Sample records for access management techniques

  1. Economic effects of access management techniques in North Carolina.

    DOT National Transportation Integrated Search

    2010-12-21

    The NCDOT has made significant strides to reduce collisions and increase capacity along : strategic highway corridors across the state. Efforts have led to the implementation of many : different access management techniques along corridors, such as i...

  2. Methodology for assessing the effectiveness of access management techniques : executive summary.

    DOT National Transportation Integrated Search

    1998-09-14

    A methodology for assessing the effectiveness of access management techniques on suburban arterial highways is developed. The methodology is described as a seven-step process as follows: (1) establish the purpose of the analysis (2) establish the mea...

  3. Comparison of 3 airway access techniques during suspected spine injury management in American football.

    PubMed

    Toler, Julianne D; Petschauer, Meredith A; Mihalik, Jason P; Oyama, Sakiko; Halverson, S Doug; Guskiewicz, Kevin M

    2010-03-01

    To determine how head movement and time to access airway were affected by 3 emergency airway access techniques used in American football. Prospective counterbalanced design. University research laboratory. Eighteen certified athletic trainers (ATCs) and 18 noncertified students (NCSs). Each participant performed 1 trial of each of the 3 after airway access techniques: quick release mechanism (QRM), cordless screwdriver (CSD), and pocket mask insertion (PMI). Time to task completion in seconds, head movement in each plane (sagittal, frontal, and transverse), maximum head movement in each plane, helmet movement in each plane, and maximum helmet movement in each plane. We observed a significant difference between all 3 techniques with respect to time required to achieve airway access (F(2,68) = 263.88; P < 0.001). The PMI allowed for the quickest access followed by the QRM and CSD techniques, respectively. The PMI technique also resulted in significantly less head movement (F(2,68) = 9.06; P = 0.001) and less maximum head movement (F(2,68) = 13.84; P < 0.001) in the frontal plane compared with the QRM and CSD techniques. The PMI technique should be used to gain rapid airway access when managing a football athlete experiencing respiratory arrest in the presence of a suspected cervical spine injury. In the event the athlete does not present with respiratory arrest, the facemask may be removed carefully with a pocket mask ready. Medical professionals must be familiar with differences in equipment and the effects these may have on the management of the spine-injured athlete.

  4. Safety evaluation of access management policies and techniques, TechBrief

    DOT National Transportation Integrated Search

    2015-08-01

    Access management is the process that provides (or manages) access to land development while simultaneously preserving the flow of traffic on the surrounding road network for safety, capacity, and speed. Access management provides important benefits ...

  5. Methodology for assessing the effectiveness of access management techniques : final report, September 14, 1998.

    DOT National Transportation Integrated Search

    1998-09-14

    A methodology for assessing the effectiveness of access management techniques on suburban arterial highways is developed. The methodology is described as a seven-step process as follows: (1) establish the purpose of the analysis (2) establish the mea...

  6. Benefits of access management.

    DOT National Transportation Integrated Search

    2003-01-01

    This brochure serves as a guide to the major benefits of several : access management techniques in use across the United States. The : purpose of this brochure is to provide a comprehensive and succinct : examination of the benefits of access managem...

  7. Land Development and Subdivision Regulations that Support Access Management

    DOT National Transportation Integrated Search

    1993-01-01

    This report examines the role of the comprehensive plan in developing an access : management program, aspects of current regulatory practice that contribute to : access problems, and regulatory techniques that support access management : principles. ...

  8. Proceedings of the Mobile Satellite System Architectures and Multiple Access Techniques Workshop

    NASA Technical Reports Server (NTRS)

    Dessouky, Khaled

    1989-01-01

    The Mobile Satellite System Architectures and Multiple Access Techniques Workshop served as a forum for the debate of system and network architecture issues. Particular emphasis was on those issues relating to the choice of multiple access technique(s) for the Mobile Satellite Service (MSS). These proceedings contain articles that expand upon the 12 presentations given in the workshop. Contrasting views on Frequency Division Multiple Access (FDMA), Code Division Multiple Access (CDMA), and Time Division Multiple Access (TDMA)-based architectures are presented, and system issues relating to signaling, spacecraft design, and network management constraints are addressed. An overview article that summarizes the issues raised in the numerous discussion periods of the workshop is also included.

  9. Access management for Kentucky.

    DOT National Transportation Integrated Search

    2004-02-01

    The Access Management Manual published by the Transportation Research Board in 2003 defines access management as the "systematic control of the location, spacing, design, and operation of driveways, median openings, interchanges, and street connectio...

  10. Matrix Management in Practice in Access Services at the NCSU Libraries

    ERIC Educational Resources Information Center

    Harris, Colleen S.

    2010-01-01

    The former Associate Head of Access and Delivery Services of the North Carolina State University Libraries reports on successful use of matrix management techniques for the Circulation and Reserves unit of the department. Despite their having fallen out of favor in much of the management literature, matrix management principles are useful for…

  11. Roundabouts and access management : [summary].

    DOT National Transportation Integrated Search

    2014-03-01

    Roundabouts, once rare in the U.S., are : being installed more often to address access : management and safety concerns. Access : management is how planners look at means of : entering and exiting a roadway, for example, how : to place features such ...

  12. Managing Information Resources for Accessibility.

    ERIC Educational Resources Information Center

    General Services Administration, Washington, DC. Clearinghouse on Computer Accommodation.

    This handbook presents guidance for federal managers and other personnel who are unfamiliar with the policy and practice of information accessibility to accommodate users with disabilities and to provide for their effective access to information resources. It addresses federal requirements for accessibility, adopting accessibility as a sound…

  13. Development of access management performance measures.

    DOT National Transportation Integrated Search

    2009-05-01

    In 2007, the Virginia General Assembly passed legislation calling for Access Management, the : regulation of entrances and intersections along highway corridors in Virginia. Some property owners may oppose : access management. Therefore, performance ...

  14. The transferability of safety-driven access management models for application to other sites.

    DOT National Transportation Integrated Search

    2001-01-01

    Several research studies have produced mathematical models that predict the safety impacts of selected access management techniques. Since new models require substantial resources to construct, this study evaluated five existing models with regard to...

  15. Identity and Access Management and Security in Higher Education.

    ERIC Educational Resources Information Center

    Bruhn, Mark; Gettes, Michael; West, Ann

    2003-01-01

    Discusses the drivers for an identity management system (IdM), components of this system, and its role within a school security strategy, focusing on: basic access management; requirements for access management; middleware support for an access management system; IdM implementation considerations (e.g., access eligibilities, authentication…

  16. The 'SAFARI' Technique Using Retrograde Access Via Peroneal Artery Access

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

    Zhuang, Kun Da, E-mail: zkunda@gmail.com; Tan, Seck Guan; Tay, Kiang Hiong

    2012-08-15

    The 'SAFARI' technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially givemore » more options for endovascular interventions in lower limb CTOs.« less

  17. 50 CFR 660.330 - Open access fishery-management measures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Open access fishery-management measures... West Coast Groundfish-Open Access Fisheries § 660.330 Open access fishery—management measures. (a) General. Groundfish species taken in open access fisheries will be managed with cumulative trip limits...

  18. 50 CFR 660.330 - Open access fishery-management measures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Open access fishery-management measures... West Coast Groundfish-Open Access Fisheries § 660.330 Open access fishery—management measures. (a) General. Groundfish species taken in open access fisheries will be managed with cumulative trip limits...

  19. 50 CFR 660.330 - Open access fishery-management measures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 13 2013-10-01 2013-10-01 false Open access fishery-management measures... West Coast Groundfish-Open Access Fisheries § 660.330 Open access fishery—management measures. (a) General. Groundfish species taken in open access fisheries will be managed with cumulative trip limits...

  20. 50 CFR 660.330 - Open access fishery-management measures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 13 2012-10-01 2012-10-01 false Open access fishery-management measures... West Coast Groundfish-Open Access Fisheries § 660.330 Open access fishery—management measures. (a) General. Groundfish species taken in open access fisheries will be managed with cumulative trip limits...

  1. 50 CFR 660.330 - Open access fishery-management measures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Open access fishery-management measures... West Coast Groundfish-Open Access Fisheries § 660.330 Open access fishery—management measures. (a) General. Groundfish species taken in open access fisheries will be managed with cumulative trip limits...

  2. Managing Self-Access Language Learning: Principles and Practice

    ERIC Educational Resources Information Center

    Gardner, David; Miller, Lindsay

    2011-01-01

    This paper is based on a research project looking at the management of self-access language learning (SALL) from the perspective of the managers of self-access centres. It looks at the factors which influence the practice of seven managers of self-access language learning in tertiary institutions in Hong Kong. The discussion centres around five…

  3. Impact of access management practices to pedestrian safety.

    DOT National Transportation Integrated Search

    2017-03-31

    This study focused on the impact of access management practices to the safety of pedestrians. Some : of the access management practices considered to impact pedestrian safety included limiting direct : access to and from major streets, locating signa...

  4. Management of hemodialysis access infections.

    PubMed

    Ryan, Sean V; Calligaro, Keith D; Dougherty, Matthew J

    2004-03-01

    Management of hemodialysis (HD) access infection is one of the most challenging and most common problems faced by surgeons, interventional radiologists, and nephrologists. The goal to eradicate infection is often at odds with the need to maintain access. Patients on HD are immunocompromised and typically have significant comorbid conditions placing them at high risk for the occurrence of access infection. Infection is most common with central-vein catheter access, followed by prosthetic arteriovenous grafts (AVG) and is rare with autogenous fistulas. The diagnosis is usually evident on physical exam, but it is not uncommon for these patients to present with atypical symptoms and lack of clinical findings. Although Staphylococcal species are the most common organism to cause infection, early empiric antimicrobial therapy should also include coverage for Gram-negative organisms. Management of central-vein catheter infection includes removal and delayed replacement or, in patients with mild clinical symptoms, catheter exchange over a guide wire. Our management of AVG infection includes total graft excision when patients present with sepsis or the entire graft is bathed in pus, subtotal graft excision when all of the graft is removed except a small oversewn cuff of prosthetic material on an underlying patent artery, and partial graft excision when only a limited infected portion of the graft is removed and a new graft is rerouted in adjacent sterile tissue to maintain patency of the original graft. This strategy has proven to be highly successful in the management of these complicated cases.

  5. Percutaneous management of vascular access in transfemoral transcatheter aortic valve implantation

    PubMed Central

    Dato, Ilaria; Burzotta, Francesco; Trani, Carlo; Crea, Filippo; Ussia, Gian Paolo

    2014-01-01

    Transcatheter aortic valve implantation (TAVI) using stent-based bioprostheses has recently emerged as a promising alternative to surgical valve replacement in selected patients. The main route for TAVI is retrograde access from the femoral artery using large sheaths (16-24 F). Vascular access complications are a clinically relevant issue in TAVI procedures since they are reported to occur in up to one fourth of patients and are strongly associated with adverse outcomes. In the present paper, we review the different types of vascular access site complications associated with transfemoral TAVI. Moreover, we discuss the possible optimal management strategies with particular attention to the relevance of early diagnosis and prompt treatment using endovascular techniques. PMID:25228962

  6. 50 CFR 660.383 - Open access fishery management measures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Open access fishery management measures... West Coast Groundfish Fisheries § 660.383 Open access fishery management measures. (a) General. Groundfish species taken in open access fisheries will be managed with cumulative trip limits (see trip...

  7. Roundabouts and access management.

    DOT National Transportation Integrated Search

    2014-03-01

    Transportation engineers and planners are becoming more interested in using roundabouts to address access : management and safety concerns in the transportation system. While roundabouts are being used increasingly in a : variety of contexts, existin...

  8. Pigeon chest: comparative analysis of surgical techniques in minimal access repair of pectus carinatum (MARPC).

    PubMed

    Muntean, Ancuta; Stoica, Ionica; Saxena, Amulya K

    2018-02-01

    After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair for pectus carinatum (MARPC) and compare the outcomes. Literature was reviewed on PubMed with the terms "pectus carinatum", "minimal access repair", "thoracoscopy" and "children". Twelve MARPC techniques that included 13 articles and 140 patients with mean age 15.46 years met the inclusion criteria. Success rate of corrections was n = 125, about 89% in cumulative reports, with seven articles reporting 100%. The complication rate was 39.28%. Since the pectus bar is placed over the sternum and has a large contact area, skin irritation was the most frequent morbidity (n = 20, 14.28%). However, within the complication group (n = 55), wire breakage (n = 21, 38.18%) and bar displacement (n = 10, 18.18%) were the most frequent complications. Twenty-two (15.71%) patients required a second procedure. Recurrences have been reported in four of twelve techniques. There were no lethal outcomes. MARPC techniques are not standardized, as MIRPE are, so comparative analysis is difficult as the only common denominator is minimal access. Surgical morbidity is high in MARPC and affects > 2/3rd patients with about 15% requiring surgery for complication management.

  9. Bench-Top Feasibility Testing of a Novel Percutaneous Renal Access Technique: The Laser Direct Alignment Radiation Reduction Technique (DARRT).

    PubMed

    Khater, Nazih; Shen, Jim; Arenas, Javier; Keheila, Mohamed; Alsyouf, Muhannad; Martin, Jacob A; Lightfoot, Michelle A; Li, Roger; Olgin, Gaudencio; Smith, Jason C; Baldwin, D Duane

    2016-11-01

    Traditional techniques for obtaining percutaneous renal access utilize continuous fluoroscopy. In an attempt to minimize radiation exposure, we describe a novel laser direct alignment radiation reduction technique (DARRT) for percutaneous access and test it in a bench-top model. In this randomized-controlled bench-top study, 20 medical personnel obtained renal accesses using both the conventional bullseye technique and the laser DARRT. The primary endpoint was total fluoroscopy time. Secondary endpoints included insertion time, puncture attempts, course corrections, and subjective procedural difficulty. In the laser DARRT, fluoroscopy was used with the C-arm positioned with the laser beam at a 30° angle. The access needle and hub were aligned with the laser beam. Effective caliceal puncture was confirmed with fluoroscopy and direct vision. The Paired samples Wilcoxon signed rank test was used for statistical analysis with significance at p < 0.05. A total of 120 needle placements were recorded. Fluoroscopy time for needle access using the laser DARRT was significantly lower than the bullseye technique in all groups as follows: attendings (7.09 vs 18.51 seconds; p < 0.001), residents (6.55 vs 13.93 seconds; p = 0.001), and medical students (6.69 vs 20.22 seconds; p < 0.001). Students rated the laser DARRT easier to use (2.56 vs 4.89; p < 0.001). No difference was seen in total access time, puncture attempts, or course corrections between techniques. The laser DARRT reduced fluoroscopy time by 63%, compared with the conventional bullseye technique. The least experienced users found the laser DARRT significantly easier to learn. This novel technique is promising and merits additional testing in animal and human models.

  10. Arroyo Management Plan (Alameda County): A Plan for Implementing Access and Restoring Riparian Habitats

    Treesearch

    Kent E. Watson; Jim Horner; Louise Mozingo

    1989-01-01

    Innovative techniques for restoring riparian habitats are of little value without a community endorsed plan for their implementation. A flood control district commissioned the Arroyo Management Plan in order to determine how it might provide public access and improve habitat along its current and future channels in a fast-growing area of Northern California. The Plan,...

  11. Management Techniques for Librarians.

    ERIC Educational Resources Information Center

    Evans, G. Edward

    This textbook on library management techniques is concerned with basic management problems. Examples of problems in planning, organization, and coordination are drawn from situations in libraries or information centers. After an introduction to library management, the history of management is covered. Several styles of management and organization…

  12. Quantification of the benefits of access management for Kentucky : final report.

    DOT National Transportation Integrated Search

    2006-07-01

    This report describes the benefits quantification performed for the proposed access management plan for Kentucky. This study evaluates the capacity, safety and economic impacts associated with access management programs. The proposed Kentucky access ...

  13. Marshall Space Flight Center's role in EASE/ACCESS mission management

    NASA Technical Reports Server (NTRS)

    Hawkins, Gerald W.

    1987-01-01

    The Marshall Space Flight Center (MSFC) Spacelab Payload Project Office was responsible for the mission management and development of several successful payloads. Two recent space construction experiments, the Experimental Assembly of Structures in Extravehicular Activity (EASE) and the Assembly Concept for Construction of Erectable Space Structures (ACCESS), were combined into a payload managed by the center. The Ease/ACCESS was flown aboard the Space Shuttle Mission 61-B. The EASE/ACCESS experiments were the first structures assembled in space, and the method used to manage this successful effort will be useful for future space construction missions. The MSFC mission management responsibilities for the EASE/ACCESS mission are addressed and how the lessons learned from the mission can be applied to future space construction projects are discussed.

  14. Black and White Women Managers: Access to Opportunity

    ERIC Educational Resources Information Center

    Hite, Linda M.

    2004-01-01

    This study explores the differing views of Black and White female managers regarding access to key career opportunities for White women and women of color. Items addressed include access to hiring, promotions, key assignments, salary increases, acknowledgment for work, and mentors. Access to each is described by comparing White women and women of…

  15. Increasing access and support for emergency management higher education programs.

    PubMed

    Cwiak, Carol L

    2014-01-01

    The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.

  16. Access management classification and spacing standards

    DOT National Transportation Integrated Search

    1996-08-23

    The specific objectives of this background paper are:(1)Provide an overview of : the relationship between the functional integrity of the highway system and the : access management classification system, (2)Review and evaluate the current : Oregon De...

  17. Aerospace management techniques: Commercial and governmental applications

    NASA Technical Reports Server (NTRS)

    Milliken, J. G.; Morrison, E. J.

    1971-01-01

    A guidebook for managers and administrators is presented as a source of useful information on new management methods in business, industry, and government. The major topics discussed include: actual and potential applications of aerospace management techniques to commercial and governmental organizations; aerospace management techniques and their use within the aerospace sector; and the aerospace sector's application of innovative management techniques.

  18. Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

    PubMed

    Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

    2017-10-01

    Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

  19. Implementing a successful data-management framework: the UK10K managed access model

    PubMed Central

    2013-01-01

    This paper outlines the history behind open access principles and describes the development of a managed access data-sharing process for the UK10K Project, currently Britain’s largest genomic sequencing consortium (2010 to 2013). Funded by the Wellcome Trust, the purpose of UK10K was two-fold: to investigate how low-frequency and rare genetic variants contribute to human disease, and to provide an enduring data resource for future research into human genetics. In this paper, we discuss the challenge of reconciling data-sharing principles with the practicalities of delivering a sequencing project of UK10K’s scope and magnitude. We describe the development of a sustainable, easy-to-use managed access system that allowed rapid access to UK10K data, while protecting the interests of participants and data generators alike. Specifically, we focus in depth on the three key issues that emerge in the data pipeline: study recruitment, data release and data access. PMID:24229443

  20. Safety management of Ethernet broadband access based on VLAN aggregation

    NASA Astrophysics Data System (ADS)

    Wang, Li

    2004-04-01

    With broadband access network development, the Ethernet technology is more and more applied access network now. It is different from the private network -LAN. The differences lie in four points: customer management, safety management, service management and count-fee management. This paper mainly discusses the safety management related questions. Safety management means that the access network must secure the customer data safety, isolate the broad message which brings the customer private information, such as ARP, DHCP, and protect key equipment from attack. Virtue LAN (VLAN) technology can restrict network broadcast flow. We can config each customer port with a VLAN, so each customer is isolated with others. The IP address bound with VLAN ID can be routed rightly. But this technology brings another question: IP address shortage. VLAN aggregation technology can solve this problem well. Such a mechanism provides several advantages over traditional IPv4 addressing architectures employed in large switched LANs today. With VLAN aggregation technology, we introduce the notion of sub-VLANs and super-VLANs, a much more optimal approach to IP addressing can be realized. This paper will expatiate the VLAN aggregation model and its implementation in Ethernet access network. It is obvious that the customers in different sub-VLANs can not communication to each other because the ARP packet is isolated. Proxy ARP can enable the communication among them. This paper will also expatiate the proxy ARP model and its implementation in Ethernet access network.

  1. 75 FR 4007 - Risk Management Controls for Brokers or Dealers With Market Access

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... 3235-AK53 Risk Management Controls for Brokers or Dealers With Market Access AGENCY: Securities and... or other persons, to implement risk management controls and supervisory procedures reasonably... access may not utilize any pre-trade risk management controls (i.e., ``unfiltered'' or ``naked'' access...

  2. Identity and Access Management: Technological Implementation of Policy

    ERIC Educational Resources Information Center

    von Munkwitz-Smith, Jeff; West, Ann

    2004-01-01

    Navigating the multiple processes for accessing ever-multiplying campus information systems can be a daunting task for students, faculty, and staff. This article provides a brief overview of Identity and Access Management Services. The authors review key characteristics and components of this new information architecture and address the issue of…

  3. Oregon Department of Transportation : access management best practices manual.

    DOT National Transportation Integrated Search

    2012-12-01

    This manual is provided as a resource to help Oregon transportation professionals quantify the expected benefits of various access management applications. As a result, this manual includes recommendations for how to evaluate potential access managem...

  4. Shifting the Paradigm: Monitoring Access in Medicare Managed Care

    PubMed Central

    Docteur, Elizabeth R.; Colby, David C.; Gold, Marsha

    1996-01-01

    Medicare managed care enrollment growth points to the need to develop an approach for monitoring access to care for the increasing number of beneficiaries who use these arrangements. This article describes the issues to be addressed in designing a system for monitoring managed care plan enrollees' ability to obtain needed medical care on a timely basis. We review components of the monitoring approach used for traditional fee-for-service (FFS) Medicare, including the conceptual framework, data, measures, and subgroups targeted in monitoring efforts, and discuss the adaptation of that approach for monitoring access in Medicare managed care. PMID:10165713

  5. Shifting the paradigm: monitoring access in Medicare managed care.

    PubMed

    Docteur, E R; Colby, D C; Gold, M

    1996-01-01

    Medicare managed care enrollment growth points to the need to develop an approach for monitoring access to care for the increasing number of beneficiaries who use these arrangements. This article describes the issues to be addressed in designing a system for monitoring managed care plan enrollees' ability to obtain needed medical care on a timely basis. We review components of the monitoring approach used for traditional fee-for-service (FFS) Medicare, including the conceptual framework, data, measures, and subgroups targeted in monitoring efforts, and discuss the adaptation of that approach for monitoring access in Medicare managed care.

  6. Management of First Branchial Cleft Anomalies via a Cartilage-Splitting Technique.

    PubMed

    Schmidt, Richard; Conrad, David; Field, Erin; O'Reilly, Robert

    2015-06-01

    First branchial cleft anomalies are uncommon lesions that often present as periauricular infections. They have high recurrence rates, due in part to scarring secondary to prior infections and their management. These lesions have a close relationship with the facial nerve, and most authors recommend its identification and dissection because of this relationship. Nonetheless, facial nerve palsy has been reported in up to 15% of cases. We describe a novel technique for the management of first branchial cleft anomalies. Such lesions that presented in an infra- or postauricular location were approached via an incision through the cartilage of the pinna, between the tragus and antitragus. This technique affords direct access to the lesion without the need for facial nerve dissection. Six patients were treated. Five had prior surgery, including 3 with previous attempts at excision. There were no complications. The median follow-up was 35 months. One patient developed a recurrence. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  7. Management of Central Venous Access Device-Associated Skin Impairment: An Evidence-Based Algorithm.

    PubMed

    Broadhurst, Daphne; Moureau, Nancy; Ullman, Amanda J

    Patients relying on central venous access devices (CVADs) for treatment are frequently complex. Many have multiple comorbid conditions, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the CVAD insertion site, resulting in an increased likelihood of skin damage when standard CVAD management practices are employed. Supported by the World Congress of Vascular Access (WoCoVA), developed an evidence- and consensus-based algorithm to improve CVAD-associated skin impairment (CASI) identification and diagnosis, guide clinical decision-making, and improve clinician confidence in managing CASI. A scoping review of relevant literature surrounding CASI management was undertaken March 2014, and results were distributed to an international advisory panel. A CASI algorithm was developed by an international advisory panel of clinicians with expertise in wounds, vascular access, pediatrics, geriatric care, home care, intensive care, infection control and acute care, using a 2-phase, modified Delphi technique. The algorithm focuses on identification and treatment of skin injury, exit site infection, noninfectious exudate, and skin irritation/contact dermatitis. It comprised 3 domains: assessment, skin protection, and patient comfort. External validation of the algorithm was achieved by prospective pre- and posttest design, using clinical scenarios and self-reported clinician confidence (Likert scale), and incorporating algorithm feasibility and face validity endpoints. The CASI algorithm was found to significantly increase participants' confidence in the assessment and management of skin injury (P = .002), skin irritation/contact dermatitis (P = .001), and noninfectious exudate (P < .01). A majority of participants reported the algorithm as easy to understand (24/25; 96%), containing all necessary information (24/25; 96%). Twenty-four of 25 (96%) stated that they would recommend the tool to

  8. Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

    PubMed Central

    2012-01-01

    Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as

  9. Ultrasound-Guided Renal Access for Percutaneous Nephrolithotomy: A Description of Three Novel Ultrasound-Guided Needle Techniques

    PubMed Central

    Chu, Carissa; Masic, Selma; Usawachintachit, Manint; Hu, Weiguo; Yang, Wenzeng; Stoller, Marshall; Li, Jianxing

    2016-01-01

    Abstract Ultrasound-guided renal access for percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure commonly performed worldwide, but a technique underutilized by urologists in the United States. The purpose of this article is to familiarize the practicing urologist with methods for ultrasound guidance for percutaneous renal access. We discuss two alternative techniques for gaining renal access for PCNL under ultrasound guidance. We also describe a novel technique of using the puncture needle to reposition residual stone fragments to avoid additional tract dilation. With appropriate training, ultrasound-guided renal access for PCNL can lead to reduced radiation exposure, accurate renal access, and excellent stone-free success rates and clinical outcomes. PMID:26414304

  10. First-line managers' descriptions and reflections regarding their staff's access to empowering structures.

    PubMed

    Skytt, Bernice; Hagerman, Heidi; Strömberg, Annika; Engström, Maria

    2015-11-01

    To elucidate first-line managers' descriptions and reflections regarding their staff's access to empowering structures using Kanter's theory of structural empowerment. Good structural conditions within workplaces are essential to employees' wellbeing, and their ability to access empowerment structures is largely dependent on the management. Twenty-eight first-line managers in elderly care were interviewed. Deductive qualitative content analysis was used to analyse data. Managers perceived that staff had varying degrees of access to the empowering structures described in Kanter's theory - and that they possessed formal power in their roles as contact persons and representatives. The descriptions mostly started from the managers' own actions, although some started from the needs of staff members. All managers described their staff's access to the empowering structures in Kanter's theory as important, yet it seemed as though this was not always reflected on and discussed as a strategic issue. Managers could make use of performance and appraisal dialogues to keep up to date on staff's access to empowering structures. Recurrent discussions in the management group based on such current information could promote staff's access to power through empowering structures and make job definitions a strategic issue in the organisation. © 2014 John Wiley & Sons Ltd.

  11. Clinical nutrition managers have access to sources of empowerment.

    PubMed

    Mislevy, J M; Schiller, M R; Wolf, K N; Finn, S C

    2000-09-01

    To ascertain perceived access of dietitians to power in the workplace. The conceptual framework was Kanter's theory of organizational power. The Conditions for Work Effectiveness Questionnaire was used to measure perceived access to sources of power: information, support, resources, and opportunities. Demographic data were collected to identify factors that may enhance empowerment. The questionnaire was sent to a random sample of 348 dietitians chosen from members of the Clinical Nutrition Management dietetic practice group of the American Dietetic Association. Blank questionnaires were returned by 99 (28.4%) people not working as clinical nutrition managers, which left 249 in the sample. Descriptive statistics were used to organize and summarize data. One-way analysis of variance and t tests were performed to identify differences in responses based on levels of education, work setting, and information technology skills. Usable questionnaires were received from 178 people (71.5%). On a 5-point scale, scores for access to information (mean +/- standard deviation [SD] = 3.8 +/- 0.7), opportunity (mean +/- SD = 3.6 +/- 0.7), support (mean +/- SD = 3.2 +/- 0.9), and resources (mean +/- SD = 3.1 +/- 0.8) demonstrated that clinical nutrition managers perceived themselves as having substantial access to sources of empowerment. Those having higher levels of education, working in larger hospitals, having better-developed information technology skills, and using information technology more frequently had statistically significant higher empowerment scores (P = < or = .05) than contrasting groups in each category. Clinical nutrition managers are empowered and able to assume leadership roles in today's health care settings. Their power may be enhanced by asserting more pressure to gain greater access to sources of power: support, information, resources, and opportunities.

  12. Use Management Techniques in Office Practice

    ERIC Educational Resources Information Center

    Holehan, E. Lee

    1977-01-01

    Notes that authenticity can be added to student work projects in an office practice class by having the teacher assume the role of the office manager or supervisor and putting office management techniques into practice. Ways in which such techniques may be infused into classes are examined. (TA)

  13. Access Control Management for SCADA Systems

    NASA Astrophysics Data System (ADS)

    Hong, Seng-Phil; Ahn, Gail-Joon; Xu, Wenjuan

    The information technology revolution has transformed all aspects of our society including critical infrastructures and led a significant shift from their old and disparate business models based on proprietary and legacy environments to more open and consolidated ones. Supervisory Control and Data Acquisition (SCADA) systems have been widely used not only for industrial processes but also for some experimental facilities. Due to the nature of open environments, managing SCADA systems should meet various security requirements since system administrators need to deal with a large number of entities and functions involved in critical infrastructures. In this paper, we identify necessary access control requirements in SCADA systems and articulate access control policies for the simulated SCADA systems. We also attempt to analyze and realize those requirements and policies in the context of role-based access control that is suitable for simplifying administrative tasks in large scale enterprises.

  14. Managing Large Scale Project Analysis Teams through a Web Accessible Database

    NASA Technical Reports Server (NTRS)

    O'Neil, Daniel A.

    2008-01-01

    Large scale space programs analyze thousands of requirements while mitigating safety, performance, schedule, and cost risks. These efforts involve a variety of roles with interdependent use cases and goals. For example, study managers and facilitators identify ground-rules and assumptions for a collection of studies required for a program or project milestone. Task leaders derive product requirements from the ground rules and assumptions and describe activities to produce needed analytical products. Disciplined specialists produce the specified products and load results into a file management system. Organizational and project managers provide the personnel and funds to conduct the tasks. Each role has responsibilities to establish information linkages and provide status reports to management. Projects conduct design and analysis cycles to refine designs to meet the requirements and implement risk mitigation plans. At the program level, integrated design and analysis cycles studies are conducted to eliminate every 'to-be-determined' and develop plans to mitigate every risk. At the agency level, strategic studies analyze different approaches to exploration architectures and campaigns. This paper describes a web-accessible database developed by NASA to coordinate and manage tasks at three organizational levels. Other topics in this paper cover integration technologies and techniques for process modeling and enterprise architectures.

  15. Public access management as an adaptive wildlife management tool

    USGS Publications Warehouse

    Ouren, Douglas S.; Watts, Raymond D.

    2005-01-01

    One key issue in the Black Mesa – Black Canyon area is the interaction between motorized vehicles and. The working hypothesis for this study is that early season elk movement onto private lands and the National Park is precipitated by increased use of Off Highway Vehicles (OHV’s). Data on intensity of motorized use is extremely limited. In this study, we monitor intensity of motorized vehicle and trail use on elk movements and habitat usage and analyze interactions. If management agencies decide to alter accessibility, we will monitor wildlife responses to changes in the human-use regime. This provides a unique opportunity for adaptive management experimentation based on coordinated research and monitoring. The products from this project will provide natural resource managers across the nation with tools and information to better meet these resource challenges.

  16. Access Management Awareness Program. Phase II Report

    DOT National Transportation Integrated Search

    1997-01-01

    This report presents the results of a number of detailed Iowa access management case studies. Case studies were selected to provide a cross-section of locations and community sizes in Iowa as well as a variety of project types. Projects were analyzed...

  17. Microsimulation of the Impact of Access Management Practices to Pedestrians

    DOT National Transportation Integrated Search

    2018-12-31

    The study applied microsimulation to analyze the impact of access management (AM) to the operational performances of vehicles and pedestrians. A conceptual model was developed in VISSIM and VISWALK to examine the effect of access and signals density ...

  18. Enhancing Learning Management Systems Utility for Blind Students: A Task-Oriented, User-Centered, Multi-Method Evaluation Technique

    ERIC Educational Resources Information Center

    Babu, Rakesh; Singh, Rahul

    2013-01-01

    This paper presents a novel task-oriented, user-centered, multi-method evaluation (TUME) technique and shows how it is useful in providing a more complete, practical and solution-oriented assessment of the accessibility and usability of Learning Management Systems (LMS) for blind and visually impaired (BVI) students. Novel components of TUME…

  19. CILogon: An Integrated Identity and Access Management Platform for Science

    NASA Astrophysics Data System (ADS)

    Basney, J.

    2016-12-01

    When scientists work together, they use web sites and other software to share their ideas and data. To ensure the integrity of their work, these systems require the scientists to log in and verify that they are part of the team working on a particular science problem. Too often, the identity and access verification process is a stumbling block for the scientists. Scientific research projects are forced to invest time and effort into developing and supporting Identity and Access Management (IAM) services, distracting them from the core goals of their research collaboration. CILogon provides an IAM platform that enables scientists to work together to meet their IAM needs more effectively so they can allocate more time and effort to their core mission of scientific research. The CILogon platform enables federated identity management and collaborative organization management. Federated identity management enables researchers to use their home organization identities to access cyberinfrastructure, rather than requiring yet another username and password to log on. Collaborative organization management enables research projects to define user groups for authorization to collaboration platforms (e.g., wikis, mailing lists, and domain applications). CILogon's IAM platform serves the unique needs of research collaborations, namely the need to dynamically form collaboration groups across organizations and countries, sharing access to data, instruments, compute clusters, and other resources to enable scientific discovery. CILogon provides a software-as-a-service platform to ease integration with cyberinfrastructure, while making all software components publicly available under open source licenses to enable re-use. Figure 1 illustrates the components and interfaces of this platform. CILogon has been operational since 2010 and has been used by over 7,000 researchers from more than 170 identity providers to access cyberinfrastructure including Globus, LIGO, Open Science Grid

  20. Access management research and awareness program : phase IV final report

    DOT National Transportation Integrated Search

    1999-11-01

    Access management involves balancing the dual roles that roadways must play - through travel and access to property and economic activity. When these roles are not in proper balance, the result is a roadway system that functions sub-optimally. The Io...

  1. [Thrombosis in vascular accesses for haemodialysis: rescue treatment using invasive vascular radiological techniques].

    PubMed

    García Medina, J; Lacasa Pérez, N; Muray Cases, S; Pérez Garrido, I; García Medina, V

    2009-01-01

    The purpose of this paper is to communicate our experience in the salvage of thrombosed haemodialysis vascular accesses using interventional radiology techniques. In the last four years, we have treated, by radiological means, 101 thrombosed haemodialysis vascular accesses. There were 44 autologous arteriovenous fistulas (43.56%) and 57 PTFE grafts (56.44%). There were 69 men (68.3%) and 32 women (31.7%). The mean age was 67.73 years (range 33-84). The mean vascular access age was 23.79 months (range 1-132). Manual catheter-directed aspiration was used. Fragmented, triturated or pushed the thrombus against the pulmonary circulation was avoided in all cases. 78 accesses were salvaged (77.2%). Autologous fistulas average and PTFE grafts success rate were 84.44% and 71.42% respectively. Angioplasty in one or more lesions after thromboaspiration was performed in all accesses, except six (5.9%). Metallic endoprostheses were implanted in 14 accesses (13.9%). Mean follow-up was 9 months (range 0-44). Primary patency was 42.3% +/- 5 at 6 months and 32% +/- 4 at one year. Autologous fistulas patency was better than PTFE grafts patency (p < or =0,05). Our results suggest thrombosed autologous arteriovenous fistulas salvage is better than PTFE grafts. This justifies interventional radiology techniques in these situations.

  2. Placement of Upper Extremity Arteriovenous Access in Patients with Central Venous Occlusions: A Novel Technique.

    PubMed

    Murga, Allen G; Chiriano, Jason T; Bianchi, Christian; Sheng, Neha; Patel, Sheela; Abou-Zamzam, Ahmed M; Teruya, Theodore H

    2017-07-01

    Central venous occlusion is a common occurrence in patients with end-stage renal disease. Placement of upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins is often not an option. Avoidance of lower extremity vascular access can decrease morbidity and infection. The central venous lesions were crossed centrally via femoral access. The wire was retrieved in the neck extravascularly. A Hemodialysis Reliable Outflow catheter was then placed in the right atrium and completed with an arterial anastomosis. We describe a novel technique for placing upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins. This technique was utilized in 3 patients. The technical success was 100%. The placement of upper extremity arteriovenous access in patients with central venous occlusions is technically feasible. Published by Elsevier Inc.

  3. Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

    PubMed

    Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

    Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

  4. Developing an Oregon access management best practices manual.

    DOT National Transportation Integrated Search

    2013-02-01

    This Report reviews an Oregon research effort to develop an Oregon Access Management Best Practices Manual. In particular, this research effort develops a resource to help transportation professionals quantify safety and operational effects of variou...

  5. Advanced Techniques for Deploying Reliable and Efficient Access Control: Application to E-healthcare.

    PubMed

    Jaïdi, Faouzi; Labbene-Ayachi, Faten; Bouhoula, Adel

    2016-12-01

    Nowadays, e-healthcare is a main advancement and upcoming technology in healthcare industry that contributes to setting up automated and efficient healthcare infrastructures. Unfortunately, several security aspects remain as main challenges towards secure and privacy-preserving e-healthcare systems. From the access control perspective, e-healthcare systems face several issues due to the necessity of defining (at the same time) rigorous and flexible access control solutions. This delicate and irregular balance between flexibility and robustness has an immediate impact on the compliance of the deployed access control policy. To address this issue, the paper defines a general framework to organize thinking about verifying, validating and monitoring the compliance of access control policies in the context of e-healthcare databases. We study the problem of the conformity of low level policies within relational databases and we particularly focus on the case of a medical-records management database defined in the context of a Medical Information System. We propose an advanced solution for deploying reliable and efficient access control policies. Our solution extends the traditional lifecycle of an access control policy and allows mainly managing the compliance of the policy. We refer to an example to illustrate the relevance of our proposal.

  6. Economic Techniques of Occupational Health and Safety Management

    NASA Astrophysics Data System (ADS)

    Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.

    2016-10-01

    The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.

  7. From managing access to managing care: the impact of primary care on health care delivery organizations.

    PubMed

    Hickey, M E

    1995-10-01

    Professional "revenge of the nerds" is currently taking place, as managed care evolves generalist physicians into new professional prominence. Primary care physicians are finding themselves at the center of health care market reform as health plans, insurers, and other financing organizations turn to them as the key to cost control. In short supply, they are prospering financially from the demand. As the source of patients, they are gaining in prestige from specialists and hospitals who once demeaned them. But these newfound roles are only the initial steps in the transformation of the primary care practitioner. The change that the generalists are experiencing is essentially managing access to care, not truly managing care itself. There are large and crucial differences between managing access to care and actually managing care. These differences are, in many ways, a higher calling for primary care practitioners as they refocus attention on patient outcomes, which will in itself result in a lower resource utilization above and beyond the crude controlling of access. What those differences are, what new roles they require, and what impact they will have on organizations that either house or contract with primary care physicians will be the focus of this article.

  8. Techniques for Efficiently Managing Large Geosciences Data Sets

    NASA Astrophysics Data System (ADS)

    Kruger, A.; Krajewski, W. F.; Bradley, A. A.; Smith, J. A.; Baeck, M. L.; Steiner, M.; Lawrence, R. E.; Ramamurthy, M. K.; Weber, J.; Delgreco, S. A.; Domaszczynski, P.; Seo, B.; Gunyon, C. A.

    2007-12-01

    We have developed techniques and software tools for efficiently managing large geosciences data sets. While the techniques were developed as part of an NSF-Funded ITR project that focuses on making NEXRAD weather data and rainfall products available to hydrologists and other scientists, they are relevant to other geosciences disciplines that deal with large data sets. Metadata, relational databases, data compression, and networking are central to our methodology. Data and derived products are stored on file servers in a compressed format. URLs to, and metadata about the data and derived products are managed in a PostgreSQL database. Virtually all access to the data and products is through this database. Geosciences data normally require a number of processing steps to transform the raw data into useful products: data quality assurance, coordinate transformations and georeferencing, applying calibration information, and many more. We have developed the concept of crawlers that manage this scientific workflow. Crawlers are unattended processes that run indefinitely, and at set intervals query the database for their next assignment. A database table functions as a roster for the crawlers. Crawlers perform well-defined tasks that are, except for perhaps sequencing, largely independent from other crawlers. Once a crawler is done with its current assignment, it updates the database roster table, and gets its next assignment by querying the database. We have developed a library that enables one to quickly add crawlers. The library provides hooks to external (i.e., C-language) compiled codes, so that developers can work and contribute independently. Processes called ingesters inject data into the system. The bulk of the data are from a real-time feed using UCAR/Unidata's IDD/LDM software. An exciting recent development is the establishment of a Unidata HYDRO feed that feeds value-added metadata over the IDD/LDM. Ingesters grab the metadata and populate the Postgre

  9. Subxyphoid access of the normal pericardium: a novel drug delivery technique.

    PubMed

    Laham, R J; Simons, M; Hung, D

    1999-05-01

    The pericardial space may potentially serve as a drug delivery reservoir that might be used to deliver therapeutic substances to the heart. This study describes a novel delivery technique that enables safe and rapid percutaneous subxyphoid access of the normal pericardium in a large animal model (49 Yorkshire pigs). An epidural introducer needle (Tuohy-17) is advanced gently under fluoroscopic guidance with a continuous positive pressure of 20-30 mm Hg (achieved by saline infusion using an intraflow system). The positive pressure is intended to push the right ventricle (with a lower pressure) away from the needle's path. Entry of the pericardial space is suspected after an increase in the saline flow through the intraflow system. Access to the pericardial space is confirmed by the injection of 1 ml of diluted contrast under fluoroscopy. A soft floppy-tip 0.025" guidewire is then advanced to the pericardial space and the needle is exchanged for an infusion catheter. Access of the pericardial space was achieved in all animals without any adverse events and without any hemodynamic compromise even with the delivery of fluid volumes as large as 50 ml. Histologic examination in 15 animals 4 weeks after pericardial access did not reveal any delivery-related myocardial damage. The safety, ease, and absence of hemodynamic compromise make this technique a potentially useful method for intrapericardial drug delivery and a good alternative to standard pericardiocentesis in patients with small pericardial effusions at higher risk for complications.

  10. Optical multiple access techniques for on-board routing

    NASA Technical Reports Server (NTRS)

    Mendez, Antonio J.; Park, Eugene; Gagliardi, Robert M.

