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Deciphering Corneal Staining Scales
A look at the impact of grading scales and study designs on corneal staining results in clinical studies.
Dr.Lasswell is Director, Clinical Research, Eye Care and Refractive Surgery, at Advanced Medical Optics, Inc. He has over 30 years of ophthalmic industry experience, has given more than 50 professional presentations and published several papers related to contact lenses and refractive surgery.
Mr.Huth is a Research Investigator for Eye Care R&D at AMO. He holds 14 US patents and has 13 patent applications pending.
Ms. Tran works in Eye Care R&D for AMO. She graduated from UC Irvine with a degree in Chemistry in 2005.
By Lynn Lasswell, OD, FAAO, Stan Huth, MA, & Denise Tran, BS
Corneal staining is a valuable clinical tool for assessing corneal epithelial integrity at the slit lamp. Recent reports of clinically significant corneal staining with silicone hydrogel lenses have highlighted the importance of understanding the interaction of lenses, lens care solutions and the corneal surface.
Understanding these relationships and integrating the study findings into the current body of knowledge requires comparable data from multiple studies. This is difficult to achieve when investigators use different patient populations, different scales to generate staining scores and different benchmarks for staining intensity and clinical severity.
Here we'll present a summary of the major corneal staining grading scales, discuss a study that uses its own internal grading scale to evaluate a variety of multipurpose solution and lens combinations, provide previously unpublished data from six studies using two different corneal staining scales for one lens solution and several lenses, and report on other contributors to corneal staining.
Sliding Scales
We have no universal standard for grading the extent or severity of corneal staining. The major grading scales are not in congruence with one another. The scales currently employed are subject to differences in grading precision between different observers (inter-reader reliability) and between one test and another for the same observer (intra-reader reliability). In an interesting study that examined how investigators assess corneal staining, Begley et al (1996) reported that there was significant inter-reader variability in how the investigators within a multicenter study arrived at the final corneal staining score, even though all three sites were provided with the same guide for assessing corneal staining. The authors demonstrated that, depending upon the process used, two investigators could report significantly different scores for the same level of corneal staining.
In one study presented here, a multipurpose solution marketed under different names but used with the same silicone hydrogel lens and evaluated using the same scale, produced variations in staining results.
Practitioners should pay careful attention to the grading scales, study designs, populations studied and the consistency of results from several studies before relying on the conclusions presented in any given report.
Traditional Corneal Staining Grading Scales
Corneal staining grading scales were developed to help clinicians monitor changes of the cornea and choose a course of action. Clinicians observe the corneal surface under the slit lamp, compare it to written descriptions, photographic, artist-rendered or computer-generated images of different severities of corneal staining and assign a grade based on one or more elements of the staining and the number of zones of staining on the cornea. The grading systems help clinicians assess which corneal staining patterns are within the range of normal and which are pathological and in need of therapeutic intervention.
Each of the major grading systems employs a method of dividing the cornea into zones and for evaluating one or more staining variables in each zone.
In the five-zone model, Zone 1 is a circle in the center of the cornea and the four equal segments of the ring surrounding this central zone are Zones 2 through 5 (superior, temporal, nasal and inferior zones). The observer makes an estimate of the zonal area involvement and calculates the staining score based on the number and/or type of staining variables.
Efron The Efron system is based on the work of Nathan Efron, DSc, MCOptom, FAAO, FCLSA, FBCLA, FIACLE (currently based at the University of Queensland, Australia) when he was at the European Centre for Contact Lens Research, Department of Optometry and Neuroscience, University of Manchester in the United Kingdom.
The Efron system uses one variable, the degree of staining per zone based on an ordinal scale of 0 to 4: 0=no staining, 1=trace staining, 2=mild staining, 3= moderate staining, 4=severe staining. The Efron system has been validated for clinical use with an expected accuracy of ±1.2 grading scale units, a rather large range of error for a four-point scale.
CCLRU The scale developed by the Cornea and Contact Lens Research Unit (CCLRU), School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia, calls for three variables per zone: type, depth and extent of surface area staining.
Figure 1 shows the CCLRU punctate staining types. Type 0 means there is no staining. Type 1 is micropunctate; Type 2, macropunctate; Type 3, coalescent macropunctate staining; and Type 4 is a coalescent patch of 1mm or greater in size.
The other two variables in the CCLRU system are depth and extent of staining. If there is no staining, the depth is graded as 0. Superficial epithelial involvement is Grade 1. The presence of a stromal glow within 30 seconds is Grade 2. An immediate localized stromal glow is Grade 3, and immediate diffuse stromal glow is Grade 4.
If there is no staining, the extent is graded as 0. From 1 to 15 percent of surface involvement is Grade 1, 16 to 30 percent surface involvement is Grade 2, 31 to 45 percent surface involvement is Grade 3 and 46 percent or greater surface involvement is Grade 4.
The CCLRU scale uses the zone of greatest staining to determine clinical significance. Under their criteria, corneal staining is clinically significant when it is persistent, its type is greater than Type 2 (macropunctate) and/or its depth is greater than Grade 1 (superficial epithelial involvement) and/or its extent is greater than Grade 1 (1 to 15 percent surface involvement) in a given zone. Micropunctate staining is considered not clinically significant by the CCLRU unless it involves more than 15 percent of the corneal surface.
Figure 1. Types of punctate fluorescein staining in CCLRU standards superimposed on a photo from the CCLR group. Image copyright is owned by the Centre for Contact Lens Research, School of Optometry, University of Waterloo, Ontario, Canada. Used with permission.
