly subject to a requirement to “prove their worth” as a suicide prevention strategy. The purpose of this paper is to: first, provide a detailed overview of the evidence on the impact of telephone crisis services on suicidal users; second, determine the limitations of the outcome measures used in this evidence; and third, suggest directions for future research.Design/methodology/approach– MEDLINE via Pubmed (from 1966), PsycINFO APA (from 1967) and ProQuest Dissertation and Theses (all to 4 June 2015) were searched. Papers were systematically extracted by title then abstract according to predefined inclusion and exclusion criteria.Findings– In total, 18 articles met inclusion criteria representing a range of outcome measures: changes during calls, reutilization of service, compliance with advice, caller satisfaction and counsellor satisfaction. The majority of studies showed beneficial impact on an immediate and intermediate degree of suicidal urgency, depressive mental states as well as positive feedback from users and counsellors.Research limitations/implications– A major limitation pertains to differences in the use of the term “suicidal”. Other limitations include the lack of long-term follow-up and of controlled research designs. Future research should include a focus on long-term follow-up designs, involving strict data protection. Furthermore, more qualitative research is needed in order to capture the essential nature of the intervention.Originality/value– This paper attempts to broaden the study and the concept of “effectiveness” as hitherto used in the literature about telephone crisis services and offers suggestions for future research.

Assessment of Knowledge about Priorities of Nurses’ Responsibilities at Emergency Departments in Baghdad Teaching Hospitals

Priorities of responsibility are essential function in emergency department. Effective priorities of responsibilities system aim to ensure that patients who seek emergency care receive an appropriate attention, in a suitable location, with the requisite degree of urgency. Such an emergency care is an initial in response to clinical need rather than order of arrival. This study therefore aimsto assess the knowledge and skills of priorities of responsibilities among nurses who work in the Emergency Departments in Baghdad Teaching Hospitals. Objective:The study objective is to assess knowledge about priorities of nurses' responsibilities at Emergency Departments and to determine the association between knowledge about prioritization of nurses' responsibilities and demographic characteristics of age, level of education and gender. Methodology:A descriptive study was conducted in the Baghdad Teaching Hospitals. Starting from December 20 th , 2015 up to the August 30th, 2016. A purposive non-probability sample of (80) nurses, who have been working in emergency departments, were selected from Baghdad Teaching Hospitals which include Al-Yarmook Teaching Hospital, Baghdad Teaching Hospital, Al-Kindy Teaching Hospital, Al-Karama Teaching Hospital, and Al-Kadhmiyia Teaching Hospital. Descriptive statistical measures were used to analyze the data.The data were collected through the use of constructed questionnaire, which consists of two parts; (1) Demographic data which consists of (6) items, and (2) Nurses' knowledge which consists of (28) items. Thereliability was determined through a pilot study.The validity was determined through a panel of (14) experts. Descriptive statistical measures (frequency, percentage, mean of score), and inferential statistical measures (Chi-square and Relative Sufficiency) were used for the data analysis. Results: The study results indicate thatmore than a third of the study participants are of the 23-27 years-old age group (35%), more than a half of them are males (57.5%),more than a third of them are Secondary Nursing School graduates (35%),less than two fifth of them had (1-5) years of experience in hospital (37.5%),most of them had 1-5 years of experience in emergency department (72.5%), and more than two fifth of them had one training session(42.5%). Conclusions:The majority of the nurses had poor knowledge concerning priorities of responsibilities and there was non-significant association between the nurses' knowledge and their gender and age, but there is a significant association between nurses' knowledge and their educational level. Recommendations:The researchersrecommend that the referral hospitals should develop procedure manuals that provide detailed information about all priorities of responsibilities. The procedure manual should be subjected to an annual audit, and active steps should be initiated to remedy identified deficiencies.