    1992-01-01

    The purpose of this research contract was to design and analyze an optical multiple access system, based on Code Division Multiple Access (CDMA) techniques, for on board routing applications on a future communication satellite. The optical multiple access system was to effect the functions of a circuit switch under the control of an autonomous network controller and to serve eight (8) concurrent users at a point to point (port to port) data rate of 180 Mb/s. (At the start of this program, the bit error rate requirement (BER) was undefined, so it was treated as a design variable during the contract effort.) CDMA was selected over other multiple access techniques because it lends itself to bursty, asynchronous, concurrent communication and potentially can be implemented with off the shelf, reliable optical transceivers compatible with long term unattended operations. Temporal, temporal/spatial hybrids and single pulse per row (SPR, sometimes termed 'sonar matrices') matrix types of CDMA designs were considered. The design, analysis, and trade offs required by the statement of work selected a temporal/spatial CDMA scheme which has SPR properties as the preferred solution. This selected design can be implemented for feasibility demonstration with off the shelf components (which are identified in the bill of materials of the contract Final Report). The photonic network architecture of the selected design is based on M(8,4,4) matrix codes. The network requires eight multimode laser transmitters with laser pulses of 0.93 ns operating at 180 Mb/s and 9-13 dBm peak power, and 8 PIN diode receivers with sensitivity of -27 dBm for the 0.93 ns pulses. The wavelength is not critical, but 830 nm technology readily meets the requirements. The passive optical components of the photonic network are all multimode and off the shelf. Bit error rate (BER) computations, based on both electronic noise and intercode crosstalk, predict a raw BER of (10 exp -3) when all eight users are

  11. Airway management and vascular access simulation during a medical student rotation.

    PubMed

    Sakawi, Yasser; Vetter, Thomas R

    2011-03-01

    Medical students electing to spend a month in anaesthesiology during their third or fourth year often experience airway management and vascular access for the first time on an actual patient. An airway management and vascular access simulation course for medical students was developed and implemented at our institution. The purpose of this study was to assess the subjective comfort level after implementing this teaching tool in medical students. A brief didactic course on airway management and vascular access was provided to medical students on the first day of their anaesthesiology rotation. A survey was presented to the students immediately after a focused 1-hour lecture and prior to a simulation session. The pre-simulation survey was comprised of eight questions asking the medical students to rate their level of comfort with both types of procedures. The lecture was followed by a 1-hour simulation course on manikins. The medical students were asked to complete a post-simulation survey, which was comprised of the same initial eight questions. After participating in the didactic course and manikin simulation, the self-perceived comfort level of medical students with airway management (p < 0.0005), vascular access (p < 0.0005) and interpretation of the vascular pressure waveforms (p < 0.0005) demonstrated significant improvement. The results of this study suggest that providing medical students with a brief didactic session on airway and vascular access, including simulation on manikins, prior to the start of their encounter with actual surgical patients, can improve their comfort level in performing both procedures. © Blackwell Publishing Ltd 2011.

  12. Effect of access to anticoagulation management services on warfarin use in patients with atrial fibrillation.

    PubMed

    Burkiewicz, Jill S

    2005-08-01

    To determine the effect of access to ambulatory anticoagulation management services (AMS) on the rate of warfarin use in patients with atrial fibrillation. Retrospective medical record review. Two ambulatory care clinics in the same managed care system: one with and one without access to pharmacist-managed AMS. One hundred seventy-eight patients with atrial fibrillation diagnosed between June 2000 and June 2001. Warfarin use was assessed overall and by contraindications and risk factors for stroke. Independent predictors of therapy were identified. The overall rate of warfarin use in atrial fibrillation was higher in the clinic with access to AMS than in the clinic without access (77.9% vs 61.7%, p=0.03). In patients with no known contraindications, warfarin use increased by 20.2% with access to AMS versus no access (80.2% vs 60.0%, p=0.023). Patients aged 65 years or older with one or more risk factors for stroke and no contraindications were more likely to receive warfarin in the clinic with access to AMS than in the clinic without access (85.1% vs 53.8%, p=0.001). Access to AMS was an independent predictor of warfarin use (odds ratio 2.19, 95% confidence interval [CI] 1.05-4.56). Female sex was an independent negative predictor of warfarin use (odds ratio 0.48, 95% CI 0.24-0.96). In the managed care setting, use of warfarin for stroke prophylaxis in patients with atrial fibrillation was higher in the ambulatory care clinic with access to pharmacist-managed AMS than in the clinic without access.

  13. Integrating RFID technique to design mobile handheld inventory management system

    NASA Astrophysics Data System (ADS)

    Huang, Yo-Ping; Yen, Wei; Chen, Shih-Chung

    2008-04-01

    An RFID-based mobile handheld inventory management system is proposed in this paper. Differing from the manual inventory management method, the proposed system works on the personal digital assistant (PDA) with an RFID reader. The system identifies electronic tags on the properties and checks the property information in the back-end database server through a ubiquitous wireless network. The system also provides a set of functions to manage the back-end inventory database and assigns different levels of access privilege according to various user categories. In the back-end database server, to prevent improper or illegal accesses, the server not only stores the inventory database and user privilege information, but also keeps track of the user activities in the server including the login and logout time and location, the records of database accessing, and every modification of the tables. Some experimental results are presented to verify the applicability of the integrated RFID-based mobile handheld inventory management system.

  14. Improving collaboration and consensus building in the coordination of access management and land use in corridor planning.

    DOT National Transportation Integrated Search

    2015-06-01

    The success of access management depends on the coordination of access management planning and land use planning, : but the Virginia Department of Transportation (VDOT) has control over access management in Virginia and cities and counties : adjacent...

  15. Improving access to adequate pain management in Taiwan.

    PubMed

    Scholten, Willem

    2015-06-01

    There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring access for medical and scientific purposes while preventing diversion, harmful use and dependence. Furthermore, international law requires that countries ensure access to opioid analgesics for medical and scientific purposes. There is evidence that opioid analgesics for chronic pain are not associated with a major risk for developing dependence. Barriers for access can be classified in the categories of overly restrictive laws and regulations; insufficient medical training on pain management and problems related to assessment of medical needs; attitudes like an excessive fear for dependence or diversion; and economic and logistical problems. The GOPI project found many examples of such barriers in Asia. Access to opioid medicines in Taiwan can be improved by analysing the national situation and drafting a plan. The WHO policy guidelines Ensuring Balance in National Policies on Controlled Substances can be helpful for achieving this purpose, as well as international guidelines for pain treatment. Copyright © 2015. Published by Elsevier B.V.

  16. Mobility management techniques for the next-generation wireless networks

    NASA Astrophysics Data System (ADS)

    Sun, Junzhao; Howie, Douglas P.; Sauvola, Jaakko J.

    2001-10-01

    The tremendous demands from social market are pushing the booming development of mobile communications faster than ever before, leading to plenty of new advanced techniques emerging. With the converging of mobile and wireless communications with Internet services, the boundary between mobile personal telecommunications and wireless computer networks is disappearing. Wireless networks of the next generation need the support of all the advances on new architectures, standards, and protocols. Mobility management is an important issue in the area of mobile communications, which can be best solved at the network layer. One of the key features of the next generation wireless networks is all-IP infrastructure. This paper discusses the mobility management schemes for the next generation mobile networks through extending IP's functions with mobility support. A global hierarchical framework model for the mobility management of wireless networks is presented, in which the mobility management is divided into two complementary tasks: macro mobility and micro mobility. As the macro mobility solution, a basic principle of Mobile IP is introduced, together with the optimal schemes and the advances in IPv6. The disadvantages of the Mobile IP on solving the micro mobility problem are analyzed, on the basis of which three main proposals are discussed as the micro mobility solutions for mobile communications, including Hierarchical Mobile IP (HMIP), Cellular IP, and Handoff-Aware Wireless Access Internet Infrastructure (HAWAII). A unified model is also described in which the different micro mobility solutions can coexist simultaneously in mobile networks.

  17. Earth Science Keyword Stewardship: Access and Management through NASA's Global Change Master Directory (GCMD) Keyword Management System (KMS)

    NASA Astrophysics Data System (ADS)

    Stevens, T.; Olsen, L. M.; Ritz, S.; Morahan, M.; Aleman, A.; Cepero, L.; Gokey, C.; Holland, M.; Cordova, R.; Areu, S.; Cherry, T.; Tran-Ho, H.

    2012-12-01

    Discovering Earth science data can be complex if the catalog holding the data lacks structure. Controlled keyword vocabularies within metadata catalogues can improve data discovery. NASA's Global Change Master Directory's (GCMD) Keyword Management System (KMS) is a recently released a RESTful web service for managing and providing access to controlled keywords (science keywords, service keywords, platforms, instruments, providers, locations, projects, data resolution, etc.). The KMS introduces a completely new paradigm for the use and management of the keywords and allows access to these keywords as SKOS Concepts (RDF), OWL, standard XML, and CSV. A universally unique identifier (UUID) is automatically assigned to each keyword, which uniquely identifies each concept and its associated information. A component of the KMS is the keyword manager, an internal tool that allows GCMD science coordinators to manage concepts. This includes adding, modifying, and deleting broader, narrower, or related concepts and associated definitions. The controlled keyword vocabulary represents over 20 years of effort and collaboration with the Earth science community. The maintenance, stability, and ongoing vigilance in maintaining mutually exclusive and parallel keyword lists is important for a "normalized" search and discovery, and provides a unique advantage for the science community. Modifications and additions are made based on community suggestions and internal review. To help maintain keyword integrity, science keyword rules and procedures for modification of keywords were developed. This poster will highlight the use of the KMS as a beneficial service for the stewardship and access of the GCMD keywords. Users will learn how to access the KMS and utilize the keywords. Best practices for managing an extensive keyword hierarchy will also be discussed. Participants will learn the process for making keyword suggestions, which subsequently help in building a controlled keyword

  18. A rapid prototyping/artificial intelligence approach to space station-era information management and access

    NASA Technical Reports Server (NTRS)

    Carnahan, Richard S., Jr.; Corey, Stephen M.; Snow, John B.

    1989-01-01

    Applications of rapid prototyping and Artificial Intelligence techniques to problems associated with Space Station-era information management systems are described. In particular, the work is centered on issues related to: (1) intelligent man-machine interfaces applied to scientific data user support, and (2) the requirement that intelligent information management systems (IIMS) be able to efficiently process metadata updates concerning types of data handled. The advanced IIMS represents functional capabilities driven almost entirely by the needs of potential users. Space Station-era scientific data projected to be generated is likely to be significantly greater than data currently processed and analyzed. Information about scientific data must be presented clearly, concisely, and with support features to allow users at all levels of expertise efficient and cost-effective data access. Additionally, mechanisms for allowing more efficient IIMS metadata update processes must be addressed. The work reported covers the following IIMS design aspects: IIMS data and metadata modeling, including the automatic updating of IIMS-contained metadata, IIMS user-system interface considerations, including significant problems associated with remote access, user profiles, and on-line tutorial capabilities, and development of an IIMS query and browse facility, including the capability to deal with spatial information. A working prototype has been developed and is being enhanced.

  19. Central venous access devices: an investigation of oncology nurses' troubleshooting techniques.

    PubMed

    Mason, Tina M; Ferrall, Sheila M; Boyington, Alice R; Reich, Richard R

    2014-08-01

    Experienced oncology nurses use different troubleshooting techniques for clearing occluded central venous access devices (CVADs) with varying degrees of success. The purpose of this study was to explore troubleshooting techniques used for clearing occluded CVADs by experienced oncology RNs and identify the perceived effectiveness of each technique. An invitation for a web-based survey was sent to select RN members of the Oncology Nursing Society. All nurses (N = 224) reported asking patients to raise and/or move their arm. Most nurses asked patients to lie down, cough, and take deep breaths. Respondents considered instilling a thrombolytic agent to be the most effective technique. No associations were found between techniques and respondents' years in oncology nursing, work setting, certification, or academic degree. The findings contribute to knowledge about care of patients with occluded devices and will help formulate direction for additional investigation of CVADs. Establishing the appropriateness of practice-related troubleshooting techniques may eliminate unnecessary steps and save nursing time. Educating nurses on the topic will also help reduce techniques that are not expected to yield results or are contraindicated.

  20. Access management : transportation policy considerations for a growing Virginia.

    DOT National Transportation Integrated Search

    1998-01-01

    This report analyzes comprehensive highway access management programs and looks at the potential benefits and legal limits to Virginia adopting such a program to replace Virginia's rather limited site specific permitting process. In 1942, Virginia pa...

  1. Improving access for patients – a practice manager questionnaire

    PubMed Central

    Meade, James G; Brown, James S

    2006-01-01

    Background The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. Methods A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. Results There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062). Conclusion The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study. PMID:16784530

  2. Laparoscopic access overview: Is there a safest entry method?

    PubMed

    Bianchi, G; Martorana, E; Ghaith, A; Pirola, G M; Rani, M; Bove, P; Porpiglia, F; Manferrari, F; Micali, S

    2016-01-01

    Laparoscopy is a minimally invasive technique to access the abdominal cavity, for diagnostic or therapeutic applications. Optimizing the access technique is an important step for laparoscopic procedures. The aim of this study is to assess the outcomes of different laparoscopic access techniques and to identify the safest one. Laparoscopic access questionnaire was forwarded via e-mail to the 60 centers who are partners in working group for laparoscopic and robotic surgery of the Italian Urological Society (SIU) and their American and European reference centers. The response rate was 68.33%. The total number of procedures considered was 65.636. 61.5% of surgeons use Veress needle to create pneumoperitoneum. Blind trocar technique is the most commonly used, but has the greatest number of complications. Optical trocar technique seems to be the safest, but it's the less commonly used. The 28,2% of surgeons adopt open Hasson's technique. Total intra-operative complications rate was 3.3%. Open conversion rate was 0.33%, transfusion rate was 1.13%, and total post-operative complication rate was 2.53%. Laparoscopic access is a safe technique with low complication rate. Most of complications can be managed conservatively or laparoscopically. The choice of access technique can affect the rate and type of complications and should be planned according to surgeon experience, safety of each technique and patient characteristics. All access types have perioperative complications. According with our study, optical trocar technique seems to be the safest. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Popliteal versus tibial retrograde access for subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique.

    PubMed

    Hua, W R; Yi, M Q; Min, T L; Feng, S N; Xuan, L Z; Xing, J

    2013-08-01

    This study aimed to ascertain differences in benefit and effectiveness of popliteal versus tibial retrograde access in subintimal arterial flossing with the antegrade-retrograde intervention (SAFARI) technique. This was a retrospective study of SAFARI-assisted stenting for long chronic total occlusion (CTO) of TASC C and D superficial femoral lesions. 38 cases had superficial femoral artery lesions (23 TASC C and 15 TASC D). All 38 cases underwent SAFARI-assisted stenting. The ipsilateral popliteal artery was retrogradely punctured in 17 patients. A distal posterior tibial (PT) or dorsalis pedis (DP) artery was retrogradely punctured in 21 patients, and 16 of them were punctured after open surgical exposure. SAFARI technical success was achieved in all cases. There was no significant difference in 1-year primary patency (75% vs. 78.9%, p = .86), secondary patency (81.2% vs. 84.2%, p = .91) and access complications (p = 1.00) between popliteal and tibial retrograde access. There was statistical difference in operation time between popliteal (140.1 ± 28.4 min) and tibial retrograde access with PT/DP punctures after surgical vessel exposure (120.4 ± 23.0 min, p = .04). The SAFARI technique is a safe and feasible option for patients with infrainguinal CTO (TASC II C and D). The PT or DP as the retrograde access after surgical vessel exposure is a good choice when using the SAFARI technique. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Dynamic Key Management Schemes for Secure Group Access Control Using Hierarchical Clustering in Mobile Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Tsaur, Woei-Jiunn; Pai, Haw-Tyng

    2008-11-01

    The applications of group computing and communication motivate the requirement to provide group access control in mobile ad hoc networks (MANETs). The operation in MANETs' groups performs a decentralized manner and accommodated membership dynamically. Moreover, due to lack of centralized control, MANETs' groups are inherently insecure and vulnerable to attacks from both within and outside the groups. Such features make access control more challenging in MANETs. Recently, several researchers have proposed group access control mechanisms in MANETs based on a variety of threshold signatures. However, these mechanisms cannot actually satisfy MANETs' dynamic environments. This is because the threshold-based mechanisms cannot be achieved when the number of members is not up to the threshold value. Hence, by combining the efficient elliptic curve cryptosystem, self-certified public key cryptosystem and secure filter technique, we construct dynamic key management schemes based on hierarchical clustering for securing group access control in MANETs. Specifically, the proposed schemes can constantly accomplish secure group access control only by renewing the secure filters of few cluster heads, when a cluster head joins or leaves a cross-cluster. In such a new way, we can find that the proposed group access control scheme can be very effective for securing practical applications in MANETs.

  5. Preliminary application of a single-port access technique for laparoscopic ovariohysterectomy in dogs

    PubMed Central

    Sánchez-Margallo, F. M.; Tapia-Araya, A.; Díaz-Güemes, I.

    2015-01-01

    Laparoscopic ovariohysterectomy using single-portal access was performed in nine selected owned dogs admitted for elective ovariohysterectomy and the surgical technique and outcomes were detailed. A multiport device (SILS Port, Covidien, USA) was placed at the umbilical area through a single 3 cm incision. Three cannulae were introduced in the multiport device through the access channels and laparoscopic ovariohysterectomy was performed using a 5-mm sealing device, a 5-mm articulating grasper and a 5-mm 30° laparoscope. The mean total operative time was 52.66±15.20 minutes and the mean skin incision during surgery was 3.09±0.20 cm. Of the nine cases examined, in the one with an ovarian tumour, the technique was converted to multiport laparoscopy introducing an additional 5-mm trocar. No surgical complications were encountered and intraoperative blood loss was minimum in all animals. Clashing of the instruments and reduced triangulation were the main limitations of this technique. The combination of articulated and straight instruments facilitated triangulation towards the surgical field and dissection capability. One month after surgery a complete wound healing was observed in all animals. The present data showed that ovariohysterectomy performed with a single-port access is technically feasible in dogs. The unique abdominal incision minimises the abdominal trauma with good cosmetic results. PMID:26568831

  6. The Role of the Access Services Manager in the Virtual Library

    ERIC Educational Resources Information Center

    Jetton, Lora Lennertz; Bailey, Alberta S.

    2010-01-01

    This article updates a previous article published in 1992 that described the role of the access services manager in policy formation. Since that time, the access services department and mission has matured and evolved to a prominent position within the library organization. Technological changes and innovation in the marketplace of wired and…

  7. Managing Access: Extending Medicaid to Children Through School-Based HMO Coverage

    PubMed Central

    Coulam, Robert F.; Irvin, Carol V.; Calore, Kathleen A.; Kidder, David E.; Rosenbach, Margo L.

    1997-01-01

    This study explores how a health maintenance organization's (HMO) capacity and incentives to manage care might be used to improve access. In the early 1990s, the Florida Healthy Kids (FHK) demonstration extended Medicaid-like HMO coverage to indigent children in the public schools of Volusia County, Florida. The study finds that uninsured student months in area public schools were likely reduced by one-half. Utilization and cost levels for these indigent enrollees proved to be indistinguishable from commercial clients; and measures of access, utilization, and satisfaction for enrollees were in line with (and in some cases, superior to) non-enrollees with private insurance. Overall, these results suggest the value of using schools as a medium for providing coverage, and the importance of taking deliberate steps to manage access to reduce non-financial barriers to care. PMID:10170346

  8. Stress Management Techniques for Young Children.

    ERIC Educational Resources Information Center

    Piper, Francesca M.

    The director of a not-for-profit nursery school adapted the adult stress management techniques of exercise and relaxation for use with 3- to 5-year-old children. Specifically, children were taught visualization techniques and yoga exercises involving deep breathing. The goal of the practicum was to rechannel children's negative stress-related…

  9. Method and apparatus for managing access to a memory

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

    DeBenedictis, Erik

    A method and apparatus for managing access to a memory of a computing system. A controller transforms a plurality of operations that represent a computing job into an operational memory layout that reduces a size of a selected portion of the memory that needs to be accessed to perform the computing job. The controller stores the operational memory layout in a plurality of memory cells within the selected portion of the memory. The controller controls a sequence by which a processor in the computing system accesses the memory to perform the computing job using the operational memory layout. The operationalmore » memory layout reduces an amount of energy consumed by the processor to perform the computing job.« less

  10. The Hall Technique for managing carious primary molars.

    PubMed

    Innes, Nicola; Evans, Dafydd; Hall, Norna

    2009-10-01

    The Hall Technique, a method of managing carious primary molars effectively with preformed metal crowns, without the use of local anaesthesia, caries removal or tooth preparation of any kind, is described.The technique is illustrated with a case report.The evidence underpinning the technique is discussed, along with indications and contra-indications for its use, and details of where clinicians can obtain further information on the technique if they are considering using it. Research evidence has indicated that the Hall Technique is effective in managing dental caries in primary molar teeth when used by General Dental Practitioners, and is preferred by them, their child patients and the children's parents to conventional restorative methods for these teeth.

  11. Group decision-making techniques for natural resource management applications

    USGS Publications Warehouse

    Coughlan, Beth A.K.; Armour, Carl L.

    1992-01-01

    This report is an introduction to decision analysis and problem-solving techniques for professionals in natural resource management. Although these managers are often called upon to make complex decisions, their training in the natural sciences seldom provides exposure to the decision-making tools developed in management science. Our purpose is to being to fill this gap. We present a general analysis of the pitfalls of group problem solving, and suggestions for improved interactions followed by the specific techniques. Selected techniques are illustrated. The material is easy to understand and apply without previous training or excessive study and is applicable to natural resource management issues.

  12. Reaching the Connected Generation: "College Access Marketers" Slow in Adopting New Techniques

    ERIC Educational Resources Information Center

    Gastwirth, David

    2007-01-01

    This author states that "college access marketing" efforts aimed at increasing college attendance and success have been slow to incorporate new techniques such as "buzz marketing," "viral marketing," "product seeding," and "guerrilla marketing." Yet for a "connected generation" of potential college students, these kinds of strategies could be…

  13. An incremental database access method for autonomous interoperable databases

    NASA Technical Reports Server (NTRS)

    Roussopoulos, Nicholas; Sellis, Timos

    1994-01-01

    We investigated a number of design and performance issues of interoperable database management systems (DBMS's). The major results of our investigation were obtained in the areas of client-server database architectures for heterogeneous DBMS's, incremental computation models, buffer management techniques, and query optimization. We finished a prototype of an advanced client-server workstation-based DBMS which allows access to multiple heterogeneous commercial DBMS's. Experiments and simulations were then run to compare its performance with the standard client-server architectures. The focus of this research was on adaptive optimization methods of heterogeneous database systems. Adaptive buffer management accounts for the random and object-oriented access methods for which no known characterization of the access patterns exists. Adaptive query optimization means that value distributions and selectives, which play the most significant role in query plan evaluation, are continuously refined to reflect the actual values as opposed to static ones that are computed off-line. Query feedback is a concept that was first introduced to the literature by our group. We employed query feedback for both adaptive buffer management and for computing value distributions and selectivities. For adaptive buffer management, we use the page faults of prior executions to achieve more 'informed' management decisions. For the estimation of the distributions of the selectivities, we use curve-fitting techniques, such as least squares and splines, for regressing on these values.

  14. Percutaneous Endovascular Salvage Techniques for Implanted Venous Access Device Dysfunction

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

    Breault, Stéphane, E-mail: stephane.breault@chuv.ch; Glauser, Frédéric, E-mail: frederic.glauser@chuv.ch; Babaker, Malik, E-mail: malik.babaker@chuv.ch

    2015-06-15

    PurposeImplanted venous access devices (IVADs) are often used in patients who require long-term intravenous drug administration. The most common causes of device dysfunction include occlusion by fibrin sheath and/or catheter adherence to the vessel wall. We present percutaneous endovascular salvage techniques to restore function in occluded catheters. The aim of this study was to evaluate the feasibility, safety, and efficacy of these techniques.Methods and MaterialsThrough a femoral or brachial venous access, a snare is used to remove fibrin sheath around the IVAD catheter tip. If device dysfunction is caused by catheter adherences to the vessel wall, a new “mechanical adhesiolysis”more » maneuver was performed. IVAD salvage procedures performed between 2005 and 2013 were analyzed. Data included clinical background, catheter tip position, success rate, recurrence, and rate of complication.ResultsEighty-eight salvage procedures were performed in 80 patients, mostly women (52.5 %), with a mean age of 54 years. Only a minority (17.5 %) of evaluated catheters were located at an optimal position (i.e., cavoatrial junction ±1 cm). Mechanical adhesiolysis or other additional maneuvers were used in 21 cases (24 %). Overall technical success rate was 93.2 %. Malposition and/or vessel wall adherences were the main cause of technical failure. No complications were noted.ConclusionThese IVAD salvage techniques are safe and efficient. When a catheter is adherent to the vessel wall, mechanical adhesiolysis maneuvers allow catheter mobilization and a greater success rate with no additional risk. In patients who still require long-term use of their IVAD, these procedures can be performed safely to avoid catheter replacement.« less

  15. The sterile-male-release technique in Great Lakes sea lamprey management

    USGS Publications Warehouse

    Twohey, Michael B.; Heinrich, John W.; Seelye, James G.; Fredricks, Kim T.; Bergstedt, Roger A.; Kaye, Cheryl A.; Scholefield, Ron J.; McDonald, Rodney B.; Christie, Gavin C.

    2003-01-01

    The implementation of a sterile-male-release technique from 1991 through 1999 and evaluation of its effectiveness in the Great Lakes sea lamprey (Petromyzon marinus) management program is reviewed. Male sea lampreys were injected with the chemosterilant bisazir (P,P-bis(1-aziridinyl)-N-methylphosphinothioic amide) using a robotic device. Quality assurance testing indicated the device delivered a consistent and effective dose of bisazir. Viability of embryos in an untreated control group was 64% compared to 1% in a treatment group. A task force developed nine hypotheses to guide implementation and evaluation of the technique. An annual average of 26,000 male sea lampreys was harvested from as many as 17 Great Lakes tributaries for use in the technique. An annual average of 16,100 sterilized males was released into 33 tributaries of Lake Superior to achieve a theoretical 59% reduction in larval production during 1991 to 1996. The average number of sterile males released in the St. Marys River increased from 4,000 during 1991 to 1996 to 20,100 during 1997 to 1999. The theoretical reduc-stertion in reproduction when combined with trapping was 57% during 1991 to 1996 and 86% during 1997 to 1999. Evaluation studies demonstrated that sterilized males were competitive and reduced production of larvae in streams. Field studies and simulation models suggest reductions in reproduction will result in fewer recruits, but there is risk of periodic high recruitment events independent of sterile-male release. Strategies to reduce reproduction will be most reliable when low densities of reproducing females are achieved. Expansion of the technique is limited by access to additional males for sterilization. Sterile-male release and other alternative controls are important in delivering integrated pest management and in reducing reliance on pesticides.

  16. Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

    PubMed Central

    Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

    2002-01-01

    BACKGROUND: Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. AIM: To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. DESIGN OF STUDY: A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. SETTING: Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. METHOD: Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. RESULTS: The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. CONCLUSION: A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children. PMID:12528583

  17. Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

    PubMed

    Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

    2002-12-01

    Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children.

  18. Vascular Access Type and Patient and Technique Survival in Home Hemodialysis Patients: The Canadian Organ Replacement Register.

    PubMed

    Perl, Jeffrey; Nessim, Sharon J; Moist, Louise M; Wald, Ron; Na, Yingbo; Tennankore, Karthik K; Chan, Christopher T

    2016-02-01

    While central venous catheter (CVC) use has expanded home hemodialysis (HHD) eligibility to many patients who may be unable to self-cannulate an arteriovenous (AV) access, the association between CVC use and mortality has not been directly examined among HHD patients. Registry-based retrospective observational cohort study. Incident HHD patients in The Canadian Organ Replacement Register who had information for vascular access type (CVC vs AV access) within the first year of HHD therapy initiation. Use of a CVC versus an AV access (AV fistula or graft) within the first year of HHD therapy initiation. The composite of all-cause mortality and technique failure (long-term transfer to an alternate dialysis modality). A Cox proportional hazards model was used to evaluate the adjusted composite outcome and each outcome separately. 1,869 patients initiated HHD therapy in Canada in 1996 to 2012, of whom 1,217 had an access type recorded within the first year of HHD therapy initiation. Compared to CVC use (n=523) and during a median follow-up of 513 and 427 days for AV access and CVC patients, respectively, AV access use (n=694) was associated with lower risk for the composite event of death and technique failure (490 events; adjusted HR, 0.78; 95% CI, 0.64-0.94) and lower adjusted all-cause mortality (129 deaths; adjusted HR, 0.63; 95% CI, 0.43-0.91); the risk for technique failure was nominally lower, but this result was not statistically significant (361 events; adjusted HR, 0.84; 95% CI, 0.67-1.05). Results were robust to sensitivity analyses and after missing data imputation. Missing information for vascular access type (n=659[35% of patients]) and lack of information for longitudinal changes in vascular access type. Compared to CVC use, AV access use was associated with superior survival. Minimizing CVC use and maximizing AV access use while addressing barriers to their placement and self-cannulation may improve HHD outcomes. Copyright © 2016 National Kidney

  19. Managed access technology to combat contraband cell phones in prison: Findings from a process evaluation.

    PubMed

    Grommon, Eric

    2018-02-01

    Cell phones in correctional facilities have emerged as one of the most pervasive forms of modern contraband. This issue has been identified as a top priority for many correctional administrators in the United States. Managed access, a technology that utilizes cellular signals to capture transmissions from contraband phones, has received notable attention as a promising tool to combat this problem. However, this technology has received little evaluative attention. The present study offers a foundational process evaluation and draws upon output measures and stakeholder interviews to identify salient operational challenges and subsequent lessons learned about implementing and maintaining a managed access system. Findings suggest that while managed access captures large volumes of contraband cellular transmissions, the technology requires significant implementation planning, personnel support, and complex partnerships with commercial cellular carriers. Lessons learned provide guidance for practitioners to navigate these challenges and for scholars to improve future evaluations of managed access. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. User Access Management Based on Network Pricing for Social Network Applications

    PubMed Central

    Ma, Xingmin; Gu, Qing

    2018-01-01

    Social applications play a very important role in people’s lives, as users communicate with each other through social networks on a daily basis. This presents a challenge: How does one receive high-quality service from social networks at a low cost? Users can access different kinds of wireless networks from various locations. This paper proposes a user access management strategy based on network pricing such that networks can increase its income and improve service quality. Firstly, network price is treated as an optimizing access parameter, and an unascertained membership algorithm is used to make pricing decisions. Secondly, network price is adjusted dynamically in real time according to network load. Finally, selecting a network is managed and controlled in terms of the market economy. Simulation results show that the proposed scheme can effectively balance network load, reduce network congestion, improve the user's quality of service (QoS) requirements, and increase the network’s income. PMID:29495252

  1. Managing Both Quality and Access at Higher Educational Institutions in Tobago

    ERIC Educational Resources Information Center

    Julien Sealey, Beverley

    2011-01-01

    This paper will focus on the island of Tobago and indicate what practical solutions are best suited for administrators to manage quality and access at higher educational institutions on the island. The key areas to managing quality identified are the inclusiveness of a quality plan, administrators desire to see quality as an institutional culture…

  2. Innovations in information management and access for assessments

    PubMed Central

    Champion, Sarah M.; Kunkel, Kenneth E.; Tilmes, Curt

    2017-01-01

    The third National Climate Assessment (NCA3) included goals for becoming a more timely, inclusive, rigorous, and sustained process, and for serving a wider variety of decision makers. In order to accomplish these goals, it was necessary to deliberately design an information management strategy that could serve multiple stakeholders and manage different types of information - from highly mature government-supported climate science data, to isolated practitioner-generated case study information - and to do so in ways that are consistent and appropriate for a highly influential assessment. Meeting the information management challenge for NCA3 meant balancing relevance and authority, complexity and accessibility, inclusivity and rigor. Increasing traceability of data behind figures and graphics, designing a public-facing website, managing hundreds of technical inputs to the NCA, and producing guidance for over 300 participants on meeting the Information Quality Act were all aspects of a deliberate, multi-faceted, and strategic information management approach that nonetheless attempted to be practical and usable for a variety of participants and stakeholders. PMID:29081560

  3. Multiple access techniques and spectrum utilization of the GLOBALSTAR mobile satellite system

    NASA Astrophysics Data System (ADS)

    Louie, Ming; Cohen, Michel; Rouffet, Denis; Gilhousen, Klein S.

    The GLOBALSTAR System is a Low Earth Orbit (LEO) satellite-based mobile communications system that is interoperable with the current and future Public Land Mobile Network (PLMN). The GLOBALSTAR System concept is based upon technological advancement in two key areas: (1) the advancement in LEO satellite technology; (2) the advancement in cellular telephone technology, including the commercial applications of Code Division Multiple Access (CDMA) technologies, and of the most recent progress in Time Division Multiple Access technologies. The GLOBALSTAR System uses elements of CDMA, Frequency Division Multiple Access (FDMA), and Time Division Multiple Access (TDMA) technology, combining with satellite Multiple Beam Antenna (MBA) technology, to arrive at one of the most efficient modulation and multiple access system ever proposed for a satellite communications system. The technology used in GLOBALSTAR exploits the following techniques in obtaining high spectral efficiency and affordable cost per channel, with minimum coordination among different systems: power control, in open and closed loops, voice activation, spot beam satellite antenna for frequency reuse, weighted satellite antenna gain, multiple satellite coverage, and handoff between satellites. The GLOBALSTAR system design will use the following frequency bands: 1610-1626.5 MHz for up-link and 2483.5-2500 MHz for down-link.

  4. Workplace Learning: The Roles of Knowledge Accessibility and Management

    ERIC Educational Resources Information Center

    Li, Jessica; Brake, Gary; Champion, Angeline; Fuller, Tony; Gabel, Sandy; Hatcher-Busch, Lori

    2009-01-01

    Purpose: The purpose of this paper is to examine how knowledge management systems have been used by the studied organizations to improve knowledge accessibility and knowledge sharing in order to increase workplace learning. Design/methodology/approach: The study relies on a qualitative multisite case study method. Data were obtained from five…

  5. Organic Techniques for Protecting Virtual Private Network (VPN) Services from Access Link Flooding Attacks

    DTIC Science & Technology

    2002-01-01

    Submitted to ICN 2002 Organic Techniques for Protecting Virtual Private Network (VPN) Services from Access Link Flooding Attacks1 Ranga S. Ramanujan ...using these techniques is also described. Contact author: Dr. Ranga S. Ramanujan Architecture Technology Corporation 9971 Valley View Road Eden Prairie...OF ABSTRACT 18. NUMBER OF PAGES 15 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c . THIS PAGE unclassified

  6. Pressures on safety net access: the level of managed care penetration and uninsurance rate in a community.

    PubMed

    Cunningham, P J

    1999-04-01

    To examine the effects of managed care penetration and the uninsurance rate in an area on access to care of low-income uninsured persons and to compare differences in access between low-income insured and uninsured persons across these different market areas. Primarily the Community Tracking Study household survey. Other market-level data were obtained from the Community Tracking Study physician survey, American Hospital Association annual survey of hospitals, Area Resource File, HCFA Administrative Data, Bureau of Primary Care data on Community Health Centers. Individuals are grouped based on the level of managed care penetration and uninsurance rate in the site where they reside. Measures of managed care include overall managed care penetration in the site, and the level of Medicaid managed care penetration in the state. Uninsurance rate is defined as the percentage of people uninsured in the site. Measures of access include the percentage with a usual source of care, percentage with any ambulatory care use, and percentage of persons who reported unmet medical care needs. Estimates are adjusted to control for other confounding factors, including both individual and market-level characteristics. A survey, primarily telephoned, of households concentrated in 60 sites, defined as metropolitan statistical areas and nonmetropolitan areas. Access to care for low-income uninsured persons is lower in states with high Medicaid managed care penetration, compared to uninsured persons in states with low Medicaid managed care penetration. Access to care for low-income uninsured persons is also lower in areas with high uninsurance rates. The "access gap" (differences in access between insured and uninsured persons) is also larger in areas with high Medicaid managed care penetration and areas with high uninsurance rates. Efforts to achieve cost savings under managed care may result in financial pressures that limit cross-subsidization of care to the medically indigent

  7. Utilizing LIDAR data to analyze access management criteria in Utah.

    DOT National Transportation Integrated Search

    2017-05-01

    The primary objective of this research was to increase understanding of the safety impacts across the state related to access management. This was accomplished by using the Light Detection and Ranging (LiDAR) database to evaluate driveway spacing and...

  8. Hoshin Kanri: a technique for strategic quality management.

    PubMed

    Tennant, C; Roberts, P A

    2000-01-01

    This paper describes a technique for Strategic Quality Management (SQM), known as Hoshin Kanri, which has been operated as a management system in many Japanese companies since the 1960s. It represents a core aspect of Japanese companies' management systems, and is stated as: the means by which the overall control system and Total Quality Management (TQM) are deployed. Hoshin Kanri is not particularly unique in its concept of establishing and tracking individual goals and objectives, but the manner in which the objectives and the means to achieve them are developed and deployed is. The problem with applying the concept of Strategic Quality Management (SQM) using Hoshin Kanri, is that it can tend to challenge the traditional authoritarian strategic planning models, which have become the paradigms of modern business. Yet Hoshin Kanri provides an appropriate tool for declaration of the strategic vision for the business while integrating goals and targets in a single holistic model. There have been various adaptations of Hoshin Kanri to align the technique to Western thinking and management approaches, yet outside Japan its significance has gone largely unreported. It is proposed that Hoshin Kanri is an effective methodology for SQM, which has a number of benefits over the more conventional planning techniques. The benefits of Hoshin Kanri as a tool for Strategic Quality Management (SQM) compared to conventional planning systems include: integration of strategic objectives with tactical daily management, the application of the plan-do-check-act cycle to business process management, parallel planning and execution methodology, company wide approach, improvements in communication, increased consensus and buy-in to goal setting, and cross-functional-management integration.

  9. Performance management of multiple access communication networks

    NASA Astrophysics Data System (ADS)

    Lee, Suk; Ray, Asok

    1993-12-01

    This paper focuses on conceptual design, development, and implementation of a performance management tool for computer communication networks to serve large-scale integrated systems. The objective is to improve the network performance in handling various types of messages by on-line adjustment of protocol parameters. The techniques of perturbation analysis of Discrete Event Dynamic Systems (DEDS), stochastic approximation (SA), and learning automata have been used in formulating the algorithm of performance management. The efficacy of the performance management tool has been demonstrated on a network testbed. The conceptual design presented in this paper offers a step forward to bridging the gap between management standards and users' demands for efficient network operations since most standards such as ISO (International Standards Organization) and IEEE address only the architecture, services, and interfaces for network management. The proposed concept of performance management can also be used as a general framework to assist design, operation, and management of various DEDS such as computer integrated manufacturing and battlefield C(sup 3) (Command, Control, and Communications).

  10. Access to laboratory testing: the impact of managed care in the Pacific Northwest.

    PubMed

    LaBeau, K M; Simon, M; Steindel, S J

    1999-01-01

    Patient access to health-care services has become an important issue owing to the growth of managed care organizations and the number of patients enrolled. To better understand the current issues related to access to laboratory testing, with a particular focus on the impact of managed care, we gathered information from a network of clinical laboratories in the Pacific Northwest. Two questionnaires were sent to the 257 Laboratory Medicine Sentinel Monitoring Network participants in November 1995 and March 1996 to investigate trends in the availability and utilization of laboratory testing services and changes in onsite testing menus. Although laboratories reported that managed care was a factor in their decisions about laboratory practices, testing decisions were more likely made for business reasons, based on medical practice changes and marketplace influences not associated with managed care.

  11. Assessment and validation of managed lanes weaving and access guidelines.

    DOT National Transportation Integrated Search

    2010-06-01

    The goal of this project was to establish spacing requirements for access points to managed lanes : with respect to the location of entrance and exit ramps on the general purpose lanes of the freeway. Traffic : entering the freeway destined for the m...

  12. Database Access Manager for the Software Engineering Laboratory (DAMSEL) user's guide

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Operating instructions for the Database Access Manager for the Software Engineering Laboratory (DAMSEL) system are presented. Step-by-step instructions for performing various data entry and report generation activities are included. Sample sessions showing the user interface display screens are also included. Instructions for generating reports are accompanied by sample outputs for each of the reports. The document groups the available software functions by the classes of users that may access them.

  13. Application of Fiber-Optical Techniques in the Access Transmission and Backbone Transport of Mobile Networks

    NASA Astrophysics Data System (ADS)

    Hilt, Attila; Pozsonyi, László

    2012-09-01

    Fixed access networks widely employ fiber-optical techniques due to the extremely wide bandwidth offered to subscribers. In the last decade, there has also been an enormous increase of user data visible in mobile systems. The importance of fiber-optical techniques within the fixed transmission/transport networks of mobile systems is therefore inevitably increasing. This article summarizes a few reasons and gives examples why and how fiber-optic techniques are employed efficiently in second-generation networks.

  14. Biliary access in technically difficult biliary cannulation: the mucosal bridge technique

    PubMed Central

    Thomas, Rebecca; Shah, Suhaila Rizal; Worthley, Christopher S

    2009-01-01

    Background: The use of precut sphincterotomy during endoscopic retrograde cholangiopancreatography (ERCP) facilitates selective bile duct access in difficult procedures. However, it is also associated with high rates of complications. Several techniques for precut sphincterotomy have been described in the literature. This paper reports our experience with a non-needle-knife technique for precut sphincterotomy, namely, the mucosal bridge technique. Methods: We analysed the experience of a single surgical endoscopist at our centre in performing precut sphincterotomies by retrospectively examining information in the database for January 2002 to February 2008, which had been stored prospectively using Endoscribe. Results: The mucosal bridge technique was performed in 16 (3.19%) of 501 patients. Success rates were 75% and 100% after first and second ERCPs, respectively. The failure of initial procedures was caused by bleeding, tissue oedema, poorly visualized papilla or a poorly distensible duodenum and oedematous papilla. There were four cases of complications, which included periductular extravasation of contrast, bleeding, and sepsis in two patients. However, these complications were not a direct consequence of the precut sphincterotomy. Conclusions: The mucosal bridge technique can be used to increase the likelihood of successful bile duct cannulation, thus preventing the need for a second intervention. PMID:19590645

  15. Traffic management mechanism for intranets with available-bit-rate access to the Internet

    NASA Astrophysics Data System (ADS)

    Hassan, Mahbub; Sirisena, Harsha R.; Atiquzzaman, Mohammed

    1997-10-01

    The design of a traffic management mechanism for intranets connected to the Internet via an available bit rate access- link is presented. Selection of control parameters for this mechanism for optimum performance is shown through analysis. An estimate for packet loss probability at the access- gateway is derived for random fluctuation of available bit rate of the access-link. Some implementation strategies of this mechanism in the standard intranet protocol stack are also suggested.

  16. Managing complex processing of medical image sequences by program supervision techniques

    NASA Astrophysics Data System (ADS)

    Crubezy, Monica; Aubry, Florent; Moisan, Sabine; Chameroy, Virginie; Thonnat, Monique; Di Paola, Robert

    1997-05-01

    Our objective is to offer clinicians wider access to evolving medical image processing (MIP) techniques, crucial to improve assessment and quantification of physiological processes, but difficult to handle for non-specialists in MIP. Based on artificial intelligence techniques, our approach consists in the development of a knowledge-based program supervision system, automating the management of MIP libraries. It comprises a library of programs, a knowledge base capturing the expertise about programs and data and a supervision engine. It selects, organizes and executes the appropriate MIP programs given a goal to achieve and a data set, with dynamic feedback based on the results obtained. It also advises users in the development of new procedures chaining MIP programs.. We have experimented the approach for an application of factor analysis of medical image sequences as a means of predicting the response of osteosarcoma to chemotherapy, with both MRI and NM dynamic image sequences. As a result our program supervision system frees clinical end-users from performing tasks outside their competence, permitting them to concentrate on clinical issues. Therefore our approach enables a better exploitation of possibilities offered by MIP and higher quality results, both in terms of robustness and reliability.