CCLR/Global Staining Score Lyndon Jones, PhD, FCOptom, FAAO, at the Centre for Contact Lens Research (CCLR), School of Optometry, University of Waterloo, Ontario, Canada, expanded on the CCLRU system to make it more sensitive by changing the ordinal scale of 0 to 4 to an integer scale of 0 to 100. Under this system, the type of staining in each zone is graded on a 0 (none) to 100 (total) scale. The mean outcome measure, the Global Staining Score, is the product of the type of staining in each of five zones (one central and four peripheral) times the percentage area of the zone with the staining. Under this system, the scale ranges from 0 (none per zone) to 50,000 (total staining in all 5 zones). Recently, the scoring was modified slightly in an attempt to normalize the scores to represent a typical score for a given sector. The Global Staining Score is now divided by 5, for a maximum average sector staining score of 10,000. For example, one corneal sector with micropunctate staining (score 25) over 10 percent of its surface would have a total score of 250 (25 × 10). If all have sectors had the same score, the total score would be 1,250 (250 × 5), but this would be normalized to 250. An average sector score of less than about 1,200 (or total Global Staining Score of 6,000) is considered clinically insignificant. Figure 2 shows the representative staining score for each of the CCLR types of punctate fluorescein staining.
Differences among the leading grading systems appear in Table 1.
Difficulty in Comparing Staining Scales in Studies
The difficulty in drawing conclusions from various studies arises when these studies utilize different staining scales and methodologies. This is illustrated in a study presented as a poster at the Association for Research in Vision and Ophthalmology (ARVO) meeting in May 2006 and at the American Optometric Association (AOA) meeting in June 2006 (Andrasko et al). Researchers used a modified CCLRU scale, the pairs of lenses and solutions have different numbers of subjects, and the same solution marketed under different brand names produced different staining scores.
This is a double-masked, randomized, crossover study at a single site with a planned enrollment of 200 patients in a series of one-week studies with different combinations of contact lenses and multipurpose solutions. Researchers evaluated fluorescein staining as well as lens and solution comfort at baseline (after 15 minutes of lens wear) and at two and four hours of lens wear. The investigators use their own corneal staining scoring system that differs from the aforementioned quantitative scales and also is not comparable to the CCLRU qualitative scales. The staining score is based on area of staining in each of the five corneal regions. The investigators assessed the percentage of each stained corneal region and averaged the percent area scores for the five regions to give a composite staining value. The average staining levels for the worse eye of each subject are reported. This is a measure of area stained, not a qualitative measure of type or depth of the staining.
The researchers planned the pilot study for nine to 14 patients in a two-period crossover study and the other studies for 30 patients each, one a two-period and the other a five-period crossover study.
The number of subjects and staining scores for several of the pairings were changed without notice or explanation between two recent updates of this study's online staining grid. The sample size for the PureVision (Bausch & Lomb) lens/Opti-Free Express solution (Alcon) combination was 36 in the Oct. 17 update, or six more subjects than most of the other study combinations, and was inexplicably reduced to 30 at the Nov. 9 update. The staining score of 6 percent with 36 subjects was lowered to 4 percent with 30 subjects.
Also in this study, the same care solution formulation marketed under three different brand names returned different outcomes. Wal-Mart's Equate brand and the Target brand of lens care solutions are the same formulation as ReNu MultiPlus multi-purpose solution (B&L). The formulation was associated with 24 percent (N=29, ReNu MultiPlus MPS), 28 percent (N=30, Target MPS) and 41 percent (N=30, Equate MPS) corneal staining with O2Optix lenses (CIBA Vision). When paired with Night & Day (CIBA Vision) lenses, corneal staining was 24 percent (N=30, ReNu MultiPlus MPS), 24 percent (N=30, Target MPS) and 36 percent (N=30, Equate MPS). Different patient populations or, as other studies have noted, discrepancies in inter- and intra-reader repeatability, can produce different results.
Figure 2. Global staining scores are shown for each type of punctate fluorescein staining (CCLR standards). Image copyright is owned by the Centre for Contact Lens Research, School of Optometry, University of Waterloo, Ontario, Canada. Used with permission.
Standard Staining Scales, Different Solutions
The above study reported poor results for Complete MoisturePlus Multi-Purpose Solution (Advanced Medical Optics, Inc.). We report six previously unpublished studies with Complete MoisturePlus solution and silicone hydrogel lenses (Table 2). All were based on recognized staining scales. Studies 1, 2 and 3 were based on the CCLR/Global Staining Score scale and Studies 4, 5 and 6 on the Efron scale. The Efron scores showed no significant staining for O2Optix, Acuvue Advance (Vistakon), Night & Day and Acuvue Oasys (Vistakon) contact lenses. Similarly, the more sensitive Global Staining Scores showed no significant corneal staining with O2Optix, Acuvue Advance and Night & Day contact lenses.
Supporting these AMO studies is a study from Bausch & Lomb. B&L found insignificant levels of corneal staining in a three-month, 25-site prospective study of corneal staining with silicone hydrogel lenses paired with ReNu MultiPlus (N=151), Opti-Free Express (N=150) or Complete MoisturePlus (N =156) multipurpose solutions. The researchers conducted slit lamp evaluations at two weeks, one month, two months and three months and at any unscheduled visit. Opti-Free Express solution had 92.7 percent with no corneal staining, 6.3 percent with Grade 1 (trace), 0.8 percent with Grade 2 (mild), 0.2 percent with Grade 3 (moderate) and 0 percent with Grade 4 (severe) staining. ReNu MultiPlus solution had 90.5 percent with no corneal staining, 8.8 percent Grade 1, 0.5 percent Grade 2 and 0.1 percent Grade 3. Complete MoisturePlus had 91.6 percent with no corneal staining, 8.2 percent Grade 1, 0.2 percent Grade 2 and 0 percent Grade 3.
An earlier study by Amos and colleagues (2004) showed solution-related differences in corneal staining in 25 contact lens wearers switched to Night & Day silicone hydrogel lenses who used ReNu MultiPlus solution for the lens in one eye and Focus Aqua (Aquify in the United States, [CIBA Vision]) solution for the other. Mean corneal staining was 0.8 at baseline for ReNu MultiPlus eyes and 0.7 in the Focus Aqua eyes (P=NS) on a scale of 0 to 4. Corneal staining was clinically and statistically significantly higher with ReNu MultiPlus than with Focus Aqua at both the two week (1.5 vs 0.8) and one month (1.2 vs 0.5) visits (P=0.0001 for both). The disinfecting agent and preservative for both these solutions is polyhexamethyl biguanide (PHMB). PHMB is present in similar amounts in the two solutions, suggesting that other constituents in the formulation play a role in the development of corneal staining.