Anaesthesia for nephrectomy

### Key points This paper will summarize the perioperative anaesthetic considerations for patients undergoing nephrectomy for both non-neoplastic and neoplastic disease of the kidney. It does not include the management of patients undergoing living donor nephrectomy. Nephrectomy for patients with renal cell carcinoma (RCC) was first described in 1969.1 Surgical treatment varies with the pathology. Simple nephrectomy is the preferred option for those with non-neoplastic disease (e.g. trauma, non-functioning kidney with chronic infection) with radical nephrectomy being preferred in those with neoplastic disease. Radical nephrectomy implies resection of the whole of Gerota's fascia, including the perinephric fat, lymphatics, and the ipsilateral adrenal gland. The vast majority (∼90%) of solid renal masses are RCC; the remainder comprising mainly of transitional cell carcinoma or Wilm's tumour (in children). RCC accounts for between 1% and 3% of all visceral malignancies. It is twice as common in men when compared with women and most commonly presents in the seventh decade of life. The main environmental risk factor is cigarette smoking, contributing to one-third of all cases. Other important risk factors include obesity, hypertension, asbestos exposure, and acquired polycystic kidney disease. If symptomatic, presentation is usually with haematuria, loin pain, and a palpable mass. Non-specific symptoms such as malaise, …

A contemporary risk model for predicting 30-day mortality following percutaneous coronary intervention in England and Wales

BackgroundThe current risk model for percutaneous coronary intervention (PCI) in the UK is based on outcomes of patients treated in a different era of interventional cardiology. This study aimed to create a new model, based on a contemporary cohort of PCI treated patients, which would: predict 30day mortality; provide good discrimination; and be well calibrated across a broad risk-spectrum. Methods and resultsThe model was derived from a training dataset of 336,433 PCI cases carried out between 2007 and 2011 in England and Wales, with 30day mortality provided by record linkage. Candidate variables were selected on the basis of clinical consensus and data quality. Procedures in 2012 were used to perform temporal validation of the model. The strongest predictors of 30-day mortality were: cardiogenic shock; dialysis; and the indication for PCI and the degree of urgency with which it was performed. The model had an area under the receiver operator characteristic curve of 0.85 on the training data and 0.86 on validation. Calibration plots indicated a good model fit on development which was maintained on validation. ConclusionWe have created a contemporary model for PCI that encompasses a range of clinical risk, from stable elective PCI to emergency primary PCI and cardiogenic shock. The model is easy to apply and based on data reported in national registries. It has a high degree of discrimination and is well calibrated across the risk spectrum. The examination of key outcomes in PCI audit can be improved with this risk-adjusted model.

Consultation–liaison psychiatric services in Dubai, UAE: a descriptive analysis study