  17. An Intelligent Content Discovery Technique for Health Portal Content Management

    PubMed Central

    2014-01-01

    Background Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. Objective This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content Methods A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. Results The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and

  18. An intelligent content discovery technique for health portal content management.

    PubMed

    De Silva, Daswin; Burstein, Frada

    2014-04-23

    Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective

  19. Patients' experiences of an open access follow up arrangement in managing inflammatory bowel disease

    PubMed Central

    Rogers, A; Kennedy, A; Nelson, E; Robinson, A

    2004-01-01

    Background: Improving access is a key policy issue in improving quality of care and extending patient choice and participation. People's experience of changing from fixed outpatient appointments to more flexible direct access arrangements for chronic disease has been underexplored. Objectives: To examine patients' views on using an open system of access compared with fixed outpatient appointments as part of a guided self-management intervention for inflammatory bowel disease (IBD). Design: Embedded qualitative study undertaken alongside a randomised controlled trial. Semi-structured interviews were undertaken to obtain an in depth understanding of patients' experience of the change in access arrangements. Participants: A purposive sample (n = 30) was drawn from the intervention group (n = 700) according to a range of responses to the trial baseline and follow up quantitative measures. Results: 28 interviews were included in the analysis. Compared with the previous system of fixed appointments, preference for the new open access system was based on enhanced personal control in contacting services and the view that it fitted better with everyday routine management and the requirement for urgent medical contact when symptoms fail to respond to medication. Preference for retaining fixed appointments was based on a sense of security from gaining access which did not require the individual to initiate the request for medical help. Conclusions: Open access may fit better with patients' self-management of their condition and everyday routines, roles and responsibilities. Ensuring that outpatient organisational arrangements and personnel are responsive to patient initiated requests for appointments is likely to impact on the acceptability of this type of access arrangement. Some people may continue to prefer the fixed appointment system which should be retained if patient choice is to be respected. PMID:15465941

  20. Integrated Employee Assistance Program/Managed Behavioral Healthcare Benefits: Relationship with Access and Client Characteristics

    PubMed Central

    Merrick, Elizabeth S. Levy; Hodgkin, Dominic; Horgan, Constance M.; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G.

    2009-01-01

    This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioral health versus standard managed behavioral health care plans. A national managed behavioral health care organization’s claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioral health services (OR 1.20, CI 1.17–1.24), and substance abuse services specifically (OR 1.23, CI 1.06–1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier. PMID:19690952

  1. Access management implementation in Kentucky technical support document and status report.

    DOT National Transportation Integrated Search

    2008-05-01

    This report describes the efforts of the Kentucky Transportation Cabinet's Access Management implementation Task Force. The task force was established in May 2004 and was charged with the responsibility of reviewing and refining the recommendations i...

  2. Critical analysis of procurement techniques in construction management sectors

    NASA Astrophysics Data System (ADS)

    Tiwari, Suman Tiwari Suresh; Chan, Shiau Wei; Faraz Mubarak, Muhammad

    2018-04-01

    Over the last three decades, numerous procurement techniques have been one of the highlights of the Construction Management (CM) for ventures, administration contracting, venture management as well as design and construct. Due to the development and utilization of those techniques, various researchers have explored the criteria for their choice and their execution in terms of time, cost and quality. Nevertheless, there is a lack of giving an account on the relationship between the procurement techniques and the progressed related issues, for example, supply chain, sustainability, innovation and technology development, lean construction, constructability, value management, Building Information Modelling (BIM) as well as e-procurement. Through chosen papers from the reputable CM-related academic journals, the specified scopes of these issues are methodically assessed with the objective to explore the status and trend in procurement related research. The result of this paper contributes theoretically as well as practically to the researchers and industrialist in order to be aware and appreciate the development of procurement techniques.

  3. Representation of Knowledge on Some Management Accounting Techniques in Textbooks

    ERIC Educational Resources Information Center

    Golyagina, Alena; Valuckas, Danielius

    2016-01-01

    This paper examines the coverage of management accounting techniques in several popular management accounting texts, assessing each technique's claimed position within practice, its benefits and limitations, and the information sources substantiating these claims. Employing the notion of research genres, the study reveals that textbooks in their…

  4. Influence of socio-economic status on access to different components of SCI management across Indian population.

    PubMed

    Chhabra, H S; Bhalla, A M

    2015-11-01

    To assess the influence of financial constraints on access to different components of spinal cord injury (SCI) management in various socio-economic strata of the Indian population. Indian Spinal Injuries Centre (ISIC). One hundred fifty SCI individuals who came for follow-up at ISIC between March 2009 and March 2013 with at least 1 year of community exposure after discharge were included in the study. Socio-economic classification was carried out according to the Kuppuswamy scale, a standard scale for the Indian population. A self-designed questionnaire was administered. No sample was available from the lower group. There was a statistically significant difference (P<0.05) for the levels of difficulty perceived by different socio-economic groups in accessing different components of SCI management. Aided upper lower group was dependent on welfare schemes for in-hospital treatment but could not access other components of management once discharged. Unaided upper lower group either faced severe difficulty or could not access management. Majority of lower middle group faced severe difficulty. Upper middle group was equally divided into facing severe, moderate or no difficulty. Most patients in the upper group faced no difficulty, whereas some faced moderate and a small number of severe difficulty. Financial constraints affected all components of SCI management in all except the upper group. The results of the survey suggest that a very large percentage of the Indian population would find it difficult to access comprehensive SCI management and advocate extension of essential medical coverage to unaided upper lower, lower middle and upper middle groups.

  5. Personnel Management in Access Services: A General Overview of the Literature, 1990-2002

    ERIC Educational Resources Information Center

    Lee, Leslie A.; Wu, Michelle M.

    2003-01-01

    Access services is not unique in its need for effective personnel management. A review of the literature indicates that there are many publications on or relating to library personnel administration; however, relatively few of them are dedicated to the narrow topic of access services. As such, this review encompasses literature that is general to…

  6. Techniques to Access Databases and Integrate Data for Hydrologic Modeling

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

    Whelan, Gene; Tenney, Nathan D.; Pelton, Mitchell A.

    2009-06-17

    This document addresses techniques to access and integrate data for defining site-specific conditions and behaviors associated with ground-water and surface-water radionuclide transport applicable to U.S. Nuclear Regulatory Commission reviews. Environmental models typically require input data from multiple internal and external sources that may include, but are not limited to, stream and rainfall gage data, meteorological data, hydrogeological data, habitat data, and biological data. These data may be retrieved from a variety of organizations (e.g., federal, state, and regional) and source types (e.g., HTTP, FTP, and databases). Available data sources relevant to hydrologic analyses for reactor licensing are identified and reviewed.more » The data sources described can be useful to define model inputs and parameters, including site features (e.g., watershed boundaries, stream locations, reservoirs, site topography), site properties (e.g., surface conditions, subsurface hydraulic properties, water quality), and site boundary conditions, input forcings, and extreme events (e.g., stream discharge, lake levels, precipitation, recharge, flood and drought characteristics). Available software tools for accessing established databases, retrieving the data, and integrating it with models were identified and reviewed. The emphasis in this review was on existing software products with minimal required modifications to enable their use with the FRAMES modeling framework. The ability of four of these tools to access and retrieve the identified data sources was reviewed. These four software tools were the Hydrologic Data Acquisition and Processing System (HDAPS), Integrated Water Resources Modeling System (IWRMS) External Data Harvester, Data for Environmental Modeling Environmental Data Download Tool (D4EM EDDT), and the FRAMES Internet Database Tools. The IWRMS External Data Harvester and the D4EM EDDT were identified as the most promising tools based on their ability to

  7. Fault Tolerance Design and Redundancy Management Techniques.

    DTIC Science & Technology

    1980-09-01

    de la turbulence atmosphdrique. Pour pouvoir 6tre implantdes sur le calcula- teur de bord , ces techniques doivent de plus 6tre...automatiques ia vitesse de tanga- ge et obtenua par une fausse ddrivation de laesiatta - redondance analytique. Toutes le e sures accessibles A bord ...particulier de I& preesion dynemique. 4-5 111.4 - Les capteurs A bord d’un avion, on dispose de nombreuses informations. L16quipement de base est

  8. A Survey Of Techniques for Managing and Leveraging Caches in GPUs

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

    Mittal, Sparsh

    2014-09-01

    Initially introduced as special-purpose accelerators for graphics applications, graphics processing units (GPUs) have now emerged as general purpose computing platforms for a wide range of applications. To address the requirements of these applications, modern GPUs include sizable hardware-managed caches. However, several factors, such as unique architecture of GPU, rise of CPU–GPU heterogeneous computing, etc., demand effective management of caches to achieve high performance and energy efficiency. Recently, several techniques have been proposed for this purpose. In this paper, we survey several architectural and system-level techniques proposed for managing and leveraging GPU caches. We also discuss the importance and challenges ofmore » cache management in GPUs. The aim of this paper is to provide the readers insights into cache management techniques for GPUs and motivate them to propose even better techniques for leveraging the full potential of caches in the GPUs of tomorrow.« less

  9. Integrated employee assistance program/managed behavioral health care benefits: relationship with access and client characteristics.

    PubMed

    Levy Merrick, Elizabeth S; Hodgkin, Dominic; Horgan, Constance M; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G

    2009-11-01

    This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioral health versus standard managed behavioral health care plans. A national managed behavioral health care organization's claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioral health services (OR 1.20, CI 1.17-1.24), and substance abuse services specifically (OR 1.23, CI 1.06-1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier.

  10. Globus Identity, Access, and Data Management: Platform Services for Collaborative Science

    NASA Astrophysics Data System (ADS)

    Ananthakrishnan, R.; Foster, I.; Wagner, R.

    2016-12-01

    Globus is software-as-a-service for research data management, developed at, and operated by, the University of Chicago. Globus, accessible at www.globus.org, provides high speed, secure file transfer; file sharing directly from existing storage systems; and data publication to institutional repositories. 40,000 registered users have used Globus to transfer tens of billions of files totaling hundreds of petabytes between more than 10,000 storage systems within campuses and national laboratories in the US and internationally. Web, command line, and REST interfaces support both interactive use and integration into applications and infrastructures. An important component of the Globus system is its foundational identity and access management (IAM) platform service, Globus Auth. Both Globus research data management and other applications use Globus Auth for brokering authentication and authorization interactions between end-users, identity providers, resource servers (services), and a range of clients, including web, mobile, and desktop applications, and other services. Compliant with important standards such as OAuth, OpenID, and SAML, Globus Auth provides mechanisms required for an extensible, integrated ecosystem of services and clients for the research and education community. It underpins projects such as the US National Science Foundation's XSEDE system, NCAR's Research Data Archive, and the DOE Systems Biology Knowledge Base. Current work is extending Globus services to be compliant with FEDRAMP standards for security assessment, authorization, and monitoring for cloud services. We will present Globus IAM solutions and give examples of Globus use in various projects for federated access to resources. We will also describe how Globus Auth and Globus research data management capabilities enable rapid development and low-cost operations of secure data sharing platforms that leverage Globus services and integrate them with local policy and security.

  11. The Relationship between Anger Management Techniques and Discipline Reports

    ERIC Educational Resources Information Center

    Brooks, LaTorea; McGahey, James Todd; Jenkins, Marvin

    2017-01-01

    The purpose of this study was to target students who show aggressive and bullying behavior due to a lack of anger management and self-control skills. Two groups of boys in grades 2-4 participated in anger managements groups that either followed an anger management curriculum or followed the anger management curriculum plus breathing techniques.…

  12. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1985-01-01

    This bibliography lists 706 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1984. Entries, which include abstracts, are arranged in the following categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs, and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy. Subject, personal author, corporate source, contract number, report number, and accession number indexes are included.

  13. Identification and Access Management: An Action Research Approach to Develop a Training Strategy for Higher Education

    ERIC Educational Resources Information Center

    San Nicolas-Rocca, Tonia

    2010-01-01

    Identification and access management has been among the top security issues facing institutions of higher education. Most institutions of higher education require end users to provide usernames and passwords to gain access to personally identifiable information (PII). This leaves universities vulnerable to unauthorized access and unauthorized…

  14. Contract management in USA hospitals: service duplication and access within local markets.

    PubMed

    Carey, Kathleen; Dor, Avi

    2008-08-01

    This paper examines the extent to which hospitals that are under external contract management engage in service duplication, as well as the degree to which the various services they offer contribute to or detract from community access. The study incorporates all USA hospitals using data from the American Hospital Association Annual Survey Database, supplemented by county level measures obtained from the area resource file (ARF). Using data on the 3794 hospitals classified as acute care facilities in 2002, we performed a set of logistic regressions that analyzed whether a hospital offered each of 74 distinct services. For each service (regression), key independent variables measured the number of other hospitals in the local market area that also offered the service. Local area market definitions are the areas circumscribed by the hospital within distances of 10 and 20 miles. Results suggest that contract-managed (CM) hospitals display a more competitive pattern (service duplication) than hospitals in general, but CM hospitals that are the sole provider of services locally are less likely to offer services than traditionally managed sole hospital providers. Contract management does not appear to offer any particular advantages in improving access to hospital services.

  15. Integrating modal-based NDE techniques and bridge management systems using quality management

    NASA Astrophysics Data System (ADS)

    Sikorsky, Charles S.

    1997-05-01

    The intent of bridge management systems is to help engineers and managers determine when and where to spend bridge funds such that commerce and the motoring public needs are satisfied. A major shortcoming which states are experiencing is the NBIS data available is insufficient to perform certain functions required by new bridge management systems, such as modeling bridge deterioration and predicting costs. This paper will investigate how modal based nondestructive damage evaluation techniques can be integrated into bridge management using quality management principles. First, quality from the manufacturing perspective will be summarized. Next, the implementation of quality management in design and construction will be reinterpreted for bridge management. Based on this, a theory of approach will be formulated to improve the productivity of a highway transportation system.

  16. Understanding Pupil Behaviour: Classroom Management Techniques for Teachers

    ERIC Educational Resources Information Center

    Lewis, Ramon

    2009-01-01

    This book describes a system of successful classroom behaviour management techniques developed by the author over more than twenty-five years. It outlines the difficulties confronting teachers trying to manage pupils' misbehaviour in schools and describes four types of pupil who can be helped to behave responsibly. In "Understanding Pupil…

  17. Venous Access Ports: Indications, Implantation Technique, Follow-Up, and Complications

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

    Walser, Eric M., E-mail: walser.eric@mayo.edu

    The subcutaneous venous access device (SVAD or 'port') is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient's lifestyle. Because of improved materials and catheter technology, today's ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist ofmore » catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.« less

  18. Access management performance measures for Virginia : a practical approach for public accountability.

    DOT National Transportation Integrated Search

    2010-04-01

    In order to develop performance measures to communicate the effect of Virginias access management program, five : tasks were performed: (1) the appropriate literature was reviewed, (2) a catalog of potential performance measures was : developed, (...

  19. Barriers of access to care in a managed competition model: lessons from Colombia

    PubMed Central

    2010-01-01

    Background The health sector reform in Colombia, initiated by Law 100 (1993) that introduced a managed competition model, is generally presented as a successful experience of improving access to care through a health insurance regulated market. The study's objective is to improve our understanding of the factors influencing access to the continuum of care in the Colombian managed competition model, from the social actors' point of view. Methods An exploratory, descriptive-interpretative qualitative study was carried out, based on case studies of four healthcare networks in rural and urban areas. Individual semi-structured interviews were conducted to a three stage theoretical sample: I) cases, II) providers and III) informants: insured and uninsured users (35), health professionals (51), administrative personnel (20), and providers' (18) and insurers' (10) managers. Narrative content analysis was conducted; segmented by cases, informant's groups and themes. Results Access, particularly to secondary care, is perceived as complex due to four groups of obstacles with synergetic effects: segmented insurance design with insufficient services covered; insurers' managed care and purchasing mechanisms; providers' networks structural and organizational limitations; and, poor living conditions. Insurers' and providers' values based on economic profit permeate all factors. Variations became apparent between the two geographical areas and insurance schemes. In the urban areas barriers related to market functioning predominate, whereas in the rural areas structural deficiencies in health services are linked to insufficient public funding. While financial obstacles are dominant in the subsidized regime, in the contributory scheme supply shortage prevails, related to insufficient private investment. Conclusions The results show how in the Colombian healthcare system structural and organizational barriers to care access, that are common in developing countries, are widened by both

  20. Barriers of access to care in a managed competition model: lessons from Colombia.

    PubMed

    Vargas, Ingrid; Vázquez, María Luisa; Mogollón-Pérez, Amparo Susana; Unger, Jean-Pierre

    2010-10-29

    The health sector reform in Colombia, initiated by Law 100 (1993) that introduced a managed competition model, is generally presented as a successful experience of improving access to care through a health insurance regulated market. The study's objective is to improve our understanding of the factors influencing access to the continuum of care in the Colombian managed competition model, from the social actors' point of view. An exploratory, descriptive-interpretative qualitative study was carried out, based on case studies of four healthcare networks in rural and urban areas. Individual semi-structured interviews were conducted to a three stage theoretical sample: I) cases, II) providers and III) informants: insured and uninsured users (35), health professionals (51), administrative personnel (20), and providers' (18) and insurers' (10) managers. Narrative content analysis was conducted; segmented by cases, informant's groups and themes. Access, particularly to secondary care, is perceived as complex due to four groups of obstacles with synergetic effects: segmented insurance design with insufficient services covered; insurers' managed care and purchasing mechanisms; providers' networks structural and organizational limitations; and, poor living conditions. Insurers' and providers' values based on economic profit permeate all factors. Variations became apparent between the two geographical areas and insurance schemes. In the urban areas barriers related to market functioning predominate, whereas in the rural areas structural deficiencies in health services are linked to insufficient public funding. While financial obstacles are dominant in the subsidized regime, in the contributory scheme supply shortage prevails, related to insufficient private investment. The results show how in the Colombian healthcare system structural and organizational barriers to care access, that are common in developing countries, are widened by both the insurers' use of mechanisms that

  1. Remote sensing techniques in cultural resource management archaeology

    NASA Astrophysics Data System (ADS)

    Johnson, Jay K.; Haley, Bryan S.

    2003-04-01

    Cultural resource management archaeology in the United States concerns compliance with legislation set in place to protect archaeological resources from the impact of modern activities. Traditionally, surface collection, shovel testing, test excavation, and mechanical stripping are used in these projects. These methods are expensive, time consuming, and may poorly represent the features within archaeological sites. The use of remote sensing techniques in cultural resource management archaeology may provide an answer to these problems. Near-surface geophysical techniques, including magnetometry, resistivity, electromagnetics, and ground penetrating radar, have proven to be particularly successful at efficiently locating archaeological features. Research has also indicated airborne and satellite remote sensing may hold some promise in the future for large-scale archaeological survey, although this is difficult in many areas of the world where ground cover reflect archaeological features in an indirect manner. A cost simulation of a hypothetical data recovery project on a large complex site in Mississippi is presented to illustrate the potential advantages of remote sensing in a cultural resource management setting. The results indicate these techniques can save a substantial amount of time and money for these projects.

  2. Project TEAMS (Techniques and Education for Achieving Management Skills): Independent Business Owner/Managers.

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

    These Project TEAMS (Techniques and Education for Achieving Managerial Skills) instructional materials consist of five units for use in training independent business owner/managers. The first unit contains materials which deal with management skills relating to personal characteristics of successful business people, knowledge of self and chosen…

  3. Short-Term Coping Techniques for Managing Stress.

    ERIC Educational Resources Information Center

    Grasha, Anthony F.

    1987-01-01

    A number of brief, focused self-help interventions designed to help faculty manage stress more effectively are described such as being assertive, setting priorities, and using quick relaxation techniques. Related causes of stress are cited. (MSE)

  4. Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique

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

    Miyayama, Shiro; Matsui, Osamu; Taki, Keiichi

    2005-12-15

    We retrospectively evaluated the usefulness of both arterial and venous access with the pull-through technique in endovascular treatment of totally occluded Brescia-Cimino fistulas. We treated 26 patients (17 men, 9 women; age range 43-82 years, mean age 66 years) with occluded Brescia-Cimino fistulas. First, the occluded segment was traversed from the antegrade brachial arterial access using a microcatheter-guidewire system. Second, the vein was retrogradely punctured after confirmation of all diseased segments, and a 0.014- or 0.016-inch guidewire was pulled through the venous access when the occluded segment was long. All interventions including thrombolysis, thromboaspiration, angioplasty, and stent placement were performedmore » via the venous access. The occlusion was successfully crossed via the brachial arterial access in 23 patients (88%). In 2 patients it was done from the venous approach. In the remaining patient it was not possible to traverse the occluded segment. The pull-through technique was successful in all 19 attempts. Clinical success was achieved in 96%, the primary patency rates at 6, 12, and 18 months were 83%, 78%, and 69%, the primary assisted patency rates were 92%, 92%, and 72%, and the secondary patency rates were 92%, 92%, and 92%, respectively. Minor complications in 5 patients included venous perforation in 2 (8%), venous rupture in 1 (4%), and regional hematoma in 2 (8%). Our study suggests that endovascular treatments with both arterial and venous access using the pull-through technique are highly effective in restoring function in totally occluded Brescia-Cimino fistulas.« less

  5. Minimal access surgery of pediatric inguinal hernias: a review.

    PubMed

    Saranga Bharathi, Ramanathan; Arora, Manu; Baskaran, Vasudevan

    2008-08-01

    Inguinal hernia is a common problem among children, and herniotomy has been its standard of care. Laparoscopy, which gained a toehold initially in the management of pediatric inguinal hernia (PIH), has managed to steer world opinion against routine contralateral groin exploration by precise detection of contralateral patencies. Besides detection, its ability to repair simultaneously all forms of inguinal hernias (indirect, direct, combined, recurrent, and incarcerated) together with contralateral patencies has cemented its role as a viable alternative to conventional repair. Numerous minimally invasive techniques for addressing PIH have mushroomed in the past two decades. These techniques vary considerably in their approaches to the internal ring (intraperitoneal, extraperitoneal), use of ports (three, two, one), endoscopic instruments (two, one, or none), sutures (absorbable, nonabsorbable), and techniques of knotting (intracorporeal, extracorporeal). In addition to the surgeons' experience and the merits/limitations of individual techniques, it is the nature of the defect that should govern the choice of technique. The emerging techniques show a trend toward increasing use of extracorporeal knotting and diminishing use of working ports and endoscopic instruments. These favor wider adoption of minimal access surgery in addressing PIH by surgeons, irrespective of their laparoscopic skills and experience. Growing experience, wider adoption, decreasing complications, and increasing advantages favor emergence of minimal access surgery as the gold standard for the treatment of PIH in the future. This article comprehensively reviews the laparoscopic techniques of addressing PIH.

  6. Peri-procedural protocols for interventional pain management techniques: a survey of US pain centers.

    PubMed

    Ahmed, Shihab U; Tonidandel, William; Trella, Jason; Martin, Nicole M; Chang, Yuchiao

    2005-04-01

    Interventional techniques are now an integral part of chronic pain management. As new procedures are arising at a rapid pace, decisions regarding patient safety and comfort are becoming more challenging. No peri-procedural consensus protocol currently addresses issues such as 1. nulla per os (NPO) status, 2. sedation, 3. monitoring, or 4. recovery. In establishing safety guidelines for interventional pain procedures, the knowledge of current peri-procedural protocols is required. To survey interventional pain practices and to obtain current peri-procedural protocols. We faxed a one-page questionnaire to 105 United States pain practices identified using the directory of the American Pain Society. Fifty-seven academic and private pain practices (54%) responded and were included in the analysis. Monitoring devices such as electrocardiogram (EKG), blood pressure, and pulse oximetry are not universally employed for cervical or lumbar spinal procedures. Even procedures that are often performed by anesthesiologists in operating rooms, such as Bier blocks, are not monitored in a uniform manner when performed in pain clinics. Establishment of intravenous access for procedures also varies among practitioners. Most (72%) practices had treated patients with vasovagal reactions over the past 12 months, but only 42% had simulated cardiac arrests to prepare for these situations. While various trends in peri-procedural care are observable, standards of care are not well established. In order to minimize complications associated with interventional pain management techniques, the pain management community should agree on safety guidelines for all procedures, much as these advocated by the American Society of Anesthesiology for surgical anesthetic care.

  7. An automated system for access to derived climate indices in support of ecological impacts assessments and resource management

    NASA Astrophysics Data System (ADS)

    Walker, J.; Morisette, J. T.; Talbert, C.; Blodgett, D. L.; Kunicki, T.

    2012-12-01

    A U.S. Geological Survey team is working with several providers to establish standard data services for the climate projection data they host. To meet the needs of climate adaptation science and landscape management communities, the team is establishing a set of climate index calculation algorithms that will consume data from various providers and provide directly useful data derivatives. Climate projections coming from various scenarios, modeling centers, and downscaling methods are increasing in number and size. Global change impact modeling and assessment, generally, requires inputs in the form of climate indices or values derived from raw climate projections. This requirement puts a large burden on a community not familiar with climate data formats, semantics, and processing techniques and requires storage capacity and computing resources out of the reach of most. In order to fully understand the implications of our best available climate projections, assessments must take into account an ensemble of climate projections and potentially a range of parameters for calculation of climate indices. These requirements around data access and processing are not unique from project to project, or even among projected climate data sets, pointing to the need for a reusable tool to generate climate indices. The U.S. Geological Survey has developed a pilot application and supporting web service framework that automates the generation of climate indices. The web service framework consists of standards-based data servers and a data integration broker. The resulting system allows data producers to publish and maintain ownership of their data and data consumers to access climate derivatives via a simple to use "data product ordering" workflow. Data access and processing is completed on enterprise "cloud" computing resources and only the relatively small, derived climate indices are delivered to the scientist or land manager. These services will assist the scientific and land

  8. Microcomputer Database Management Systems that Interface with Online Public Access Catalogs.

    ERIC Educational Resources Information Center

    Rice, James

    1988-01-01

    Describes a study that assessed the availability and use of microcomputer database management interfaces to online public access catalogs. The software capabilities needed to effect such an interface are identified, and available software packages are evaluated by these criteria. A directory of software vendors is provided. (4 notes with…

  9. Vibroacoustic Payload Environment Prediction System (VAPEPS): VAPEPS management center remote access guide

    NASA Technical Reports Server (NTRS)

    Fernandez, J. P.; Mills, D.

    1991-01-01

    A Vibroacoustic Payload Environment Prediction System (VAPEPS) Management Center was established at the JPL. The center utilizes the VAPEPS software package to manage a data base of Space Shuttle and expendable launch vehicle payload flight and ground test data. Remote terminal access over telephone lines to the computer system, where the program resides, was established to provide the payload community a convenient means of querying the global VAPEPS data base. This guide describes the functions of the VAPEPS Management Center and contains instructions for utilizing the resources of the center.

  10. Comparison of two underwater acoustic communications techniques for multi-user access

    NASA Astrophysics Data System (ADS)

    Hursky, Paul; Siderius, T. Martin; Kauaiex Group

    2004-05-01

    Frequency hopped frequency shift keying (FHFSK) and code division multiple access (CDMA) are two different modulation techniques for multiple users to communicate with a single receiver simultaneously. In July 2003, these two techniques were tested alongside each other in a shallow water coastal environment off the coast of Kauai. A variety of instruments were used to measure the prevailing oceanography, enabling detailed modeling of the channel. The channel was acoustically probed using LFM waveforms and m-sequences as well. We will present the results of demodulating the FHFSK and CDMA waveforms and discuss modeling the channel for the purpose of predicting multi-user communications performance. a)Michael B. Porter, Paul Hursky, Martin Siderius (SAIC), Mohsen Badiey (UD), Jerald Caruthers (USM), William S. Hodgkiss, Kaustubha Raghukumar (SIO), Dan Rouseff, Warren Fox (APL-UW), Christian de Moustier, Brian Calder, Barbara J. Kraft (UNH), Keyko McDonald (SPAWARSSC), Peter Stein, James K. Lewis, and Subramaniam Rajan (SSI).

  11. Uniform Data Management and Access to Near Real-Time Seismic Data (Invited)

    NASA Astrophysics Data System (ADS)

    Casey, R.; Ahern, T. K.; Benson, R. B.; Karstens, R.; Stromme, S.; Trabant, C. M.; Weertman, B. R.

    2010-12-01

    The IRIS Data Management Center has its ears to the ground, receiving relayed seismic telemetry from all parts of the globe with delay times as little as a few seconds from sensor to data center. This immediacy of always-on geophysical information has spawned a demand for ready access to persistent data streams, quality assurance metrics, and automatic production of data products based on specific triggers. For the last ten years, IRIS DMC has developed an effective near real-time data pipeline that serves the needs of seismic networks needing a central data management system as well as the scientific community that need the ability to monitor and respond to events that occurred only moments before. A number of accessible applications have been developed that provide useful data both through the web and through freely available software. Metrics and products of the raw data are cataloged and managed as a chain of events that occur in near-real time. The technical challenges faced with such a system are general to the data management community. Delayed transmission of packetized data, out of order data transmissions, verification of complete data transmission, and data flow concurrency have all been areas of focus in order to provide the best possible level of service to scientists and educators.

  12. [Access control management in electronic health records: a systematic literature review].

    PubMed

    Carrión Señor, Inmaculada; Fernández Alemán, José Luis; Toval, Ambrosio

    2012-01-01

    This study presents the results of a systematic literature review of aspects related to access control in electronic health records systems, wireless security and privacy and security training for users. Information sources consisted of original articles found in Medline, ACM Digital Library, Wiley InterScience, IEEE Digital Library, Science@Direct, MetaPress, ERIC, CINAHL and Trip Database, published between January 2006 and January 2011. A total of 1,208 articles were extracted using a predefined search string and were reviewed by the authors. The final selection consisted of 24 articles. Of the selected articles, 21 dealt with access policies in electronic health records systems. Eleven articles discussed whether access to electronic health records should be granted by patients or by health organizations. Wireless environments were only considered in three articles. Finally, only four articles explicitly mentioned that technical training of staff and/or patients is required. Role-based access control is the preferred mechanism to deploy access policy by the designers of electronic health records. In most systems, access control is managed by users and health professionals, which promotes patients' right to control personal information. Finally, the security of wireless environments is not usually considered. However, one line of research is eHealth in mobile environments, called mHealth. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  13. Pattern of parental acceptance of management techniques used in pediatric dentistry.

    PubMed

    Peretz, Benjamin; Kharouba, Johnny; Blumer, Sigalit

    2013-01-01

    To evaluate parents' acceptance of management techniques in Israeli pediatric dental clinics. Ninety parents who accompanied their children to three pediatric dental clinics provided information on selected parameters including their attitudes about management techniques. 68.9% of the parents preferred to stay in the treatment room. The most accepted technique was positive reinforcement (81.1%) followed by tell-show-do (TSD) (76.7%, with younger parents more accepting than older, p = 0.049). The least accepted techniques were restraint (1.1%) and voice control (7.8%, especially by parents with the highest dental anxiety, p = 0.002). Sedation was unacceptable by 15.6% of the parents: those with the lowest dental anxiety agreed to sedation significantly more than those with greater dental anxiety (p = 0.031). Parents preferred more positive approaches and management techniques that involve demonstrations geared for the child's level of understanding. Restraint and voice control were more strongly rejected than sedation.

  14. Advantages and Disadvantages of Aquatic Plant Management Techniques

    DTIC Science & Technology

    2000-09-01

    This report provides an overview of the environmental and practical advantages and disadvantages of the major aquatic plant management methods, including biological, chemical, mechanical, and physical control techniques.

  15. Impact of Serials Management, Access and Use on Publication Output of Lecturers in Nigerian Universities

    ERIC Educational Resources Information Center

    Akinbode, Rahmon O. Onaolapo; Nwalo, Kenneth Ivo Ngozi

    2017-01-01

    This study investigates serials management in university libraries, determines the extent to which serials are accessed and used and appraises the influence of availability, accessibility and use of serials on publications output of lecturers in federal universities in Nigeria. Questionnaire administration method was adopted to accumulate data for…

  16. Easy access to geophysical data sets at the IRIS Data Management Center

    NASA Astrophysics Data System (ADS)

    Trabant, C.; Ahern, T.; Suleiman, Y.; Karstens, R.; Weertman, B.

    2012-04-01

    At the IRIS Data Management Center (DMC) we primarily manage seismological data but also have other geophysical data sets for related fields including atmospheric pressure and gravity measurements and higher level data products derived from raw data. With a few exceptions all data managed by the IRIS DMC are openly available and we serve an international research audience. These data are available via a number of different mechanisms from batch requests submitted through email, web interfaces, near real time streams and more recently web services. Our initial suite of web services offer access to almost all of the raw data and associated metadata managed at the DMC. In addition, we offer services that apply processing to the data before it is sent to the user. Web service technologies are ubiquitous with support available in nearly every programming language and operating system. By their nature web services are programmatic interfaces, but by choosing a simple subset of web service methods we make our data available to a very broad user base. These interfaces will be usable by professional developers as well as non-programmers. Whenever possible we chose open and recognized standards. The data returned to the user is in a variety of formats depending on type, including FDSN SEED, QuakeML, StationXML, ASCII, PNG images and in some cases where no appropriate standard could be found a customized XML format. To promote easy access to seismological data for all researchers we are coordinating with international partners to define web service interfaces standards. Additionally we are working with key partners in Europe to complete the initial implementation of these services. Once a standard has been adopted and implemented at multiple data centers researchers will be able to use the same request tools to access data across multiple data centers. The web services that apply on-demand processing to requested data include the capability to apply instrument corrections and

  17. Rising Expectations: Access to Biomedical Information

    PubMed Central

    Lindberg, D. A. B.; Humphreys, B. L.

    2008-01-01

    Summary Objective To provide an overview of the expansion in public access to electronic biomedical information over the past two decades, with an emphasis on developments to which the U.S. National Library of Medicine contributed. Methods Review of the increasingly broad spectrum of web-accessible genomic data, biomedical literature, consumer health information, clinical trials data, and images. Results The amount of publicly available electronic biomedical information has increased dramatically over the past twenty years. Rising expectations regarding access to biomedical information were stimulated by the spread of the Internet, the World Wide Web, advanced searching and linking techniques. These informatics advances simplified and improved access to electronic information and reduced costs, which enabled inter-organizational collaborations to build and maintain large international information resources and also aided outreach and education efforts The demonstrated benefits of free access to electronic biomedical information encouraged the development of public policies that further increase the amount of information available. Conclusions Continuing rapid growth of publicly accessible electronic biomedical information presents tremendous opportunities and challenges, including the need to ensure uninterrupted access during disasters or emergencies and to manage digital resources so they remain available for future generations. PMID:18587496

  18. A survey of techniques for architecting and managing GPU register file

    DOE PAGES

    Mittal, Sparsh

    2016-04-07

    To support their massively-multithreaded architecture, GPUs use very large register file (RF) which has a capacity higher than even L1 and L2 caches. In total contrast, traditional CPUs use tiny RF and much larger caches to optimize latency. Due to these differences, along with the crucial impact of RF in determining GPU performance, novel and intelligent techniques are required for managing GPU RF. In this paper, we survey the techniques for designing and managing GPU RF. We discuss techniques related to performance, energy and reliability aspects of RF. To emphasize the similarities and differences between the techniques, we classify themmore » along several parameters. Lastly, the aim of this paper is to synthesize the state-of-art developments in RF management and also stimulate further research in this area.« less

  19. A survey of techniques for architecting and managing GPU register file

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

    Mittal, Sparsh

    To support their massively-multithreaded architecture, GPUs use very large register file (RF) which has a capacity higher than even L1 and L2 caches. In total contrast, traditional CPUs use tiny RF and much larger caches to optimize latency. Due to these differences, along with the crucial impact of RF in determining GPU performance, novel and intelligent techniques are required for managing GPU RF. In this paper, we survey the techniques for designing and managing GPU RF. We discuss techniques related to performance, energy and reliability aspects of RF. To emphasize the similarities and differences between the techniques, we classify themmore » along several parameters. Lastly, the aim of this paper is to synthesize the state-of-art developments in RF management and also stimulate further research in this area.« less

  20. User-Centered Indexing for Adaptive Information Access

    NASA Technical Reports Server (NTRS)

    Chen, James R.; Mathe, Nathalie

    1996-01-01

    We are focusing on information access tasks characterized by large volume of hypermedia connected technical documents, a need for rapid and effective access to familiar information, and long-term interaction with evolving information. The problem for technical users is to build and maintain a personalized task-oriented model of the information to quickly access relevant information. We propose a solution which provides user-centered adaptive information retrieval and navigation. This solution supports users in customizing information access over time. It is complementary to information discovery methods which provide access to new information, since it lets users customize future access to previously found information. It relies on a technique, called Adaptive Relevance Network, which creates and maintains a complex indexing structure to represent personal user's information access maps organized by concepts. This technique is integrated within the Adaptive HyperMan system, which helps NASA Space Shuttle flight controllers organize and access large amount of information. It allows users to select and mark any part of a document as interesting, and to index that part with user-defined concepts. Users can then do subsequent retrieval of marked portions of documents. This functionality allows users to define and access personal collections of information, which are dynamically computed. The system also supports collaborative review by letting users share group access maps. The adaptive relevance network provides long-term adaptation based both on usage and on explicit user input. The indexing structure is dynamic and evolves over time. Leading and generalization support flexible retrieval of information under similar concepts. The network is geared towards more recent information access, and automatically manages its size in order to maintain rapid access when scaling up to large hypermedia space. We present results of simulated learning experiments.

  1. Minimal access portoenterostomy: advantages and disadvantages of standard laparoscopic and robotic techniques.

    PubMed

    Dutta, Sanjeev; Woo, Russell; Albanese, Craig T

    2007-04-01

    Minimal access portoenterostomy (Kasai procedure) for biliary atresia represents a technically challenging operation. The standard laparoscopic approach yields results comparable to the open technique. After an initial experience with standard laparoscopy, we assessed the potentially superior optics and dexterity of a surgical robotic system for performing portoenterostomy. We reviewed our experience with minimal access portoenterostomy to compare the relative advantages and disadvantages of standard laparoscopic and robotic approaches to biliary atresia. We reviewed the charts of all patients who underwent either laparoscopic or robotic portoenterostomy at our institution between October 2002 and October 2005. Outcome measures included the need to convert to laparotomy, complications, functional outcome expressed either as the direct bilirubin at most recent follow-up (> or = 3 months) or age at transplant, and density of adhesions at transplant. Surgeons' impressions of the two minimal access modalities were also reviewed. A total of 10 patients underwent minimal access portoenterostomy (7 standard laparoscopy; 3 robotic-assisted). Mean follow-up was 20 months (range, 1-36 months). There were no conversions to laparotomy and no intraoperative complications. There was one port site infection that resolved with antibiotics. Five patients (4 laparoscopic, 1 robotic) had progressed to transplantation at the time of follow-up. At transplant, one patient had mild adhesions and two had dense adhesions. Adhesions were not noted for 2 patients. We believe both surgical modalities are feasible from a technical point of view. However, the optical and dexterity advantages of the robotic system were offset by the large instrument size and lack of force feedback.

  2. Coping Styles as Mediators of Teachers' Classroom Management Techniques

    ERIC Educational Resources Information Center

    Lewis, Ramon; Roache, Joel; Romi, Shlomo

    2011-01-01

    This study reports the relationships between coping styles of Australian teachers and the classroom based classroom management techniques they use to cope with student misbehaviour. There is great interest internationally in improving educational systems by upgrading the quality of teachers' classroom management. However, the relationship between…

  3. The development of an audit technique to assess the quality of safety barrier management.

    PubMed

    Guldenmund, Frank; Hale, Andrew; Goossens, Louis; Betten, Jeroen; Duijm, Nijs Jan

    2006-03-31

    This paper describes the development of a management model to control barriers devised to prevent major hazard scenarios. Additionally, an audit technique is explained that assesses the quality of such a management system. The final purpose of the audit technique is to quantify those aspects of the management system that have a direct impact on the reliability and effectiveness of the barriers and, hence, the probability of the scenarios involved. First, an outline of the management model is given and its elements are explained. Then, the development of the audit technique is described. Because the audit technique uses actual major hazard scenarios and barriers within these as its focus, the technique achieves a concreteness and clarity that many other techniques often lack. However, this strength is also its limitation, since the full safety management system is not covered with the technique. Finally, some preliminary experiences obtained from several test sites are compiled and discussed.

  4. Accessing and Visualizing Satellite Data for Fisheries Managers in the Northeast Large Marine Ecosystem

    NASA Astrophysics Data System (ADS)

    Young Morse, R.; Mecray, E. L.; Pershing, A. J.

    2015-12-01

    As interest in the global change in temperatures and precipitation patterns grow, federal, state, and local agencies are turning to the delivery of 'actionable science and information' or 'information for decision-makers.' NOAA/National Centers for Environmental Information's Regional Climate Services program builds these bridges between the user of information and the producers of the information. With the Climate Data Records program, this study will present the extraction and use of the sea-surface temperature datasets specifically for access and use by fisheries managers in the north Atlantic. The work demonstrates the staged approach of accessing the records, converting their initial data formats into maps and charts, and the delivery of the data as a value-added information dashboard for use by managers. The questions to be reviewed include the ease of access, the delivery of open source software for visualizing the information, and a discussion on the roles of government and the private sector in the provision of climate information at different scales.

  5. Current role of modern radiotherapy techniques in the management of breast cancer

    PubMed Central

    Ozyigit, Gokhan; Gultekin, Melis

    2014-01-01

    Breast cancer is the most common type of malignancy in females. Advances in systemic therapies and radiotherapy (RT) provided long survival rates in breast cancer patients. RT has a major role in the management of breast cancer. During the past 15 years several developments took place in the field of imaging and irradiation techniques, intensity modulated RT, hypofractionation and partial-breast irradiation. Currently, improvements in the RT technology allow us a subsequent decrease in the treatment-related complications such as fibrosis and long-term cardiac toxicity while improving the loco-regional control rates and cosmetic results. Thus, it is crucial that modern radiotherapy techniques should be carried out with maximum care and efficiency. Several randomized trials provided evidence for the feasibility of modern radiotherapy techniques in the management of breast cancer. However, the role of modern radiotherapy techniques in the management of breast cancer will continue to be defined by the mature results of randomized trials. Current review will provide an up-to-date evidence based data on the role of modern radiotherapy techniques in the management of breast cancer. PMID:25114857

  6. Fluoroscopy guided percutaneous renal access in prone position

    PubMed Central

    Sharma, Gyanendra R; Maheshwari, Pankaj N; Sharma, Anshu G; Maheshwari, Reeta P; Heda, Ritwik S; Maheshwari, Sakshi P

    2015-01-01

    Percutaneous nephrolithotomy is a very commonly done procedure for management of renal calculus disease. Establishing a good access is the first and probably the most crucial step of this procedure. A proper access is the gateway to success. However, this crucial step has the steepest learning curve for, in a fluoroscopy guided access, it involves visualizing a three dimensional anatomy on a two dimensional fluoroscopy screen. This review describes the anatomical basis of the renal access. It provides a literature review of all aspects of percutaneous renal access along with the advances that have taken place in this field over the years. The article describes a technique to determine the site of skin puncture, the angle and depth of puncture using a simple mathematical principle. It also reviews the common problems faced during the process of puncture and dilatation and describes the ways to overcome them. The aim of this article is to provide the reader a step by step guide for percutaneous renal access. PMID:25789297

  7. Managed Care for Children: Effect on Access to Care and Utilization of Health Services.

    ERIC Educational Resources Information Center

    Szilagyi, Peter G.