Etiologies of Corneal Staining
Corneal staining is linked to many factors, not all of which are contact lens-related, and some of which may represent normal levels of staining in healthy eyes. Schwallie et al (2001) identified corneal staining in healthy eyes of non-contact lens wearers as 0.5 on a 0 to 4 scale with 0.5-step differences. Dundas et al (2001) studied 102 subjects who were non-contact lens wearers or who had no recent contact lens wear. They found some degree of fluorescein staining on 79 percent of subjects' corneas based on the CCLRU grading scale. Half of the subjects showed staining in the inferior or superior zones and 5 percent had staining in the central zone.
Corneal staining also occurs in successful hydrogel lens wearers and may result from issues other than the care system, including the experimental conditions of the study. Begley and colleagues in Columbus, Ohio (1996) conducted a multicenter study with 98 full-time contact lens wearers using different lens care systems and soft contact lenses. Grading was on the 0 to 4 scale with half-step differences for each of five corneal zones. The average staining grade was 0.50 in both eyes, but the between-eye values were significantly different, 0.57 for the right and 0.44 for the left eye (P=0.001).
Nichols and colleagues (2002) examined 500 fulltime successful hydrogel contact lens wearers and found corneal staining in at least one eye in 55.7 percent of wearers. Eight percent had moderate to severe staining. The authors concluded that moderate to severe staining was associated with noncompliance with the care systems, a conventional rather than a planned or disposable lens replacement schedule, and lenses with powers greater than −3.00D.
Topically Applied Solutions
Fluorescein appears to increase corneal permeability with repeated use, as does the topical anesthetic proparacaine hydrochloride. Josephson and Caffery (1988) looked at five quadrants of the cornea for the presence or absence of corneal staining after sequential instillations of 9mg fluorescein and following administration of proparacaine hydrochloride 0.5% with benzalkonium chloride (BAK) in 148 eyes of 74 healthy subjects who did not wear contact lenses. A single exposure to 9mg of fluorescein resulted in 26 eyes (17.6 percent) with staining and 122 eyes (82.4 percent) with no staining at 60 seconds. The anesthetic was instilled followed two minutes later by fluorescein. Of the stained eyes, 10 (38.5 percent) remained at the same level and 16 eyes (61.5 percent) had increased staining. Of the unstained eyes, 59 (48.4 percent) continued to have no staining and 63 eyes (51.6 percent) developed staining.
Corneal Disease
Corneal staining may be a sign of corneal disease and can identify patients who are at risk of developing corneal infiltrates. Papas and colleagues (2006) at the Institute for Eye Research in Sydney, Australia, studied 609 subjects over 16 clinical trials using various lens-solution combinations for up to three months. One out of 10 subjects who had staining had an infiltrate, and subjects who had diffuse punctate staining in at least four of five areas of the cornea were three times more at risk of developing a corneal infiltrative event. Hydrogen peroxide solutions had low toxic staining rates.
Long-term Studies
The studies listed above are all short-term. Few studies have looked beyond the first three months of wear to examine persistent staining. Santodomingo-Rubido (2006) identified a significant subjective increase in corneal staining over the first three months of silicone hydrogel lens wear in 45 patients using Opti-Free Express MPS or ReNu MultiPlus MPS and followed for 18 months (p<0.05).
Differences in grading scales and study designs make it difficult to compare results across clinical studies. Investigators use different scales to generate corneal staining scores, and these scales are subject to differences in grading precision. A study comparing numerous contact lens and contact lens care solution combinations produced disparate corneal staining results for the same care solution marketed under three different names. This disparity highlights the need in evaluating clinical study reports to pay attention to the grading systems used, the populations studied, and the consistency of results from several studies. CLS
To obtain references for this article, please visit http://www.clspectrum.com/references.asp and click on document #137.


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text: 03/13/2013 (10:00PM - 11:00PM) (Wednesday) : AN INJURED FIREFIGHTER FACES LIFE AFTER THE JOB - After he's injured in a terrible fire at an auto machine shop, Jose Vargas (Mo Gallini) is forced to go on disability and leave his life as a firefighter behind - a task he finds incredibly difficult. Chief Boden (Eamonn Walker) tries to help a suspected teenage firebug (guest star Cody Sullivan). Also, Severide (Taylor Kinney) receives an enticing invitation from Renee (guest star Sarah Shahi), a woman who he saved from a car crash incident involving live electrical wires. Meanwhile, Cruz (Joe Minoso) tries to save his younger brother Leon (guest star Jeff Lima) from the gang he is involved with. Jesse Spencer, David Eigenberg, Charlie Barnett, Monica Raymund and Lauren German also star.