Introduction Liaison psychiatry refers to the interface between psychiatry and general hospital patients. It involves psychiatrist’s intervention in the care of medically ill patients who present with psychiatric symptoms while in a general hospital setting. It may also involve the assessment of patients who have pre-existing psychiatric illness or those who develop psychiatric symptoms because of their medical or surgical illness. It is estimated that nearly 26.5–60% of the general medical inpatients suffer psychiatric comorbidity. Aim of the study The aim of this study was to evaluate the pattern and the characteristics of liaison referral to the psychiatric department from other general medical and surgical departments at Al Rashid Hospital, Dubai, and its association with clinical and diagnostic factors, and to study the quality and appropriateness of information presented in the referral letters to the psychiatric department. Patients and methods The patients included in the study were recruited from individuals who had been consecutively assessed and treated by the liaison psychiatric team at Rashid Hospital, Dubai, UAE, during the period of 6 months from 1 November 2012 to 30 April 2013. A specially designed data sheet was developed and a pilot analysis on 20 patients was undertaken using the designed data sheet to assess the applicability of data collection and tool arrangement of items, and to estimate the time needed and the feasibility of the study. The data sheet included demographic data, data of patterns of descriptive psychopathology, either physical or mental, before presentation, a mental state examination and cognitive assessment through the Mini Mental State Scale. We identified the following parameters to evaluate the referred letters from GP and other medical or surgical specialists or consultants: the degree of urgency − reason of referral, symptom-relevant life events or stresses, family history of psychiatric disorder, medical history, psychiatric history, treatment given, physical examination and any investigations that have been performed, mental state examination and psychiatric diagnosis. Results The number of referrals over the indicated period was 60 patients (6 months). Suicidal behaviour was the highest among the reasons for referral. The main comorbid physical disorders included 13 (21.7%) endocrine disorders, 11 (18.3%) gastrointestinal tract disorders, 10 (16.7%) central nervous system disorders, seven (11.7%) musculoskeletal system disorders, six (10%) respiratory system disorders, five (8.3%) coronary artery diseases, five (8.3%) urogenital disorders and three (5%) sensory deprivation. The medical history was not mentioned in 46 (76.7%) of the referral letters The action taken by the psychiatrist after assessments were admission to the psychiatric ward for 21 patients (35%), outpatient appointments for 24 (40%) and discharge from psychiatric service for 15 patients (25%). Psychiatrists agreed with the GP diagnosis in 15 cases (25%), but considered the diagnosis inaccurate in 27 (45%) of these cases. Replies of the psychiatrists to the GP referrals were made only in 18 patients (30%); no reply was written in 42 (70%) cases. Conclusion Future research is needed to understand how liaison service can be utilized and sustained most effectively as part of general hospital care. A comprehensive consultation–liaison unit that comprises a sufficient number of multidisciplinary mental health professionals (psychiatrist, psychologist, social worker) is vital in general hospital settings to address the unmet needs.

COALAA-GEN: A General Adaptive Approach for Ambient Assistive Applications

This paper presents the design and the implementation of general and adaptive framework for ambient assisted living applications. The challenge is to deal with a dynamic environment in order to provide an adequate service to an elderly or a sick person at home in a cooperative way. It is necessary to take into account constraints such as, the degree of urgency of the service and the intrusion degree of the system. The evolution of the degree of intrusion based on the degree of urgency and the availability of the different communication devices of the ambient environment are particularly targeted.Through an adaptive approach based on coalitions of agents, the multi-agents system ensures answers to various and/or unforeseen situations. The originality is to employ a declarative method for modeling the coalitions formation process by means of a rule-based system.

Consolidation sequence of rural residential land，based on consolidation potential and urgency degree

Consolidation sequence of rural residential land，based on consolidation potential and urgency degree

ANESTHESIA FOR CESAREAN SECTION AND POSTOPERATIVE ANALGESIA FOR THE PARTURIENT

Considering the physiological changes during pregnancy and the fact that there are two lives, obstetric anesthesia is an extremely specific and challenging area of work. The physiological changes that occur during pregnancy are among the contributing factors for complications during general and regional anesthesia. Therefore, the preoperative consideration is very important in the prevention of complications. Neuraxial anesthesia is increasingly replacing a widely applied general anesthesia, and has become the technique of choice for the majority of caesarean sections. General anesthesia is accompanied by risks related to the airway, but is still indicated for caesarean sections of the first degree of urgency. The choice of anesthesia depends on the urgency of surgery, general condition of the mother and fetus, comorbidity of pregnant woman and her consent to the proposed anesthetic procedure. The ultimate goal of all procedures is to provide safe anesthesia for mother and fetus. Multimodal analgesia is the best form of the pain treatment after cesarean section. Acta Medica Medianae 2015;54(4):72-78.