    1998-01-01

    Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)

  8. N-butyl cyanoacrylate embolotherapy: techniques, complications, and management

    PubMed Central

    Hill, Hannah; Chick, Jeffrey Forris Beecham; Hage, Anthony; Srinivasa, Ravi N.

    2018-01-01

    The purpose of this article is to describe acute complications associated with adhesive cyanoacrylate deposition in the peripheral circulation and their management. Despite best efforts, n-butyl cyanoacrylate glue embolization is inherently unpredictable and complications do occur. An understanding of preparation techniques that minimize adverse event rates and the technical skillset required to manage complications are necessary for the safe and efficient use of liquid embolic agents. PMID:29467116

  9. Project TEAMS (Techniques and Education for Achieving Management Skills): Business and Industrial Supervisors.

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

    These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training business and industrial supervisors. Unit 1 is designed to help managers in business or industry increase management skills in regard to leadership techniques, problem solving and decision making, and…

  10. Vibroacoustic payload environment prediction system (VAPEPS): Data base management center remote access guide

    NASA Technical Reports Server (NTRS)

    Thomas, V. C.

    1986-01-01

    A Vibroacoustic Data Base Management Center has been established at the Jet Propulsion Laboratory (JPL). The center utilizes the Vibroacoustic Payload Environment Prediction System (VAPEPS) software package to manage a data base of shuttle and expendable launch vehicle flight and ground test data. Remote terminal access over telephone lines to a dedicated VAPEPS computer system has been established to provide the payload community a convenient means of querying the global VAPEPS data base. This guide describes the functions of the JPL Data Base Management Center and contains instructions for utilizing the resources of the center.

  11. (Low-level radioactive waste management techniques)

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

    Van Hoesen, S.D.; Kennerly, J.M.; Williams, L.C.

    1988-08-08

    The US team consisting of representatives of Oak Ridge National Laboratory (ORNL), Savannah River plant (SRP), Idaho National Engineering Laboratory (INEL), and the Department of Energy, Oak Ridge Operations participated in a training program on French low-level radioactive waste (LLW) management techniques. Training in the rigorous waste characterization, acceptance and certification procedures required in France was provided at Agence Nationale pour les Gestion des Dechets Radioactif (ANDRA) offices in Paris.

  12. Robotic percutaneous access to the kidney: comparison with standard manual access.

    PubMed

    Su, Li-Ming; Stoianovici, Dan; Jarrett, Thomas W; Patriciu, Alexandru; Roberts, William W; Cadeddu, Jeffrey A; Ramakumar, Sanjay; Solomon, Stephen B; Kavoussi, Louis R

    2002-09-01

    To evaluate the efficiency, accuracy, and safety of robotic percutaneous access to the kidney (PAKY) for percutaneous nephrolithotomy in comparison with conventional manual techniques. We compared the intraoperative access variables (number of access attempts, time to successful access, estimated blood loss, complications) of 23 patients who underwent robotic PAKY with the remote center of motion device (PAKY-RCM) with the same data from a contemporaneous series of 23 patients who underwent conventional manual percutaneous access to the kidney. The PAKY-RCM incorporates a robotic arm and a friction transmission with axial loading system to accurately position and insert a standard 18-gauge needle percutaneously into the kidney. The blood loss during percutaneous access was estimated on a four-point scale (1 = minimal to 4 = large). The color of effluent urine was graded on a four-point scale (1 = clear to 4 = red). The mean target calix width was 13.5 +/- 9.2 mm in the robotic group and 12.2 +/- 4.5 mm in the manual group (P = 0.57). When comparing PAKY-RCM with standard manual techniques, the mean number of attempts was 2.2 +/- 1.6 v 3.2 +/- 2.5 (P = 0.14), time to access was 10.4 +/- 6.5 minutes v 15.1 +/- 8.8 minutes (P = 0.06), estimated blood loss score was 1.3 +/- 0.49 v 1.7 +/- 0.66 (P = 0.14), and color of effluent urine following access was 2.0 +/- 0.90 v 2.1 +/- 0.7 (P = 0.82). The PAKY-RCM was successful in obtaining access in 87% (20 of 23) of cases. The other three patients (13%) required conversion to manual techniques. There were no major intraoperative complications in either group. Robotic PAKY is a feasible, safe, and efficacious method of obtaining renal access for nephrolithotomy. The number of attempts and time to access were comparable to those of standard manual percutaneous access techniques. These findings provide the groundwork for the development of a completely automated robot-assisted percutaneous renal access device.

  13. Access, labor, and wild floral greens management in western Washington's forests.

    Treesearch

    Kathryn A. Lynch; Rebecca J. McLain

    2003-01-01

    This report compares the changes that took place between 1994 and 2002 in the nontimber forest product (NTFP) management regime that governed access to floral greens and other NTFPs in western coastal Washington. A rapid rural appraisal approach was used to gather data from 24 NTFP stakeholders during phase I (1994) and from 37 NTFP stakeholders during phase II (2002...

  14. A New Technique for Femoral Venous Access in Infants Using Arterial Injection Venous Return Guidance

    PubMed Central

    Ebishima, Hironori; Kitano, Masataka; Kurosaki, Kenichi; Shiraishi, Isao

    2017-01-01

    Objectives: Although venography guidance is helpful for central venous catheter placement, it is sometimes difficult to place a peripheral intravenous cannula for enhancement. We designed a new technique for establishing femoral venous access using venography guidance in the return phase of peripheral arteriography. This new technique was named arterial injection venous return guidance. Here we assessed the efficacy and safety of arterial injection venous return guidance. Methods: We reviewed data of 29 infants less than 6 months old undergoing catheter intervention at our institute in 2014. Of the 29 patients, femoral venous cannulation was performed using arterial injection venous return guidance in 5 patients, venography in 20 patients, and the landmark method in 4 patients. The technical success rates and incidence of complications were compared. Results: The overall success rates were 100% in the arterial injection venous return-guided and venography-guided groups. The mean procedure duration and mean contrast material injection time were similar between the groups. The contrast effect on the femoral vein in the arterial injection venous return-guided group was lower than that in the venography-guided group, but adequate for surgery. The overall complication rate was 17%, and obstruction of previously placed intravenous catheters was the most common complication. Conclusions: Therefore, the arterial injection venous return guidance technique was as safe and efficient as venography for establishing venous access. PMID:29034015

  15. Software-Enabled Project Management Techniques and Their Relationship to the Triple Constraints

    ERIC Educational Resources Information Center

    Elleh, Festus U.

    2013-01-01

    This study investigated the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). There was the dearth of academic literature that focused on the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). Based on the gap…

  16. ISWHM: Tools and Techniques for Software and System Health Management

    NASA Technical Reports Server (NTRS)

    Schumann, Johann; Mengshoel, Ole J.; Darwiche, Adnan

    2010-01-01

    This presentation presents status and results of research on Software Health Management done within the NRA "ISWHM: Tools and Techniques for Software and System Health Management." Topics include: Ingredients of a Guidance, Navigation, and Control System (GN and C); Selected GN and C Testbed example; Health Management of major ingredients; ISWHM testbed architecture; and Conclusions and next Steps.

  17. Classroom Management Through the Application of Behavior Modification Techniques.

    ERIC Educational Resources Information Center

    Ferinden, William E., Jr.

    The primary aim of this book is to bring to the grade school teacher a survey of the most recent techniques and ideas of behavior modification which are applicable to good classroom management. All of the approaches and techniques presented could be of interest to teachers working at all grade levels. Since research has shown that the systematic…

  18. USING BIOASSAYS TO EVALUATE THE PERFORMANCE OF RISK MANAGEMENT TECHNIQUES

    EPA Science Inventory

    Often, the performance of risk management techniques is evaluated by measuring the concentrations of the chemials of concern before and after risk management effoprts. However, using bioassays and chemical data provides a more robust understanding of the effectiveness of risk man...

  19. Accessibility Evaluation of Online Learning Management System for Persons with Visual Impairment

    ERIC Educational Resources Information Center

    Suwannawut, Nantanoot

    2014-01-01

    Many academic institutions around the world are utilizing and investing in online learning management systems (LMS). While several research studies have examined the functionality of this type of technology, little attention has been paid to accessibility issues, in particular to the complex web-based interfaces for learners with disabilities,…

  20. Mobile multiple access study

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Multiple access techniques (FDMA, CDMA, TDMA) for the mobile user and attempts to identify the current best technique are discussed. Traffic loading is considered as well as voice and data modulation and spacecraft and system design. Emphasis is placed on developing mobile terminal cost estimates for the selected design. In addition, design examples are presented for the alternative techniques of multiple access in order to compare with the selected technique.

  1. The relationship between treatment access and spending in a managed behavioral health organization.

    PubMed

    Cuffel, B J; Regier, D

    2001-07-01

    This study replicated an earlier study that showed a linear relationship between level of treatment access and behavioral health spending. The study reported here examined whether this relationship varies by important characteristics of behavioral health plans. Access rates and total spending over a five- to seven-year period were computed for 30 behavioral health plans. Regression analysis was used to estimate the relationship between access and spending and to examine whether it varied with the characteristics of benefit plans. A linear relationship was found between level of treatment access and behavioral health spending. However, the relationship closely paralleled that found in the earlier study only for benefit plans with an employee assistance program linked to the managed behavioral health organization and for plans that do not allow the use of out-of-network providers. The results of this study replicate those of the earlier study in showing a linear relationship between access and spending, but they suggest that the magnitude of this relationship may vary according to key plan characteristics.

  2. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Wildlife Management Areas Access Restrictions III Appendix III to Subpart P of Part 922 Commerce and Foreign Trade Regulations Relating to... National Marine Sanctuary Pt. 922, Subpt. P, App. III Appendix III to Subpart P of Part 922—Wildlife...

  3. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Wildlife Management Areas Access Restrictions III Appendix III to Subpart P of Part 922 Commerce and Foreign Trade Regulations Relating to... National Marine Sanctuary Pt. 922, Subpt. P, App. III Appendix III to Subpart P of Part 922—Wildlife...

  4. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Wildlife Management Areas Access Restrictions III Appendix III to Subpart P of Part 922 Commerce and Foreign Trade Regulations Relating to... National Marine Sanctuary Pt. 922, Subpt. P, App. III Appendix III to Subpart P of Part 922—Wildlife...

  5. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Wildlife Management Areas Access Restrictions III Appendix III to Subpart P of Part 922 Commerce and Foreign Trade Regulations Relating to... National Marine Sanctuary Pt. 922, Subpt. P, App. III Appendix III to Subpart P of Part 922—Wildlife...

  6. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Wildlife Management Areas Access Restrictions III Appendix III to Subpart P of Part 922 Commerce and Foreign Trade Regulations Relating to... National Marine Sanctuary Pt. 922, Subpt. P, App. III Appendix III to Subpart P of Part 922—Wildlife...

  7. Behavior Management Techniques in Predoctoral and Postdoctoral Pediatric Dentistry Programs.

    ERIC Educational Resources Information Center

    Belanger, Gary K.; Tilliss, Terri S.

    1993-01-01

    A survey determined the extent to which selected pediatric dental behavior management techniques are taught both didactically and clinically in 46 predoctoral and 45 postdoctoral programs. Results and trends are reported within the four categories of sedation, restraint, parental presence, and communications behavior management. (GLR)

  8. Influence of Medical Insurance Under the Affordable Care Act on Access to Pain Management of the Trauma Patient.

    PubMed

    Wiznia, Daniel H; Zaki, Theodore; Maisano, Julianna; Kim, Chang-Yeon; Halaszynski, Thomas M; Leslie, Michael P

    The Affordable Care Act intended to "extend affordable coverage" and "ensure access" for vulnerable patient populations. This investigation examined whether the type of insurance (Medicaid, Medicare, Blue Cross, cash pay) carried by trauma patients influences access to pain management specialty care. Investigators phoned 443 board-certified pain specialists, securing office visits with 235 pain physicians from 8 different states. Appointments for pain management were for a patient who sustained an ankle fracture requiring surgery and experiencing difficulty weaning off opioids. Offices were phoned 4 times assessing responses to the 4 different payment methodologies. Fifty-three percent of pain specialists contacted (235 of 443) were willing to see new patients to manage pain medication. Within the 53% of positive responses, 7.2% of physicians scheduled appointments for Medicaid patients, compared with 26.8% for cash-paying patients, 39.6% for those with Medicare, and 41.3% with Blue Cross (P < 0.0001). There were no differences in appointment access between states that had expanded Medicaid eligibility for low-income adults versus states that had not expanded Medicaid eligibility. Neither Medicaid nor Medicare reimbursement levels for new patient visits correlated with ability to schedule an appointment or influenced wait times. Access to pain specialists for management of pain medication in the postoperative trauma patient proved challenging. Despite the Affordable Care Act, Medicaid patients still experienced curtailed access to pain specialists and confronted the highest incidence of barriers to receiving appointments.

  9. A Parent-Focused Early Intervention Program for Autism: Who Gets Access?

    ERIC Educational Resources Information Center

    Birkin, Christina; Anderson, Angelika; Seymour, Fred; Moore, Dennis W.

    2008-01-01

    Background: The EarlyBird program is a psycho-educational early intervention program for parents of children with autistic spectrum disorder (ASD). It aims to provide parents with skills to increase their child's communication and manage challenging behaviour using behavioural techniques. Method: Two interlinked studies examined access to the…

  10. Evidence-Informed Leadership in the Japanese Context: Middle Managers at a University Self-Access Center

    ERIC Educational Resources Information Center

    Adamson, John; Brown, Howard

    2012-01-01

    This study reports on the steering of a self-access learning center in a Japanese university by its "middle management" committee over the first years of its operation. Middle management practice was informed by an ethnographic archive of various facets of center use, particularly concerning language policy and curriculum integration, issues about…

  11. Research in network management techniques for tactical data communications networks

    NASA Astrophysics Data System (ADS)

    Boorstyn, R.; Kershenbaum, A.; Maglaris, B.; Sarachik, P.

    1982-09-01

    This is the final technical report for work performed on network management techniques for tactical data networks. It includes all technical papers that have been published during the control period. Research areas include Packet Network modelling, adaptive network routing, network design algorithms, network design techniques, and local area networks.

  12. An evolutionary outlook of air traffic flow management techniques

    NASA Astrophysics Data System (ADS)

    Kistan, Trevor; Gardi, Alessandro; Sabatini, Roberto; Ramasamy, Subramanian; Batuwangala, Eranga

    2017-01-01

    In recent years Air Traffic Flow Management (ATFM) has become pertinent even in regions without sustained overload conditions caused by dense traffic operations. Increasing traffic volumes in the face of constrained resources has created peak congestion at specific locations and times in many areas of the world. Increased environmental awareness and economic drivers have combined to create a resurgent interest in ATFM as evidenced by a spate of recent ATFM conferences and workshops mediated by official bodies such as ICAO, IATA, CANSO the FAA and Eurocontrol. Significant ATFM acquisitions in the last 5 years include South Africa, Australia and India. Singapore, Thailand and Korea are all expected to procure ATFM systems within a year while China is expected to develop a bespoke system. Asia-Pacific nations are particularly pro-active given the traffic growth projections for the region (by 2050 half of all air traffic will be to, from or within the Asia-Pacific region). National authorities now have access to recently published international standards to guide the development of national and regional operational concepts for ATFM, geared to Communications, Navigation, Surveillance/Air Traffic Management and Avionics (CNS+A) evolutions. This paper critically reviews the field to determine which ATFM research and development efforts hold the best promise for practical technological implementations, offering clear benefits both in terms of enhanced safety and efficiency in times of growing air traffic. An evolutionary approach is adopted starting from an ontology of current ATFM techniques and proceeding to identify the technological and regulatory evolutions required in the future CNS+A context, as the aviation industry moves forward with a clearer understanding of emerging operational needs, the geo-political realities of regional collaboration and the impending needs of global harmonisation.

  13. Stress Management Apps With Regard to Emotion-Focused Coping and Behavior Change Techniques: A Content Analysis

    PubMed Central

    Hoffmann, Alexandra; Bleser, Gabriele

    2017-01-01

    Background Chronic stress has been shown to be associated with disease. This link is not only direct but also indirect through harmful health behavior such as smoking or changing eating habits. The recent mHealth trend offers a new and promising approach to support the adoption and maintenance of appropriate stress management techniques. However, only few studies have dealt with the inclusion of evidence-based content within stress management apps for mobile phones. Objective The aim of this study was to evaluate stress management apps on the basis of a new taxonomy of effective emotion-focused stress management techniques and an established taxonomy of behavior change techniques. Methods Two trained and independent raters evaluated 62 free apps found in Google Play with regard to 26 behavior change and 15 emotion-focused stress management techniques in October 2015. Results The apps included an average of 4.3 behavior change techniques (SD 4.2) and 2.8 emotion-focused stress management techniques (SD 2.6). The behavior change technique score and stress management technique score were highly correlated (r=.82, P=.01). Conclusions The broad variation of different stress management strategies found in this sample of apps goes in line with those found in conventional stress management interventions and self-help literature. Moreover, this study provided a first step toward more detailed and standardized taxonomies, which can be used to investigate evidence-based content in stress management interventions and enable greater comparability between different intervention types. PMID:28232299

  14. Boosting the FM-Index on the GPU: Effective Techniques to Mitigate Random Memory Access.

    PubMed

    Chacón, Alejandro; Marco-Sola, Santiago; Espinosa, Antonio; Ribeca, Paolo; Moure, Juan Carlos

    2015-01-01

    The recent advent of high-throughput sequencing machines producing big amounts of short reads has boosted the interest in efficient string searching techniques. As of today, many mainstream sequence alignment software tools rely on a special data structure, called the FM-index, which allows for fast exact searches in large genomic references. However, such searches translate into a pseudo-random memory access pattern, thus making memory access the limiting factor of all computation-efficient implementations, both on CPUs and GPUs. Here, we show that several strategies can be put in place to remove the memory bottleneck on the GPU: more compact indexes can be implemented by having more threads work cooperatively on larger memory blocks, and a k-step FM-index can be used to further reduce the number of memory accesses. The combination of those and other optimisations yields an implementation that is able to process about two Gbases of queries per second on our test platform, being about 8 × faster than a comparable multi-core CPU version, and about 3 × to 5 × faster than the FM-index implementation on the GPU provided by the recently announced Nvidia NVBIO bioinformatics library.

  15. A hollow definitive obturator fabrication technique for management of partial maxillectomy.

    PubMed

    Patil, Pravinkumar Gajanan; Patil, Smita Pravinkumar

    2012-11-01

    Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis.

  16. Sustaining change: the imperative for patient access strategies.

    PubMed

    Glynn, Peter A R

    2006-01-01

    The paper by Trypuc, MacLeod and Hudson provides a timely and important overview of methods to sustain provincial wait time strategies. The emphasis on accountability for patient access to timely care throughout the healthcare system comes through strongly--as it should. These accountabilities are made "real" through purchase service agreements. Physician-hospital relationships are a fundamental aspect of this accountability. This commentary suggests the inclusion of two additional supporting tools in addition to those cited by the authors of the lead paper--quality monitoring and the use of industrial engineering techniques for queue management and patient flow analysis. Strong and persistent leadership of patient access strategies will ensure sustainable change.

  17. Does the Implantation Technique for Totally Implantable Venous Access Ports (TIVAPs) Influence Long-Term Outcome?

    PubMed

    Biacchi, Daniele; Sammartino, Paolo; Sibio, Simone; Accarpio, Fabio; Cardi, Maurizio; Sapienza, Paolo; De Cesare, Alessandro; Atta, Joseph Maher Fouad; Impagnatiello, Alessio; Di Giorgio, Angelo

    2016-02-01

    Totally implantable venous access ports (TIVAP) are eventually explanted for various reasons, related or unrelated to the implantation technique used. Having more information on long-term explantation would help improve placement techniques. From a series of 1572 cancer patients who had TIVAPs implanted in our center with the cutdown technique or Seldinger technique, we studied the 542 patients who returned to us to have their TIVAP explanted after 70 days or more. As outcome measures we distinguished between TIVAPs explanted for long-term complications (infection, catheter-, reservoir-, and patient-related complications) and TIVAPs no longer needed. Univariate and multivariate analyses were run to investigate the reasons for explantation and their possible correlation with implantation techniques. The most common reason for explantation was infection (47.6 %), followed by catheter-related (20.8 %), patient-related (14.7 %), and reservoir-related complications (4.7 %). In the remaining 12.2 % of cases, the TIVAP was explanted complication free after the planned treatments ended. Infection correlated closely with longer TIVAP use. Univariate and multivariate analyses identified the Seldinger technique as a major risk factor for venous thrombosis and catheter dislocation. The need for long-term TIVAP explantation in about one-third of cancer patients is related to the implantation techniques used.

  18. [Access to prenatal care and quality of care in the Family Health Strategy: infrastructure, care, and management].

    PubMed

    Guimarães, Wilderi Sidney Gonçalves; Parente, Rosana Cristina Pereira; Guimarães, Thayanne Louzada Ferreira; Garnelo, Luiza

    2018-05-10

    This study focuses on access to prenatal care and quality of care in the Family Health Strategy in Brazil as a whole and in the North region, through evaluation of infrastructure characteristics in the health units, management, and supply of care provided by the teams, from the perspective of regional and state inequalities. A cross-sectional evaluative and normative study was performed, drawing on the external evaluation component of the second round of the Program for Improvement of Access and Quality of Primary Care, in 2013-2014. The results revealed the inadequacy of the primary healthcare network's infrastructure for prenatal care, low adequacy of clinical actions for quality of care, and the teams' low management capacity to guarantee access and quality of care. In the distribution according to geopolitical regions, the findings pertaining to the units' infrastructure indicate a direct relationship between the infrastructure's adequacy and social contexts with higher municipal human development indices and income. For the clinical actions in patient care, the teams in all the regions scored low on adequacy, with slightly better results in the North and South regions of the country. There were important differences between the states of the North, and the states with higher mean income and human development scored higher on adequacy. The results indicate important organizational difficulties in both access and quality of care provided by the health teams, in addition to visible insufficiency in management activities aimed to improve access and quality of prenatal care.

  19. Improving patient safety and optimizing nursing teamwork using crew resource management techniques.

    PubMed

    West, Priscilla; Sculli, Gary; Fore, Amanda; Okam, Nwoha; Dunlap, Cleveland; Neily, Julia; Mills, Peter

    2012-01-01

    This project describes the application of the "sterile cockpit rule," a crew resource management (CRM) technique, targeted to improve efficacy and safety for nursing assistants in the performance of patient care duties. Crew resource management techniques have been successfully implemented in the aviation industry to improve flight safety. Application of these techniques can improve patient safety in medical settings. The Veterans Affairs (VA) National Center for Patient Safety conducted a CRM training program in select VA nursing units. One unit developed a novel application of the sterile cockpit rule to create protected time for certified nursing assistants (CNAs) while they collected vital signs and blood glucose data at the beginning of each shift. The typical nursing authority structure was reversed, with senior nurses protecting CNAs from distractions. This process led to improvements in efficiency and communication among nurses, with the added benefit of increased staff morale. Crew resource management techniques can be used to improve efficiency, morale, and patient safety in the healthcare setting.

  20. Stress Management Apps With Regard to Emotion-Focused Coping and Behavior Change Techniques: A Content Analysis.

    PubMed

    Christmann, Corinna Anna; Hoffmann, Alexandra; Bleser, Gabriele

    2017-02-23

    Chronic stress has been shown to be associated with disease. This link is not only direct but also indirect through harmful health behavior such as smoking or changing eating habits. The recent mHealth trend offers a new and promising approach to support the adoption and maintenance of appropriate stress management techniques. However, only few studies have dealt with the inclusion of evidence-based content within stress management apps for mobile phones. The aim of this study was to evaluate stress management apps on the basis of a new taxonomy of effective emotion-focused stress management techniques and an established taxonomy of behavior change techniques. Two trained and independent raters evaluated 62 free apps found in Google Play with regard to 26 behavior change and 15 emotion-focused stress management techniques in October 2015. The apps included an average of 4.3 behavior change techniques (SD 4.2) and 2.8 emotion-focused stress management techniques (SD 2.6). The behavior change technique score and stress management technique score were highly correlated (r=.82, P=.01). The broad variation of different stress management strategies found in this sample of apps goes in line with those found in conventional stress management interventions and self-help literature. Moreover, this study provided a first step toward more detailed and standardized taxonomies, which can be used to investigate evidence-based content in stress management interventions and enable greater comparability between different intervention types. ©Corinna Anna Christmann, Alexandra Hoffmann, Gabriele Bleser. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.02.2017.

  1. A hollow definitive obturator fabrication technique for management of partial maxillectomy

    PubMed Central

    Patil, Smita Pravinkumar

    2012-01-01

    Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis. PMID:23236579

  2. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

    PubMed

    Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

    2017-11-29

    Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

  3. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

    PubMed Central

    Kuupiel, Desmond; Bawontuo, Vitalis

    2017-01-01

    Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings. PMID:29186013

  4. A Review of the Usefulness of R & D Management Techniques.

    DTIC Science & Technology

    1981-09-01

    Logistics Air Force Institute of Technology, WAFB, OH I1. CONTROLLING OFFICE N-34E AND ADDRESS 12. REPORT DATE Department of Communication and Humanities...First, upper level managers sometimes fail to accurately translate their understanding of corporate objectives and goals into the technical envi...could also be classified as a "style" of management. A management technique according to John Argenti is "a recognized method of analyzing or solving a

  5. Contemporary behavior management techniques in clinical pediatric dentistry: out with the old and in with the new?

    PubMed

    Oliver, Kelly; Manton, David John

    2015-01-01

    Effective behavior management guides children through the complex social context of dentistry utilizing techniques based on a current understanding of the social, emotional, and cognitive development of children. Behavior management techniques facilitate effective communication and establish social and behavioral guidelines for the dental environment. Contemporary parenting styles, expectations, and attitudes of modern parents and society have influenced the use of behavior management techniques with a prevailing emphasis on communicative techniques and pharmacological management over aversive techniques.

  6. Moving Toward Real Time Data Handling: Data Management at the IRIS DMC

    NASA Astrophysics Data System (ADS)

    Ahern, T. K.; Benson, R. B.

    2001-12-01

    The IRIS Data Management Center at the University of Washington has become a major archive and distribution center for a wide variety of seismological data. With a mass storage system with a 360-terabyte capacity, the center is well positioned to manage the data flow, both inbound and outbound, from all anticipated seismic sources for the foreseeable future. As data flow in and out of the IRIS DMC at an increasing rate, new methods to deal with data using purely automated techniques are being developed. The on-line and self-service data repositories of SPYDERr and FARM are collections of seismograms for all larger events. The WWW tool WILBER and the client application WEED are examples of tools that provide convenient access to the 1/2 terabyte of SPYDERr and FARM data. The Buffer of Uniform Data (BUD) system provides access to continuous data available in real time from GSN, FDSN, US regional networks, and other globally distributed stations. Continuous data that have received quality control are always available from the archive of continuous data. This presentation will review current and future data access techniques supported at IRIS. One of the most difficult tasks at the DMC is the management of the metadata that describes all the stations, sensors, and data holdings. Demonstrations of tools that provide access to the metadata will be presented. This presentation will focus on the new techniques of data management now being developed at the IRIS DMC. We believe that these techniques are generally applicable to other types of geophysical data management as well.

  7. Blowing away the pain: a technique for pediatric pain management.

    PubMed

    Jacobs, Adrian; Price, Harper N; Popenhagen, Mark P

    2014-01-01

    Painful medical procedures in childhood may have long-term negative effects on development and future tolerance of pain. We describe a distraction technique for pediatric pain management that involves "blowing away the pain." This technique may be used for acute pediatric procedures as well as for patients with chronic pain. © 2014 Wiley Periodicals, Inc.

  8. Management of Gustilo Anderson III B open tibial fractures by primary fascio-septo-cutaneous local flap and primary fixation: The 'fix and shift' technique.

    PubMed

    Ramasamy, P R

    2017-01-01

    Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult. Thirty six Gustilo Anderson III B open tibial fractures managed between June 2002 and December 2013 with "fix and shift" technique were retrospectively reviewed. All the 36 patients managed by this technique had open wounds measuring >5 cm (post debridement). Under fix and shift technique, stable fixation involved primary external fixator application or primary intramedullary nailing of the tibial fracture and immediate soft tissue cover involved septocutaneous shift, i.e., shifting of fasciocutaneous segments based on septocutaneous perforators. Primary fracture union rate was 50% and reoperation rate (bone stimulating procedures) was 50%. Overall fracture union rate was 100%. The rate of malunion was 14% and deep infection was 16%. Failure of septocutaneous shift was 2.7%. There was no incidence of amputation. Management of Gustilo Anderson III B open tibial fractures with "fix and shift" technique has resulted in better outcome in terms of skeletal factors (primary fracture union, overall union, and time for union and malunion) and soft tissue factors (wound healing, flap failure, access to secondary procedures, and esthetic appearance) when compared to standard methods adopted earlier. Hence, "fix and shift" could be recommended as one of the treatment modalities for open III B tibial fractures.

  9. Hacking Blackboard: Customizing Access to Library Resources through the Blackboard Course Management System

    ERIC Educational Resources Information Center

    Kellam, Lynda M.; Cox, Richard; Winkler, Hannah

    2009-01-01

    Academic libraries have long been trying to gain access to users through their favorite online spaces, such as social networking sites. In this article a project of the University of North Carolina at Greensboro's University Libraries, which integrated library resources with the campus course management system, Blackboard, is detailed. The main…

  10. Optimizing tertiary storage organization and access for spatio-temporal datasets

    NASA Technical Reports Server (NTRS)

    Chen, Ling Tony; Rotem, Doron; Shoshani, Arie; Drach, Bob; Louis, Steve; Keating, Meridith

    1994-01-01

    We address in this paper data management techniques for efficiently retrieving requested subsets of large datasets stored on mass storage devices. This problem represents a major bottleneck that can negate the benefits of fast networks, because the time to access a subset from a large dataset stored on a mass storage system is much greater that the time to transmit that subset over a network. This paper focuses on very large spatial and temporal datasets generated by simulation programs in the area of climate modeling, but the techniques developed can be applied to other applications that deal with large multidimensional datasets. The main requirement we have addressed is the efficient access of subsets of information contained within much larger datasets, for the purpose of analysis and interactive visualization. We have developed data partitioning techniques that partition datasets into 'clusters' based on analysis of data access patterns and storage device characteristics. The goal is to minimize the number of clusters read from mass storage systems when subsets are requested. We emphasize in this paper proposed enhancements to current storage server protocols to permit control over physical placement of data on storage devices. We also discuss in some detail the aspects of the interface between the application programs and the mass storage system, as well as a workbench to help scientists to design the best reorganization of a dataset for anticipated access patterns.

  11. Suitability of online 3D visualization technique in oil palm plantation management

    NASA Astrophysics Data System (ADS)

    Mat, Ruzinoor Che; Nordin, Norani; Zulkifli, Abdul Nasir; Yusof, Shahrul Azmi Mohd

    2016-08-01

    Oil palm industry has been the backbone for the growth of Malaysia economy. The exports of this commodity increasing almost every year. Therefore, there are many studies focusing on how to help this industry increased its productivity. In order to increase the productivity, the management of oil palm plantation need to be improved and strengthen. One of the solution in helping the oil palm manager is by implementing online 3D visualization technique for oil palm plantation using game engine technology. The potential of this application is that it can helps in fertilizer and irrigation management. For this reason, the aim of this paper is to investigate the issues in managing oil palm plantation from the view of oil palm manager by interview. The results from this interview will helps in identifying the suitable issues could be highlight in implementing online 3D visualization technique for oil palm plantation management.

  12. An Authentication and Key Management Mechanism for Resource Constrained Devices in IEEE 802.11-based IoT Access Networks.

    PubMed

    Kim, Ki-Wook; Han, Youn-Hee; Min, Sung-Gi

    2017-09-21

    Many Internet of Things (IoT) services utilize an IoT access network to connect small devices with remote servers. They can share an access network with standard communication technology, such as IEEE 802.11ah. However, an authentication and key management (AKM) mechanism for resource constrained IoT devices using IEEE 802.11ah has not been proposed as yet. We therefore propose a new AKM mechanism for an IoT access network, which is based on IEEE 802.11 key management with the IEEE 802.1X authentication mechanism. The proposed AKM mechanism does not require any pre-configured security information between the access network domain and the IoT service domain. It considers the resource constraints of IoT devices, allowing IoT devices to delegate the burden of AKM processes to a powerful agent. The agent has sufficient power to support various authentication methods for the access point, and it performs cryptographic functions for the IoT devices. Performance analysis shows that the proposed mechanism greatly reduces computation costs, network costs, and memory usage of the resource-constrained IoT device as compared to the existing IEEE 802.11 Key Management with the IEEE 802.1X authentication mechanism.

  13. An Authentication and Key Management Mechanism for Resource Constrained Devices in IEEE 802.11-based IoT Access Networks

    PubMed Central

    Han, Youn-Hee; Min, Sung-Gi

    2017-01-01

    Many Internet of Things (IoT) services utilize an IoT access network to connect small devices with remote servers. They can share an access network with standard communication technology, such as IEEE 802.11ah. However, an authentication and key management (AKM) mechanism for resource constrained IoT devices using IEEE 802.11ah has not been proposed as yet. We therefore propose a new AKM mechanism for an IoT access network, which is based on IEEE 802.11 key management with the IEEE 802.1X authentication mechanism. The proposed AKM mechanism does not require any pre-configured security information between the access network domain and the IoT service domain. It considers the resource constraints of IoT devices, allowing IoT devices to delegate the burden of AKM processes to a powerful agent. The agent has sufficient power to support various authentication methods for the access point, and it performs cryptographic functions for the IoT devices. Performance analysis shows that the proposed mechanism greatly reduces computation costs, network costs, and memory usage of the resource-constrained IoT device as compared to the existing IEEE 802.11 Key Management with the IEEE 802.1X authentication mechanism. PMID:28934152

  14. Energy-efficient process-stacking multiplexing access for 60-GHz mm-wave wireless personal area networks.

    PubMed

    Estevez, Claudio; Kailas, Aravind

    2012-01-01

    Millimeter-wave technology shows high potential for future wireless personal area networks, reaching over 1 Gbps transmissions using simple modulation techniques. Current specifications consider dividing the spectrum into effortlessly separable spectrum ranges. These low requirements open a research area in time and space multiplexing techniques for millimeter-waves. In this work a process-stacking multiplexing access algorithm is designed for single channel operation. The concept is intuitive, but its implementation is not trivial. The key to stacking single channel events is to operate while simultaneously obtaining and handling a-posteriori time-frame information of scheduled events. This information is used to shift a global time pointer that the wireless access point manages and uses to synchronize all serviced nodes. The performance of the proposed multiplexing access technique is lower bounded by the performance of legacy TDMA and can significantly improve the effective throughput. Work is validated by simulation results.

  15. Report: Improvements Needed in CSB’s Identity and Access Management and Incident Response Security Functions

    EPA Pesticide Factsheets

    Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.

  16. Data Mining Techniques for Customer Relationship Management

    NASA Astrophysics Data System (ADS)

    Guo, Feng; Qin, Huilin

    2017-10-01

    Data mining have made customer relationship management (CRM) a new area where firms can gain a competitive advantage, and play a key role in the firms’ management decision. In this paper, we first analyze the value and application fields of data mining techniques for CRM, and further explore how data mining applied to Customer churn analysis. A new business culture is developing today. The conventional production centered and sales purposed market strategy is gradually shifting to customer centered and service purposed. Customers’ value orientation is increasingly affecting the firms’. And customer resource has become one of the most important strategic resources. Therefore, understanding customers’ needs and discriminating the most contributed customers has become the driving force of most modern business.

  17. Sewage Management Changes in the North-eastern Poland After Accession to the European Union

    NASA Astrophysics Data System (ADS)

    Skarżyński, Szymon; Bartkowska, Izabela

    2018-02-01

    Poland's accession to the European Union contributed to the infrastructure development of the whole country. One of the elements of the modernized infrastructure is the sewage network and facilities on this network, as well as facilities for waste water treatment and disposal of sludge. A wide stream of funds flowing to the country, and consequently also to the north-eastern polish voivodeships (Podlaskie, Warmian-Masurian, Lublin), allowed modernization, organize, and sometimes to build a new sewage management of this part of the country. The main factors and parameters that allow us to evaluate the development of the sewage management in north-eastern Poland are included: percentage of population using sewage treatment plants, number of municipal sewage plants with the division of their type, number of industrial plants, number of septic tanks, amount of sewage purified in a year, amount of sludge produced in the year, design capacity of sewage treatment plant, size of plant in population equivalent (PE). From a number of investments in the field of wastewater management carried out in the discussed area in the period after Poland's accession to the European Union, 9 investments were considered the most important, 3 from each of the voivodeships.

  18. Stress Management Techniques for Graduate Students: Cognitive Coping, Problem-Solving and Time Management.

    ERIC Educational Resources Information Center

    Kolko, David J.

    The application of stress management techniques to highly specialized populations and disorders has become an increasingly important clinical endeavor in recent years. Curiously, however, individuals undergoing one of the most stress-laden experiences, graduate school, have rarely been the focus of such efforts. There are three major forms of…

  19. Nurses' Educational Needs Assessment for Financial Management Education Using the Nominal Group Technique.

    PubMed

    Noh, Wonjung; Lim, Ji Young

    2015-06-01

    The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. After analyzing the results, nine key components were selected: corporate management and accounting, introduction to financial management in hospitals, basic structure of accounting, basics of hospital accounting, basics of financial statements, understanding the accounts of financial statements, advanced analysis of financial statements, application of financial management, and capital financing of hospitals. The present findings can be used to develop a financial management education program to strengthen the financial management competencies of nurses. Copyright © 2015. Published by Elsevier B.V.

  20. Project TEAMS (Techniques and Education for Achieving Management Skills): Health Care Administrators.

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

    These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training health care administrators. Unit 1 contains materials designed to help the health care administrators increase their management skills in regard to self-awareness, time management, problem solving,…

  1. First Approximations of Prescribed Fire Risks Relative to Other Management Techniques Used on Private Lands.

    PubMed

    Twidwell, Dirac; Wonkka, Carissa L; Sindelar, Michael T; Weir, John R

    2015-01-01

    Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1) a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2) a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3) an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related) equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands.

  2. First Approximations of Prescribed Fire Risks Relative to Other Management Techniques Used on Private Lands

    PubMed Central

    Twidwell, Dirac; Wonkka, Carissa L.; Sindelar, Michael T.; Weir, John R.

    2015-01-01

    Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1) a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2) a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3) an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related) equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands. PMID:26465329

  3. The effects of perineal management techniques on labor complications

    PubMed Central

    Fahami, Fariba; Shokoohi, Zohreh; Kianpour, Mariam

    2012-01-01

    Background: Many women suffer from perineal trauma during the normal vaginal delivery. Perineal trauma is mainly associated with pain and complications after the childbirth. Perineal management techniques can play a significant role in perineal trauma reduction. This study aimed to compare the effects of perineal management techniques (hands-off technique, Ritgen maneuver and perineal massage using a lubricant during delivery) on the labor complications. Materials and Methods: This quasi-experimental clinical trial was conducted on 99 primiparous women who referred to Daran Hospital, Isfahan, Iran for normal vaginal delivery in 2009. The subjects were selected using a convenient method and randomly assigned to three groups of Ritgen maneuver, hands-off technique and perineal massage with lubricant. A questionnaire was used to determine the demographic characteristics of the participants and complications after birth. The short form of McGill Pain Questionnaire and the visual analogue scale for pain were also employed. The incidence and degree of perineal tears were evaluated immediately after delivery. Moreover, the incidence and severity of perineal pain were assessed 24 hours and also 6 weeks after delivery. Findings: In the Ritgen maneuver group, the frequency of tears, the relative frequency of tear degrees, the severity of perineal pain 24 hours after delivery and the frequency of pain and perineal pain severity 6 weeks after delivery were significantly different from the other two methods. Conclusions: Hands-off technique during parturition of the neonate's head was associated with fewer complications after delivery. It was even better than perineal massage during the parturition. PMID:23493441

  4. Risk Management Technique for design and operation of facilities and equipment

    NASA Technical Reports Server (NTRS)

    Fedor, O. H.; Parsons, W. N.; Coutinho, J. De S.

    1975-01-01

    The Risk Management System collects information from engineering, operating, and management personnel to identify potentially hazardous conditions. This information is used in risk analysis, problem resolution, and contingency planning. The resulting hazard accountability system enables management to monitor all identified hazards. Data from this system are examined in project reviews so that management can decide to eliminate or accept these risks. This technique is particularly effective in improving the management of risks in large, complex, high-energy facilities. These improvements are needed for increased cooperation among industry, regulatory agencies, and the public.

  5. 75 FR 21662 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-26

    ...] Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget's (OMB... Regulation on Access to Employee Exposure and Medical Records (29 CFR 1910.1020). DATES: Comments must be... operating small businesses, and to reduce to the maximum extent feasible unnecessary duplication of efforts...

  6. Mobility based key management technique for multicast security in mobile ad hoc networks.

    PubMed

    Madhusudhanan, B; Chitra, S; Rajan, C

    2015-01-01

    In MANET multicasting, forward and backward secrecy result in increased packet drop rate owing to mobility. Frequent rekeying causes large message overhead which increases energy consumption and end-to-end delay. Particularly, the prevailing group key management techniques cause frequent mobility and disconnections. So there is a need to design a multicast key management technique to overcome these problems. In this paper, we propose the mobility based key management technique for multicast security in MANET. Initially, the nodes are categorized according to their stability index which is estimated based on the link availability and mobility. A multicast tree is constructed such that for every weak node, there is a strong parent node. A session key-based encryption technique is utilized to transmit a multicast data. The rekeying process is performed periodically by the initiator node. The rekeying interval is fixed depending on the node category so that this technique greatly minimizes the rekeying overhead. By simulation results, we show that our proposed approach reduces the packet drop rate and improves the data confidentiality.

  7. Comparison of a novel real-time SonixGPS needle-tracking ultrasound technique with traditional ultrasound for vascular access in a phantom gel model.