text: My friend Landon sent me the link I needed to say "math proves that math is equivalent to programming"; it actually says something more like "there is an isomorphism between proofs of deductive logic and constructions of Lambda Calculus" but even that I'm saying badly, the link is http://en.wikipedia.org/wiki/Curry-Howard_isomorphism Gratifyingly, the intro has the phrase "Proofs are Programs" :-) On second thought my guestimate of the size of a program that might be produced from the Clasification of Finite Simple Groups is excessive. I'm thinking 100MB would be more fair order of magnitude than 1GB. I don't mean that the possible huge size of source code justifies 64 bit words, it's enough, to me, that a huge integer can fit into a register, for number theory. But yes we humans can indeed create vast grotesque edifices of scholarship without the necessity of machine generation. But the machines will, of course, win in the end :-) Peter On 4/11/07, Peter St. John <peter.st.john at gmail.com> wrote: > > Jon, > > On 4/10/07, Jon Forrest <jlforrest at berkeley.edu> wrote: > > > > > > But I stand firm on my claim that no human, or group > > of humans, can write a program that requires more than > > 32-bits of text space. > > > I like to say that proving a theorem is alot like writing a program. I > don't know about the biggest software projects, but the Classification of > Finite Simple Groups was huge; from Wiki: > "In all, the work comprises tens of thousands of pages in 500 journal > articles by some 100 authors." > My thumbnail guesstimate of how much bytes are in a typical journal page > of mathematics (maybe less than AMSTeX source, but more than 2k of plaintext > prose, because all the symbols have to be expressed as abbreivations...) > suggests that this work, done by humans, amounts to more than 4 GB. > I'm not clear, myself, about the "infinite flat address space", as I want > my data space to be a bit more structured (in my view of the C source, say) > and don't want to care about how it looks to the compiler (as long as the > compiler is happy). However, the killer app to me is what RGB mentioned; I > know and love numbers that don't fit in one 32-bit word. > Peter > > Cordially, > > -- > > Jon Forrest > > Unix Computing Support > > College of Chemistry > > 173 Tan Hall > > University of California Berkeley > > Berkeley, CA > > 94720-1460 > > 510-643-1032 > > jlforrest at berkeley.edu > > _______________________________________________ > > Beowulf mailing list, Beowulf at beowulf.org > > To change your subscription (digest mode or unsubscribe) visit > > http://www.beowulf.org/mailman/listinfo/beowulf > > > > -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://www.beowulf.org/pipermail/beowulf/attachments/20070411/fd3055f6/attachment.html>


text:
Policy: XV.A.1
Issued: August 1, 1993
Owner: University Comptroller
Latest Revision: July 2, 2010
This policy is currently under revision at the University. Although the statements herein reflect enforced policy guidance, please contact the "Owner" listed above if you have questions about how this policy applies to your office. The statements herein are to be used as general guidance until the policy has been revised and added to the University Policy Directory. Thank you.
1.0 Purpose
This policy describes the University's position on conflict of interest.
2.0 Policy [Top]
NOTE: See also the Conflict of Interest policy within the Faculty Handbook.
NOTE: This policy applies to employment contracts, employment renewals, or other contracts entered into July 1, 1983 or later, and reflects changes brought about by the State and Local Government Conflict of Interests Act of 1987 (as amended through 2005).
2.1 Employee Responsibilities
This policy has been established to ensure that each employee (faculty, staff and officer) is aware of his/her responsibilities when performing duties for the University. It is intended to incorporate and also supplement the requirements of the State and Local Government Conflict of Interests Act of the Code of Virginia 2.2-3100 through 2.2-3131, and the Virginia Public Procurement Act, Article 6, Ethics in Public Contracting, Code of Virginia Section 2.2-4367. However, this policy does not restate those Acts verbatim; and employees who have questions about conflict of interests may wish to consult the Acts themselves. Copies of the applicable Code sections are available in the Department of Procurement & Supplier Diversity Services and the Office of the General Counsel.
Employees should disclose actual or potential conflict of interests and should not initiate any contract or transaction to which the University is a party until approval is received from the Assistant Vice President and University Comptroller.
See also:
Procedure 15-1, "Providing Notice of Possible Conflict of Interests."
2.2 Departmental Responsibilities
It is the responsibility of the dean/department head to investigate and report to the Assistant Vice President for Finance and University Comptroller any potential conflict of interests affecting contracts or transactions to which the University is a party.
It is also the responsibility of the dean/department head to certify that a conflict of interests does not exist in employment situations having the appearance of conflict.
See also:
Procedure 15-2, "Certification that No Conflict of Interest Exists."
2.3 Employment Restrictions
In addition to the Conflict of Interest Act, University policy provides that no faculty or staff member shall serve as the immediate supervisor or exercise any control over the employment or employment activities of a person related by family or marriage or an individual sharing the same household.
See also:
Procedure 15-2, "Certification That No Conflict of Interest Exists."
2.4 Restrictions on Procurement Activities
No employee having official responsibility for a procurement transaction (purchase or lease of goods or services) shall participate in the procurement when the employee knows that:
- He/she is also employed by the bidder, offeror, or contractor.
- The employee, the employee's partner, or any member of the employee's "immediate family":
- Holds a position with the bidder, offeror, or contractor.
- Is employed by the bidder, offeror, or contractor in a capacity involving substantial participation in the procurement transaction.
- Owns or controls an interest exceeding five percent (5%) of the business of the bidder, offeror, or contractor.
- Has a pecuniary interest in the bidder, offeror, or contractor.
- Is negotiating, or has an arrangement concerning prospective employment with the bidder, offeror, or contractor.
No employee or former employee having official responsibility for procurement transactions shall accept employment with any bidder, offeror or contractor with whom he/she has dealt in an official capacity concerning procurement transactions for a period of one year after termination of the employee's University employment.
Exception: An exception is allowed if the employee/former employee notifies his/her Vice President/former Vice President, the Assistant Vice President for Human Resources, and the Chief Contracting Officer in writing before starting the new position.
2.5 Prohibited Conduct Regarding Contracts
No employee shall have a "personal interest in a contract" with:
- The University other than one's own contract of employment.
- Any other State Agency, unless the contract is awarded through a competitive process as defined by the Virginia Public Procurement Act.
- An employee may have a "personal interest" in: A University employment contract of a person related by family or marriage or an individual sharing the same household, if the employee neither exercises control nor is in a position to influence the employment or employment activities of the other person.