PACIENTE ADULTO MAYOR Y CIRUGÍA NO CARDÍACA: ¿QUÉ DEBEMOS SABER?

elderly patient and non cardiac surgery: What should we know? The surgical procedures in elderly patients are and will be more common. They are characterized by greater morbidity and mortality than those in younger patients, so it is essential an appropriate preoperative evaluation, a diligent intraoperative monitoring and a proper management of the postoperative period. The old age has a number of physiological changes and an increased incidence of chronic diseases and together determine a decline in physiological reserve and functional capacity. In the preoperative evaluation is important a systematic assessment of comorbidities and drugs routinely prescribed, “fragility” of these patients due to the surgical procedure and the risk of developing postoperative cognitive deficit. Type of surgery, degree of urgency and patient conditions are the main factors to consider at time to choose type of anesthesia. Common complications include the development of postoperative delirium and postoperative cognitive decline, where efforts should be directed at prevention rather than treatment, because it significantly increases perioperative morbidity.

Head, Neck and Dental Emergencies

This attractively presented little book is a further addition to the Oxford Handbook series. It is in the pocket reference format with a plastic flexicover to which we have become accustomed since the first Oxford Handbook of Clinical Medicine was first published 20 years ago and has matching ribbon page markers in yellow and red. It aims to provide the reader with a working approach to diagnosis and management of patients presenting in the accident and emergency department, concentrating as would be expected from the title on urgent and emergency problems above the collar bones. However, of necessity, the first three chapters covering general assessment, first aid measures and infections take a rather more whole body approach, as do the concluding glossary and last two sections on burns and miscellaneous conditions. The bulk of the book runs sequentially through trauma and other emergency conditions involving the head, neck, face, ears, eyes, mouth and salivary glands. The editor points out that many of the subjects covered are not true emergencies that may immediately threaten life, sight or limb but that, nevertheless, the text endeavours to cover the majority of conditions in the anatomical region for which patients regularly attend the casualty department. On average, one topic within each overall heading is covered over three pages with a system of four icons used throughout, to allow rapid identification of the degree of urgency. The explanatory key to the icons appears helpfully on both the inside front cover and again within the preface. Emergency care by its very nature should be as simple and as quick as possible. To this end, the layout comprising short notes, diagrams and photographs together with a remarkably comprehensive index provides the reader with an easily assimilated set of information, which should prove extremely valuable in an emergency situation. There is an emphasis on maintaining a high index of suspicion and on frequent re-assessment to ensure that pathology and potential complications are not missed. A minor disappointment was the quality of some of the photographs, the majority of which are in monochrome, that contrasts with those in colour printed on higher quality paper in the chapter devoted to the eye. The editor, who has extensive experience as a trauma team leader and who is now based in Belfast, has drawn together 14 contributors from a range of surgical specialties, together with ophthalmology and dentistry. The book is recommended mainly for junior doctors and also nurses in accident and emergency, oral and maxillofacial surgery, ENT, ophthalmology, anaesthetics and plastic surgery, as well as for undergraduates. However, it is likely to have wider appeal even to more senior colleagues, who may not regularly deal with emergencies around the head and neck but who occasionally may be called upon to do so.

Seeing red in young children: the importance of the red reflex.

The single most important piece of clinical information that a paediatric ophthalmologist requires is the presence or absence of a red reflex. An absent red reflex usually suggests sight-threatening pathology (cataract) and may mean life-threatening pathology (retinoblastoma). Referrals from general practice are semi-urgent and need assessment within the week. In children <2 years of age, referrals that do not mention the red reflex state make it difficult to assess the degree of urgency. Inevitably, this means that some children may have a worse outcome as a result of delayed diagnosis. The opposite situation arises where a 6-week-old baby with ‘pale’ or ‘absent’ red reflexes (usually because of ethnic variation) is referred and seen within a week, only for the parents to be told that their child has ‘normal’ red reflexes. It is hardly surprising that parents express sentiments including bewilderment, anger, and great relief. To a paediatric ophthalmologist, the importance of a red reflex in a child aged <2 years is similar to the importance of temperature measurement …

Survey of French spine surgeons reveals significant variability in spine trauma practices in 2013