    PubMed

    Kopac, Daniel S; Chen, Jerry; Tang, Raymond; Sawka, Andrew; Vaghadia, Himat

    2013-09-01

    Ultrasound-guided percutaneous vascular access for endovascular procedures is well established in surgical practice. Despite this, rates of complications from venous and arterial access procedures remain a significant cause of morbidity. We hypothesized that the use of a new technique of vascular access using an ultrasound with a novel needle-guidance positioning system (GPS) would lead to improved success rates of vascular puncture for both in-plane and out-of-plane techniques compared with traditional ultrasound. A prospective, randomized crossover study of medical students from all years of medical school was conducted using a phantom gel model. Each medical student performed three ultrasound-guided punctures with each of the four modalities (in-plane no GPS, in-plane with GPS, out-of-plane no GPS, out-of-plane with GPS) for a total of 12 attempts. The success or failure was judged by the ability to aspirate a simulated blood solution from the model. The time to successful puncture was also recorded. A poststudy validated NASA Task Load Index workload questionnaire was conducted to assess the student's perceptions of the two different techniques. A total of 30 students completed the study. There was no significant difference seen in the mean times of vascular access for each of the modalities. Higher success rates for vascular access using the GPS for both the in-plane (94% vs 91%) and the out-of-plane (86% vs 70%) views were observed; however, this was not statistically significant. The students perceived the mental demand (median 12.0 vs 14.00; P = .035) and effort to be lower (mean 11.25 vs 14.00; P = .044) as well as the performance to be higher (mean 15.50 vs 14.00; P = .041) for the GPS vs the traditional ultrasound-guided technique. Students also perceived their ability to access vessels increased with the aid of the GPS (7.00 vs 6.50; P = .007). The majority of students expressed a preference for GPS (26/30, 87%) as opposed to the traditional counterpart

  8. Integration of EGA secure data access into Galaxy.

    PubMed

    Hoogstrate, Youri; Zhang, Chao; Senf, Alexander; Bijlard, Jochem; Hiltemann, Saskia; van Enckevort, David; Repo, Susanna; Heringa, Jaap; Jenster, Guido; J A Fijneman, Remond; Boiten, Jan-Willem; A Meijer, Gerrit; Stubbs, Andrew; Rambla, Jordi; Spalding, Dylan; Abeln, Sanne

    2016-01-01

    High-throughput molecular profiling techniques are routinely generating vast amounts of data for translational medicine studies. Secure access controlled systems are needed to manage, store, transfer and distribute these data due to its personally identifiable nature. The European Genome-phenome Archive (EGA) was created to facilitate access and management to long-term archival of bio-molecular data. Each data provider is responsible for ensuring a Data Access Committee is in place to grant access to data stored in the EGA. Moreover, the transfer of data during upload and download is encrypted. ELIXIR, a European research infrastructure for life-science data, initiated a project (2016 Human Data Implementation Study) to understand and document the ELIXIR requirements for secure management of controlled-access data. As part of this project, a full ecosystem was designed to connect archived raw experimental molecular profiling data with interpreted data and the computational workflows, using the CTMM Translational Research IT (CTMM-TraIT) infrastructure http://www.ctmm-trait.nl as an example. Here we present the first outcomes of this project, a framework to enable the download of EGA data to a Galaxy server in a secure way. Galaxy provides an intuitive user interface for molecular biologists and bioinformaticians to run and design data analysis workflows. More specifically, we developed a tool -- ega_download_streamer - that can download data securely from EGA into a Galaxy server, which can subsequently be further processed. This tool will allow a user within the browser to run an entire analysis containing sensitive data from EGA, and to make this analysis available for other researchers in a reproducible manner, as shown with a proof of concept study.  The tool ega_download_streamer is available in the Galaxy tool shed: https://toolshed.g2.bx.psu.edu/view/yhoogstrate/ega_download_streamer.

  9. Integration of EGA secure data access into Galaxy

    PubMed Central

    Hoogstrate, Youri; Zhang, Chao; Senf, Alexander; Bijlard, Jochem; Hiltemann, Saskia; van Enckevort, David; Repo, Susanna; Heringa, Jaap; Jenster, Guido; Fijneman, Remond J.A.; Boiten, Jan-Willem; A. Meijer, Gerrit; Stubbs, Andrew; Rambla, Jordi; Spalding, Dylan; Abeln, Sanne

    2016-01-01

    High-throughput molecular profiling techniques are routinely generating vast amounts of data for translational medicine studies. Secure access controlled systems are needed to manage, store, transfer and distribute these data due to its personally identifiable nature. The European Genome-phenome Archive (EGA) was created to facilitate access and management to long-term archival of bio-molecular data. Each data provider is responsible for ensuring a Data Access Committee is in place to grant access to data stored in the EGA. Moreover, the transfer of data during upload and download is encrypted. ELIXIR, a European research infrastructure for life-science data, initiated a project (2016 Human Data Implementation Study) to understand and document the ELIXIR requirements for secure management of controlled-access data. As part of this project, a full ecosystem was designed to connect archived raw experimental molecular profiling data with interpreted data and the computational workflows, using the CTMM Translational Research IT (CTMM-TraIT) infrastructure http://www.ctmm-trait.nl as an example. Here we present the first outcomes of this project, a framework to enable the download of EGA data to a Galaxy server in a secure way. Galaxy provides an intuitive user interface for molecular biologists and bioinformaticians to run and design data analysis workflows. More specifically, we developed a tool -- ega_download_streamer - that can download data securely from EGA into a Galaxy server, which can subsequently be further processed. This tool will allow a user within the browser to run an entire analysis containing sensitive data from EGA, and to make this analysis available for other researchers in a reproducible manner, as shown with a proof of concept study.  The tool ega_download_streamer is available in the Galaxy tool shed: https://toolshed.g2.bx.psu.edu/view/yhoogstrate/ega_download_streamer. PMID:28232859

  10. Investigation of energy management strategies for photovoltaic systems - An analysis technique

    NASA Technical Reports Server (NTRS)

    Cull, R. C.; Eltimsahy, A. H.

    1982-01-01

    Progress is reported in formulating energy management strategies for stand-alone PV systems, developing an analytical tool that can be used to investigate these strategies, applying this tool to determine the proper control algorithms and control variables (controller inputs and outputs) for a range of applications, and quantifying the relative performance and economics when compared to systems that do not apply energy management. The analysis technique developed may be broadly applied to a variety of systems to determine the most appropriate energy management strategies, control variables and algorithms. The only inputs required are statistical distributions for stochastic energy inputs and outputs of the system and the system's device characteristics (efficiency and ratings). Although the formulation was originally driven by stand-alone PV system needs, the techniques are also applicable to hybrid and grid connected systems.

  11. Investigation of energy management strategies for photovoltaic systems - An analysis technique

    NASA Astrophysics Data System (ADS)

    Cull, R. C.; Eltimsahy, A. H.

    Progress is reported in formulating energy management strategies for stand-alone PV systems, developing an analytical tool that can be used to investigate these strategies, applying this tool to determine the proper control algorithms and control variables (controller inputs and outputs) for a range of applications, and quantifying the relative performance and economics when compared to systems that do not apply energy management. The analysis technique developed may be broadly applied to a variety of systems to determine the most appropriate energy management strategies, control variables and algorithms. The only inputs required are statistical distributions for stochastic energy inputs and outputs of the system and the system's device characteristics (efficiency and ratings). Although the formulation was originally driven by stand-alone PV system needs, the techniques are also applicable to hybrid and grid connected systems.

  12. Self Management Techniques and Disclosure of Sero Status

    ERIC Educational Resources Information Center

    Falaye, Ajibola; Afolayan, Joel Adeleke

    2015-01-01

    This study looked at using Self Management Technique (SMT) to promote self-disclosure of Sero status in Kwara State, Nigeria. A pre-test, post-test and control group quasi experimental design using a 2x2x2 factorial matrix was adopted. Sixty participants were sampled by balloting from two HIV/AIDS screening centres. Four instruments were used such…

  13. Treatment of hand ischemia following angioaccess surgery using the distal revascularization interval-ligation technique with preservation of vascular access: description of an 18-case series.

    PubMed

    Sessa, Carmine; Riehl, Gregory; Porcu, Paolo; Pichot, Olivier; Palacin, Pedro; Maghlaoua, Mohamed; Magne, Jean-Luc

    2004-11-01

    Hand ischemia is a rare complication of angioaccess surgery for hemodialysis. Management usually requires ligation of the arteriovenous fistula (AVF). The purpose of this report is to describe our experience with the use of the distal revascularization interval-ligation (DRIL) technique for treatment of ischemia without ligation of the AVF. From January 1999 to September 2002, the DRIL technique was used to treat 18 patients (10 men, 8 women, 10 diabetic patients) with severe paresthesia of the hand (n = 9) and finger necrosis (n = 10). The AVF was located at the elbow in 16 patients and at the wrist in 2 patients. Mean flow distal to the AVF was less than 10 mL in 5 patients, less than 5 mL in 10, and unmeasurable in 3. The conduit used for all DRIL arterial bypasses, including 15 brachiobrachial bypasses, 1 axillobrachial bypass, 1 brachioradial bypass, and 1 radioradial bypass, was the great saphenous vein graft. Trophic manifestations required finger amputation in five patients, pulpar necrosis resection in four, and transmetacarpal amputation of the index finger in one patient. Symptoms disappeared in 13 patients (73%) and improved in 5 (27%). The time required for healing of finger amputations and trophic manifestations ranged from 15 days to 2 months. Mean arterial flow through the DRIL bypass was 50 mL/min (range, 20-90 mL/min). With a mean follow-up interval of 16 months (range, 5-48 months), primary patency of the DRIL artery bypass and AVF was 94% and the limb salvage rate was 100%. The DRIL technique is the most effective procedure for treatment of angioaccess-induced hand ischemia. This technique can be used to achieve persistent relief of symptoms with continued access patency. The DRIL artery bypass improves vacularization of the hand, and ligature of the artery stops the vascular steal without affecting hemodialysis access. The DRIL technique should be proposed as first-line treatment for hand ischemia due to AVF for hemodialysis.

  14. A Scalable Data Access Layer to Manage Structured Heterogeneous Biomedical Data.

    PubMed

    Delussu, Giovanni; Lianas, Luca; Frexia, Francesca; Zanetti, Gianluigi

    2016-01-01

    This work presents a scalable data access layer, called PyEHR, designed to support the implementation of data management systems for secondary use of structured heterogeneous biomedical and clinical data. PyEHR adopts the openEHR's formalisms to guarantee the decoupling of data descriptions from implementation details and exploits structure indexing to accelerate searches. Data persistence is guaranteed by a driver layer with a common driver interface. Interfaces for two NoSQL Database Management Systems are already implemented: MongoDB and Elasticsearch. We evaluated the scalability of PyEHR experimentally through two types of tests, called "Constant Load" and "Constant Number of Records", with queries of increasing complexity on synthetic datasets of ten million records each, containing very complex openEHR archetype structures, distributed on up to ten computing nodes.

  15. A Scalable Data Access Layer to Manage Structured Heterogeneous Biomedical Data

    PubMed Central

    Lianas, Luca; Frexia, Francesca; Zanetti, Gianluigi

    2016-01-01

    This work presents a scalable data access layer, called PyEHR, designed to support the implementation of data management systems for secondary use of structured heterogeneous biomedical and clinical data. PyEHR adopts the openEHR’s formalisms to guarantee the decoupling of data descriptions from implementation details and exploits structure indexing to accelerate searches. Data persistence is guaranteed by a driver layer with a common driver interface. Interfaces for two NoSQL Database Management Systems are already implemented: MongoDB and Elasticsearch. We evaluated the scalability of PyEHR experimentally through two types of tests, called “Constant Load” and “Constant Number of Records”, with queries of increasing complexity on synthetic datasets of ten million records each, containing very complex openEHR archetype structures, distributed on up to ten computing nodes. PMID:27936191

  16. Federated web-accessible clinical data management within an extensible neuroimaging database.

    PubMed

    Ozyurt, I Burak; Keator, David B; Wei, Dingying; Fennema-Notestine, Christine; Pease, Karen R; Bockholt, Jeremy; Grethe, Jeffrey S

    2010-12-01

    Managing vast datasets collected throughout multiple clinical imaging communities has become critical with the ever increasing and diverse nature of datasets. Development of data management infrastructure is further complicated by technical and experimental advances that drive modifications to existing protocols and acquisition of new types of research data to be incorporated into existing data management systems. In this paper, an extensible data management system for clinical neuroimaging studies is introduced: The Human Clinical Imaging Database (HID) and Toolkit. The database schema is constructed to support the storage of new data types without changes to the underlying schema. The complex infrastructure allows management of experiment data, such as image protocol and behavioral task parameters, as well as subject-specific data, including demographics, clinical assessments, and behavioral task performance metrics. Of significant interest, embedded clinical data entry and management tools enhance both consistency of data reporting and automatic entry of data into the database. The Clinical Assessment Layout Manager (CALM) allows users to create on-line data entry forms for use within and across sites, through which data is pulled into the underlying database via the generic clinical assessment management engine (GAME). Importantly, the system is designed to operate in a distributed environment, serving both human users and client applications in a service-oriented manner. Querying capabilities use a built-in multi-database parallel query builder/result combiner, allowing web-accessible queries within and across multiple federated databases. The system along with its documentation is open-source and available from the Neuroimaging Informatics Tools and Resource Clearinghouse (NITRC) site.

  17. New MPLS network management techniques based on adaptive learning.

    PubMed

    Anjali, Tricha; Scoglio, Caterina; de Oliveira, Jaudelice Cavalcante

    2005-09-01

    The combined use of the differentiated services (DiffServ) and multiprotocol label switching (MPLS) technologies is envisioned to provide guaranteed quality of service (QoS) for multimedia traffic in IP networks, while effectively using network resources. These networks need to be managed adaptively to cope with the changing network conditions and provide satisfactory QoS. An efficient strategy is to map the traffic from different DiffServ classes of service on separate label switched paths (LSPs), which leads to distinct layers of MPLS networks corresponding to each DiffServ class. In this paper, three aspects of the management of such a layered MPLS network are discussed. In particular, an optimal technique for the setup of LSPs, capacity allocation of the LSPs and LSP routing are presented. The presented techniques are based on measurement of the network state to adapt the network configuration to changing traffic conditions.

  18. Accessibility of online self-management support websites for people with osteoarthritis: A text content analysis.

    PubMed

    Chapman, Lara; Brooks, Charlotte; Lawson, Jem; Russell, Cynthia; Adams, Jo

    2017-01-01

    Objectives This study assessed accessibility of online self-management support webpages for people with osteoarthritis by considering readability of text and inclusion of images and videos. Methods Eight key search terms developed and agreed with patient and public involvement representatives were entered into the Google search engine. Webpages from the first page of Google search results were identified. Readability of webpage text was assessed using two standardised readability indexes, and the number of images and videos included on each webpage was recorded. Results Forty-nine webpages met the inclusion criteria and were assessed. Only five of the webpages met the recommended reading level for health education literature. Almost half (44.9%) of webpages did not include any informative images to support written information. A minority of the webpages (6.12%) included relevant videos. Discussion Information provided on health webpages aiming to support patients to self-manage osteoarthritis may not be read, understood or used effectively by many people accessing it. Recommendations include using accessible language in health information, supplementing written information with visual resources and reviewing content and readability in collaboration with patient and public involvement representatives.

  19. Coronary and peripheral stenting in aorto-ostial protruding stents: The balloon assisted access to protruding stent technique.

    PubMed

    Helmy, Tarek A; Sanchez, Carlos E; Bailey, Steven R

    2016-03-01

    Treatment of aorto-ostial in-stent restenosis lesions represents a challenge for interventional cardiologists. Excessive protrusion of the stent into the aorta may lead to multiple technical problems, such as difficult catheter reengagement of the vessel ostium or inability to re-wire through the stent lumen in repeat interventions. We describe a balloon assisted access to protruding stent technique in cases where conventional coaxial engagement of an aorto-ostial protruding stent with the guide catheter or passage of the guide wire through the true lumen is not feasible. This technique is applicable both in coronary and peripheral arteries. © 2015 Wiley Periodicals, Inc.

  20. Access technique and its problems in parenteral nutrition – Guidelines on Parenteral Nutrition, Chapter 9

    PubMed Central

    Jauch, K. W.; Schregel, W.; Stanga, Z.; Bischoff, S. C.; Braß, P.; Hartl, W.; Muehlebach, S.; Pscheidl, E.; Thul, P.; Volk, O.

    2009-01-01

    Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7–10 days) parenteral nutrition (PN) requires central venous access whereas for PN <3 weeks percutaneously inserted catheters and for PN >3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7–10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site. PMID:20049083

  1. Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.

    PubMed

    Naganuma, Toshihide; Takemoto, Yoshiaki

    2017-01-01

    We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.

  2. Outcome of 7-S, TQM technique for healthcare waste management.

    PubMed

    Ullah, Junaid Habib; Ahmed, Rashid; Malik, Javed Iqbal; Khan, M Amanullah

    2011-12-01

    To assess the present waste management system of healthcare facilities (HCFs) attached with Shalamar Hospital, Lahore by applying the 7-S technique of Total Quality Management (TQM) and to find out the outcome after imparting training. Interventional quasi-experimental study. The Shalamar Hospital, Lahore, Punjab, Pakistan, November, 2009 to November, 2010. Mckinsey's 7-S, technique of TQM was applied to assess the 220 HCFs from Lahore, Gujranwala and Sheikhupura districts for segregation, collection, transportation and disposal (SCTD) of hospital waste. Direct interview method was applied. Trainings were provided in each institution. After one year action period, the status of four areas of concern was compared before and after training. The parameters studied were segregation, collection, transportation and disposal systems in the 220 HCFs. Each of these were further elaborated by strategy, structure, system, staff, skill, style and stakeholder/shared value factors. Standard error of difference of proportion was applied to assess significance using 95% confidence level. There was marked improvement in all these areas ranging from 20% to 77% following a training program of 3 months. In case of disposal of the waste strategy, structure and system an increase of 60%, 65% and 75% was observed after training. The 7-S technique played a vital role in assessing the hospital waste management system. Training for the healthcare workers played a significant role in healthcare facilities.

  3. The Role of Interventional Radiology Techniques in the Management of Renal Angiomyolipomas.

    PubMed

    Kiefer, Ryan M; Stavropoulos, S William

    2017-05-01

    Although benign, renal angiomyolipoma (AML) may lead to serious complications without appropriate management. The purpose of this review is to describe the role of and evidence for interventional radiology techniques in the management of patients with AML. For patients with renal masses and non-diagnostic imaging studies, image-guided percutaneous biopsy is found to be highly accurate and useful in directing patient management. Once the diagnosis of AML has been made based on either imaging or biopsy, arterial embolization of tumors that are symptomatic or >4 cm has been demonstrated to reduce the risk of hemorrhage as well as tumor size. Percutaneous ablation devices have been proposed as alternative strategies but remain investigational. The utility of interventional radiology techniques including percutaneous core needle biopsy and prophylactic super-selective arterial embolization is safe and effective management strategies for patients presenting with AML tumors.

  4. 17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... determining that such customer, based on its position in the transaction and relationship with an ultimate... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the...

  5. 17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... determining that such customer, based on its position in the transaction and relationship with an ultimate... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the...

  6. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  7. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  8. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  9. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  10. Modified McCash Technique for Management of Dupuytren Contracture.

    PubMed

    Lesiak, Alex C; Jarrett, Nicole J; Imbriglia, Joseph E

    2017-05-01

    Despite recent advancements in the nonsurgical treatment for Dupuytren contracture, a number of patients remain poor nonsurgical candidates or elect for surgical management. The traditional McCash technique releases contractures while leaving open palmar wounds. Although successful in alleviating contractures, these wounds are traditionally large, transverse incisions across the palm. A modification of this technique has been performed that permits the surgeon to utilize smaller wounds while eliminating debilitating contractures. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Support for the development and implementation of an access management program through research and analysis of collision data : final report.

    DOT National Transportation Integrated Search

    2015-11-11

    The South Carolina Access and Roadside Management Standards (ARMS) provides standards and guidelines for : permitting access encroachments onto SCDOT right-of-way. In April, 2013, SCDOT initiated research that would be : used to update this manual wi...

  12. Channel Access in Erlang

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

    Nicklaus, Dennis J.

    2013-10-13

    We have developed an Erlang language implementation of the Channel Access protocol. Included are low-level functions for encoding and decoding Channel Access protocol network packets as well as higher level functions for monitoring or setting EPICS process variables. This provides access to EPICS process variables for the Fermilab Acnet control system via our Erlang-based front-end architecture without having to interface to C/C++ programs and libraries. Erlang is a functional programming language originally developed for real-time telecommunications applications. Its network programming features and list management functions make it particularly well-suited for the task of managing multiple Channel Access circuits and PVmore » monitors.« less

  13. 17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

  14. 17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

  15. A Survey of Managers' Access to Key Performance Indicators via HIS: The Case of Iranian Teaching Hospitals.

    PubMed

    Ahmadi, Maryam; Khorrami, Farid; Dehnad, Afsaneh; Golchin, Mohammad H; Azad, Mohsen; Rahimi, Shafei

    2018-01-01

    The challenges of using health information systems in developing countries are different from developed countries for various reasons such as infrastructure and data culture of organizations. The aim of this study is to assess managers' access to key performance indicators (KPI) via Hospital Information System (HIS) in teaching hospitals of Iran. All managers (Census method) of the four teaching hospitals affiliated to Hormozgan University of Medical Sciences (HUMS) were included in this study. KPIs which are linked to the strategic objectives of organizations were adopted from the strategic plan of HUMS. The questionnaire used in this study included three categories: Financial, Human Resources and clinical. One-sample t-test was used and the significant difference score was calculated for the acceptable level. We found that HIS cannot facilitate access to KPIs for managers in the main categories, but it was effective in two subcategories of income (p = 0.314) and salary (P = 0.289)). A study of barriers to the use of managers of HIS in hospitals is suggested.

  16. Managing Construction Operations Visually: 3-D Techniques for Complex Topography and Restricted Visibility

    ERIC Educational Resources Information Center

    Rodriguez, Walter; Opdenbosh, Augusto; Santamaria, Juan Carlos

    2006-01-01

    Visual information is vital in planning and managing construction operations, particularly, where there is complex terrain topography and salvage operations with limited accessibility and visibility. From visually-assessing site operations and preventing equipment collisions to simulating material handling activities to supervising remotes sites…

  17. Using mediation techniques to manage conflict and create healthy work environments.

    PubMed

    Gerardi, Debra

    2004-01-01

    Healthcare organizations must find ways for managing conflict and developing effective working relationships to create healthy work environments. The effects of unresolved conflict on clinical outcomes, staff retention, and the financial health of the organization lead to many unnecessary costs that divert resources from clinical care. The complexity of delivering critical care services makes conflict resolution difficult. Developing collaborative working relationships helps to manage conflict in complex environments. Working relationships are based on the ability to deal with differences. Dealing with differences requires skill development and techniques for balancing interests and communicating effectively. Techniques used by mediators are effective for resolving disputes and developing working relationships. With practice, these techniques are easily transferable to the clinical setting. Listening for understanding, reframing, elevating the definition of the problem, and forming clear agreements can foster working relationships, decrease the level of conflict, and create healthy work environments that benefit patients and professionals.

  18. Analysis and Simulation of Traffic Control for Resource Management in DVB-Based Broadband Satellite Access Networks

    NASA Astrophysics Data System (ADS)

    Impemba, Ernesto; Inzerilli, Tiziano

    2003-07-01

    Integration of satellite access networks with the Internet is seen as a strategic goal to achieve in order to provide ubiquitous broadband access to Internet services in Next Generation Networks (NGNs). One of the main interworking aspects which has been most studied is an efficient management of satellite resources, i.e. bandwidth and buffer space, in order to satisfy most demanding application requirements as to delay control and bandwidth assurance. In this context, resource management in DVB-S/DVB-RCS satellite technologies, emerging technologies for broadband satellite access and transport of IP applications, is a research issue largely investigated as a means to provide efficient bi-directional communications across satellites. This is in particular one of the principal goals of the SATIP6 project, sponsored within the 5th EU Research Programme Framework, i.e. IST. In this paper we present a possible approach to efficiently exploit bandwidth, the most critical resource in a broadband satellite access network, while pursuing satisfaction of delay and bandwidth requirements for applications with guaranteed QoS through a traffic control architecture to be implemented in ground terminals. Performance of this approach is assessed in terms of efficient exploitation of the uplink bandwidth and differentiation and minimization of queuing delays for most demanding applications over a time-varying capacity. Opnet simulations is used as analysis tool.

  19. 44 CFR 6.32 - Granting access.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... access. (a) Upon receipt of a request for access to non-exempt records, the system manager shall make... its receipt by FEMA. The acknowledgment shall indicate when the system manager will make the records available. (b) If the system manager anticipates more than a 10 day delay in making a record available, he...

  20. 44 CFR 6.32 - Granting access.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... access. (a) Upon receipt of a request for access to non-exempt records, the system manager shall make... its receipt by FEMA. The acknowledgment shall indicate when the system manager will make the records available. (b) If the system manager anticipates more than a 10 day delay in making a record available, he...

  1. 44 CFR 6.32 - Granting access.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... access. (a) Upon receipt of a request for access to non-exempt records, the system manager shall make... its receipt by FEMA. The acknowledgment shall indicate when the system manager will make the records available. (b) If the system manager anticipates more than a 10 day delay in making a record available, he...

  2. 44 CFR 6.32 - Granting access.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... access. (a) Upon receipt of a request for access to non-exempt records, the system manager shall make... its receipt by FEMA. The acknowledgment shall indicate when the system manager will make the records available. (b) If the system manager anticipates more than a 10 day delay in making a record available, he...

  3. Reverse waffle cone technique in management of stent dislodgement into intracranial aneurysms.

    PubMed

    Luo, Chao-Bao; Lai, Yen-Jun; Teng, Michael Mu-Huo; Chang, Feng-Chi; Lin, Chung-Jung; Guo, Wan-Yuo

    2013-09-01

    Stent-assisted coil embolization (SACE) is a common method to manage intracranial wide-neck aneurysm. Using this technique, a stent must be successfully deployed into the parent artery to cross the aneurysm neck. We describe the reverse waffle cone technique in management of intra-procedural stent dislodgement during SACE of internal carotid artery (ICA) wide-neck aneurysms. Two patients with unruptured wide-neck ICA aneurysms underwent SACE. Intra-procedural forward stent migration occurred during catheterization with proximal stent dislodgement and migration into the aneurysm sac. Navigation of a second stent to bridge the aneurysm neck failed in one patient because the second stent was impeded by the dislodged stent. Using the reverse waffle cone technique, a microcatheter was navigated into the aneurysm sacs. Coils were safely detached into each aneurysm sac without any device assistance. The two wide-neck aneurysms were successfully treated with preservation of flow to the internal carotid arteries. The complication of intra-procedural distal stent migration and dislodgement, with proximal stent prolapse into an aneurysm sac, may not result in a failure to coil the aneurysm. The reverse waffle cone technique provides an effective treatment in the management of this complication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. The Impact of Teachers' Aggressive Management Techniques on Students' Attitudes to Schoolwork

    ERIC Educational Resources Information Center

    Romi, Shlomo; Lewis, Ramon; Roache, Joel; Riley, Philip

    2011-01-01

    Previous studies have shown that teachers' aggressive classroom management impacts negatively on students. The authors compared student reaction to teachers' use of aggressive management techniques in Australia, China, and Israel. Reactions included distraction negativity toward teachers and perceptions that teachers' responses were unjustified,…

  5. Technical management techniques for identification and control of industrial safety and pollution hazards

    NASA Technical Reports Server (NTRS)

    Campbell, R.; Dyer, M. K.; Hoard, E. G.; Little, D. G.; Taylor, A. C.

    1972-01-01

    Constructive recommendations are suggested for pollution problems from offshore energy resources industries on outer continental shelf. Technical management techniques for pollution identification and control offer possible applications to space engineering and management.

  6. Access to destinations : annual accessibility measure for the Twin Cities Metropolitan Region.

    DOT National Transportation Integrated Search

    2012-11-01

    This report summarizes previous phases of the Access to Destinations project and applies the techniques developed : over the course of the project to conduct an evaluation of accessibility in the Twin Cities metropolitan region for : 2010. It describ...

  7. Physical therapy modalities and rehabilitation techniques in the management of neuropathic pain.

    PubMed

    Akyuz, Gulseren; Kenis, Ozge

    2014-03-01

    Neuropathic pain is an important problem because of its complex natural history, unclear etiology, and poor response to standard physical therapy agents. It causes severe disability unrelated to its etiology. The primary goals of the management of neuropathic pain are to detect the underlying cause, to define the differential diagnosis and eliminate risk factors, and to reduce the pain. The physician should also know the functional and psychologic conditions of the patient. Therefore, a multimodal management plan in neuropathic pain is essential. This review aimed to reflect a diverse point of view about various physical therapy modalities and rehabilitation techniques. Physical therapy modalities and rehabilitation techniques are important options and must be considered when pharmacotherapy alone is not sufficient. In addition, psychosocial support and cognitive behavioral therapy could also be taken into consideration. It has been suggested that the importance of pain rehabilitation techniques will increase in time and these will take a larger part in the management of neuropathic pain. However, it is now early to comment on these methods because of the lack of adequate publications.

  8. Strategies for managing aortoiliac occlusions: access, treatment and outcomes

    PubMed Central

    Clair, Daniel G; Beach, Jocelyn M

    2015-01-01

    Treatment of severe aortoiliac disease has dramatically evolved from a dependence on open aortobifemoral grafting to hybrid and endovascular only approaches. Open surgery has been the gold standard treatment of severe aortoiliac disease with excellent patency rates, but with increased length of stay and major complications. In contrast, endovascular interventions can successfully treat almost any lesion with decreased risk, compared to open surgery. Although primary patency rates remain inferior, secondary endovascular interventions are often minor procedures resulting in comparable long-term outcomes. The risks of renal insufficiency, embolization and access complications are not insignificant; however, most can be prevented or managed without significant clinical consequence. Endovascular therapies should be considered a first-line treatment option for all patients with aortoiliac disease, especially those with high-risk cardiovascular comorbidities. PMID:25907618

  9. Pediatric Enteric Feeding Techniques: Insertion, Maintenance, and Management of Problems

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

    Nijs, Els L. F., E-mail: nijs@email.chop.ed; Cahill, Anne Marie, E-mail: cahill@email.chop.ed

    Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.

  10. Failure detection and fault management techniques for flush airdata sensing systems

    NASA Technical Reports Server (NTRS)

    Whitmore, Stephen A.; Moes, Timothy R.; Leondes, Cornelius T.

    1992-01-01

    Methods based on chi-squared analysis are presented for detecting system and individual-port failures in the high-angle-of-attack flush airdata sensing system on the NASA F-18 High Alpha Research Vehicle. The HI-FADS hardware is introduced, and the aerodynamic model describes measured pressure in terms of dynamic pressure, angle of attack, angle of sideslip, and static pressure. Chi-squared analysis is described in the presentation of the concept for failure detection and fault management which includes nominal, iteration, and fault-management modes. A matrix of pressure orifices arranged in concentric circles on the nose of the aircraft indicate the parameters which are applied to the regression algorithms. The sensing techniques are applied to the F-18 flight data, and two examples are given of the computed angle-of-attack time histories. The failure-detection and fault-management techniques permit the matrix to be multiply redundant, and the chi-squared analysis is shown to be useful in the detection of failures.

  11. Thoracoscopic management of empyema thoracis

    PubMed Central

    Wait, Michael A; Beckles, Daniel L; Paul, Michelle; Hotze, Margaret; DiMaio, Michael J

    2007-01-01

    Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development. Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema. Complex empyema requires adjunctive treatment in addition to VATS. PMID:19789675

  12. 43 CFR 10005.15 - Planning and management techniques applicable to the plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... applicable to the plan. 10005.15 Section 10005.15 Public Lands: Interior Regulations Relating to Public Lands... AND IMPLEMENTING THE COMMISSION'S MITIGATION AND CONSERVATION PLAN § 10005.15 Planning and management techniques applicable to the plan. The Commission recognizes that there are a wide range of techniques that...

  13. System access control study

    DOT National Transportation Integrated Search

    1974-06-01

    The report presents a summary of a study conducted for the Transportation Systems Center of promising access control techniques which are applicable to an aeronautical satellite system. Several frequency division multiple access (FDMA) and time divis...

  14. Managing Age Discrimination: An Examination of the Techniques Used when Seeking Employment

    ERIC Educational Resources Information Center

    Berger, Ellie D.

    2009-01-01

    Purpose: This article examines the age-related management techniques used by older workers in their search for employment. Design and Methods: Data are drawn from interviews with individuals aged 45-65 years (N = 30). Results: Findings indicate that participants develop "counteractions" and "concealments" to manage perceived age discrimination.…

  15. Federated Web-accessible Clinical Data Management within an Extensible NeuroImaging Database

    PubMed Central

    Keator, David B.; Wei, Dingying; Fennema-Notestine, Christine; Pease, Karen R.; Bockholt, Jeremy; Grethe, Jeffrey S.

    2010-01-01

    Managing vast datasets collected throughout multiple clinical imaging communities has become critical with the ever increasing and diverse nature of datasets. Development of data management infrastructure is further complicated by technical and experimental advances that drive modifications to existing protocols and acquisition of new types of research data to be incorporated into existing data management systems. In this paper, an extensible data management system for clinical neuroimaging studies is introduced: The Human Clinical Imaging Database (HID) and Toolkit. The database schema is constructed to support the storage of new data types without changes to the underlying schema. The complex infrastructure allows management of experiment data, such as image protocol and behavioral task parameters, as well as subject-specific data, including demographics, clinical assessments, and behavioral task performance metrics. Of significant interest, embedded clinical data entry and management tools enhance both consistency of data reporting and automatic entry of data into the database. The Clinical Assessment Layout Manager (CALM) allows users to create on-line data entry forms for use within and across sites, through which data is pulled into the underlying database via the generic clinical assessment management engine (GAME). Importantly, the system is designed to operate in a distributed environment, serving both human users and client applications in a service-oriented manner. Querying capabilities use a built-in multi-database parallel query builder/result combiner, allowing web-accessible queries within and across multiple federated databases. The system along with its documentation is open-source and available from the Neuroimaging Informatics Tools and Resource Clearinghouse (NITRC) site. PMID:20567938

  16. Database Access Systems.

    ERIC Educational Resources Information Center

    Dalrymple, Prudence W.; Roderer, Nancy K.

    1994-01-01

    Highlights the changes that have occurred from 1987-93 in database access systems. Topics addressed include types of databases, including CD-ROMs; enduser interface; database selection; database access management, including library instruction and use of primary literature; economic issues; database users; the search process; and improving…

  17. Reflective Database Access Control

    ERIC Educational Resources Information Center

    Olson, Lars E.

    2009-01-01

    "Reflective Database Access Control" (RDBAC) is a model in which a database privilege is expressed as a database query itself, rather than as a static privilege contained in an access control list. RDBAC aids the management of database access controls by improving the expressiveness of policies. However, such policies introduce new interactions…

  18. The Human Genome Project: Information access, management, and regulation. Final report

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

    McInerney, J.D.; Micikas, L.B.

    The Human Genome Project is a large, internationally coordinated effort in biological research directed at creating a detailed map of human DNA. This report describes the access of information, management, and regulation of the project. The project led to the development of an instructional module titled The Human Genome Project: Biology, Computers, and Privacy, designed for use in high school biology classes. The module consists of print materials and both Macintosh and Windows versions of related computer software-Appendix A contains a copy of the print materials and discs containing the two versions of the software.

  19. Mini access guide to simplify calyceal access during percutaneous nephrolithotomy: A novel device.

    PubMed

    Chowdhury, Puskar Shyam; Nayak, Prasant; David, Deepak; Mallick, Sujata

    2017-01-01

    A precise puncture of the renal collecting system is the most essential step for percutaneous nephrolithotomy (PCNL). There are many techniques describing this crucial first step in PCNL including the bull's eye technique, triangulation technique, free-hand technique, and gradual descensus technique. We describe a novel puncture guide to assist accurate percutaneous needle placement during bull's eye technique. The mini access guide (MAG) stabilizes the initial puncture needle by mounting it on an adjustable multidirectional carrier fixed to the patient's skin, which aids in achieving the "bull's eye" puncture. It also avoids a direct fluoroscopic exposure of the urologist's hand during the puncture. Sixty consecutive patients with solitary renal calculus were randomized to traditional hand versus MAG puncture during bull's eye technique of puncture and the fluoroscopy time was assessed. The median fluoroscopy screening time for traditional free-hand bull's eye and MAG-guided bull's eye puncture (fluoroscopic screening time for puncture) was 55 versus 21 s ( P = 0.001) and the median time to puncture was 80 versus 55 s ( P = 0.052), respectively. Novice residents also learned puncture technique faster with MAG on simulator. The MAG is a simple, portable, cheap, and novel assistant to achieve successful PCNL puncture. It would be of great help for novices to establish access during their learning phase of PCNL. It would also be an asset toward significantly decreasing the radiation dose during PCNL access.

  20. Network acceleration techniques

    NASA Technical Reports Server (NTRS)

    Crowley, Patricia (Inventor); Maccabe, Arthur Barney (Inventor); Awrach, James Michael (Inventor)

    2012-01-01

    Splintered offloading techniques with receive batch processing are described for network acceleration. Such techniques offload specific functionality to a NIC while maintaining the bulk of the protocol processing in the host operating system ("OS"). The resulting protocol implementation allows the application to bypass the protocol processing of the received data. Such can be accomplished this by moving data from the NIC directly to the application through direct memory access ("DMA") and batch processing the receive headers in the host OS when the host OS is interrupted to perform other work. Batch processing receive headers allows the data path to be separated from the control path. Unlike operating system bypass, however, the operating system still fully manages the network resource and has relevant feedback about traffic and flows. Embodiments of the present disclosure can therefore address the challenges of networks with extreme bandwidth delay products (BWDP).

  1. Optimization techniques applied to spectrum management for communications satellites

    NASA Astrophysics Data System (ADS)

    Ottey, H. R.; Sullivan, T. M.; Zusman, F. S.

    This paper describes user requirements, algorithms and software design features for the application of optimization techniques to the management of the geostationary orbit/spectrum resource. Relevant problems include parameter sensitivity analyses, frequency and orbit position assignment coordination, and orbit position allotment planning. It is shown how integer and nonlinear programming as well as heuristic search techniques can be used to solve these problems. Formalized mathematical objective functions that define the problems are presented. Constraint functions that impart the necessary solution bounds are described. A versatile program structure is outlined, which would allow problems to be solved in stages while varying the problem space, solution resolution, objective function and constraints.

  2. Predicting Student Misbehavior, Responsibility and Distraction from Schoolwork from Classroom Management Techniques: The Students' Views

    ERIC Educational Resources Information Center

    Tran, Van Dat

    2015-01-01

    This study reports students' perceptions of the classroom management techniques utilized in fourteen classrooms at eight junior high schools in one province in Vietnam. It examines data from 498 students in fifteen high schools in one district in Vietnam in grades 10 to 12 to identify how teachers' use of various management techniques, and the…

  3. Totally implantable vascular access device (TIVAD) placement: a modified technique that takes post-procedure aesthetic aspects into account.

    PubMed

    Liberale, Gabriel

    2017-04-01

    Major progress has been made in breast cancer reconstruction surgery. The standard technique for totally implanted vascular access device (TIVAD) implantation generally requires an incision for port insertion on the anterior part of the thorax that leaves a scar in the middle of the neckline in patients who have undergone mastectomy with complex breast reconstruction. The aim of this technical note is to report our revised surgical technique for TIVAD placement. In patients with breast cancer, we take a lateralized approach, performing an oblique incision on the lowest part of the deltopectoral groove. This allows us to introduce the port and to place it on the anterolateral part of the thorax, thus avoiding an unaesthetic scar on the anterior part of the thorax. Our modified technique for TIVAD implantation is described.

  4. A comparison of the boomerang wire vascular access management system versus manual compression alone during percutaneous diagnostic and interventional cardiovascular procedures.

    PubMed

    Echeverria, Angela; Krajcer, Zvonimir

    2016-01-01

    Vascular closure devices allow for early sheath removal, allowing for earlier patient mobilization The Boomerang vascular access management system does not alter arterial integrity for future interventions Access site complications provide significant morbidity in diagnostic and therapeutic interventions. © 2016 Wiley Periodicals, Inc.

  5. Managing Lost and Missing Books

    ERIC Educational Resources Information Center

    Sewell, Bethany Badgett; Miller, Andrew Jonathan

    2008-01-01

    The University of Denver's Penrose Library's Stacks Maintenance unit is a separately managed unit that works in collaboration with all library departments to ensure complete access to the library's print collections. This unit takes advantage of a variety of techniques and tools to fulfill its mission, including a fine-tuned tracer system for…

  6. Suppression, accessibility of death-related thoughts, and cultural worldview defense: exploring the psychodynamics of terror management.

    PubMed

    Arndt, J; Greenberg, J; Solomon, S; Pyszczynski, T; Simon, L

    1997-07-01

    Previous research has shown that after a mortality-salience (MS) treatment, death thought accessibility and worldview defense are initially low and then increase after a delay, suggesting that a person's initial response to conscious thoughts of mortality is to actively suppress death thoughts. If so, then high cognitive load, by disrupting suppression efforts, should lead to immediate increases in death thought accessibility and cultural worldview defense. Studies 1 and 2 supported this reasoning. Specifically, Study 1 replicated the delayed increase in death accessibility after MS among low cognitive load participants but showed a reversed pattern among participants under high cognitive load. Study 2 showed that, unlike low cognitive load participants, high cognitive load participants exhibited immediate increase in pro-American bias after MS. Study 3 demonstrated that worldview defense in response to MS reduces the delayed increase in death accessibility. Implications of these findings for understanding both terror management processes and psychological defense in general are discussed.

  7. Airway emergencies presenting to the paediatric emergency department requiring advanced management techniques.

    PubMed

    Simma, Leopold; Cincotta, Domenic; Sabato, Stefan; Long, Elliot

    2017-09-01

    Airway emergencies presenting to the emergency department (ED) are usually managed with conventional equipment and techniques. The patient group managed urgently in the operating room (OR) has not been described. This study aims to describe a case series of children presenting to the ED with airway emergencies managed urgently in the OR, particularly the anaesthetic equipment and techniques used and airway findings. A retrospective cohort study undertaken at The Royal Children's Hospital, Melbourne, Australia. All patients presenting to the ED between 1 January 2012 and 30 July 2015 (42 months) with an airway emergency who were subsequently managed in the OR were included. Patient characteristics, anaesthetic equipment and technique and airway findings were recorded. Twenty-two airway emergencies in 21 patients were included over the study period, on average one every 2 months. Median age was 18 months and 43% were male. Inhalational induction was used in 77.3%, combined inhalational and intravenous induction in 9.1%, and intravenous induction alone in 13.6%. The most commonly used inhalational induction agent was sevoflurane, and the most commonly used intravenous induction agents were ketamine and propofol. Ten airway emergencies did not require intubation, seven for removal of inhaled foreign body, two with progressive tracheal stenosis requiring emergent dilatation and one examination under anaesthesia to rule out inhaled foreign body. Of the 12 airway emergencies that required immediate intubation, direct laryngoscopy was used in 9 and fibre-optic intubating bronchoscopy in 3. For intubations performed by direct laryngoscopy, one was difficult (Cormack and Lehane grade 3). First pass success was 83.3%. Adverse events occurred in 3/22 (13.6%) cases. Advanced airway techniques, including inhalational induction and intubation via fibre-optic intubating bronchoscope, are rarely but predictably required in the management of patients presenting to the ED

  8. In emergency departments, radiologists' access to EHRs may influence interpretations and medical management.

    PubMed

    Franczak, Michael J; Klein, Madeline; Raslau, Flavius; Bergholte, Jo; Mark, Leighton P; Ulmer, John L

    2014-05-01

    The adoption of electronic health records (EHRs) that meet federal meaningful-use standards is a major US national policy priority. Policy makers recognize the potential of electronic communication in delivering high-quality health care, particularly in an environment of expanding remote access to medical care and the ever-increasing need to transmit health care records across institutions. To demonstrate this principle, we sought to estimate the significance of EHR access in emergent neuroradiologic interpretations. Three neuroradiologists conducted a prospective expert-rater analysis of 2,000 consecutive head computed tomography (CT) exams ordered by emergency department (ED) physicians. For each head CT exam, the neuroradiologists compared medical information generated by ED physicians to information generated by the interpreting radiologists who had access to additional EHR-derived patient data. In 6.1 percent of the head CT exams, the neuroradiologists reached consensus--meaning two out of three agreed--that the additional clinical data derived from the EHR was "very likely" to influence radiological interpretations and that the lack of that data would have adversely affected medical management in those patients. Health care providers must recognize the value of implementing EHRs and foster their widespread adoption.