- [July 1, 2006] A contract between the University and a firm when the officer's or employee's personal interest in the contract is by reason of ownership in the contracting firm in excess of 3% of the contracting firm's equity, provided that (i) the officer or employee's ownership or other equity interest and that of any immediate family member in the contracting firm is disclosed in writing to the president of the institution, which writing certifies that the officer or employee has not and will not participate in the contract negotiations on behalf of the contracting firm or the institution, (ii) the president of the institution makes a written finding as a matter of public record that the contract is in the best interests of the institution, (iii) the officer or employee either does not have authority to participate in the procurement or letting of the contract on behalf of the institution or disqualifies himself as a matter of public record, and (iv) does not participate on behalf of the institution in negotiating the contract or approving the contract; PROCEDURE 15-3 TEMPLATE DISCLOSURE LETTER The template letter serves only as an example of what is required. You may use another form so long as it complies with the requirements of the Conflict of Interest Act.
- One's own contract of employment with another State agency.
- A University contract to sell goods or services at uniform prices to the general public.
- The sale, lease, or exchange of real property between the employee and the University, if the employee does not participate in any way for the University in the sale, lease or exchange, and such is stated as a matter of public record. *
- A University contract involving the publishing of official notices.
- A contract between the University and a publisher of educational materials, if the employee's "personal interest" accrues to him/her solely from having authored such educational materials.
- Contracts between the University and a contracting firm when the employee, his/her spouse, or immediate family member's sole interest in the firm is by reason of salary in excess of $10,000, so long as the employee's spouse or immediate family member
- Neither participates in nor has authority to participate in the procurement or letting of the contract for the contracting firm, AND
- Either does not have authority to participate in the contract for the University, or disqualifies him/herself as a matter of public record and does not participate in the negotiations or approval of the contract for the University.
- Contracts between the University and public service corporations, financial institutions, or public utilities in which the employee has a "personal interest", if the employee disqualifies him/herself as a matter of public record and does not negotiate or approve the contract. *
- Contracts purchasing goods or services when the contract does not exceed $500.
- Grants or other payments under any program wherein uniform rates for, or the amounts paid to, all qualified applicants are established solely by the University.
- A contract for research and development between the University and a business in which the employee (or member of his/her immediate family) has a personal interest if (1) the personal interest has been disclosed to and approved by the University, in accordance with institutional policy approved by the State Council of Higher Education, prior to the time the contract is entered into; and (2) the employee promptly files a disclosure statement pursuant to the Code of Virginia Section 2.1-639.15 both with appropriate officials of the University as provided by Procedure 15-1 of the FINANCIAL AND ADMINISTRATIVE PROCEDURES MANUAL, and with the Secretary of the Commonwealth of Virginia, and annually thereafter on or before January 15.
- A contract between the University and a not-for-profit, non- stock corporation which operates a clinical practice within the University of which the University employee is also a member or employee.
- A contract of employment of an immediate family member provided, (1) both the employee and the family member are in teaching, research, or administrative support positions, and (2) the Board of Visitors finds that it is in the best interests on the institution and the Commonwealth for such dual employment to exist, and (3) The Board of Visitors ensures that neither the employee nor family member has control or influence over the employment activities of the other.
* NOTE: All employees with "personal interests in contracts" should disclose this fact as required and not initiate the contract to which the University is a party until approval is received from the Assistant Vice President for Finance and University Comptroller.
See also:
Procedure 15-1, "Providing Notice of Possible Conflict of Interests."
2.6 Prohibited Conduct Regarding "Transactions"
Each employee shall disqualify him/herself from representing the University in a "transaction" when:
He/she has a "personal interest in the transaction", and the "transaction" has "specific application" to the employee.
In this situation, the employee will not vote or represent the University in the "transaction," and the University will record the disqualification in writing. Even after disqualifying oneself, the employee may still represent him/herself, one's spouse, or any relative in the "transaction." The employee must not be compensated for his/her representation and must comply with the disqualification and recording requirements above.
NOTE: All employees with "personal interests in transactions" should disclose this fact as required.
See also:
Procedure 15-1.
If an employee's disqualification leaves less than the required number of persons needed to act on the "transaction," the remaining members will have authority to act by majority vote or unanimous vote of the remaining members, as required. If action is taken when these above conditions are not met, the University may rescind the action, as required.
NOTE: The above disqualifications and disclosures are in addition to the disclosure of economic interest required for certain positions designated by the Governor. The Department of Human Resources sends out the disclosure form annually to select employees.
2.7 Solicitation and Acceptance of Gifts, Travel, etc.
An employee of the University shall not:
- Solicit or accept money or other things of value, for services performed within the scope of his/her official duties except for compensation, expenses or other remuneration paid directly to him/her or approved for him/her by the University. This prohibition will not prohibit the acceptance of special benefits authorized by law.
- Accept any money, gift, loan, advance, favor, special discount, or service of material value that might reasonably tend to influence him/her in the discharge of his/her duties.
- Offer or accept money or anything of value for or in payment of employment, an appointment, a promotion, or a privilege with the University.
- Accept a business or professional opportunity for financial benefit, if he/she knows or should know that the opportunity is offered to influence the discharge of his/her official duties.
- Accept a business or personal trip paid for by a vendor, for any reason whatsoever, without first obtaining written approval from the executive director of the Hospital or the employee's Vice- President as applicable. SEE NOTES IMMEDIATELY BELOW.
NOTE: The Department of Procurement & Supplier Diversity Services can arrange, through the procurement process, for vendors or potential vendors to pay for travel to inspect or be trained on new equipment. Such arrangements should be approved BEFORE Purchasing and Materials Services issues the request for proposal or invitation to bid.
NOTE: If a department wants an employee to travel at a vendor's expense and the arrangements were not part of the procurement process, several measures should be taken. AT LEAST TWO WEEKS PRIOR TO THE TRAVEL, the department head should:
- Request the Chief Contracting Officer to issue an opinion to the applicable Vice-President(s) on the appropriateness of the vendor- paid travel.
- Notify the applicable Vice-President(s) or Executive Director of the Hospital.
An employee having authority to conduct or influence the buying of goods or services for the University must not solicit or accept any gift, payment, loan or anything else, other than miscellaneous items bearing advertising, such as matches, calendars, rulers, note pads, or other items of nominal or minimal value from a bidder, offeror, contractor, or subcontractor. This rule does not prohibit employees from buying goods or services, or obtaining loans, for their personal use where they pay equal consideration for the goods, services or loans; nor does it prohibit employees from accepting meals or beverages from vendors when offered to a large group of people at a trade show, exhibit or other professional meeting.