BackgroundIn France, attempts to define common ground during spine surgery meetings have revealed significant variability in clinical practices across different schools of surgery and the two specialities involved in spine surgery, namely, neurosurgery and orthopaedic surgery. ObjectivesTo objectively characterise this variability by performing a survey based on a fictitious spine trauma case. Our working hypothesis was that significant variability existed in trauma practices and that this variability was related to a lack of strong scientific evidence in spine trauma care. MethodsWe performed a cross-sectional survey based on a clinical vignette describing a 31-year-old male with an L1 burst fracture and neurologic symptoms (numbness). Surgeons received the vignette and a 14-item questionnaire on the management of this patient. For each question, surgeons had to choose among five possible answers. Differences in answers across surgeons were assessed using the Index of Qualitative Variability (IQV), in which 0 indicates no variability and 1 maximal variability. Surgeons also received a questionnaire about their demographics and surgical experience. ResultsOf 405 invited spine surgeons, 200 responded to the survey. Five questions had an IQV greater than 0.9, seven an IQV between 0.5 and 0.9, and two an IQV lower than 0.5. Variability was greatest about the need for MRI (IQV=0.93), degree of urgency (IQV=0.93), need for fusion (IQV=0.92), need for post-operative bracing (IQV=0.91), and routine removal of instrumentation (IQV=0.94). Variability was lowest for questions about the need for surgery (IQV=0.42) and use of the posterior approach (IQV=0.36). Answers were influenced by surgeon specialty, age, experience level, and type of centre. ConclusionClinical practice regarding spine trauma varies widely in France. Little published evidence is available on which to base recommendations that would diminish this variability.

Mari Helena Salminen-Tuomaala, Päivi Leikkola, Riitta Mikkola, Eija Paavilainen

Background: Counselling family members of acutely ill patients has not been studied from the perspective of out-of-hospital emergency care. The purpose of this study was to fill the research gap by describing care providers’ experiences of factors that influence counselling and supporting family members in out-of-hospital emergency care. Methods: The data were collected by semi-structured interviews of emergency care providers (N=15) in Finland in 2014 and analysed using content analysis. Results: Factors that influence the counselling aimed at family members in out-of-hospital emergency care can depend on the patient, family member, emergency care provider or context. Patient-dependent factors involve the patient’s personality, severity of physical and psychological symptoms, criticality of the situation, the patient’s memory, responses, behaviour and cognitive abilities and emotional resources. Family member-dependent factors include the family members’ needs and responses, fears, anxiety, feelings of not having control, needs for support, cognitive and emotional preparedness to commit themselves to help and support the patient and willingness to engage in supporting the patient. Care provider-dependent factors include the care provider’s personality, clinical expertise, theoretical and practical competence, work and life experience and attitudes. Context-dependent factors include time, degree of urgency, safety of the environment and the circumstances. Conclusions: Care providers must gain an overall idea of the family’s function and their ability to endure stress in acute situations, so that counselling can be founded on the family’s strengths and limitations regarding the patient’s follow-up care and coping at home. Ability to differentiate between various factors in counselling situations helps care providers concentrate on factors that they can affect. The results can be used in the education of health carestudents and professionals and in developing the quality of counselling.

The Psychology of Homicide, Divorce and Issues in Marriages: Mental Health and Family Life Matters