  9. Moisture Management in an Active Sportswear: Techniques and Evaluation—A Review Article

    NASA Astrophysics Data System (ADS)

    Senthilkumar, Mani; Sampath, M. B.; Ramachandran, T.

    2012-10-01

    Moisture management property is an important aspect of any fabric meant for active sportswear, which decides the comfort level of that fabric. Every human being sweats during different kinds of activities. An important feature of any fabric is how it transports this water out of the body, so as to make the wearer feel comfortable. This paper reports the concept of moisture management, various production techniques and evaluation of the moisture management characteristics on fabrics for active sportswear.

  10. Computer assisted audit techniques for UNIX (UNIX-CAATS)

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

    Polk, W.T.

    1991-12-31

    Federal and DOE regulations impose specific requirements for internal controls of computer systems. These controls include adequate separation of duties and sufficient controls for access of system and data. The DOE Inspector General`s Office has the responsibility to examine internal controls, as well as efficient use of computer system resources. As a result, DOE supported NIST development of computer assisted audit techniques to examine BSD UNIX computers (UNIX-CAATS). These systems were selected due to the increasing number of UNIX workstations in use within DOE. This paper describes the design and development of these techniques, as well as the results ofmore » testing at NIST and the first audit at a DOE site. UNIX-CAATS consists of tools which examine security of passwords, file systems, and network access. In addition, a tool was developed to examine efficiency of disk utilization. Test results at NIST indicated inadequate password management, as well as weak network resource controls. File system security was considered adequate. Audit results at a DOE site indicated weak password management and inefficient disk utilization. During the audit, we also found improvements to UNIX-CAATS were needed when applied to large systems. NIST plans to enhance the techniques developed for DOE/IG in future work. This future work would leverage currently available tools, along with needed enhancements. These enhancements would enable DOE/IG to audit large systems, such as supercomputers.« less

  11. Computer assisted audit techniques for UNIX (UNIX-CAATS)

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

    Polk, W.T.

    1991-01-01

    Federal and DOE regulations impose specific requirements for internal controls of computer systems. These controls include adequate separation of duties and sufficient controls for access of system and data. The DOE Inspector General's Office has the responsibility to examine internal controls, as well as efficient use of computer system resources. As a result, DOE supported NIST development of computer assisted audit techniques to examine BSD UNIX computers (UNIX-CAATS). These systems were selected due to the increasing number of UNIX workstations in use within DOE. This paper describes the design and development of these techniques, as well as the results ofmore » testing at NIST and the first audit at a DOE site. UNIX-CAATS consists of tools which examine security of passwords, file systems, and network access. In addition, a tool was developed to examine efficiency of disk utilization. Test results at NIST indicated inadequate password management, as well as weak network resource controls. File system security was considered adequate. Audit results at a DOE site indicated weak password management and inefficient disk utilization. During the audit, we also found improvements to UNIX-CAATS were needed when applied to large systems. NIST plans to enhance the techniques developed for DOE/IG in future work. This future work would leverage currently available tools, along with needed enhancements. These enhancements would enable DOE/IG to audit large systems, such as supercomputers.« less

  12. Multimedia case management system implemented in Java

    NASA Astrophysics Data System (ADS)

    Stewart, Howard D.; Davis, Midge L.; Handy, Dale L.; Kvarfordt, Kent B.; Ford, Glenn

    1999-01-01

    Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau (CIB) of the state of Idaho, created a Northwest testbed to develop and integrate a multimedia case management system. A system was developed to assist investigators in tracking and maintaining investigative cases and improving access to internal and external data resources. In this paper, we discuss the results of our case management system development and the ability to present state and federal information incorporating object oriented and multimedia techniques. We then outline our plans for future research and development.

  13. How do older people with sight loss manage their general health? A qualitative study.

    PubMed

    Burton, Amy E; Gibson, Jonathan M; Shaw, Rachel L

    2016-11-01

    Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

  14. Open access and beyond

    PubMed Central

    Mathur, Shawn; Schmidt, Christian; Das, Chhaya; Tucker, Philip W

    2006-01-01

    Uncensored exchange of scientific results hastens progress. Open Access does not stop at the removal of price and permission barriers; still, censorship and reading disabilities, to name a few, hamper access to information. Here, we invite the scientific community and the public to discuss new methods to distribute, store and manage literature in order to achieve unfettered access to literature. PMID:16956402

  15. Open Access and beyond.

    PubMed

    Mathur, Shawn; Schmidt, Christian; Das, Chhaya; Tucker, Philip W

    2006-09-06

    Uncensored exchange of scientific results hastens progress. Open Access does not stop at the removal of price and permission barriers; still, censorship and reading disabilities, to name a few, hamper access to information. Here, we invite the scientific community and the public to discuss new methods to distribute, store and manage literature in order to achieve unfettered access to literature.

  16. [A computerized system for the management of letters of authorization for access to sensitive data in a research and teaching hospital].

    PubMed

    Bodina, Annalisa; Brizzolara, Antonella; Vadruccio, Gianluca; Castaldi, Silvana

    2012-01-01

    This paper describes the experience of a hospital which has introduced a system of computerized management of letters of authorization for healthcare workers to access sensitive health data, through the use of open source software. A new corporate intranet portal was created with access given only to the privacy contacts of each operational unit of the hospital. Once the privacy contact has entered the relevant user authorization, these must be approved first by the Directors of the respective operational units and finally by the privacy officer. The introduction of this system has allowed a systematic approach to the management of authorization for access to health data by hospital staff, regular updating and monitoring of the authorization and the start of a process of digitalization of documents.

  17. Management: A continuing literature survey with indexes

    NASA Technical Reports Server (NTRS)

    1978-01-01

    This bibliography lists 782 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1977. The citations, and abstracts when available, are reproduced exactly as they appeared originally in IAA and STAR, including the original accession numbers from the respective announcement journals. Topics cover the management of research and development contracts, production, logistics, personnel, safety, reliability and quality control citations. Includes references on: program, project and systems management; management policy, philosophy, tools, and techniques; decisionmaking processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting.

  18. Management of end-stage central venous access in children referred for possible small bowel transplantation.

    PubMed

    Rodrigues, A F; van Mourik, I D M; Sharif, K; Barron, D J; de Giovanni, J V; Bennett, J; Bromley, P; Protheroe, S; John, P; de Ville de Goyet, J; Beath, S V

    2006-04-01

    The 3-year survival after small bowel transplantation (SBTx) has improved to between 73% and 88%. Impaired venous access for parenteral nutrition can be an indication for SBTx in children with chronic intestinal failure. To report our experience in management of children with extreme end-stage venous access. The study consisted of 6 children (all boys), median age of assessment 27 months (range, 13-52 months), diagnosed with total intestinal aganglionosis (1), protracted diarrhea (1), and short bowel syndrome (4), of which gastroschisis (2) and malrotation with midgut volvulus (2) were the causes. All had a documented history of more than 10 central venous catheter insertions previously. All had venograms, and 1 child additionally had a magnetic resonance angiogram to evaluate venous access. Five of 6 presented with thrombosis of the superior vena cava (SVC) and/or inferior vena cava. Venous access was reestablished as follows: transhepatic venous catheters (5), direct intra-atrial catheter via midline sternotomy (4), azygous venous catheters (2), dilatation of left subclavian vein after passage of a guide wire and then placing a catheter to reach the right atrium (1), radiological recanalization of the SVC and placement of a central venous catheter in situ (1), and direct puncture of SVC stump(1). Complications included serous pleural effusion after direct intra-atrial line insertion, which resolved after chest drain insertion (1), displacement of transhepatic catheter needing repositioning (2), and SVC stent narrowing requiring repeated balloon dilatation. Four children with permanent intestinal failure on assessment were offered SBTx, 3 of which were transplanted and were established on full enteral nutrition; the family of 1 child declined the procedure. In the remaining 2 children in whom bowel adaptation was still a possibility, attempts were made to provide adequate central venous access as feeds and drug manipulations were undertaken. One of them received

  19. Percutaneous Portal Vein Access and Transhepatic Tract Hemostasis

    PubMed Central

    Saad, Wael E. A.; Madoff, David C.

    2012-01-01

    Percutaneous portal vein interventions require minimally invasive access to the portal venous system. Common approaches to the portal vein include transjugular hepatic vein to portal vein access and direct transhepatic portal vein access. A major concern of the transhepatic route is the risk of postprocedural bleeding, which is increased when patients are anticoagulated or receiving pharmaceutical thrombolytic therapy. Thus percutaneous portal vein access and subsequent closure are important technical parts of percutaneous portal vein procedures. At present, various techniques have been used for either portal access or subsequent transhepatic tract closure and hemostasis. Regardless of the method used, meticulous technique is required to achieve the overall safety and effectiveness of portal venous procedures. This article reviews the various techniques of percutaneous transhepatic portal vein access and the various closure and hemostatic methods used to reduce the risk of postprocedural bleeding. PMID:23729976

  20. Architectural Techniques For Managing Non-volatile Caches

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

    Mittal, Sparsh

    As chip power dissipation becomes a critical challenge in scaling processor performance, computer architects are forced to fundamentally rethink the design of modern processors and hence, the chip-design industry is now at a major inflection point in its hardware roadmap. The high leakage power and low density of SRAM poses serious obstacles in its use for designing large on-chip caches and for this reason, researchers are exploring non-volatile memory (NVM) devices, such as spin torque transfer RAM, phase change RAM and resistive RAM. However, since NVMs are not strictly superior to SRAM, effective architectural techniques are required for making themmore » a universal memory solution. This book discusses techniques for designing processor caches using NVM devices. It presents algorithms and architectures for improving their energy efficiency, performance and lifetime. It also provides both qualitative and quantitative evaluation to help the reader gain insights and motivate them to explore further. This book will be highly useful for beginners as well as veterans in computer architecture, chip designers, product managers and technical marketing professionals.« less

  1. Using Powerpoint Animations to Teach Operations Management Techniques and Concepts

    ERIC Educational Resources Information Center

    Treleven, Mark D.; Penlesky, Richard J.; Callarman, Thomas E.; Watts, Charles A.; Bragg, Daniel J.

    2014-01-01

    This article examines the value of using complex animated PowerPoint presentations to teach operations management techniques and concepts. To provide context, literature covering the use of PowerPoint animations in business education is briefly reviewed. The specific animations employed in this study are identified and their expected benefits to…

  2. Semantic Entity-Component State Management Techniques to Enhance Software Quality for Multimodal VR-Systems.

    PubMed

    Fischbach, Martin; Wiebusch, Dennis; Latoschik, Marc Erich

    2017-04-01

    Modularity, modifiability, reusability, and API usability are important software qualities that determine the maintainability of software architectures. Virtual, Augmented, and Mixed Reality (VR, AR, MR) systems, modern computer games, as well as interactive human-robot systems often include various dedicated input-, output-, and processing subsystems. These subsystems collectively maintain a real-time simulation of a coherent application state. The resulting interdependencies between individual state representations, mutual state access, overall synchronization, and flow of control implies a conceptual close coupling whereas software quality asks for a decoupling to develop maintainable solutions. This article presents five semantics-based software techniques that address this contradiction: Semantic grounding, code from semantics, grounded actions, semantic queries, and decoupling by semantics. These techniques are applied to extend the well-established entity-component-system (ECS) pattern to overcome some of this pattern's deficits with respect to the implied state access. A walk-through of central implementation aspects of a multimodal (speech and gesture) VR-interface is used to highlight the techniques' benefits. This use-case is chosen as a prototypical example of complex architectures with multiple interacting subsystems found in many VR, AR and MR architectures. Finally, implementation hints are given, lessons learned regarding maintainability pointed-out, and performance implications discussed.

  3. 41 CFR 60-250.81 - Access to records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Access to records. 60-250.81 Section 60-250.81 Public Contracts and Property Management Other Provisions Relating to Public... VETERANS Ancillary Matters § 60-250.81 Access to records. Each contractor shall permit access during normal...

  4. 41 CFR 60-250.81 - Access to records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Access to records. 60-250.81 Section 60-250.81 Public Contracts and Property Management Other Provisions Relating to Public... VETERANS Ancillary Matters § 60-250.81 Access to records. Each contractor shall permit access during normal...

  5. A Study of the Applicability of Scientific Management Techniques for the Administration of Small, Private Church-Related Colleges.

    ERIC Educational Resources Information Center

    Ferguson, Albert S.

    Experiences with various modern management techniques and practices in selected small, private church-related colleges were studied. For comparative purposes, practices in public colleges and universities were also assessed. Management techniques used in small companies were identified through review of the literature and the management seminars…

  6. Ver-i-Fus: an integrated access control and information monitoring and management system

    NASA Astrophysics Data System (ADS)

    Thomopoulos, Stelios C.; Reisman, James G.; Papelis, Yiannis E.

    1997-01-01

    This paper describes the Ver-i-Fus Integrated Access Control and Information Monitoring and Management (IAC-I2M) system that INTELNET Inc. has developed. The Ver-i-Fus IAC-I2M system has been designed to meet the most stringent security and information monitoring requirements while allowing two- way communication between the user and the system. The systems offers a flexible interface that permits to integrate practically any sensing device, or combination of sensing devices, including a live-scan fingerprint reader, thus providing biometrics verification for enhanced security. Different configurations of the system provide solutions to different sets of access control problems. The re-configurable hardware interface, tied together with biometrics verification and a flexible interface that allows to integrate Ver-i-Fus with an MIS, provide an integrated solution to security, time and attendance, labor monitoring, production monitoring, and payroll applications.

  7. A Soft Casting Technique for Managing Pediatric Hand and Foot Burns.

    PubMed

    Choi, Young Mee; Nederveld, Cindy; Campbell, Kristen; Moulton, Steven

    2018-04-04

    Hand and foot burns in children are difficult to dress. The authors have developed a soft casting technique to manage burns to these areas. The aim of this study is to report the outcomes using weekly dressing changes with a soft casting technique to manage pediatric hand and foot burns in the outpatient setting. A retrospective chart review was performed on children with burns to the hands or feet, who underwent dressing changes with a soft casting technique at the Children's Hospital Colorado Burn Center. Soft casting was performed by placing antibiotic ointment-impregnated nonadherent gauze over the burn wound(s), wrapping the extremity using rolled gauze, applying soft cast pad, plaster, soft cast tape, and an elastic bandage. This was changed weekly. Two hundred ninety-eight children with hand burns had a mean age of 16.8 ± 2 months. Two hundred forty-eight children had partial thickness burn injuries (83%), 50 had full thickness burn injuries (17%), and the mean total body surface area (TBSA) was 1 ± 2.4%. The mean time to heal was 10.1 ± 1.7 days for all subjects. Sixty-six children with foot burns were identified with a mean age of 24 ± 2.6 months. Forty-six children had partial thickness injuries (70%), 20 had full thickness burn injuries (30%), and the mean TBSA was 2.3 ± 2.9%. The mean time to heal was 14.1 ± 2.2 days for all subjects. Weekly dressing changes using a soft casting technique are effective for the outpatient management of pediatric hand and foot burns. This method avoids costly inpatient hospital care, reduces the number of painful dressing changes, and allows children to heal in their own environment.

  8. Parental acceptance of pediatric behavior management techniques: a comparative study.

    PubMed

    Elango, I; Baweja, D K; Shivaprakash, P K

    2012-01-01

    To evaluate and compare the attitude toward behavior techniques among parents of healthy and special children in Indian subpopulation. Parents of healthy (Group A) and special children (Group B) watched videotape vignette of 10 behavior management techniques (BMTs) in groups and rated them using Visual Analog Scale (VAS). Group B parents were subgrouped as: Group B 1 (34 parents of medically compromised children), Group B 2 (34 parents of physically compromised children), and Group B 3 (34 parents of children with neuropathological disorders). Both Group A and Group B subjects judged all techniques as "acceptable." Group B parents were less accepting to techniques than Group A parents, except live modeling. Contingent escape and live modeling were the first ranked techniques in Group A and Group B parents, respectively. Voice control (VC) and hand-over-mouth exercise (HOM) were the least accepted techniques in both groups. Parents with low income and less education were more receptive to the techniques studied. A total of 25.49% of parents in each group did not consent to the use of HOM. Factors such as having a disabled child, low income, and less education influenced parental acceptability. HOM should be used with great caution and clinicians should approach the issue of informed consent on an individual basis.

  9. 15 CFR 923.24 - Shorefront access and protection planning.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Shorefront access and protection... COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Special Management Areas § 923.24 Shorefront access and protection planning. (a) The management program must include a definition of the term...

  10. 15 CFR 923.24 - Shorefront access and protection planning.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Shorefront access and protection... COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Special Management Areas § 923.24 Shorefront access and protection planning. (a) The management program must include a definition of the term...

  11. 15 CFR 923.24 - Shorefront access and protection planning.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Shorefront access and protection... COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Special Management Areas § 923.24 Shorefront access and protection planning. (a) The management program must include a definition of the term...

  12. 15 CFR 923.24 - Shorefront access and protection planning.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Shorefront access and protection... COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Special Management Areas § 923.24 Shorefront access and protection planning. (a) The management program must include a definition of the term...

  13. 15 CFR 923.24 - Shorefront access and protection planning.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Shorefront access and protection... COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Special Management Areas § 923.24 Shorefront access and protection planning. (a) The management program must include a definition of the term...

  14. Patient access to healthcare services and optimisation of self-management for ethnic minority populations living with diabetes: a systematic review.

    PubMed

    Wilson, Charlotte; Alam, Rahul; Latif, Saima; Knighting, Katherine; Williamson, Susan; Beaver, Kinta

    2012-01-01

    A higher risk of diabetes mellitus in South Asian and Black African populations combined with lower reported access and self-management-related health outcomes informed the aims of this study. Our aims were to synthesise and evaluate evidence relating to patient self-management and access to healthcare services for ethnic minority groups living with diabetes. A comprehensive search strategy was developed capturing a full range of study types from 1995-2010, including relevant hand-searched literature pre-dating 1995. Systematic database searches of MEDLINE, Cochrane, DARE, HTA and NHSEED, the British Nursing Index, CAB abstracts, EMBASE, Global Health, Health Management Information Consortium and PsychInfo were conducted, yielding 21,288 abstracts. Following search strategy refinement and the application of review eligibility criteria; 11 randomised controlled trials (RCTs), 18 qualitative studies and 18 quantitative studies were evaluated and principal results extracted. Results suggest that self-management practices are in need of targeted intervention in terms of patients' knowledge and understanding of their illness, inadequacy of information and language and communication difficulties arising from cultural differences. Access to health-care is similarly hindered by a lack of cultural sensitivity in service provision and under use of clinic-based interpreters and community-based services. Recommendations for practice and subsequent intervention primarily rest at the service level but key barriers at patient and provider levels are also identified. © 2011 Blackwell Publishing Ltd.

  15. Surgical management of vascular access related aneurysms to salvage dialysis access: case report and a systematic review of the literature.

    PubMed

    Furukawa, Hiroshi

    2015-01-01

    We retrospectively evaluated the surgical outcome of revising vascular access related aneurysms (VARAs) to salvage dialysis access. Twenty-six consecutive hemodialysis patients (mean age 67.6 years, range: 32-89 years) who presented with true or false VARA and underwent surgery between January 2006 and February 2011 were enrolled in this study, and comprised 11 women and 15 men. Aneurysms were true in 21 patients and false in five; native arteriovenous fistulas (AVFs) were reported in 23, including one infected native pseudoaneurysm, and arteriovenous prosthetic grafts (AVGs) in three. The mean aneurysm diameter was 29.8 ± 8.0 mm, ranging from 18 to 50 mm. Indications of surgical intervention were local pain, rapid enlargement of the aneurysm, and AVF failure due to stenosis. Surgical revision was performed by resection of VARA and concomitant creation of a new proximal arteriovenous anastomosis in 18 patients. Two aneurysms were ruptured by blunt dissection; however, bleeding did not occur due to prior clamping of the inflow artery without hemodynamic compromise. VARA plication was performed in one case in which severe calcified VARA could not be incised. No significant complications were reported, except for delayed wound healing in three patients and minor peripheral neuropathy in five. The postoperative course was uneventful without hospital mortality in all patients with VARA. Aggressive surgical management of VARAs is likely to become an acceptable procedure to salvage dialysis access and consistently maintain AVF or AVG function.

  16. Visitor Access and Transportation Guide.

    DOT National Transportation Integrated Search

    2011-09-30

    This visitor access and transportation guide presents opportunities to manage or improve circulation and travel patterns in areas managed by Federal Land Management Agencies (FLMAs), such as the National Park Service (NPS), U.S. Forest Service (USFS)...

  17. Cleft lift procedure for pilonidal disease: technique and perioperative management.

    PubMed

    Favuzza, J; Brand, M; Francescatti, A; Orkin, B

    2015-08-01

    Pilonidal disease is a common condition affecting young patients. It is often disruptive to their lifestyle due to recurrent abscesses or chronic wound drainage. The most common surgical treatment, "cystectomy," removes useful tissue unnecessarily and does not address the etiology of the condition. Herein, we describe the etiology of pilonidal disease and our technique for definitive management of pilonidal disease using the cleft lift procedure. In this paper, we present our method of performing the cleft lift procedure for pilonidal disease including perioperative management and surgical technique. We have used the cleft lift procedure in nearly 200 patients with pilonidal disease, in both primary and salvage procedures settings. It has been equally successful in both settings with a high rate of success. It results in a closed wound with relatively minimal discomfort and straightforward wound care. We have described our current approach to recurrent and complex pilonidal disease using the cleft lift procedure. Once learned, the cleft lift procedure is a straightforward and highly successful solution to a chronic and challenging condition.

  18. Management of odontogenic cysts by endonasal endoscopic techniques: A systematic review and case series.

    PubMed

    Marino, Michael J; Luong, Amber; Yao, William C; Citardi, Martin J

    2018-01-01

    Odontogenic cysts and tumors of the maxilla may be amendable to management by endonasal endoscopic techniques, which may reduce the morbidity associated with open procedures and avoid difficult reconstruction. To perform a systematic review that evaluates the feasibility and outcomes of endoscopic techniques in the management of different odontogenic cysts. A case series of our experience with these minimally invasive techniques was assembled for insight into the technical aspects of these procedures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to identify English-language studies that reported the use of endoscopic techniques in the management of odontogenic cysts. Several medical literature data bases were searched for all occurrences in the title or abstract of the terms "odontogenic" and "endoscopic" between January 1, 1950, and October 1, 2016. Publications were evaluated for the technique used, histopathology, complications, recurrences, and the follow-up period. A case series of patients who presented to a tertiary rhinology clinic and who underwent treatment of odontogenic cysts by an endoscopic technique was included. A systematic review identified 16 case reports or series that described the use of endoscopic techniques for the treatment of odontogenic cysts, including 45 total patients. Histopathologies encountered were radicular (n = 16) and dentigerous cysts (n = 10), and keratocystic odontogenic tumor (n = 12). There were no reported recurrences or major complications for a mean follow-up of 29 months. A case series of patients in our institution identified seven patients without recurrence for a mean follow-up of 10 months. Endonasal endoscopic treatment of various odontogenic cysts are described in the literature and are associated with effective treatment of these lesions for an average follow-up period of >2 years. These techniques have the potential to reduce morbidity associated with the resection of these

  19. Anatomical investigations on intraosseous access in stillborns - Comparison of different devices and techniques.

    PubMed

    Fuchs, Zeynep; Scaal, Martin; Haverkamp, Heinz; Koerber, Friederike; Persigehl, Thorsten; Eifinger, Frank

    2018-06-01

    Intraosseous (IO)-access plays an alternative route during resuscitation. Our study was performed to investigate the successful rate of IO-access in preterm and term stillborns using different devices and techniques. The cadavers used were legal donations. 16 stillborns, median: 29.2 weeks (IQR 27.2-38.4) were investigated. Two different needles (a: Butterfly needle, 21G, Venofix ® Fa.Braun; b: Arrow ® EZ-IO ® 15G, Teleflex, Dublin, Ireland) were used. Needles were inserted i: manually, using a Butterfly needle; ii: manually, using EZ-IO ® needle or iii: using a battery-powered semi-automatic drill (Arrow ® EZ-IO ® ). Spectral-CT's were performed. The diameter of the corticalis was determined from the CT-images. Successful hit rates with 95% confidence intervals (CI) and odds ratios between the three methods were estimated using a generalised linear mixed model (GLMM). Estimated success rate was 61.1% (95%CI:39.7%-78.9%) for the Butterfly needle, 43.0% (95%CI:23.4%-65.0%) for hand-twisted EZ-IO ® screwing and 39.7% (95%CI:24.1-57.7%) for the semi-automatic drill (Arrow ® EZ-IO ® ), all referring to an average diameter of the corticalis of 1.2 mm. The odds of a correct position were 2.4 times higher (95%CI:0.8-7.6) when using the Butterfly needle than with the drill. In contrast, the odds of correct positioning when inserting the needle by hand were not significantly different from using the drill (odds ratio 1.1, 95%CI: 0.4-3.3). Neither of these effects nor the diameter of the corticalis with an odds ratio near one were significant in the model. Median diameter of the bone marrow cavity was 4.0 mm [IQR 3.3-4.7]. Intraosseous access for premature and neonatal infants could be best achieved by using a manually twisted Butterfly needle. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Managing bioengineering complexity with AI techniques.

    PubMed

    Beal, Jacob; Adler, Aaron; Yaman, Fusun

    2016-10-01

    Our capabilities for systematic design and engineering of biological systems are rapidly increasing. Effectively engineering such systems, however, requires the synthesis of a rapidly expanding and changing complex body of knowledge, protocols, and methodologies. Many of the problems in managing this complexity, however, appear susceptible to being addressed by artificial intelligence (AI) techniques, i.e., methods enabling computers to represent, acquire, and employ knowledge. Such methods can be employed to automate physical and informational "routine" work and thus better allow humans to focus their attention on the deeper scientific and engineering issues. This paper examines the potential impact of AI on the engineering of biological organisms through the lens of a typical organism engineering workflow. We identify a number of key opportunities for significant impact, as well as challenges that must be overcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Advancements in Data Access at the IRIS Data Management Center to Broaden Data Use

    NASA Astrophysics Data System (ADS)

    Benson, R. B.; Trabant, C. M.; Ahern, T. K.

    2013-12-01

    The IRIS Data Management Center (DMC) has been serving digital seismic data for more than 20 years and has offered a variety of access mechanisms that have stood the test of time. However, beginning in 2010, and in response to multiple needs being requested from the IRIS DMC, we have developed web service interfaces to access our primary data repository. These new interfaces have rapidly grown in popularity. In 2013, the third full year of their operation, these services were responsible for half of all the data shipped from the DMC. In the same time period, the amount of data shipped from the other data access mechanisms has also increased. This non-linear growth of data shipments reflects the increased data usage by the research community. We believe that our new web service interfaces are well suited to fit future data access needs and signify a significant evolution in integrating different scientific data sets. Based on standardized web technologies, support for writing access software is ubiquitous. As fundamentally programmatic interfaces, the services are well suited for integration into data processing systems, in particular large-scale data processing systems. Their programmatic nature also makes then well suited for use with brokering systems where, for example, data from multiple disciplines can be integrated. In addition to providing access to raw data, the DMC created web services that apply simple, on-the-fly processing and format conversion. Processing the data (e.g. converting to Earth units) and formatting the result into something generally usable (e.g. ASCII) removes important barriers for users working in other disciplines. The end result is that we are shipping a much larger amount of data in a manner more directly usable by users. Many of these principles will be applied to the DMC's future work in the NSF's EarthCube Web Service Building Blocks project.

  2. Management of extramammary Paget's disease with a staged, modified Mohs technique.

    PubMed

    Shukla, Anant; Stringer, Matthew; Uberoi, Pansy; Hudak, Steven; Kallingal, George

    2016-08-01

    Extramammary Paget's disease (EMPD) is a rare intraepithelial adenocarcinoma arising from apocrine glands. We describe an innovative surgical technique to manage extensive cutaneous malignancies in a notoriously challenging location. The patient is a 78-year-old male who presented with 'jock itch' on his left groin refractory to topical treatment. A shave biopsy of the lesion demonstrated non-invasive EMPD which yielded a urology consult. Rather than the standard wide local excision (WLE), which can lead to positive margins, progression, and recurrence, we used a modified the Mohs technique and staged the procedure, providing excellent oncologic and cosmetic outcomes. The described technique has particular merit with uncertain margin status and when geography of lesions preclude a standard Mohs surgery.

  3. Two Student Self-Management Techniques Applied to Data-Based Program Modification.

    ERIC Educational Resources Information Center

    Wesson, Caren

    Two student self-management techniques, student charting and student selection of instructional activities, were applied to ongoing data-based program modification. Forty-two elementary school resource room students were assigned randomly (within teacher) to one of three treatment conditions: Teacher Chart-Teacher Select Instructional Activities…

  4. Mobile Thread Task Manager

    NASA Technical Reports Server (NTRS)

    Clement, Bradley J.; Estlin, Tara A.; Bornstein, Benjamin J.

    2013-01-01

    The Mobile Thread Task Manager (MTTM) is being applied to parallelizing existing flight software to understand the benefits and to develop new techniques and architectural concepts for adapting software to multicore architectures. It allocates and load-balances tasks for a group of threads that migrate across processors to improve cache performance. In order to balance-load across threads, the MTTM augments a basic map-reduce strategy to draw jobs from a global queue. In a multicore processor, memory may be "homed" to the cache of a specific processor and must be accessed from that processor. The MTTB architecture wraps access to data with thread management to move threads to the home processor for that data so that the computation follows the data in an attempt to avoid L2 cache misses. Cache homing is also handled by a memory manager that translates identifiers to processor IDs where the data will be homed (according to rules defined by the user). The user can also specify the number of threads and processors separately, which is important for tuning performance for different patterns of computation and memory access. MTTM efficiently processes tasks in parallel on a multiprocessor computer. It also provides an interface to make it easier to adapt existing software to a multiprocessor environment.

  5. Correlative visualization techniques for multidimensional data

    NASA Technical Reports Server (NTRS)

    Treinish, Lloyd A.; Goettsche, Craig

    1989-01-01

    Critical to the understanding of data is the ability to provide pictorial or visual representation of those data, particularly in support of correlative data analysis. Despite the advancement of visualization techniques for scientific data over the last several years, there are still significant problems in bringing today's hardware and software technology into the hands of the typical scientist. For example, there are other computer science domains outside of computer graphics that are required to make visualization effective such as data management. Well-defined, flexible mechanisms for data access and management must be combined with rendering algorithms, data transformation, etc. to form a generic visualization pipeline. A generalized approach to data visualization is critical for the correlative analysis of distinct, complex, multidimensional data sets in the space and Earth sciences. Different classes of data representation techniques must be used within such a framework, which can range from simple, static two- and three-dimensional line plots to animation, surface rendering, and volumetric imaging. Static examples of actual data analyses will illustrate the importance of an effective pipeline in data visualization system.

  6. Evaluation of the Role of Music as a Nonpharmacological Technique in Management of Child Patients.

    PubMed

    Gupta, Neha; Gupta, Himanshu; Gupta, Prahlad; Gupta, Nidhi

    2017-03-01

    Behavior management and reducing anxiety and pain are very important for success of treatment. Hence, apart from pharmacological management, such as conscious sedation, nonpharmacological interventions like music play a significant role. This study aims to evaluate the effects of music in reducing anxiety, pain, and behavior management. This study was conducted at the Department of Pedodontics in 2015. It consisted of 60 patients, age ranging from 3 to 7 years, who required dental treatment with local anesthesia. They were divided into three groups of 20 each. Group I consisted of upbeat music distraction group. Group II consisted of relaxing music distraction group. Group III consisted of control group. We scheduled the treatment in two visits. We used Venham picture test, North Carolina behavior rating scale, and visual analog scale test for the study. Baseline heart rate was also recorded. No significant differences were found among the three groups based on three scales used in the study. Management of child patient in dental clinic is a challenge for clinician. Apart from various pharmacological techniques, management of pediatric patients using audio music distraction has been introduced. However, music did not produce a reduction in pain, anxiety, or disruptive behavior. Various pharmacological techniques are present for the management of pediatric patients. Apart from it, there is need of introducing nonpharmacological techniques to reduce pain, anxiety, and to alter behavior of child. By this study, we have tried to evaluate the usefulness of music in child management.

  7. Interventional Management of Gastrointestinal Fistulas

    PubMed Central

    Kwon, Se Hwan; Kim, Hyoung Jung; Park, Sun Jin; Park, Ho Chul

    2008-01-01

    Gastrointestinal (GI) fistulas are frequently very serious complications that are associated with high morbidity and mortality. GI fistulas can cause a wide array of pathophysiological effects by allowing abnormal diversion of the GI contents, including digestive fluid, water, electrolytes, and nutrients, from either one intestine to another or from the intestine to the skin. As an alternative to surgery, recent technical advances in interventional radiology and percutaneous techniques have been shown as advantageous to lower the morbidity and mortality rate, and allow for superior accessibility to the fistulous tracts via the use of fistulography. In addition, new interventional management techniques continue to emerge. We describe the clinical and imaging features of GI fistulas and outline the interventional management of GI fistulas. PMID:19039271

  8. The Application of Operations Research Techniques to the Evaluation of Military Management Information Systems.

    DTIC Science & Technology

    systems such as management information systems . To provide a methodology yielding quantitative results which may assist a commander and his staff in...this analysis, it is proposed that management information systems be evaluated as a whole by a technique defined as the semantic differential. Each

  9. Access Control of Web- and Java-Based Applications

    NASA Technical Reports Server (NTRS)

    Tso, Kam S.; Pajevski, Michael J.

    2013-01-01

    Cybersecurity has become a great concern as threats of service interruption, unauthorized access, stealing and altering of information, and spreading of viruses have become more prevalent and serious. Application layer access control of applications is a critical component in the overall security solution that also includes encryption, firewalls, virtual private networks, antivirus, and intrusion detection. An access control solution, based on an open-source access manager augmented with custom software components, was developed to provide protection to both Web-based and Javabased client and server applications. The DISA Security Service (DISA-SS) provides common access control capabilities for AMMOS software applications through a set of application programming interfaces (APIs) and network- accessible security services for authentication, single sign-on, authorization checking, and authorization policy management. The OpenAM access management technology designed for Web applications can be extended to meet the needs of Java thick clients and stand alone servers that are commonly used in the JPL AMMOS environment. The DISA-SS reusable components have greatly reduced the effort for each AMMOS subsystem to develop its own access control strategy. The novelty of this work is that it leverages an open-source access management product that was designed for Webbased applications to provide access control for Java thick clients and Java standalone servers. Thick clients and standalone servers are still commonly used in businesses and government, especially for applications that require rich graphical user interfaces and high-performance visualization that cannot be met by thin clients running on Web browsers

  10. Data management support for selected climate data sets using the climate data access system

    NASA Technical Reports Server (NTRS)

    Reph, M. G.

    1983-01-01

    The functional capabilities of the Goddard Space Flight Center (GSFC) Climate Data Access System (CDAS), an interactive data storage and retrieval system, and the archival data sets which this system manages are discussed. The CDAS manages several climate-related data sets, such as the First Global Atmospheric Research Program (GARP) Global Experiment (FGGE) Level 2-b and Level 3-a data tapes. CDAS data management support consists of three basic functions: (1) an inventory capability which allows users to search or update a disk-resident inventory describing the contents of each tape in a data set, (2) a capability to depict graphically the spatial coverage of a tape in a data set, and (3) a data set selection capability which allows users to extract portions of a data set using criteria such as time, location, and data source/parameter and output the data to tape, user terminal, or system printer. This report includes figures that illustrate menu displays and output listings for each CDAS function.

  11. Carrier Estimation Using Classic Spectral Estimation Techniques for the Proposed Demand Assignment Multiple Access Service

    NASA Technical Reports Server (NTRS)

    Scaife, Bradley James

    1999-01-01

    In any satellite communication, the Doppler shift associated with the satellite's position and velocity must be calculated in order to determine the carrier frequency. If the satellite state vector is unknown then some estimate must be formed of the Doppler-shifted carrier frequency. One elementary technique is to examine the signal spectrum and base the estimate on the dominant spectral component. If, however, the carrier is spread (as in most satellite communications) this technique may fail unless the chip rate-to-data rate ratio (processing gain) associated with the carrier is small. In this case, there may be enough spectral energy to allow peak detection against a noise background. In this thesis, we present a method to estimate the frequency (without knowledge of the Doppler shift) of a spread-spectrum carrier assuming a small processing gain and binary-phase shift keying (BPSK) modulation. Our method relies on an averaged discrete Fourier transform along with peak detection on spectral match filtered data. We provide theory and simulation results indicating the accuracy of this method. In addition, we will describe an all-digital hardware design based around a Motorola DSP56303 and high-speed A/D which implements this technique in real-time. The hardware design is to be used in NMSU's implementation of NASA's demand assignment, multiple access (DAMA) service.

  12. Strategies to introduce Data Management techniques into the German university curriculum

    NASA Astrophysics Data System (ADS)

    Söding, E.; Fleischer, D.

    2017-12-01

    Data Management is high on the agenda of the German Research Organizations and Universities. While many organizations have committed to high level data management plans, these plans are often loosely binding and not followed adequately. As a consequence, few practical concepts are in place, implementing a sustainable reliable processing, archiving and publication of research data. While many institutions struggle with the organizational level, at which data management is implemented, Students are educated and time is lost, teaching them relevance, techniques and strategies in dealing in a thoughtful and ahead looking manner with their research data. Within a new research project we are tackling this problem in a two-fold way. 1. we are involving technical university personnel, who are working in labs, producing scientific data, in data management processes. This requires teaching, analysis of lab practices and the development of applications for support. 2. We are developing new teaching material, in order to introduce such DM strategies into regular practical courses conducted in such labs, by starting small scale experiments on long term time series. These can be analyzed by student within practical courses, and will demonstrate the practical use of DM practices in the courses. While the focus is on natural science labs, we also strive to create material for other disciplines using e.g. text analysis techniques, in particular in linguistics and history. By doing so, we are touching not only the traditional data-heavy disciplines, but try to bridge responsibility for this task over several disciplines and faculties, in order to raise broad acceptance and recognition in the whole university for the benefits of structured Data Management plans in projects.

  13. Botulinum toxin injection techniques for the management of adult spasticity.

    PubMed

    Walker, Heather W; Lee, Michael Y; Bahroo, Laxman B; Hedera, Peter; Charles, David

    2015-04-01

    Spasticity is often experienced by individuals with injury or illness of the central nervous system from etiologies such as stroke, spinal cord injury, brain injury, multiple sclerosis, or other neurologic conditions. Although spasticity may provide benefits in some patients, it more often leads to complications negatively impacting the patient. Nonpharmacologic treatment options often do not provide long-term reduction of spasticity, and systemic interventions, such as oral medications, can have intolerable side effects. The use of botulinum neurotoxin injections is one option for management of focal spasticity. Several localization techniques are available to physicians that allow for identification of the selected target muscles. These methods include anatomic localization in isolation or in conjunction with electromyography guidance, electrical stimulation guidance, or ultrasound guidance. This article will focus on further description of each of these techniques in relation to the treatment of adult spasticity and will discuss the advantages and disadvantages of each technique, as well as review the literature comparing the techniques. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  14. Improving playground surface accessibility

    Treesearch

    Theodore L. Laufenberg

    2004-01-01

    Could accessibility be improved and maintenance be reduced for wood fiber- based playgrounds? In July 2001, the US Access Board asked the Forest Products Laboratory (FPL) for advice and a potential solution. Since that time new product standards have been adopted by ASTM for engineered wood fiber (EWF), new test techniques have been promulgated by RESNA (Rehabilitation...

  15. Real-time emergency forecasting technique for situation management systems

    NASA Astrophysics Data System (ADS)

    Kopytov, V. V.; Kharechkin, P. V.; Naumenko, V. V.; Tretyak, R. S.; Tebueva, F. B.

    2018-05-01

    The article describes the real-time emergency forecasting technique that allows increasing accuracy and reliability of forecasting results of any emergency computational model applied for decision making in situation management systems. Computational models are improved by the Improved Brown’s method applying fractal dimension to forecast short time series data being received from sensors and control systems. Reliability of emergency forecasting results is ensured by the invalid sensed data filtering according to the methods of correlation analysis.

  16. Non-visual Web Browsing: Beyond Web Accessibility

    PubMed Central

    Ramakrishnan, I.V.; Ashok, Vikas

    2017-01-01

    People with vision impairments typically use screen readers to browse the Web. To facilitate non-visual browsing, web sites must be made accessible to screen readers, i.e., all the visible elements in the web site must be readable by the screen reader. But even if web sites are accessible, screen-reader users may not find them easy to use and/or easy to navigate. For example, they may not be able to locate the desired information without having to listen to a lot of irrelevant contents. These issues go beyond web accessibility and directly impact web usability. Several techniques have been reported in the accessibility literature for making the Web usable for screen reading. This paper is a review of these techniques. Interestingly, the review reveals that understanding the semantics of the web content is the overarching theme that drives these techniques for improving web usability. PMID:29202137

  17. Non-visual Web Browsing: Beyond Web Accessibility.

    PubMed

    Ramakrishnan, I V; Ashok, Vikas; Billah, Syed Masum

    2017-07-01

    People with vision impairments typically use screen readers to browse the Web. To facilitate non-visual browsing, web sites must be made accessible to screen readers, i.e., all the visible elements in the web site must be readable by the screen reader. But even if web sites are accessible, screen-reader users may not find them easy to use and/or easy to navigate. For example, they may not be able to locate the desired information without having to listen to a lot of irrelevant contents. These issues go beyond web accessibility and directly impact web usability. Several techniques have been reported in the accessibility literature for making the Web usable for screen reading. This paper is a review of these techniques. Interestingly, the review reveals that understanding the semantics of the web content is the overarching theme that drives these techniques for improving web usability.