2.8 Other Restrictions:
An employee of the University shall not:
Use confidential information not available to the public and acquired through one's University position for one's own or another's economic benefit.
The University shall not:
Purchase building materials, supplies or equipment for a University building or structure from any independent contractor who is providing architectural or engineering (non-construction) services to the University, or from any partnership, association or corporation in which the architect or engineer has a personal interest, except in cases of emergency.
2.9 Penalties and Remedies
Any employee who violates the provisions of the mentioned Acts is guilty of a misdemeanor, and may be fined up to $1,000 and sentenced up to a year in jail. Any employee may NOT be prosecuted if PRECEDING the potential conflict action:
- The employee made full disclosure of the facts, AND
- The employee relied on a written opinion by the Attorney General stating his/her actions did not violate the Comprehensive Conflict of Interests Act.
If convicted for this violation, the employee shall, in addition to any other fine or penalty provided by law, forfeit his/her employment. In addition, any employee who violates the requirements of this policy may otherwise be disciplined by the University.
Any money or other thing of value derived from a violation of the above policies will be forfeited to the appropriate source of funds, i.e., State Treasurer, University Bursar, etc. If the money, etc., increased in value between the time of violation and the discovery of the violation, the greater value will be forfeited.
Any purchase made in violation of the above policies may be rescinded by the University within five years of the date of such purchase.
If convicted for this violation, the employee shall, in addition to any other fine or penalty provided by law, forfeit his/her employment. In addition, any employee who violates the requirements of this policy may otherwise be disciplined by the University.
Any money or other thing of value derived from a violation of the above policies will be forfeited to the appropriate source of funds, i.e., State Treasurer, University Bursar, etc. If the money, etc., increased in value between the time of violation and the discovery of the violation, the greater value will be forfeited.
Any purchase made in violation of the above policies may be rescinded by the University within five years of the date of such purchase.
Any contract made in violation of the above policies may be declared void by the University within five years of the date of such contract. The contractor or subcontractor will retain or receive only the reasonable value, with no increment of profit or commission, of the property or services rendered prior to receiving notice the contract had been voided. In voiding contracts of sale, any refund will be made to the appropriate source of funds, i.e., State Treasurer, University Bursar, etc.
Approved by SCHEV 3 February 1992.
3.0 Definitions [Top]
"Official Responsibility" - Administrative or operating authority, whether intermediate or final, to initiate, approve, disapprove, or affect a procurement transaction or any resulting claim.
"Exercising control over the employment or employment activities" - This concept includes, but is not limited to, making decisions regarding initial appointment, retention, promotion, tenure, salary, leave of absence, and evaluation. This concept does not include academic or scientific conduct of instruction or research. The instructor or principal investigator of a research project is responsible for the academic or scientific work and for technical leadership.
"Contract" - Any agreement to which the University is a party, or any agreement between or on behalf of the University or any subdivision and a third party for payment from any University fund. Sub-contracts are included only if the University was a party to the original contract.
"Personal Interest in a Contract" - Being a party to a contract or having a "personal interest" in the firm, corporation, partnership, or other business entity which is a party to the contract.
"Transaction" - Any matter considered by the University or one of its subdivisions on which official action is taken or contemplated.
"Personal Interest in a Transaction" - Where an employee or his/her spouse, or immediate family member, has a "personal interest" in property, or in either a firm, corporation, partnership or business entity, or in one representing an entity, which is the subject of the transaction in question, or will benefit or may reasonably be expected to benefit, directly or indirectly, or suffer from the transaction.
"Personal Interest" - A financial benefit or liability of an employee, or immediate family member, if such benefit or liability is included in one of the categories outlined below:
- Ownership interest in a business which exceeds three percent (3%) of the equity of the business;
- Annual income exceeding $10,000 from ownership in property or in a business;
- Salary or benefits paid by a business which exceeds $10,000 annually;
- Interest in real or personal property which exceeds $10,000;
- Liability incurred on behalf of a business, which exceeds three percent (3%) of the asset value of the business.
"Specific Application Transaction" - A transaction affecting the personal interest of an employee. Specific application transactions do not affect the public in general, but general public transactions may include the personal interest of the employee.
"Immediate Family" - An employee's spouse, and any other person living in the same household as the employee, who depends on the officer or employee for more than 50% of his or her support, or provides more than 50% of the support for the officer or employee.
"Related by Family or Marriage" - An employee's spouse, parent, child, sibling, grandparent, grandchild, aunt, uncle, niece, nephew, in-law, or individual for whom an employee has been assigned legal responsibility or guardian.
4.0 References [Top]
5.0 Approvals and Revisions [Top]
Previous version in effect from 8/1/93 to 7/5/06 available in policy archive.


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Normal blogging will resume next week when I have regained good health. Or something close to it.
Archives for 2004
Cough. Sneeze. Sniffle.
I've Been a Bad Blogger
More accurately, not a bad blogger, but a bad blog reader.
I had an email conversation with Norma yesterday about leaving comments. As you know, Norma had a contest where all you had to do was to leave a comment and she'd award a prize to the individual who left comment #1690. Great idea! I left a comment, as did a lot of other people.
But it made me realize how infrequently I leave comments on the blogs I read. Usually my blog reading is done in a tearing hurry (as is everything in my life). And, as Norma pointed out, using Bloglines to read your blog list makes it a lot easier to read through a lot of blogs in a minimum of time. Which is great for those among us who are spare-time-challenged. But it makes it easier to not leave comments.
So my pre-New Year's resolution is to try to leave more comments on the blogs I read.
Spinning News
Last night I finished spinning up all my singles of the yummy blue Coopworth, see?
Plying will commence soon. But since I'm sick (cough, cough) not tonight.