Introduction: The homicide pandemic has continued unabated and no empirical enquiry has emerged in criminology, sociology, psychology or public health in Caribbean literature which evaluates whether or not divorce has any effect on homicide. Objectives: The aims of this study are to 1) evaluate factors that explain the interplay between homicide and divorce and marriages in Jamaica; and 2) provide theories for the uxoricides. Materials and methods: The data for this study was obtained from various Jamaica Government Publications. The period for this work was from 1950 through 2013. Ordinary least square (OLS) regression analyses and curve estimations were used to determine models and best fitted models. Results: The factors of divorce were homicide, population and GDP per capita, with those variables explaining 77.5% of the variance in divorce. A strong correlation between homicides and divorce still emerged after controlling for GDP per capita (or income; rxy = 0.843, P<0.0001). Poverty rate and the exchange rate accounted for 83.8% of the variance in homicides. Of the seven selected variables used at once in the OLS, three emerged as factors for divorce rate (exchange rate, mortality rate and poverty rate). Both factors determined 61.4% of the variance in the divorce rate. Poverty accounted for 47.0% of the variability in the marriage rate and was inversely related to the marriage rate. Hence, lower rates of poverty mean greater number of marriages and vice versa. Conclusion: Divorce produces issues, which are sometimes not fully captured in the data. Further studies on the psychology of divorce are needed from a qualitative perspective to unearth real meaning behind the behaviour of depressed adults and psychological deficient children following romantic relationship separation. We are therefore proposing that poverty and divorce as well as separation from sexual partner should be treated with the same degree of urgency and significance as non-communicable diseases. The destruction of families from divorce is such that we are forwarding it to be a psychosocial disease likened to an infectious disease that can cause a pandemic if not probably cauterized.

The Science of Bee Collapse and an Emerging Knowledge for Sustainability

The following text addresses the threats aecting the honey-bee, and which are manifesting through the unusual death rates of bee colonies. Focus is placed in reviewing the scientic knowledge that concerns the honey-bee by discussing its cognitive and ethical categories and its in uence in nature conservation, mainly centred in the EU. Results indicate that scientic knowledge plays a fundamental role in dening what the problems are, as well as their degree of urgency and holds the greatest legitimacy in informing policy-making. Further results reveal that research is dominated by STEM elds of science, and is largely conveying a dichotomized and utilitarian viewpoint of human-nature relationships. The concluding section argues for a transition towards transdisciplinarity and social learning. It emphasises a science that is able to integrate a social-ecological understanding of the value of bees as the world's common good, together with a praxis that effectively promotes sustainable change.

Increasing Evacuation Communication Through ICTs: An Agent-based Model Demonstrating Evacuation Practices and the Resulting Traffic Congestion in the Rush to the Road

AbstractUnderstanding evacuation practices and outcomes helps crisis and disaster personnel plan, manage, and rebuild during disasters. Yet the recent expansion in the number of information and communication technologies (ICTs) available to individuals and organizations has changed the speed and reach of evacuation-related messages. This study explores ICTs’ influences on evacuation decision-making and traffic congestion. Drawing from both social science and transportation science, we develop a model representative of individual decision making outcomes based on the amount of ICT use, evacuation sources, and the degree of evacuation urgency. We compare the evacuation responses when individuals receive both advance notice of evacuation (ANE) and urgent evacuation (UE) messages under conditions of no ICTs and prolific ICT use. Our findings from the scenarios when there is widespread ICT use reveal a shift in the evacuation time-scale, resulting in traffic congestion early in the evacuation cycle. The effects of this congestion in urgent situations are significantly worse than traffic congestion in the advance notice condition. Even under conditions where face-to-face communication is the only option, evacuations still occur, but at a slower rate, and there are virtually no traffic congestion issues. Our discussion elaborates on the theoretical contributions and focuses on how ICTs have changed evacuation behavior. Future research is needed to explore how to compensate for the

Revision of Project Evaluation as Part of the German Federal Transport Infrastructure Plan

This paper shows the current situation in the revision of the present evaluation method for the Federal Transport Infrastructure Plan (FTIP) in 2015. New to the evaluation process is a superior prioritizing strategy, which the degree of urgency for adaptions on the transport infrastructure has to be orientated on. This prioritizing strategy also enables a consistent merge of the single assessment modules. A focus is set on the further development of the cost-benefit analysis (CBA) as the core assessment tool of the FTIP evaluation process. Within the CBA-module the authors especially react to the topics ‘plausibility check on investment costs’, ‘measuring and assessing of infrastructure caused changes in reliability’, as well as to a big survey on values of travel time savings (VTTS).