  18. Women's Access and Provider Practices for the Case Management of Malaria during Pregnancy: A Systematic Review and Meta-Analysis

    PubMed Central

    Hill, Jenny; D'Mello-Guyett, Lauren; Hoyt, Jenna; van Eijk, Anna M.; ter Kuile, Feiko O.; Webster, Jayne

    2014-01-01

    Background WHO recommends prompt diagnosis and quinine plus clindamycin for treatment of uncomplicated malaria in the first trimester and artemisinin-based combination therapies in subsequent trimesters. We undertook a systematic review of women's access to and healthcare provider adherence to WHO case management policy for malaria in pregnant women. Methods and Findings We searched the Malaria in Pregnancy Library, the Global Health Database, and the International Network for the Rational Use of Drugs Bibliography from 1 January 2006 to 3 April 2014, without language restriction. Data were appraised for quality and content. Frequencies of women's and healthcare providers' practices were explored using narrative synthesis and random effect meta-analysis. Barriers to women's access and providers' adherence to policy were explored by content analysis using NVivo. Determinants of women's access and providers' case management practices were extracted and compared across studies. We did not perform a meta-ethnography. Thirty-seven studies were included, conducted in Africa (30), Asia (4), Yemen (1), and Brazil (2). One- to three-quarters of women reported malaria episodes during pregnancy, of whom treatment was sought by >85%. Barriers to access among women included poor knowledge of drug safety, prohibitive costs, and self-treatment practices, used by 5%–40% of women. Determinants of women's treatment-seeking behaviour were education and previous experience of miscarriage and antenatal care. Healthcare provider reliance on clinical diagnosis and poor adherence to treatment policy, especially in first versus other trimesters (28%, 95% CI 14%–47%, versus 72%, 95% CI 39%–91%, p = 0.02), was consistently reported. Prescribing practices were driven by concerns over side effects and drug safety, patient preference, drug availability, and cost. Determinants of provider practices were access to training and facility type (public versus private). Findings were limited

  19. Women's access and provider practices for the case management of malaria during pregnancy: a systematic review and meta-analysis.

    PubMed

    Hill, Jenny; D'Mello-Guyett, Lauren; Hoyt, Jenna; van Eijk, Anna M; ter Kuile, Feiko O; Webster, Jayne

    2014-08-01

    WHO recommends prompt diagnosis and quinine plus clindamycin for treatment of uncomplicated malaria in the first trimester and artemisinin-based combination therapies in subsequent trimesters. We undertook a systematic review of women's access to and healthcare provider adherence to WHO case management policy for malaria in pregnant women. We searched the Malaria in Pregnancy Library, the Global Health Database, and the International Network for the Rational Use of Drugs Bibliography from 1 January 2006 to 3 April 2014, without language restriction. Data were appraised for quality and content. Frequencies of women's and healthcare providers' practices were explored using narrative synthesis and random effect meta-analysis. Barriers to women's access and providers' adherence to policy were explored by content analysis using NVivo. Determinants of women's access and providers' case management practices were extracted and compared across studies. We did not perform a meta-ethnography. Thirty-seven studies were included, conducted in Africa (30), Asia (4), Yemen (1), and Brazil (2). One- to three-quarters of women reported malaria episodes during pregnancy, of whom treatment was sought by >85%. Barriers to access among women included poor knowledge of drug safety, prohibitive costs, and self-treatment practices, used by 5%-40% of women. Determinants of women's treatment-seeking behaviour were education and previous experience of miscarriage and antenatal care. Healthcare provider reliance on clinical diagnosis and poor adherence to treatment policy, especially in first versus other trimesters (28%, 95% CI 14%-47%, versus 72%, 95% CI 39%-91%, p = 0.02), was consistently reported. Prescribing practices were driven by concerns over side effects and drug safety, patient preference, drug availability, and cost. Determinants of provider practices were access to training and facility type (public versus private). Findings were limited by the availability, quality, scope, and

  20. Information Landscaping: Information Mapping, Charting, Querying and Reporting Techniques for Total Quality Knowledge Management.

    ERIC Educational Resources Information Center

    Tsai, Bor-sheng

    2003-01-01

    Total quality management and knowledge management are merged and used as a conceptual model to direct and develop information landscaping techniques through the coordination of information mapping, charting, querying, and reporting. Goals included: merge citation analysis and data mining, and apply data visualization and information architecture…

  1. Percutaneous Transsplenic Access to the Portal Vein for Management of Vascular Complication in Patients with Chronic Liver Disease

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

    Chu, Hee Ho; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Jae, Hwan Jun

    Purpose: To evaluate the safety and feasibility of percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver diseases. Methods: Between Sept 2009 and April 2011, percutaneous transsplenic access to the portal vein was attempted in nine patients with chronic liver disease. Splenic vein puncture was performed under ultrasonographic guidance with a Chiba needle, followed by introduction of a 4 to 9F sheath. Four patients with hematemesis or hematochezia underwent variceal embolization. Another two patients underwent portosystemic shunt embolization in order to improve portal venous blood flow. Portal vein recanalization was attempted inmore » three patients with a transplanted liver. The percutaneous transsplenic access site was closed using coils and glue. Results: Percutaneous transsplenic splenic vein catheterization was performed successfully in all patients. Gastric or jejunal varix embolization with glue and lipiodol mixture was performed successfully in four patients. In two patients with a massive portosystemic shunt, embolization of the shunting vessel with a vascular plug, microcoils, glue, and lipiodol mixture was achieved successfully. Portal vein recanalization was attempted in three patients with a transplanted liver; however, only one patient was treated successfully. Complete closure of the percutaneous transsplenic tract was achieved using coils and glue without bleeding complication in all patients. Conclusion: Percutaneous transsplenic access to the portal vein can be an alternative route for portography and further endovascular management in patients for whom conventional approaches are difficult or impossible.« less

  2. Overview of Sparse Graph for Multiple Access in Future Mobile Networks

    NASA Astrophysics Data System (ADS)

    Lei, Jing; Li, Baoguo; Li, Erbao; Gong, Zhenghui

    2017-10-01

    Multiple access via sparse graph, such as low density signature (LDS) and sparse code multiple access (SCMA), is a promising technique for future wireless communications. This survey presents an overview of the developments in this burgeoning field, including transmitter structures, extrinsic information transform (EXIT) chart analysis and comparisons with existing multiple access techniques. Such technique enables multiple access under overloaded conditions to achieve a satisfactory performance. Message passing algorithm is utilized for multi-user detection in the receiver, and structures of the sparse graph are illustrated in detail. Outlooks and challenges of this technique are also presented.

  3. Access to safe legal abortion in Malaysia: women's insights and health sector response.

    PubMed

    Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

    2015-01-01

    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

  4. Ultra-processed food product brands on Facebook pages: highly accessed by Brazilians through their marketing techniques.

    PubMed

    Horta, Paula M; Rodrigues, Fernanda T; Dos Santos, Luana C

    2018-06-01

    To analyse the content and extent of marketing of ultra-processed food products (UPP) and their brand pages on Facebook, which are highly accessed by Brazilians. Descriptive. Sixteen UPP brand pages on Facebook were selected from 250 pages that were the most liked by Brazilians in October 2015. We analysed the frequency of 'likes' and members 'talking about' each one of the pages, in addition to fifteen marketing techniques used in the previous year (September 2014 to October 2015). The number of posts, likes, 'shares' and 'commentaries', and the mean number of likes, shares and commentaries per post, were collected for one month, from 23 September to 23 October 2015. The two most liked pages were: Coke® (93 673 979 likes) and McDonald's® (59 749 819 likes). Regarding the number of people talking about the pages, McDonald's led with 555 891 commentaries, followed by Coke (287 274), Burger King® (246 148) and Kibon® (244 523). All pages used marketing techniques, which included photos, user conversations, presence of brand elements and links. Videos were observed on 93·8 % of the pages; promotions on 68·8 %; and celebrities on 62·5 %. In one month, Garoto®, Outback® and Coke were brands that published more than one post per day. Kibon achieved the highest ratio of likes per post (285 845·50) and Burger King had the highest mean shares per post (10 083·93), including commentaries per post (7958·13). UPP marketing is extensively used on Facebook pages and is highly accessed by Brazilians, with UPP companies employing a diversity of marketing strategies.

  5. SSR-based genetic diversity and structure of garlic accessions from Brazil.

    PubMed

    da Cunha, Camila Pinto; Resende, Francisco Vilela; Zucchi, Maria Imaculada; Pinheiro, José Baldin

    2014-10-01

    Garlic is a spice and a medicinal plant; hence, there is an increasing interest in 'developing' new varieties with different culinary properties or with high content of nutraceutical compounds. Phenotypic traits and dominant molecular markers are predominantly used to evaluate the genetic diversity of garlic clones. However, 24 SSR markers (codominant) specific for garlic are available in the literature, fostering germplasm researches. In this study, we genotyped 130 garlic accessions from Brazil and abroad using 17 polymorphic SSR markers to assess the genetic diversity and structure. This is the first attempt to evaluate a large set of accessions maintained by Brazilian institutions. A high level of redundancy was detected in the collection (50 % of the accessions represented eight haplotypes). However, non-redundant accessions presented high genetic diversity. We detected on average five alleles per locus, Shannon index of 1.2, HO of 0.5, and HE of 0.6. A core collection was set with 17 accessions, covering 100 % of the alleles with minimum redundancy. Overall FST and D values indicate a strong genetic structure within accessions. Two major groups identified by both model-based (Bayesian approach) and hierarchical clustering (UPGMA dendrogram) techniques were coherent with the classification of accessions according to maturity time (growth cycle): early-late and midseason accessions. Assessing genetic diversity and structure of garlic collections is the first step towards an efficient management and conservation of accessions in genebanks, as well as to advance future genetic studies and improvement of garlic worldwide.

  6. How to start a minimal access mitral valve program.

    PubMed

    Hunter, Steven

    2013-11-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: "clinical effectiveness", including reduced length of hospital stay, "risk management effectiveness", including conversion to sternotomy and aortic dissection, "patient experience" including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper.

  7. How to start a minimal access mitral valve program

    PubMed Central

    2013-01-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: “clinical effectiveness”, including reduced length of hospital stay, “risk management effectiveness”, including conversion to sternotomy and aortic dissection, “patient experience” including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper. PMID:24349981

  8. A Review of Techniques Used in the Management of Growing Skull Fractures.

    PubMed

    Vezina, Noemie; Al-Halabi, Becher; Shash, Hani; Dudley, Roy R; Gilardino, Mirko S

    2017-05-01

    Growing skull fractures (GSFs) are rare complications of pediatric head trauma that comprise skull fractures associated with an underlying dural tear and an intact arachnoid membrane. They are often misdiagnosed, and delay in management can lead to progression of the disease along with its neurological sequelae. Multiple clinical reports and qualitative reviews on this entity exist. To our knowledge, this represents the largest clinical review reporting on established techniques in the management of these fractures. A literature search was performed on the databases Embase, Medline, Cochrane, and PubMed from their inception until February 2015 using the terms "Growing," "Skull," "Fracture," and their equivalent terms. Studies included were case series with 5 or more patients describing GSFs and their management. Twenty-two articles reporting 440 patients were included in the analysis. The mean age at trauma was 8.8 months, with the mean at presentation of 21.9 months and 57.8% of the patients being males. Most commonly, a combined dura-cranioplasty was done in 61.6% of the patients. A range of autoplastic and alloplastic materials were used in both of these techniques. Improvement from preoperative clinical status in seizures and neurological deficits was noted in 18 (12.7%) and 11 (7.05%) of the patients, respectively, following operative repair and medical management. Early recognition is crucial in the management and treatment of GSF. Children at risk for developing GSF should be monitored clinically for up to 3 months following the initial insult. The surgical treatment depends on the size of the fracture and the age of the patient. A summary of the presentation, management, associated outcomes, complications, and recommendations discussed in the literature are reported within.

  9. A typology of intellectual property management for public health innovation and access: design considerations for policymakers.

    PubMed

    Taubman, Antony

    2010-01-19

    This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation - though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of 'exclusive rights', as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to give a

  10. Innovative Techniques for Estimating Illegal Activities in a Human-Wildlife-Management Conflict

    PubMed Central

    Cross, Paul; St. John, Freya A. V.; Khan, Saira; Petroczi, Andrea

    2013-01-01

    Effective management of biological resources is contingent upon stakeholder compliance with rules. With respect to disease management, partial compliance can undermine attempts to control diseases within human and wildlife populations. Estimating non-compliance is notoriously problematic as rule-breakers may be disinclined to admit to transgressions. However, reliable estimates of rule-breaking are critical to policy design. The European badger (Meles meles) is considered an important vector in the transmission and maintenance of bovine tuberculosis (bTB) in cattle herds. Land managers in high bTB prevalence areas of the UK can cull badgers under license. However, badgers are also known to be killed illegally. The extent of illegal badger killing is currently unknown. Herein we report on the application of three innovative techniques (Randomized Response Technique (RRT); projective questioning (PQ); brief implicit association test (BIAT)) for investigating illegal badger killing by livestock farmers across Wales. RRT estimated that 10.4% of farmers killed badgers in the 12 months preceding the study. Projective questioning responses and implicit associations relate to farmers' badger killing behavior reported via RRT. Studies evaluating the efficacy of mammal vector culling and vaccination programs should incorporate estimates of non-compliance. Mitigating the conflict concerning badgers as a vector of bTB requires cross-disciplinary scientific research, departure from deep-rooted positions, and the political will to implement evidence-based management. PMID:23341973

  11. Innovative techniques for estimating illegal activities in a human-wildlife-management conflict.

    PubMed

    Cross, Paul; St John, Freya A V; Khan, Saira; Petroczi, Andrea

    2013-01-01

    Effective management of biological resources is contingent upon stakeholder compliance with rules. With respect to disease management, partial compliance can undermine attempts to control diseases within human and wildlife populations. Estimating non-compliance is notoriously problematic as rule-breakers may be disinclined to admit to transgressions. However, reliable estimates of rule-breaking are critical to policy design. The European badger (Meles meles) is considered an important vector in the transmission and maintenance of bovine tuberculosis (bTB) in cattle herds. Land managers in high bTB prevalence areas of the UK can cull badgers under license. However, badgers are also known to be killed illegally. The extent of illegal badger killing is currently unknown. Herein we report on the application of three innovative techniques (Randomized Response Technique (RRT); projective questioning (PQ); brief implicit association test (BIAT)) for investigating illegal badger killing by livestock farmers across Wales. RRT estimated that 10.4% of farmers killed badgers in the 12 months preceding the study. Projective questioning responses and implicit associations relate to farmers' badger killing behavior reported via RRT. Studies evaluating the efficacy of mammal vector culling and vaccination programs should incorporate estimates of non-compliance. Mitigating the conflict concerning badgers as a vector of bTB requires cross-disciplinary scientific research, departure from deep-rooted positions, and the political will to implement evidence-based management.

  12. A Review of the Integration of Classical Biological Control with other Management Techniques to Manage Invasive Weeds in Natural Areas and Rangelands

    USDA-ARS?s Scientific Manuscript database

    Integrating classical biological control with other management techniques such as herbicide, fire, mechanical control, grazing, or plant competition, can be the most effective way to manage invasive weeds in natural areas and rangelands. Biological control agents can be protected from potential nega...

  13. Remote sensing techniques for conservation and management of natural vegetation ecosystems

    NASA Technical Reports Server (NTRS)

    Parada, N. D. J. (Principal Investigator); Verdesio, J. J.; Dossantos, J. R.

    1981-01-01

    The importance of using remote sensing techniques, in the visible and near-infrared ranges, for mapping, inventory, conservation and management of natural ecosystems is discussed. Some examples realized in Brazil or other countries are given to evaluate the products from orbital platform (MSS and RBV imagery of LANDSAT) and aerial level (photography) for ecosystems study. The maximum quantitative and qualitative information which can be obtained from each sensor, at different level, are discussed. Based on the developed experiments it is concluded that the remote sensing technique is a useful tool in mapping vegetation units, estimating biomass, forecasting and evaluation of fire damage, disease detection, deforestation mapping and change detection in land-use. In addition, remote sensing techniques can be used in controling implantation and planning natural/artificial regeneration.

  14. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

  15. Ebola salience, death-thought accessibility, and worldview defense: A terror management theory perspective.

    PubMed

    Arrowood, Robert B; Cox, Cathy R; Kersten, Michael; Routledge, Clay; Shelton, Jill Talley; Hood, Ralph W

    2017-10-01

    According to terror management theory, individuals defend their cultural beliefs following mortality salience. The current research examined whether naturally occurring instances of death (i.e., Ebola) correspond to results found in laboratory studies. The results of two experiments demonstrated that participants experienced a greater accessibility of death-related thoughts in response to an Ebola prime during a regional outbreak. Study 2 also showed that increased mortality awareness following an Ebola manipulation was associated with greater worldview defense (i.e., religious fundamentalism). Together, these results suggest that reminders of death in the form of a disease threat operate similarly to a mortality salience manipulation.

  16. Remote access thyroid surgery

    PubMed Central

    Bhatia, Parisha; Mohamed, Hossam Eldin; Kadi, Abida; Walvekar, Rohan R.

    2015-01-01

    Robot assisted thyroid surgery has been the latest advance in the evolution of thyroid surgery after endoscopy assisted procedures. The advantage of a superior field vision and technical advancements of robotic technology have permitted novel remote access (trans-axillary and retro-auricular) surgical approaches. Interestingly, several remote access surgical ports using robot surgical system and endoscopic technique have been customized to avoid the social stigma of a visible scar. Current literature has displayed their various advantages in terms of post-operative outcomes; however, the associated financial burden and also additional training and expertise necessary hinder its widespread adoption into endocrine surgery practices. These approaches offer excellent cosmesis, with a shorter learning curve and reduce discomfort to surgeons operating ergonomically through a robotic console. This review aims to provide details of various remote access techniques that are being offered for thyroid resection. Though these have been reported to be safe and feasible approaches for thyroid surgery, further evaluation for their efficacy still remains. PMID:26425450

  17. Gynecomastia: evolving paradigm of management and comparison of techniques.

    PubMed

    Petty, Paul M; Solomon, Matthias; Buchel, Edward W; Tran, Nho V

    2010-05-01

    Since 1997, the authors have used a minimally invasive technique for the management of gynecomastia using ultrasound-assisted liposuction and the arthroscopic shaver to remove breast tissue through a remote incision. This technique has allowed for a consistent, refined, "unoperated" postoperative appearance in this patient population. This study analyzes the outcomes of this procedure and compares the procedure against established techniques. A retrospective study was performed on all patients who underwent surgery for gynecomastia at the authors' institution between January of 1988 and October of 2007. A total of 227 patients were divided into four groups: group 1, open excision only (n = 45); group 2, open excision plus liposuction (n = 56); group 3, liposuction only (n = 50); and group 4, liposuction plus arthroscopic shaver (n = 76). Medical records and photographs were used to compare groups for complications and results. Complications using the liposuction plus arthroscopic shaver technique included seroma (n = 2), hematoma (n = 1), scar revision (n = 1), and skin buttonhole from the arthroscopic shaver (n = 1). There was no difference between groups in the overall incidence of complications (p < 0.20) or the need for reoperation (p < 0.325). Results were scored on a scale of 1 (poor) to 5 (excellent). Group 4 (liposuction plus arthroscopic shaver) had the overall highest mean score, with statistical significance between group 2 (open excision plus liposuction) and group 4 (p < 0.0001). Arthroscopic mastectomy for gynecomastia is a safe and effective technique, with excellent cosmetic results and an acceptable complication rate.

  18. 76 FR 13438 - AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc., and iCarbon Corp., Order of Suspension of Trading March 8, 2011. It appears to the Securities and Exchange Commission that there is a lack of current and accurate information concerning the...

  19. Flexible use and technique extension of logistics management

    NASA Astrophysics Data System (ADS)

    Xiong, Furong

    2011-10-01

    As we all know, the origin of modern logistics was in the United States, developed in Japan, became mature in Europe, and expanded in China. This is a historical development of the modern logistics recognized track. Due to China's economic and technological development, and with the construction of Shanghai International Shipping Center and Shanghai Yangshan International Deepwater development, China's modern logistics industry will attain a leap-forward development of a strong pace, and will also catch up with developed countries in the Western modern logistics level. In this paper, the author explores the flexibility of China's modern logistics management techniques to extend the use, and has certain practical and guidance significances.

  20. Proximity Displays for Access Control

    ERIC Educational Resources Information Center

    Vaniea, Kami

    2012-01-01

    Managing access to shared digital information, such as photographs and documents. is difficult for end users who are accumulating an increasingly large and diverse collection of data that they want to share with others. Current policy-management solutions require a user to proactively seek out and open a separate policy-management interface when…

  1. Survey of Airport Access Analysis Techniques - Models, Data and a Research Program

    DOT National Transportation Integrated Search

    1972-06-01

    The report points up the differences and similarities between airport access travel and general urban trip making. Models and surveys developed for, or applicable, to airport access planning are reviewed. A research program is proposed which would ge...

  2. Research to Develop Effective Teaching and Management Techniques for Severely Disturbed and Retarded Children. Final Report.

    ERIC Educational Resources Information Center

    Kauffman, James M.; Birnbrauer, Jay S.

    The final report of a project on teaching and management techniques with severely disturbed and/or retarded children presents analysis of single subject research using contingent imitation of the child as an intervention technique. The effects of this technique were examined on the following behaviors: toyplay and reciprocal imitation, self…

  3. The accessibility and acceptability of self-management support interventions for men with long term conditions: a systematic review and meta-synthesis of qualitative studies.

    PubMed

    Galdas, Paul; Darwin, Zoe; Kidd, Lisa; Blickem, Christian; McPherson, Kerri; Hunt, Kate; Bower, Peter; Gilbody, Simon; Richardson, Gerry

    2014-11-27

    Self-management support interventions can improve health outcomes, but their impact is limited by the numbers of people able or willing to access them. Men's attendance at existing self-management support services appears suboptimal despite their increased risk of developing many of the most serious long term conditions. The aim of this review was to determine whether current self-management support interventions are acceptable and accessible to men with long term conditions, and explore what may act as facilitators and barriers to access of interventions and support activities. A systematic search for qualitative research was undertaken on CINAHL, EMBASE, MEDLINE, PsycINFO and Social Science Citation Index, in July 2013. Reference lists of relevant articles were also examined. Studies that used a qualitative design to explore men's experiences of, or perceptions towards, self-management support for one or more long term condition were included. Studies which focused on experiences of living with a long term condition without consideration of self-management support were excluded. Thirty-eight studies met the inclusion criteria. A meta-ethnography approach was employed to synthesise the findings. Four constructs associated with men's experience of, and perceptions towards, self-management support were identified: 1) need for purpose; 2) trusted environments; 3) value of peers; and 4) becoming an expert. The synthesis showed that men may feel less comfortable participating in self-management support if it is viewed as incongruous with valued aspects of their identity, particularly when activities are perceived to challenge masculine ideals associated with independence, stoicism, and control. Men may find self-management support more attractive when it is perceived as action-oriented, having a clear purpose, and offering personally meaningful information and practical strategies that can be integrated into daily life. Self-management support is most likely to be

  4. Prevention and management of postoperative nausea and vomiting: a look at complementary techniques.

    PubMed

    Mamaril, Myrna E; Windle, Pamela E; Burkard, Joseph F

    2006-12-01

    Complementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse's plan of care to prevent or manage PONV.

  5. Techniques of Document Management: A Review of Text Retrieval and Related Technologies.

    ERIC Educational Resources Information Center

    Veal, D. C.

    2001-01-01

    Reviews present and possible future developments in the techniques of electronic document management, the major ones being text retrieval and scanning and OCR (optical character recognition). Also addresses document acquisition, indexing and thesauri, publishing and dissemination standards, impact of the Internet, and the document management…

  6. Central venous access: techniques and indications in oncology.

    PubMed

    Marcy, Pierre-Yves

    2008-10-01

    Long lines can be inserted centrally or peripherally through patent veins into the central venous system down to the atrial caval junction. Traditionally surgeons, anesthetists, cardiologists and more recently interventional radiologists have been placing them using vein cutdown or percutaneous needle puncture techniques. Typical candidates for implanted venous catheters are cancer patients undergoing long-term chemotherapy. The most important issues, in addition to the patency of central veins and the history of previous indwelling catheters, pacewires or venous thrombosis, are the patient's performance status, body mass index, medical history and respiratory status, and the relevant technique. The present article will give an overview of the radiological and surgical implantation techniques and will highlight the impact of imaging means on the technical feasibility, assessment and treatment of device-related complications.

  7. Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

    PubMed

    Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

    2011-01-01

    In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.

  8. Work, love, and death-thought accessibility: A terror management investigation.

    PubMed

    McCabe, Simon; Daly, Michael

    2018-05-07

    Terror management theory suggests that following culturally derived scripts for valued behaviour protects people from death concerns, and conversely, not meeting standards for cultural value can weaken this protection, heightening mortality concerns. Using this conceptual framework, we examine (1) how considerations of loss of employment, a source of cultural value for many, relates to the accessibility of death-related cognition, and (2) the moderating role of job market health, and (3) involvement in close relationships. Study 1 found that writing about being unemployed (vs. a control topic) led to greater mortality-related cognition. Study 2 found that considering unemployment heightened death cognition, but only when participants were led to perceive the job market as unhealthy. Finally, Study 3 found that considering unemployment led to greater death cognition, but not for those involved in a close relationship. Findings offer insight into a previously overlooked consequence of unemployment, and factors that may serve a protective function. © 2018 The British Psychological Society.

  9. Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

    PubMed

    Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

    2017-12-01

    Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  10. [Management of spinal metastasis by minimal invasive surgery technique: Surgical principles, indications: A literature review].

    PubMed

    Toquart, A; Graillon, T; Mansouri, N; Adetchessi, T; Blondel, B; Fuentes, S

    2016-06-01

    Spinal metastasis are getting more frequent. This raises the question of pain and neurological complications, which worsen the functional and survival prognosis of this oncological population patients. The surgical treatment must be the most complete as possible: to decompress and stabilize without delaying the management of the oncological disease. Minimal invasive surgery techniques are by definition, less harmful on musculocutaneous plan than opened ones, with a comparable efficiency demonstrated in degenerative and traumatic surgery. So they seem to be applicable and appropriate to this patient population. We detailed different minimal invasive techniques proposed in the management of spinal metastasis. For this, we used our experience developed in degenerative and traumatic pathologies, and we also referred to many authors, establishing a literature review thanks to Pubmed, Embase. Thirty eight articles were selected and allowed us to describe different techniques: percutaneous methods such as vertebro-/kyphoplasty and osteosynthesis, as well as mini-opened surgery, through a posterior or anterior way. We propose a surgical approach using these minimal invasive techniques, first according to the predominant symptom (pain or neurologic failure), then characteristics of the lesions (number, topography, type…) and the deformity degree. Whatever the technique, the main goal is to stabilize and decompress, in order to maintain a good quality of life for these fragile patients, without delaying the medical management of the oncological disease. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding

    PubMed Central

    Loffroy, Romaric F; Abualsaud, Basem A; Lin, Ming D; Rao, Pramod P

    2011-01-01

    Over the past two decades, transcatheter arterial embolization has become the first-line therapy for the management of upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the management of hemorrhage for a variety of indications, such as peptic ulcer bleeding, malignant disease, hemorrhagic Dieulafoy lesions and iatrogenic or trauma bleeding. Transcatheter interventions include the following: selective embolization of the feeding artery, sandwich coil occlusion of the gastroduodenal artery, blind or empiric embolization of the supposed bleeding vessel based on endoscopic findings and coil pseudoaneurysm or aneurysm embolization by three-dimensional sac packing with preservation of the parent artery. Transcatheter embolization is a fast, safe and effective, minimally invasive alternative to surgery when endoscopic treatment fails to control bleeding from the upper gastrointestinal tract. This article reviews the various transcatheter endovascular techniques and devices that are used in a variety of clinical scenarios for the management of hemorrhagic gastrointestinal emergencies. PMID:21860697

  12. Developing a Virtual Teach-To-Goal™ Inhaler Technique Learning Module: A Mixed Methods Approach.

    PubMed

    Wu, Meng; Woodrick, Nicole M; Arora, Vineet M; Farnan, Jeanne M; Press, Valerie G

    Most hospitalized patients with asthma or chronic obstructive pulmonary disease misuse respiratory inhalers. An in-person educational strategy, teach-to-goal (TTG), improves inpatients' inhaler technique. To develop an effective, portable education intervention that remains accessible to hospitalized patients postdischarge for reinforcement of proper inhaler technique. A mixed methods approach at an urban academic hospital was used to iteratively develop, modify, and test a virtual teach-to-goal ™ (V-TTG ™ ) educational intervention using patient end-user feedback. A survey examined access and willingness to use technology for self-management education. Focus groups evaluated patients' feedback on access, functionality, and quality of V-TTG ™ . Forty-eight participants completed the survey, with most reporting having Internet access; 77% used the Internet at home and 82% used the Internet at least once every few weeks. More than 80% reported that they were somewhat or very likely to use V-TTG ™ to gain skills to improve their health. Most participants reported smartphone access (73%); half owned laptop computers (52%). Participants with asthma versus chronic obstructive pulmonary disease were more likely to own a smartphone, have a data plan, and have daily Internet use (P < .05). Nine focus groups (n = 25) identified themes for each domain: access-platform and delivery, Internet access, and technological literacy; functionality-usefulness, content, and teaching strategy; and quality-clarity, ease of use, length, and likability. V-TTG ™ is a promising educational tool for improving patients' inhaler technique, iteratively developed and refined with patient input. Patients in our urban, academic hospital overwhelmingly reported access to platforms and willingness to use V-TTG ™ for health education. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. Water access, water scarcity, and climate change.

    PubMed

    Mukheibir, Pierre

    2010-05-01

    This article investigates the approaches of the various discourses operating in the water sector and how they address the issues of scarcity and equitable access under projected climate change impacts. Little synergy exists between the different approaches dealing with these issues. Whilst being a sustainable development and water resources management issue, a holistic view of access, scarcity and the projected impacts of climate change is not prevalent in these discourses. The climate change discourse too does not adequately bridge the gap between these issues. The projected impacts of climate change are likely to exacerbate the problems of scarcity and equitable access unless appropriate adaptation strategies are adopted and resilience is built. The successful delivery of accessible water services under projected climate change impacts therefore lies with an extension of the adaptive water management approach to include equitable access as a key driver.

  14. C-MOS array design techniques: SUMC multiprocessor system study

    NASA Technical Reports Server (NTRS)

    Clapp, W. A.; Helbig, W. A.; Merriam, A. S.

    1972-01-01

    The current capabilities of LSI techniques for speed and reliability, plus the possibilities of assembling large configurations of LSI logic and storage elements, have demanded the study of multiprocessors and multiprocessing techniques, problems, and potentialities. Evaluated are three previous systems studies for a space ultrareliable modular computer multiprocessing system, and a new multiprocessing system is proposed that is flexibly configured with up to four central processors, four 1/0 processors, and 16 main memory units, plus auxiliary memory and peripheral devices. This multiprocessor system features a multilevel interrupt, qualified S/360 compatibility for ground-based generation of programs, virtual memory management of a storage hierarchy through 1/0 processors, and multiport access to multiple and shared memory units.

  15. 5 CFR 297.205 - Access to medical records.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Access to medical records. 297.205... PROCEDURES FOR PERSONNEL RECORDS Request for Access § 297.205 Access to medical records. When a request for access involves medical or psychological records that the system manager believes requires special...

  16. 5 CFR 297.205 - Access to medical records.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Access to medical records. 297.205... PROCEDURES FOR PERSONNEL RECORDS Request for Access § 297.205 Access to medical records. When a request for access involves medical or psychological records that the system manager believes requires special...

  17. 5 CFR 297.205 - Access to medical records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Access to medical records. 297.205... PROCEDURES FOR PERSONNEL RECORDS Request for Access § 297.205 Access to medical records. When a request for access involves medical or psychological records that the system manager believes requires special...

  18. Property management tools and techniques : models for the effective management of real property assets at state departments of transportation

    DOT National Transportation Integrated Search

    2012-09-30

    The Federal Highway Administrations (FHWA) Office of Real Estate Services (HEPR) sponsored the research reported on here to review tools and techniques that SDOTs are using to manage, or inventory, their real property assets. The report is based o...

  19. The Accessible Pantry: Food Identification Tips, Tools, and Techniques

    ERIC Educational Resources Information Center

    Sokol-McKay, Debra A.; Michels, Dianne

    2006-01-01

    For individuals with visual impairments, poorly designed labels can be barriers to receiving safe and independent access to important information about products in daily use. The authors discuss how organization and proper lighting can reduce the amount of labeling needed on food products and indicate how individuals with visual impairments can…

  20. Management of Information Technology Access Controls

    DTIC Science & Technology

    1991-01-01

    Management Information Systems , (New York: American Elsevier Publishing Company, 1968), 8. 2. Webster’s Third New International Dictionary, Unabridged... Management Information Systems (New York: American Elsevier Publishing company, 1968), 37. 5. Ibid. 6. Ibid. 7. Gerald M. Ward and Jonathan D. Harris, "Data...Controls: A Visual Approach Through Integrated Management Information Systems . New York: American Elsevier Publishing Company, 1968. Brancheau, James C

  1. Ultrasound-guided pleural access.

    PubMed

    Shojaee, Samira; Argento, A Christine

    2014-12-01

    Ultrasonography of the thorax has become a more recognized tool in pulmonary medicine, thanks to continuing clinical research that has proven its many valuable roles in the day-to-day management of pulmonary and pleural diseases. Ultrasound examination is a cost-effective imaging modality that permits the pulmonologist to obtain information about the pathologies in the thorax without the risk of exposure to ionizing radiation, providing the examiner with real-time and immediate results. Its ease of use and training along with its portability to the patient's bedside and accurate examination of the pleural space has allowed for safer pleural procedures such as thoracentesis, chest tube placement, tunneled pleural catheter placement, and medical thoracoscopy. In this review, we summarize the technique of chest ultrasonography, compare ultrasound to other frequently used thoracic imaging modalities, and focus on its use in obtaining pleural access while performing invasive pleural procedures. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. E-Learning and Knowledge Management: The MEMORAe Project.

    ERIC Educational Resources Information Center

    Abel, Marie-Helene; Lenne, Dominique; Cisse, Omar

    E-learning leads to changes in the way courses are conceived. Diffused through the Web, course content cannot be the pure transcription of a "classical" course. The students need to personalize it and to access it when they need it (just-in-time). The MEMORAe project aims at applying knowledge management techniques to improve the…

  3. Unbundling in Current Broadband and Next-Generation Ultra-Broadband Access Networks

    NASA Astrophysics Data System (ADS)

    Gaudino, Roberto; Giuliano, Romeo; Mazzenga, Franco; Valcarenghi, Luca; Vatalaro, Francesco

    2014-05-01

    This article overviews the methods that are currently under investigation for implementing multi-operator open-access/shared-access techniques in next-generation access ultra-broadband architectures, starting from the traditional "unbundling-of-the-local-loop" techniques implemented in legacy twisted-pair digital subscriber line access networks. A straightforward replication of these copper-based unbundling-of-the-local-loop techniques is usually not feasible on next-generation access networks, including fiber-to-the-home point-to-multipoint passive optical networks. To investigate this issue, the article first gives a concise description of traditional copper-based unbundling-of-the-local-loop solutions, then focalizes on both next-generation access hybrid fiber-copper digital subscriber line fiber-to-the-cabinet scenarios and on fiber to the home by accounting for the mix of regulatory and technological reasons driving the next-generation access migration path, focusing mostly on the European situation.

  4. Interference-Assisted Techniques for Transmission and Multiple Access in Optical Communications

    NASA Astrophysics Data System (ADS)

    Guan, Xun

    communication (VLC) by adopting PNC, with a newly proposed phase-aligning method. PNC could improve the throughput at the bottlenecking relay node in a VLC system, and the proposed phase aligning method can improve the BER performance. The second part of this thesis discusses another interference-assisted technology in communication, that is, non-orthogonal multiple access (NOMA). NOMA multiplexes signals from multiple users in another dimension: power domain, with a non-orthogonal multiplexing in other dimensions such as time, frequency and code. Three schemes are proposed in this part. The first and the second schemes both realize NOMA in VLC, with different multiuser detection (MUD) techniques and a proposed phase pre-distortion method. Although both can decrease the system BER compared to conventional NOMA, the scheme using joint detection (JD) outperforms the one using successive interference cancellation (SIC). The third scheme investigated in this part is a combination of NOMA and a multicarrier precoding (MP) technology based on an orthogonal circulant transform matrix (OCT). This combination can avoid the complicated adaptive bit loading or electronic equalization, making NOMA more attractive in a practical system.

  5. Resistance Management Techniques of Milton H. Erickson, M.D.: An Application to Nonhypnotic Mental Health Counseling.

    ERIC Educational Resources Information Center

    Otani, Akira

    1989-01-01

    Delineates five selected hypnotically based techniques of client resistance management pioneered by Milton H. Erickson: acceptance; paradoxical encouragement; reframing; displacement; dissociation. Explains how techniques can be applied to nonhypnotic mental health counseling. Discusses relevant clinical, theoretical, and empirical issues related…

  6. A Typology of Intellectual Property Management for Public Health Innovation and Access: Design Considerations for Policymakers§

    PubMed Central

    Taubman, Antony

    2010-01-01

    This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation – though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of ‘exclusive rights’, as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to

  7. Introducing Risk Management Techniques Within Project Based Software Engineering Courses

    NASA Astrophysics Data System (ADS)

    Port, Daniel; Boehm, Barry

    2002-03-01

    In 1996, USC switched its core two-semester software engineering course from a hypothetical-project, homework-and-exam course based on the Bloom taxonomy of educational objectives (knowledge, comprehension, application, analysis, synthesis, and evaluation). The revised course is a real-client team-project course based on the CRESST model of learning objectives (content understanding, problem solving, collaboration, communication, and self-regulation). We used the CRESST cognitive demands analysis to determine the necessary student skills required for software risk management and the other major project activities, and have been refining the approach over the last 5 years of experience, including revised versions for one-semester undergraduate and graduate project course at Columbia. This paper summarizes our experiences in evolving the risk management aspects of the project course. These have helped us mature more general techniques such as risk-driven specifications, domain-specific simplifier and complicator lists, and the schedule as an independent variable (SAIV) process model. The largely positive results in terms of review of pass / fail rates, client evaluations, product adoption rates, and hiring manager feedback are summarized as well.

  8. Using typing techniques in a specific outbreak: the ethical reflection of public health professionals.

    PubMed

    Rump, B; Cornelis, C; Woonink, F; VAN Steenbergen, J; Verweij, M; Hulscher, M

    2017-05-01

    Typing techniques are laboratory methods used in outbreak management to investigate the degree to which microbes found within an outbreak are related. Knowledge about relational patterns between microbes benefits outbreak management, but inevitably also tells us something about the relational patterns of the people hosting them. Since the technique is often used without explicit consent of all individuals involved, this may raise ethical questions. The aim of this study was to unravel the complex ethical deliberation of professionals over the use of such techniques. We organised group discussions (n = 3) with Dutch outbreak managers (n = 23). The topic list was based on previously identified ethical issues and discussions were analysed for recurrent themes. We found that outbreak managers first and foremost reflect on the balance of individual harm with public health benefit. This key question was approached by way of discussing four more specific ethical themes: (1) justification of governmental intervention, (2) responsibility to prevent infections, (3) scientific uncertainty and (4) legal consequences. The themes found in this study, rephrased into accessible questions, represent the shared ethical understanding of professionals and can help to articulate the ethical dimensions of using molecular science in response to infectious disease outbreaks.

  9. Techniques for assessing relative values for multiple objective management on private forests

    Treesearch

    Donald F. Dennis; Thomas H. Stevens; David B. Kittredge; Mark G. Rickenbach

    2003-01-01

    Decision models for assessing multiple objective management of private lands will require estimates of the relative values of various nonmarket outputs or objectives that have become increasingly important. In this study, conjoint techniques are used to assess the relative values and acceptable trade-offs (marginal rates of substitution) among various objectives...

  10. Management Styles and Techniques: Time.

    ERIC Educational Resources Information Center

    Matthews, Priscilla J.

    1987-01-01

    Discusses strategies to improve individuals' use of time and personal satisfaction through time management. The 126-item bibliography includes citations for time management in general and special sections for career development, family and parenting, women, and home management. (CLB)

  11. Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques

    NASA Technical Reports Server (NTRS)

    Saha, Bhaskar; Goebel, kai

    2007-01-01

    Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and theoretically sound approach to the modern Condition- Based Maintenance (CBM)/Prognostic Health Management (PHM) paradigm. The application of the Bayesian techniques to regression and classification in the form of Relevance Vector Machine (RVM), and to state estimation as in Particle Filters (PF), provides a powerful tool to integrate the diagnosis and prognosis of battery health. The RVM, which is a Bayesian treatment of the Support Vector Machine (SVM), is used for model identification, while the PF framework uses the learnt model, statistical estimates of noise and anticipated operational conditions to provide estimates of remaining useful life (RUL) in the form of a probability density function (PDF). This type of prognostics generates a significant value addition to the management of any operation involving electrical systems.

  12. Management of third branchial pouch anomalies - an evolution of a minimally invasive technique.

    PubMed

    Wong, Phui Yee; Moore, Andrew; Daya, Hamid

    2014-03-01

    The management of third branchial pouch anomalies has evolved in recent times with the popularisation of the endoscopic diathermy technique to sclerose the pyriform fossa sinus opening. We present our experience in managing 3 children with third branchial pouch anomalies and propose a minimally invasive management algorithm avoiding open neck surgery. Retrospective case review of 3 patients including demographics, mode of presentation, investigations, management and complications. Three children, two male and one female of mean age 9.6 years presented with painful left anterior neck swelling. Axial neck imaging showed a superficial abscess with air locules and a sinus tract leading towards the left pharynx. Diagnosis was confirmed by endoscopic examination of the pyriform fossa revealing a sinus opening. Two patients underwent open excision; one combined with diathermy to the sinus opening. The last patient was diagnosed at his initial presentation and managed with endoscopic diathermy of the sinus opening combined with percutaneous needle aspiration of the neck abscess at the same sitting. One patient had two recurrences, the first after initial open surgery and the second after the first cautery. Two patients developed temporary hoarseness after the procedure, which resolved within two weeks. All patients were free from recurrences at follow-up. Introduction of the technique of endoscopic diathermy to the pyriform fossa sinus opening in children with third branchial pouch anomalies has revolutionised their management avoiding open and potentially morbid surgery. Our algorithm takes this further by advocating percutaneous needle aspiration of the infective component and performing diathermy to the sinus opening at the first presentation. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Parental Presence/Absence in the Dental Operatory as a Behavior Management Technique: A Review and Modified View.

    PubMed

    Riba, Hicham; Al-Shahrani, Asma; Al-Ghutaimel, Hayat; Al-Otaibi, Adel; Al-Kahtani, Salim

    2018-02-01

    Parental presence/absence in the dental operatory (also called: Parent-in-parent-out technique) is an extremely controversial aspect of the nonpharmacological BMTs. Historically, dentists used to exclude parents from dental operatory to avoid their interference with the dentist's aptitude to build a rapport and relationship with the child, hence increasing the child management problems by disrupting treatment and making the dentist unfocused and uncomfortable. The purpose of this article is to review and emphasize on the importance of parental presence/absence in the dental operatory, especially in a certain age group, as a behavior management technique (BMT) in pediatric dentistry, and to present a modified view of this technique. This article reviews the current literature concerning behavior management in pediatric dentistry. It includes a medline database search and review of the comprehensive textbooks in pediatric dentistry. Some recommendations were based on the opinions of experienced researchers and clinicians. Parent-in-parent-out technique in dental operatory is advocated to gain emotional support and avoid the effect of traumatic separation, especially in younger children or special health-care needs patients. The parent-in-parent-out technique in dental operatory is underused, or misused. This article clarifies the proper use of this technique along with a minor modification to it to make it more effective on young apprehensive dental patients.

  14. Low level waste management: a compilation of models and monitoring techniques. Volume 1

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

    Mosier, J.E.; Fowler, J.R.; Barton, C.J.