I actually left work early because I felt ill — something I almost never do. Sinus issues and I lost my voice as well. I'll probably stay home tomorrow and try to rest.
With Nurse Lucy.
Speaking of Lucy
A message from Lucy to Eklectika: she would like you to know that she still loves the mouse I made for her from the fiber you sent.
ScandiHOOvian Confessions
Our wonderful knitting blogring leader Julie (and thank you for everything you do in keeping the ring going) commented:
Okay, if we're talking about Swedish Christmas, I have to ask about Glogg! Do you drink it? My mother-in-law makes it every year and I love it!
And then there's lutefisk — she makes that too, and I have eaten it. Although mercifully last year she forgot to thaw it, so none was available 🙂
Next week I'll have to show my Tomtes on my blog!
1. Glogg. How I love thee! The only time I have glogg is when my parents have a holiday party. Of course, glogg is served there. It's been a couple of years now, though. ::cough, cough, hint, hint::
2. Lutfisk. Why, thank you for bringing up this topic, Julie! It's the perfect excuse for me to haul out yet another aged blog entry, The One Where Wendy Waxes Lyrical About Lutfisk. Sorry, Dad.
3. Tomtes. Yes! Please show us your tomtes, Julie! I do so love me a good tomte! And this is the perfect place for yet another segue — into my Jultomte blog post from two years ago.
Julie, I really need to put you on the payroll.
Spinnin' and Plyin'
(sung to the tune of of Bobby Lewis' Tossin' and Turnin')
I didn't knit at all last night
Got to thinkin' of you
Baby things weren't right
Well I was spinnin' and plyin'
Plyin' and spinnin'
a-spinnin' and plyin' all night.
Well, okay, I also baked scones.
But it's true — last night I never did get around to knitting. A rarity here at Wendyknits. By the time I finished baking my scones it was getting late, and Katarina looked so forlorn, that I did a bit of spinning instead of knitting.
I have, however, made a bit of progress on the Koigu Kersti sweater. The back is completed and I've started the front.
Three guesses whose tail that is in the photo.
Speaking of Baking
Dianne asked if I had made any pepparkakor. Ummmmm, errrrr, no. There will be no baking of holiday cookies here at Wendyknits. I am SO over the whole holiday cookie baking thing. Just say no to holiday cookie baking. (Hands over ears, chanting "lalalalalalala.")
Don't ask.
But fortunately, L-B sent me some pepparkakor! They are even made in Sweden. *sigh*
(We are not over holiday cookie eating chez Wendyknits.)
Three guesses whose head that is creating a chocolate blur in the photo.
She also sent me this adorable Scandinavian Santa.
I love the wistful expression on his face, and the little straw reindeer he's holding. Margene, that photo is for you!
Another St. Lucia Heard From
Kerry sent me this photo of her dog, Oakley.
She says:
I had to share my Christmas card picture this year…
The outside of the card tells the story of how the crown of candles signifies the light of the sun defeating the dark of winter and the biscuits are in remembrance of how she fed the poor. The inside says, "But not all Swedish girls are this cute."
Lucy was unmoved. In fact, all she had to say was:
"Where's my stinkin' homespun shawl??!!"
St. Lucia Day
Today, December 13, is St. Lucia Day. Long-time Wendyknits readers may remember this story.
Yes, I'm hauling out old blog entries and offering them up again. To all you ScandiHOOvians (to quote Share) out there, Happy St. Lucia Day!
We Are Amused
So said Lucy. She is pleased that you all noticed how nicely the
cat blanket shawl complements her coloring. So much so that she consented to pose for another photo.
What we will not show is the brief but ugly power struggle that ensued. I won, and the shawl is now hanging over the back of my desk chair at work.
Lucy is not nearly as amused now.
Not too much knitting tonight. Baking scones for the office party tomorrow, dontcha know.
I did, however, spin up some yummy Coopworth roving. It drafts and spins like a dream. As easy as pie.
Pronounced, of course, as Eric Cartman would: "Paaaaaaaaaaah."
Reader Q&A
Margene asked, about my Koigu Kersti:
Are you knitting with two skeins at a time?
Um . . . er . . .um . . . no I'm not. *blush, blush* Busted!
I'm throwing caution to the wind. And so far, so good. More than I deserve.
Emily said:
That shawl design looks like a wonderful solution for showcasing a few different sorts of handspun yarn together. Did the gauge match exactly between the different yarns?
Pretty darn close in gauge, I'd say. No appreciable difference.
Fun Giftie!
From L-B, chocolate penguins!
I adore penguins.
Living on the Fringe
In a surprise move, I decided that my homespun shawl would look best with fringe, after all. Lookie here:
Not only did I finish my shawl, but I have my own spokesmodel to pose with it!
I'm quite please with it. I steamed the living daylights out of it, then attached the fringe. I found it difficult to cut up my handspun into small pieces for fringe. I kept thinking "all that work . . . "
But I have to admit, the shawl looks good with fringe. So now I'm happy. For now.
And in celebration, I spun up a couple of ounces of 100% silk in a colorway called "Autumn Splendor." Darned if I can remember where I bought the fiber, though.
Koigu-y Goodness
Mmmmmmm! Love my Koigu Kersti! Here's the ribbed pullover in progress. I've got a good bit done on the back:
And a close-up of the 2×2 rib:
Reader Comments
Thanks to Leslie for suggesting I check out the David Gilmour live DVD — I've put it on my Amazon wishlist.
Mary asked:
Question: I searched the archives but didn't find any reference to this. If you are putting a zipper in a sweater–do you put it in by hand or machine?
I don't think I've mentioned zippers in knits in my blog — I haven't made a sweater with a zipper in ages. But if I were to put a zipper in a sweater, I'd sew it by hand.
Erin asked:
Kind of a random question, but is there any Spongebob merchandise that you you don't have?
Well, I don't have the Spongebob edition of the 2005 Jaguar XK . . .
Knitbloggers Knitting Basket Project
A few more donations over the weekend. Thank you! If you want to donate, the info is in my sidebar . . .


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Enjoy an Easter Craft
Please note:
Age requirements apply, ages 5+ years.
Bookings are essential - and if a session is full we may not be able fit extras in on the day.
Please cancel your place if you are unable to attend.
Parents/caregivers must remain in the Library building for duration of the session. If a child or caregiver acts in such a way to disrupt the enjoyment of the session for others they may be asked to leave the session or leave the library. Staff may take photographs at the event for promotional purposes. Please advise staff on the day if you don't wish you or your child to be photographed.
For all enquiries please phone 8366 4280 or email email@example.com


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Perhaps you're familiar with the myth that getting between the neutrals can hurt you worse than touching the hot. In fact, grounded (neutral) conductors can be as dangerous as ungrounded (hot) wires. The danger of electrocution exists any time the voltage is in excess of 30V. Consider what happens when a person becomes part of the neutral of a 120V circuit. Ohm's and Kirchoff's Law will be the basis of our calculations.
In our example, the resistance of each circuit conductor is 0.20 ohms (100 ft of 12 AWG), the load has a resistance of 200 ohms, and our accident victim has a skin contact resistance of 1,000 ohms. To determine the voltage (potential) with our accident victim as part of the neutral current path, we need only perform four short calculations:
Step 1. Determine the total resistance of the series circuit using Ohm's Law.
R1=Hot Wire=0.20 ohms
R2=Load=200 ohms
R3=Person=1,000 ohms
R4=Neutral Wire=0.20 ohms
RT=0.2 ohms+200 ohms+1,000 ohms+0.2 ohms
RT=1,200.40 ohms
Step 2. Determine the current of the series circuit.
I=120V÷1,200.40 ohms
Step 3. Determine the voltage drop across each resistor.
E Line=0.0999667A×0.20 ohms=0.02V
E Load=0.0999667A×200.00 ohms=20.00V
E Person=0.0999667A×1,000 ohms=99.96V
E Neutral=0.0999667A×0.20 ohms=0.02V
Step 4. Using Kirchoff's Law, verify the sum of the voltage drops of the circuit is equal to the voltage source.
By applying two fundamental laws in four math steps, we have proven:
The voltage potential between the accident victim and the neutral wire is almost 100V.
The electric shock hazard (100V) from the neutral is not greater than the shock hazard from a hot and neutral (120V), but it is just as dangerous.
You must realize that it's not necessary to get between two broken neutral conductors to receive a shock. You can receive the same shock if you contact the end of the neutral at the load and any grounded surface. And remember, even a ground fault circuit interrupter (GFCI) will not protect you against electric shock from a neutral-to-neutral (series) or a line-to-neutral (parallel) connection.


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Cue up the sad trombones - Infinity Blade: Dungeons, the hack-and-slash fantasy action game that wowwed crowds at the announcement of the new iPad, won't see the light of day this year according to Epic Games. PR manager Wes Phillips explains the situation.
"Ever since the talented team at Impossible Studios got their hands on Infinity Blade: Dungeons, they've been busy adding their great ideas to the game. There was also the matter of getting the Impossible Studios team up and running with desks, chairs, staplers and computers. The logistics of a new studio and implementing all these great ideas required a little extra time, so Infinity Blade: Dungeons will hit iOS in 2013."
Honestly, this game should have been ready for the launch of the new iPad. The fact that we're going to see another iPad launch before it's ready may leave Apple thinking twice about whether to let Epic share the stage with them at another keynote. Infinity Blade was apparently more profitable than Gears of War, but that's hardly a guarantee that this new studio will be as successful, even with the established and successful brand behind it. The trailer still looks nice, but will it live up to the wait and the now-rising expectations?
Source: AllThingsD


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Capitals Assign Philipp Grubauer to Hersheyby Staff Writer / Washington Capitals
ARLINGTON, Va. – The Washington Capitals have assigned goaltender Philipp Grubauer to the Hershey Bears of the American Hockey League (AHL), vice president and general manager George McPhee announced today.
Grubauer, 21, made his NHL debut on Feb. 27 in Philadelphia, stopping all 14 shots he faced in 25:05 of ice time, and made his first career NHL start on March 9 at the New York Islanders, making 40 saves. He has posted a record of 8-4-1 with a 1.99 goals-against average, a .930 save percentage and one shutout (he also combined for second shutout with Dany Sabourin on Jan. 13) in 14 games during his rookie season with Hershey. He spent the first half of the season with Reading of the East Coast Hockey League (ECHL) and was named a starter in the ECHL All-Star game after compiling a record of 19-5-1 with a 2.30 goals-against average and a .912 save percentage in 26 games played with the Royals.
The 6'1", 185-pound goaltender has collected a 42-18-5-1 record in two seasons in the ECHL with South Carolina and Reading. In addition to being named a starter for the 2013 ECHL All-Star Game, Grubauer was named to the 2012 ECHL All-Rookie team last season with South Carolina. The Rosenheim, Germany native represented Germany in the World Junior Championships in 2011, 2010, 2009 and 2008, winning the 2010 U-20 D1 gold medal while compiling the best goals-against average and best save percentage in the tournament. He led the Windsor Spitfires to the 2010 Memorial Cup Championship, winning all four games in the Memorial Cup round after helping Windsor win the OHL Championship.
Grubauer was originally drafted in the fourth round, 112th overall, in the 2010 NHL Entry Draft.


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This new Persian Kilim has been made in the city of Sanandaj. Made with 100% natural wool and Cotton, vegetable dyed and knotted by hand. This 5′ 4″X3′ 8″ fine quality Kilim is one of the kind. Please Call us for Availability 310-746-3011
Orders shipping to a P.O. Box can only contain small items and must use standard shipping. We can not ship to a P.O. Box if your order contains larger items or uses expedited shipping. Contact us for more information about shipping to a P.O. Box.