    1980-04-01

    In support of the National Low-Level Waste (LLW) Management Research and Development Program being carried out at Oak Ridge National Laboratory, Science Applications, Inc., conducted a survey of models and monitoring techniques associated with the transport of radionuclides and other chemical species from LLW burial sites. As a result of this survey, approximately 350 models were identified. For each model the purpose and a brief description are presented. To the extent possible, a point of contact and reference material are identified. The models are organized into six technical categories: atmospheric transport, dosimetry, food chain, groundwater transport, soil transport, and surfacemore » water transport. About 4% of the models identified covered other aspects of LLW management and are placed in a miscellaneous category. A preliminary assessment of all these models was performed to determine their ability to analyze the transport of other chemical species. The models that appeared to be applicable are identified. A brief survey of the state-of-the-art techniques employed to monitor LLW burial sites is also presented, along with a very brief discussion of up-to-date burial techniques.« less

  15. Management Styles and Techniques: People.

    ERIC Educational Resources Information Center

    DeLoach, Marva L.; And Others

    1987-01-01

    Three articles discuss management of library technical processes personnel. The first article focuses on the employer employee relationship and communication; the second explores management trends, including participative decision making, personnel evaluation, management by objectives, and the collegial system; and the third focuses on the…

  16. Developing nondestructive techniques for managing conflicts between fisheries and double-crested cormorant colonies

    USGS Publications Warehouse

    Suzuki, Yasuko; Roby, Daniel D.; Lyons, Donald E.; Courtot, Karen; Collis, Ken

    2015-01-01

    Double-crested cormorants (Phalacrocorax auritus) have been identified as the source of significant mortality to juvenile salmonids (Oncorhynchus spp.) in the Columbia River Basin. Management plans for reducing the size of a large colony on East Sand Island (OR, USA) in the Columbia River estuary are currently being developed. We evaluated habitat enhancement and social attraction as nondestructive techniques for managing cormorant nesting colonies during 2004–2007. We tested these techniques on unoccupied plots adjacent to the East Sand Island cormorant colony. Cormorants quickly colonized these plots and successfully raised young. Cormorants also were attracted to nest and raised young on similar plots at 2 islands approximately 25 km from East Sand Island; 1 island had a history of successful cormorant nesting whereas the other was a site where cormorants had previously nested unsuccessfully. On a third island with no history of cormorant nesting or nesting attempts, these techniques were unsuccessful at attracting cormorants to nest. Our results suggest that some important factors influencing attraction of nesting cormorants using these techniques include history of cormorant nesting, disturbance, and presence of breeding cormorants nearby. These techniques may be effective in redistributing nesting cormorants away from areas where fish stocks of conservation concern are susceptible to predation, especially if sites with a recent history of cormorant nesting are available within their foraging or dispersal range. Published 2015. Wiley Periodicals, Inc. This article is a US Government work and, as such, is in the public domain in the United States of America.

  17. PD_Manager: an mHealth platform for Parkinson's disease patient management

    PubMed Central

    Gatsios, Dimitrios; Rigas, George; Miljkovic, Dragana; Koroušić Seljak, Barbara; Bohanec, Marko; Arredondo, Maria T.; Antonini, Angelo; Konitsiotis, Spyros; Koutsouris, Dimitrios D.

    2017-01-01

    PD_Manager is a mobile health platform designed to cover most of the aspects regarding the management of Parkinson's disease (PD) in a holistic approach. Patients are unobtrusively monitored using commercial wrist and insole sensors paired with a smartphone, to automatically estimate the severity of most of the PD motor symptoms. Besides motor symptoms monitoring, the patient's mobile application also provides various non-motor self-evaluation tests for assessing cognition, mood and nutrition to motivate them in becoming more active in managing their disease. All data from the mobile application and the sensors is transferred to a cloud infrastructure to allow easy access for clinicians and further processing. Clinicians can access this information using a separate mobile application that is specifically designed for their respective needs to provide faster and more accurate assessment of PD symptoms that facilitate patient evaluation. Machine learning techniques are used to estimate symptoms and disease progression trends to further enhance the provided information. The platform is also complemented with a decision support system (DSS) that notifies clinicians for the detection of new symptoms or the worsening of existing ones. As patient's symptoms are progressing, the DSS can also provide specific suggestions regarding appropriate medication changes. PMID:28706727

  18. PD_Manager: an mHealth platform for Parkinson's disease patient management.

    PubMed

    Tsiouris, Kostas M; Gatsios, Dimitrios; Rigas, George; Miljkovic, Dragana; Koroušić Seljak, Barbara; Bohanec, Marko; Arredondo, Maria T; Antonini, Angelo; Konitsiotis, Spyros; Koutsouris, Dimitrios D; Fotiadis, Dimitrios I

    2017-06-01

    PD_Manager is a mobile health platform designed to cover most of the aspects regarding the management of Parkinson's disease (PD) in a holistic approach. Patients are unobtrusively monitored using commercial wrist and insole sensors paired with a smartphone, to automatically estimate the severity of most of the PD motor symptoms. Besides motor symptoms monitoring, the patient's mobile application also provides various non-motor self-evaluation tests for assessing cognition, mood and nutrition to motivate them in becoming more active in managing their disease. All data from the mobile application and the sensors is transferred to a cloud infrastructure to allow easy access for clinicians and further processing. Clinicians can access this information using a separate mobile application that is specifically designed for their respective needs to provide faster and more accurate assessment of PD symptoms that facilitate patient evaluation. Machine learning techniques are used to estimate symptoms and disease progression trends to further enhance the provided information. The platform is also complemented with a decision support system (DSS) that notifies clinicians for the detection of new symptoms or the worsening of existing ones. As patient's symptoms are progressing, the DSS can also provide specific suggestions regarding appropriate medication changes.

  19. SeaDataNet - Pan-European infrastructure for marine and ocean data management: Unified access to distributed data sets

    NASA Astrophysics Data System (ADS)

    Schaap, D. M. A.; Maudire, G.

    2009-04-01

    SeaDataNet is an Integrated research Infrastructure Initiative (I3) in EU FP6 (2006 - 2011) to provide the data management system adapted both to the fragmented observation system and the users need for an integrated access to data, meta-data, products and services. Therefore SeaDataNet insures the long term archiving of the large number of multidisciplinary data (i.e. temperature, salinity current, sea level, chemical, physical and biological properties) collected by many different sensors installed on board of research vessels, satellite and the various platforms of the marine observing system. The SeaDataNet project started in 2006, but builds upon earlier data management infrastructure projects, undertaken over a period of 20 years by an expanding network of oceanographic data centres from the countries around all European seas. Its predecessor project Sea-Search had a strict focus on metadata. SeaDataNet maintains significant interest in the further development of the metadata infrastructure, but its primary objective is the provision of easy data access and generic data products. SeaDataNet is a distributed infrastructure that provides transnational access to marine data, meta-data, products and services through 40 interconnected Trans National Data Access Platforms (TAP) from 35 countries around the Black Sea, Mediterranean, North East Atlantic, North Sea, Baltic and Arctic regions. These include: National Oceanographic Data Centres (NODC's) Satellite Data Centres. Furthermore the SeaDataNet consortium comprises a number of expert modelling centres, SME's experts in IT, and 3 international bodies (ICES, IOC and JRC). Planning: The SeaDataNet project is delivering and operating the infrastructure in 3 versions: Version 0: maintenance and further development of the metadata systems developed by the Sea-Search project plus the development of a new metadata system for indexing and accessing to individual data objects managed by the SeaDataNet data centres. This

  20. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    NASA Technical Reports Server (NTRS)

    Raiman, Laura B.

    1992-01-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  1. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    NASA Astrophysics Data System (ADS)

    Raiman, Laura B.

    1992-12-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  2. Teaching Natural Resource Management-Teaching Techniques and Difficulties in Greek Vocational Lyceum: A Case Study

    ERIC Educational Resources Information Center

    Koutsoukos, Marios; Mouratidis, Antonios

    2016-01-01

    The aim of the present study is to investigate the teaching techniques applied, as well as the difficulties, with which educators in teaching Natural Resource Management are confronted. For research purposes, a case study was conducted on teaching Natural Resource Management in the Third Grade of Vocational Lyceum (EPAL) in Northern Greece. It was…

  3. Managing age discrimination: an examination of the techniques used when seeking employment.

    PubMed

    Berger, Ellie D

    2009-06-01

    This article examines the age-related management techniques used by older workers in their search for employment. Data are drawn from interviews with individuals aged 45-65 years (N = 30). Findings indicate that participants develop "counteractions" and "concealments" to manage perceived age discrimination. Individuals counteract employers' ageist stereotypes by maintaining their skills and changing their work-related expectations and conceal age by altering their résumés, physical appearance, and language used. This research suggests that there is a need to reexamine the hiring practices of employers and to improve legislation in relation to their accountability.

  4. Effect of Medicaid Managed Care on racial disparities in health care access.

    PubMed

    Cook, Benjamin Lê

    2007-02-01

    To evaluate the impact of Medicaid Managed Care (MMC) on racial disparities in access to care consistent with the Institute of Medicine (IOM) definition of racial disparity, which excludes differences stemming from health status but includes socioeconomic status (SES)-mediated differences. Secondary data from the Adult Samples of the 1997-2001 National Health Interview Survey, metropolitan statistical area (MSA)-level Medicaid Health Maintenance Organization (MHMO) market share from the 1997 to 2001 InterStudy MSA Trend Dataset, and MSA characteristics from the 1997 to 2001 Area Resource File. I estimate multivariate regression models to compare racial disparities in doctor visits, emergency room (ER) use, and having a usual source of care between enrollees in MMC and Medicaid Fee-for-Service (FFS) plans. To contend with potential selection bias, I use a difference-in-difference analytical strategy and assess the impact of greater MHMO market share at the MSA level on Medicaid enrollees' access measures. To implement the IOM definition of racial disparity, I adjust for health status but not SES factors using a novel method to transform the distribution of health status for minority populations to approximate the white health status distribution. MMC enrollment is associated with lowered disparities in having any doctor visit in the last year for blacks, and in having any usual source of care for both blacks and Hispanics. Increasing Medicaid HMO market share lowered disparities in having any doctor visits in the last year for both blacks and Hispanics. Although disparities in most other measures were not much affected, black-white ER use disparities exist among MMC enrollees and in areas of high MHMO market share. MMC programs' reduction of some disparities suggests that recent shifts in Medicaid policy toward managed care plans have benefited minority enrollees. Future research should investigate whether black-white disparities in ER use within MMC groups

  5. Dynamic spectrum management: an impact on EW systems

    NASA Astrophysics Data System (ADS)

    Gajewski, P.; Łopatka, J.; Suchanski, M.

    2017-04-01

    Rapid evolution of wireless systems caused an enormous growth of data streams transmitted through the networks and, as a consequence, an accompanying demand concerning spectrum resources (SR). An avoidance of advisable disturbances is one of the main demands in military communications. To solve the interference problems, dynamic spectrum management (DSM) techniques can be used. Two main techniques are possible: centralized Coordinated Dynamic Spectrum Access (CDSA) and distributed Opportunistic Spectrum Access (OSA). CDSA enables the wireless networks planning automation, and systems dynamic reaction to random changes of Radio Environment (RE). For OSA, cognitive radio (CR) is the most promising technology that enables avoidance of interference with the other spectrum users due to CR's transmission parameters adaptation to the current radio situation, according to predefined Radio Policies rules. If DSM techniques are used, the inherent changes in EW systems are also needed. On one hand, new techniques of jamming should be elaborated, on the other hand, the rules and protocols of cooperation between communication network and EW systems should be developed.

  6. Ultra-low-power conversion and management techniques for thermoelectric energy harvesting applications

    NASA Astrophysics Data System (ADS)

    Fleming, Jerry W.

    2010-04-01

    Thermoelectric energy harvesting has increasingly gained acceptance as a potential power source that can be used for numerous commercial and military applications. However, power electronic designers have struggled to incorporate energy harvesting methods into their designs due to the relatively small voltage levels available from many harvesting device technologies. In order to bridge this gap, an ultra-low input voltage power conversion method is needed to convert small amounts of scavenged energy into a usable form of electricity. Such a method would be an enabler for new and improved medical devices, sensor systems, and other portable electronic products. This paper addresses the technical challenges involved in ultra-low-voltage power conversion by providing a solution utilizing novel power conversion techniques and applied technologies. Our solution utilizes intelligent power management techniques to control unknown startup conditions. The load and supply management functionality is also controlled in a deterministic manner. The DC to DC converter input operating voltage is 20mV with a conversion efficiency of 90% or more. The output voltage is stored into a storage device such as an ultra-capacitor or lithium-ion battery for use during brown-out or unfavorable harvesting conditions. Applications requiring modular, low power, extended maintenance cycles, such as wireless instrumentation would significantly benefit from the novel power conversion and harvesting techniques outlined in this paper.

  7. Neoinfundibulotomy for the management of symptomatic caliceal diverticula.

    PubMed

    Auge, Brian K; Munver, Ravi; Kourambas, John; Newman, Glenn E; Wu, Ning Z; Preminger, Glenn M

    2002-04-01

    Direct percutaneous access provides effective treatment for complex caliceal diverticula. Yet, access into the diverticulum alone is usually tenuous and passage of a guide wire across a stenotic infundibulum is often impossible. An alternative technique is described which creates a "neoinfundibulum" to assist in the management of symptomatic caliceal diverticula. During a 6-year period 22 patients with symptomatic caliceal diverticula were treated via a percutaneous approach, of whom 21 had calculi within the diverticula. After accessing the diverticulum directly, it was impossible to pass a guide wire through the stenotic infundibulum in 18 (82%) patients, prompting advancement of the access needle through the diverticular wall into the renal pelvis. Once secure access was established, balloon dilation was performed to 30Fr to create the "neoinfundibulum." Percutaneous ultrasonic lithotripsy was performed in the usual fashion. A 22Fr Councill catheter was placed to keep the infundibular tract open for 5 to 7 days to allow complete epithelialization and drainage. Stone-free, symptom-free and complication rates were assessed. Pain, recurrent urinary tract infections and hematuria were the presenting complaints in the subgroup of patients undergoing "neoinfundibulotomy." Average stone burden was 11.7 x 12 mm. and average hospital stay was 2.8 days. Of the patients 94% were symptom-free at 6-week followup, and 80% were stone-free on followup excretory urography. The remaining patients had residual stone fragments less than 3 mm. in diameter. Complications related to access were identified in 2 patients who sustained a pneumothorax after a supra-11th rib access, which was successfully managed with tube thoracostomy. Percutaneous management of complex caliceal diverticula provides a safe and effective option for symptomatic patients. When the stenotic infundibulum cannot be traversed with a guide wire, creation of a new infundibulum offers a secure alternative for

  8. Management of the second phase of labour: perineum protection techniques.

    PubMed

    Laganà, A S; Burgio, M A; Retto, G; Pizzo, A; Granese, R; Sturlese, E; Ciancimino, L; Chiofalo, B; Retto, A; Triolo, O

    2015-06-01

    The obstetric experience alongside scientific evidences in literature indicate several management techniques during the expulsive period of labour to minimize obstetric complications. Among the various methods that can be used for the protection of the perineum during the expulsive phase, some are performed prepartum (perineum massage), while most are used during childbirth. Among the second group, progressively increasing importance is assumed by the manual techniques to protect the perineum (using the "hands-on" and "hands-off") and by episiotomy. These techniques, when used in accordance to the guidelines, may favour the reduction of adverse outcomes for both the mother and the newborn, both immediately after birth and after a longer time. The midwife should be aware of the evidences in literature so that a critical analysis of the available techniques can be made and put in action during the expulsive phase in order to protect the mother and the foetus from any unfavourable outcomes. Currently, clinical evidence in literature is directing obstetric and medical staff towards a careful analysis of the maternal-foetal parameters, in order to achieve a precise assessment of the risks factors of intrapartum and postpartum outcomes. Increasingly, there is the need for close collaboration between the midwife and medical staff to ensure proper personalized assistance based on the peculiar characteristics of the woman and the fetus.

  9. American Thyroid Association Statement on Remote-Access Thyroid Surgery.

    PubMed

    Berber, Eren; Bernet, Victor; Fahey, Thomas J; Kebebew, Electron; Shaha, Ashok; Stack, Brendan C; Stang, Michael; Steward, David L; Terris, David J

    2016-03-01

    Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillo-breast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery.

  10. The use of behavior modification techniques to successfully manage the child dental patient.

    PubMed

    Barenie, J T; Ripa, L W

    1977-02-01

    Techniques of desensitization, modeling, and contingency management that can be used in the dental office for reducing anxiety and encouraging appropriate behavior in children are discussed. The "tell, show and do" approach is one desensitization technique easily applied in the private practice. Language should be at the child's level of understanding. An older sibling will frequently serve as an excellent model for a fearful child. Social reinforcers-a handshake, a smile, or praise-should be dispensed throughout dental treatment. Rewards should only follow desired behavior.

  11. An integrated solution for remote data access

    NASA Astrophysics Data System (ADS)

    Sapunenko, Vladimir; D'Urso, Domenico; dell'Agnello, Luca; Vagnoni, Vincenzo; Duranti, Matteo

    2015-12-01

    Data management constitutes one of the major challenges that a geographically- distributed e-Infrastructure has to face, especially when remote data access is involved. We discuss an integrated solution which enables transparent and efficient access to on-line and near-line data through high latency networks. The solution is based on the joint use of the General Parallel File System (GPFS) and of the Tivoli Storage Manager (TSM). Both products, developed by IBM, are well known and extensively used in the HEP computing community. Owing to a new feature introduced in GPFS 3.5, so-called Active File Management (AFM), the definition of a single, geographically-distributed namespace, characterised by automated data flow management between different locations, becomes possible. As a practical example, we present the implementation of AFM-based remote data access between two data centres located in Bologna and Rome, demonstrating the validity of the solution for the use case of the AMS experiment, an astro-particle experiment supported by the INFN CNAF data centre with the large disk space requirements (more than 1.5 PB).

  12. 49 CFR 633.15 - Access to information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

  13. 49 CFR 633.15 - Access to information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

  14. 49 CFR 633.15 - Access to information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

  15. 49 CFR 633.15 - Access to information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

  16. 49 CFR 633.15 - Access to information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

  17. Accessible Collaborative Learning Using Mobile Devices

    ERIC Educational Resources Information Center

    Wald, Mike; Li, Yunjia; Draffan, E. A.

    2014-01-01

    This paper describes accessible collaborative learning using mobile devices with mobile enhancements to Synote, the freely available, award winning, open source, web based application that makes web hosted recordings easier to access, search, manage, and exploit for all learners, teachers and other users. Notes taken live during lectures using…

  18. Considering User's Access Pattern in Multimedia File Systems

    NASA Astrophysics Data System (ADS)

    Cho, KyoungWoon; Ryu, YeonSeung; Won, Youjip; Koh, Kern

    2002-12-01

    Legacy buffer cache management schemes for multimedia server are grounded at the assumption that the application sequentially accesses the multimedia file. However, user access pattern may not be sequential in some circumstances, for example, in distance learning application, where the user may exploit the VCR-like function(rewind and play) of the system and accesses the particular segments of video repeatedly in the middle of sequential playback. Such a looping reference can cause a significant performance degradation of interval-based caching algorithms. And thus an appropriate buffer cache management scheme is required in order to deliver desirable performance even under the workload that exhibits looping reference behavior. We propose Adaptive Buffer cache Management(ABM) scheme which intelligently adapts to the file access characteristics. For each opened file, ABM applies either the LRU replacement or the interval-based caching depending on the Looping Reference Indicator, which indicates that how strong temporally localized access pattern is. According to our experiment, ABM exhibits better buffer cache miss ratio than interval-based caching or LRU, especially when the workload exhibits not only sequential but also looping reference property.

  19. Performance, implementation and network management techniques for a European CDMA-based land-mobile satellite system

    NASA Astrophysics Data System (ADS)

    Arenaccio, S.; Vernucci, A.; Padovani, R.; Arcidiacono, A.

    Results of a detailed comparative performance assessment between two candidate access solutions for the provision of land-mobile services, i.e., FDMA and CDMA, for the European Land-Mobile Satellite Services (LMSS) provision are presented. The design of the CDMA access system and the network architecture, system procedures, network control, operation in fading environments, and implementation aspects of the system are described. The CDMA system is shown to yield superior traffic capability, despite the absence of polarization reuse due to payload design, especially in the second-generation era (multiple spot-beams). In this case, the advantage was found to be largely dependent on the traffic distribution across spot beams. Power control techniques are proposed to cope with the geographical disadvantage suffered by mobile stations located at the beam borders to compensate for fadings.

  20. An operational data access infrastructure for accessing integrated environmental and socio-economic data from the Dutch Wadden Sea

    NASA Astrophysics Data System (ADS)

    De Bruin, T.

    2012-12-01

    The Wadden Sea, an UNESCO World Heritage Site along the Northern coasts of The Netherlands, Germany and Denmark, is a very valuable, yet also highly vulnerable tidal flats area. Knowledge is key to the sustainable management of the Wadden Sea. This knowledge should be reliable, founded on promptly accessible information and sufficiently broad to integrate both ecological and economic analyses. The knowledge is gained from extensive monotoring of both ecological and socio-economic parameters. Even though many organisations, research institutes, government agencies and NGOs carry out monitoring, there is no central overview of monitoring activities, nor easy access to the resulting data. The 'Wadden Sea Long-Term Ecosystem Research' (WaLTER) project (2011-2015) aims to set-up an integrated monitoring plan for the main environmental and management issues relevant to the Wadden Sea, such as sea-level rise, fisheries management, recreation and industry activities. The WaLTER data access infrastructure will be a distributed system of data providers, with a centralized data access portal. It is based on and makes use of the existing data access infrastructure of the Netherlands National Oceanographic Data Committee (NL-NODC), which has been operational since early 2009. The NL-NODC system is identical to and in fact developed by the European SeaDataNet project, furthering standardisation on a pan-European scale. The presentation will focus on the use of a distributed data access infrastructure to address the needs of different user groups such as policy makers, scientists and the general public.

  1. 5 CFR 1320.14 - Public access.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Public access. 1320.14 Section 1320.14 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CONTROLLING PAPERWORK BURDENS ON THE PUBLIC § 1320.14 Public access. (a) In order to enable the public to participate in and provide comments...

  2. The management of Convulsive Refractory Status Epilepticus in adults in the UK: No consistency in practice and little access to continuous EEG monitoring.

    PubMed

    Patel, Mitesh; Bagary, Manny; McCorry, Dougall

    2015-01-01

    Convulsive Status Epilepticus (CSE) is a common neurological emergency with patients presenting with prolonged epileptic activity. Sub-optimal management is coupled with high morbidity and mortality. Continuous electroencephalogram (EEG) monitoring is considered essential by the National Institute for Health and Care Excellence (NICE) in the management of Convulsive Refractory Status Epilepticus (CRSE). The aim of this research was to determine current clinical practice in the management of CRSE amongst adults in intensive care units (ICU) in the UK and establish if the use of a standardised protocol requires re-enforcement within trusts. 75 randomly selected UK NHS Trusts were contacted and asked to complete a questionnaire in addition to providing their protocol for CRSE management in ICU. 55 (73%) trusts responded. While 31 (56% of responders) had a protocol available in ICU for early stages of CSE, just 21 (38%) trusts had specific guidelines if CRSE occurred. Only 23 (42%) trusts involved neurologists at any stage of management and just 18 (33%) have access to continuous EEG monitoring. This study identifies significant inconsistency in the management of CSE in ICU's across the UK. A minority of ICU units have a protocol for CRSE or access to continuous EEG monitoring despite it being considered fundamental for management and supported by NICE guidance. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Parental acceptance of behaviour-management techniques used in paediatric dentistry and its relation to parental dental anxiety and experience.

    PubMed

    Boka, V; Arapostathis, K; Vretos, N; Kotsanos, N

    2014-10-01

    The aim of this study was to examine the acceptance by Greek parents of nine behaviour-management techniques and its association with several possible confounding factors. Following ethical approval, 106 parents whose 3- to 12-year-old children had been receiving treatment in a university postgraduate paediatric dental clinic, and 123 parents of children from a private paediatric dental practice agreed to participate. After being shown a video with nine behaviour-management techniques, parents rated the acceptance of each technique on a 0-10 scale. They were then asked to complete a questionnaire about demographics, their previous dental experience and dental anxiety (modified Corah dental anxiety scale). The best accepted technique was tell-show-do (9.76 ± 0.69), followed by parental presence/absence (PPA) technique (7.83 ± 3.06) and nitrous oxide inhalation sedation (7.09 ± 3.02). The least accepted techniques were passive restraint (4.21 ± 3.84) and general anaesthesia (4.21 ± 4.02). No correlations were found between acceptance of any individual management technique and parental age, gender, income, education, dental experience and dental anxiety or the child's age, gender and dental experience. Parents whose children had been treated at the University clinic had lower income and educational levels, and rated passive restraint, oral sedation and general anaesthesia higher than those from the private practice. When the parents were specifically asked to choose between general anaesthesia over any of the active or passive restraint, hand-over-mouth and voice control techniques, 10% preferred general anaesthesia, and these parents reported statistically significant more negative dental experience but not higher dental anxiety. Statistical significance of differences was explored using the Tukey-Kramer method. There was no correlation between parental dental experience and dental anxiety and the acceptance of any specific behaviour-management technique

  4. 36 CFR 9.3 - Access permits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Access permits. 9.3 Section 9.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.3 Access permits. (a) All special use or other permits dealing with...

  5. 36 CFR 9.3 - Access permits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Access permits. 9.3 Section 9.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.3 Access permits. (a) All special use or other permits dealing with...

  6. 36 CFR 9.3 - Access permits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Access permits. 9.3 Section 9.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.3 Access permits. (a) All special use or other permits dealing with...

  7. 36 CFR 9.3 - Access permits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Access permits. 9.3 Section 9.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.3 Access permits. (a) All special use or other permits dealing with...

  8. 36 CFR 9.3 - Access permits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Access permits. 9.3 Section 9.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.3 Access permits. (a) All special use or other permits dealing with...

  9. Direct-Access Online Care for the Management of Atopic Dermatitis: A Randomized Clinical Trial Examining Patient Quality of Life.

    PubMed

    Kornmehl, Heather; Singh, Sanminder; Johnson, Mary Ann; Armstrong, April W

    2017-09-01

    Atopic dermatitis (AD) is a chronic disease requiring regular follow-up. To increase access to dermatological care, online management of AD is being studied. However, a critical knowledge gap exists in determining AD patients' quality of life in direct-to-patient online models. In this study, we examined quality of life in AD patients managed through a direct-access online model. We randomized 156 patients to receiving care through a direct-access online platform or in person. Patients were seen for six visits over 12 months. At each visit, the patients completed Dermatology Life Quality Index/Children's Dermatology Life Quality Index (DLQI/CDLQI), and Short Form (SF-12). Between baseline and 12 months, the mean (standard deviation, SD) within-group difference in DLQI score in the online group was 4.1 (±2.3); for the in-person group, the within-group difference was 4.8 (±2.7). The mean (SD) within-group difference in CDLQI score in the online group was 4.7 (±2.8); for the in-person group, the within-group difference was 4.9 (±3.1). The mean (SD) within-group difference in physical component score (PCS) and mental component score (MCS) SF-12 scores in the online group was 6.5 (±3.8) and 8.6 (±4.3); for the in-person group, it was 6.8 (±3.2) and 9.1(±3.8), respectively. The difference in the change in DLQI, CDLQI, SF-12 PCS, and SF-12 MCS scores between the two groups was 0.72 (95% confidence interval [90% CI], -0.97 to 2.41), 0.23 (90% CI, -2.21 to 2.67), 0.34 (90% CI, -1.16 to 1.84), and 0.51 (90% CI, -1.11 to 2.13), respectively. All differences were contained within their equivalence margins. Adult and pediatric AD patients receiving direct-access online care had equivalent quality of life outcomes as those see in person. The direct-access online model has the potential to increase access to care for patients with chronic skin diseases.

  10. Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

    ERIC Educational Resources Information Center

    Brunton, Margaret Ann; Jeffrey, Lynn Maud

    2010-01-01

    This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

  11. Business and Industrial Supervisors. Project TEAMS. (Techniques and Education for Achieving Management Skills).

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

    The result of a project to develop short courses to help business and industrial supervisors in developing practical, up-to-date managerial skills, this instructional workbook provides information and exercises applicable to on-the-job situations. Unit I covers the following aspects of management: leadership techniques, problem solving, decision…

  12. Specialty pharmacy cost management strategies of private health care payers.

    PubMed

    Stern, Debbie; Reissman, Debi

    2006-01-01

    The rate of increase in spending on specialty pharmaceuticals is outpacing by far the rate of increase in spending for other drugs. To explore the strategies payers are using in response to challenges related to coverage, cost, clinical management, and access of specialty pharmaceuticals and to describe the potential implications for key stakeholders, including patients, physicians, and health care purchasers. Sources of information were identified in the course of providing consulting services in the subject area of specialty pharmaceuticals to health plans, pharmacy benefit managers, employers, and pharmaceutical manufacturers. Specialty pharmaceuticals represent the fastest growing segment of drug spending due to new product approvals, high unit costs, and increasing use. Health care payers are faced with significant challenges related to coverage, cost, clinical management, and access. A variety of short- and long-term strategies have been employed to address these challenges. Current management techniques for specialty pharmaceuticals often represent a stop-gap approach for controlling rising drug costs. Optimum cost and care management methods will evolve as further research identifies the true clinical and economic value of various specialty pharmaceuticals.

  13. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.150 Program...

  14. Distributed cluster management techniques for unattended ground sensor networks

    NASA Astrophysics Data System (ADS)

    Essawy, Magdi A.; Stelzig, Chad A.; Bevington, James E.; Minor, Sharon

    2005-05-01

    Smart Sensor Networks are becoming important target detection and tracking tools. The challenging problems in such networks include the sensor fusion, data management and communication schemes. This work discusses techniques used to distribute sensor management and multi-target tracking responsibilities across an ad hoc, self-healing cluster of sensor nodes. Although miniaturized computing resources possess the ability to host complex tracking and data fusion algorithms, there still exist inherent bandwidth constraints on the RF channel. Therefore, special attention is placed on the reduction of node-to-node communications within the cluster by minimizing unsolicited messaging, and distributing the sensor fusion and tracking tasks onto local portions of the network. Several challenging problems are addressed in this work including track initialization and conflict resolution, track ownership handling, and communication control optimization. Emphasis is also placed on increasing the overall robustness of the sensor cluster through independent decision capabilities on all sensor nodes. Track initiation is performed using collaborative sensing within a neighborhood of sensor nodes, allowing each node to independently determine if initial track ownership should be assumed. This autonomous track initiation prevents the formation of duplicate tracks while eliminating the need for a central "management" node to assign tracking responsibilities. Track update is performed as an ownership node requests sensor reports from neighboring nodes based on track error covariance and the neighboring nodes geo-positional location. Track ownership is periodically recomputed using propagated track states to determine which sensing node provides the desired coverage characteristics. High fidelity multi-target simulation results are presented, indicating the distribution of sensor management and tracking capabilities to not only reduce communication bandwidth consumption, but to also

  15. American Thyroid Association Statement on Remote-Access Thyroid Surgery

    PubMed Central

    Bernet, Victor; Fahey, Thomas J.; Kebebew, Electron; Shaha, Ashok; Stack, Brendan C.; Stang, Michael; Steward, David L.; Terris, David J.

    2016-01-01

    Background: Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. Methods: A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Results: Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillo-breast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Conclusions: Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery. PMID:26858014

  16. A novel approach to early sickness absence management: The EASY (Early Access to Support for You) way.

    PubMed

    Demou, Evangelia; Brown, Judith; Sanati, Kaveh; Kennedy, Mark; Murray, Keith; Macdonald, Ewan B

    2015-01-01

    Sickness absence (SA) is multi-causal and remains a significant problem for employees, employers and society. This makes it necessary to concurrently manage a particular disabling condition and consider the working environment and employee-employer relationship. To describe and examine the components of a novel SA management service Early Access to Support for You (EASY) and discuss their potential influence on the intervention. A new sickness absence model, starting from day one of absence, was created called EASY. EASY is planned to support both employees and managers and comprises elements already found to be associated with reduction of SA, such as maintaining regular contact; early biopsychosocial case-management; physiotherapy; mental-health counselling; work modification; phased return-to-work; and health promotion activities. During the EASY implementation period, the SA rate at a health board reversed its trend of being one of the highest rates in the Scottish National Health Service (NHS) and EASY was considered helpful by both managers and employees. This paper describes an innovative occupational health intervention to sickness absence management based on the bio-psychosocial model to provide early intervention, and discusses the pros and cons of applying cognitive behavioural principles at an early stage in sickness-absence events, in order to improve return-to-work outcomes.

  17. A refined electrofishing technique for collecting Silver Carp: Implications for management

    USGS Publications Warehouse

    Bouska, Wesley W.; Glover, David C.; Bouska, Kristen; Garvey, James E.

    2017-01-01

    Detecting nuisance species at low abundance or in newly established areas is critical to developing pest management strategies. Due to their sensitivity to disturbance and erratic jumping behavior, Silver Carp Hypophthalmichthys molitrix can be difficult to collect with traditional sampling methods. We compared catch per unit effort (CPUE) of all species from a Long Term Resource Monitoring (LTRM) electrofishing protocol to an experimental electrofishing technique designed to minimize Silver Carp evasion through tactical boat maneuvering and selective application of power. Differences in CPUE between electrofishing methods were detected for 2 of 41 species collected across 2 years of sampling at 20 sites along the Illinois River. The mean catch rate of Silver Carp using the experimental technique was 2.2 times the mean catch rate of the LTRM electrofishing technique; the increased capture efficiency at low relative abundance emphasizes the utility of this method for early detection. The experimental electrofishing also collected slightly larger Silver Carp (mean: 510.7 mm TL versus 495.2 mm TL), and nearly four times as many Silver Carp independently jumped into the boat during experimental transects. Novel sampling approaches, such as the experimental electrofishing technique used in this study, should be considered to increase probability of detection for aquatic nuisance species.

  18. Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016.

    PubMed

    Farrer, Louise M; Walker, Jennie; Harrison, Christopher; Banfield, Michelle

    2018-01-01

    General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.

  19. 30 CFR 212.200 - Maintenance of and access to records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Maintenance of and access to records. 212.200 Section 212.200 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT RECORDS AND FILES MAINTENANCE Reserved § 212.200 Maintenance of and access to records. (a) All...

  20. Access to diabetes self-management education: results of national surveys of patients, educators, and physicians.

    PubMed

    Peyrot, Mark; Rubin, Richard R; Funnell, Martha M; Siminerio, Linda M

    2009-01-01

    To examine factors related to access to diabetes self-management education (DSME), including services delivered and sought; patient, physician, and program barriers to access; educator outreach and expansion efforts; and perceptions of alternative DSME delivery strategies. Internet surveys were completed by 1169 adults with diabetes (661 with prior DSME, 508 with no prior DSME) from a national community survey panel, 1871 educators who were AADE members, and 629 physicians (212 diabetes specialists, 417 primary care practitioners) from a national physician survey panel. Physicians want patients to receive more self-management support, but some report that patients are told to do things with which the physician does not agree. Provider (physician and educator)-delivered DSME is more highly regarded among those who have received it than among those who have not received it. Physicians generally have positive perceptions of provider-delivered DSME, and educators see physicians as key to encouraging DSME use in patients. Some physicians are concerned about losing patients sent to DSME, and 11% of patients report changing physicians as a result of DSME. Most DSME programs have grown recently as a result of recruiting efforts and adding new programs/services; most programs plan more such efforts. Patients prefer traditional DSME sources/settings and are moderately accepting of media sources. Additional efforts are required to guarantee that all people with diabetes receive the DSME they need. This will require increased referral by physicians, increased follow-through by patients, and increased availability of DSME in forms that make it appealing to patients and physicians.

  1. Internet access produces misinformed patients: managing the confusion.

    PubMed

    Hungerford, David S

    2009-09-01

    The Internet has produced a truly phenomenal increase in access to information. This is really only helpful to patients if the information is filtered and appropriate to their specific needs. Too often patients access information about conditions they have self-diagnosed and bring it to the consultation with their physician, who then has to spend time disabusing the patients of the misinformation they have accumulated. Patients also return home from their initial consultation, access the Internet, and come up with all manner of promotional information from companies and even orthopedic practices that they want explained to them by their physician. It is the overwhelming conclusion of orthopedic specialists that this kind of Internet use is actually a burden for them in caring for patients and is not contributing to patient enlightenment. It does not have to be this way, if physicians will do just 2 things: first, create white papers for patients that address common current questions, such as surgical approach or bearing surfaces for implants and why we do what we do. This is a huge time saver and will preempt many questions. Second, develop their own website or select excellent nonprejudicial sites to which they can refer patients. To do less will invite a neverending parade of questions irrelevant to patient welfare.

  2. Utility of Intravascular US-Guided Portal Vein Access during Transjugular Intrahepatic Portosystemic Shunt Creation: Retrospective Comparison with Conventional Technique in 109 Patients.

    PubMed

    Pillai, Anil K; Andring, Brice; Faulconer, Nicholas; Reis, Stephen P; Xi, Yin; Iyamu, Ikponmwosa; Suthpin, Patrick D; Kalva, Sanjeeva P

    2016-08-01

    To compare safety and effectiveness of intravascular ultrasound (US)-guided portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) creation with conventional TIPS technique. In this retrospective study, TIPS creation using intravascular US guidance in 55 patients was compared with conventional TIPS creation in 54 patients by 10 operators over a 3-year period. Operators were classified as experienced if they had performed ≥ 20 TIPS procedures at the beginning of the study period. Time to portal vein access, total radiation dose, and needle pass-related capsular perforation were recorded. Baseline demographic characteristics of patients were similar (P > .05). Mean time to portal venous access was 46 minutes ± 37 for conventional TIPS and 31 minutes ± 19 for intravascular US-guided TIPS (P = .007). Intravascular US guidance allowed significantly shorter times (48 min ± 30 vs 28 min ± 16; P = .01) to portal vein access among operators (n = 5) with limited experience but failed to achieve any significant time savings (44 min ± 43 vs 34 min ± 22; P = .89) among experienced operators (n = 5). Needle pass-related capsular perforation occurred in 17/54 (34%) patients with conventional TIPS and 5/55 (9%) patients with intravascular US-guided TIPS (P = .004). Radiation dose was 2,376 mGy ± 1,816 for conventional TIPS and 1,592 mGy ± 1,263 for intravascular US-guided TIPS (P = .004). Intravascular US-guided portal vein access during TIPS creation is associated with shorter portal vein access times, decreased needle pass-related capsular perforations, and reduced radiation dose. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  3. SWS: accessing SRS sites contents through Web Services.

    PubMed

    Romano, Paolo; Marra, Domenico

    2008-03-26

    Web Services and Workflow Management Systems can support creation and deployment of network systems, able to automate data analysis and retrieval processes in biomedical research. Web Services have been implemented at bioinformatics centres and workflow systems have been proposed for biological data analysis. New databanks are often developed by taking into account these technologies, but many existing databases do not allow a programmatic access. Only a fraction of available databanks can thus be queried through programmatic interfaces. SRS is a well know indexing and search engine for biomedical databanks offering public access to many databanks and analysis tools. Unfortunately, these data are not easily and efficiently accessible through Web Services. We have developed 'SRS by WS' (SWS), a tool that makes information available in SRS sites accessible through Web Services. Information on known sites is maintained in a database, srsdb. SWS consists in a suite of WS that can query both srsdb, for information on sites and databases, and SRS sites. SWS returns results in a text-only format and can be accessed through a WSDL compliant client. SWS enables interoperability between workflow systems and SRS implementations, by also managing access to alternative sites, in order to cope with network and maintenance problems, and selecting the most up-to-date among available systems. Development and implementation of Web Services, allowing to make a programmatic access to an exhaustive set of biomedical databases can significantly improve automation of in-silico analysis. SWS supports this activity by making biological databanks that are managed in public SRS sites available through a programmatic interface.

  4. 5 CFR 297.202 - Methods of access.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PRIVACY... access to records, when such access has been granted by the Office or agency, are: (1) Inspection in person in the designated office during the hours specified by the Office or agency; or (2) Transfer of...

  5. Techniques for Improving Cash Management.

    ERIC Educational Resources Information Center

    Lykins, Ronald G.

    1973-01-01

    This article deals with several techniques for regulating cash inflow and outflow and investing surplus cash for short periods of time. The techniques are: (1) consolidating checking accounts, (2) determining surplus cash by examining bank balances in conjunction with the cash book, (3) selecting a minimum bank balance, (4) investing a greater…

  6. Internet-based stress management for distressed managers: results from a randomised controlled trial

    PubMed Central

    Dagöö, Jesper; Fjellström, Ida; Niemi, Linnea; Hansson, Katja; Zeraati, Forough; Ziuzina, Masha; Geraedts, Anna; Ljótsson, Brjánn; Carlbring, Per; Andersson, Gerhard

    2018-01-01

    Objective The aim of this randomised controlled trial (RCT) was to evaluate the efficacy of a guided internet-based stress management intervention (iSMI) among distressed managers compared with a attention control group (AC) with full access to treatment-as-usual. Method A total sample of 117 distressed managers, mainly employed in the healthcare, IT, communication and educational sector, were randomised to either iSMI (n=59) or an AC group (n=58). The iSMI consisted of eight modules including cognitive behavioural stress management and positive management techniques. Participants received a minimal and weekly guidance from a psychologist or master-level psychology student focusing on support, feedback and adherence to the intervention. Self-report data were assessed at pre, post and 6 months after the intervention. The primary outcome was perceived stress (Perceived Stress Scale-14). The secondary outcomes included mental and work-related health outcomes. Results Participants in the iSMI intervention reported significantly less symptoms of perceived stress (d=0.74, 95% CI 0.30 to 1.19) and burnout (d=0.95, 95% CI 0.53 to 1.37) compared with controls, at postassessment. Significant medium-to-large effect sizes were also found for depression, insomnia and job satisfaction. Long-term effects (6 months) were seen on the mental health outcomes. Conclusion This is one of the first studies showing that iSMIs can be an effective, accessible and potentially time-effective approach of reducing stress and other mental-related and work-related health symptoms among distressed managers. Future studies are needed addressing distressed managers and the potential of indirect effects on employee stress and satisfaction at work. PMID:28855344

  7. Healthcare organizational change: implications for access to care and its measurement.

    PubMed Central

    Miller, R. H.

    1998-01-01

    OBJECTIVES: To summarize evidence from peer-reviewed literature on access to care for vulnerable HMO enrollee populations; to discuss the potential effect of recent HMO and physician organization changes on access to care and its measurement. STUDY DESIGN: Review and summary of peer-reviewed literature for two HMO populations: those with chronic conditions and diseases, and those subject to discrimination due to income, color, or ethnic background. I also reviewed and summarized literature on three major changes in capitated organizations (HMOs and capitated physician organizations) that could affect access to care for vulnerable populations, and summarized findings from healthcare manager interviews conducted for several recent research projects on health system change. PRINCIPAL FINDINGS: Although mixed, there are enough negative results to raise some concerns about access to care for HMO enrollees with chronic conditions and diseases. Several emerging organizational changes have the potential to change access to care for the vulnerable HMO enrollees. The shift in cost-cutting from fragmented clinical management of specific services at a point in time toward more integrated clinical management of all services for specific types of patients across time may improve access to care, as may increased efforts to attract and retain HMO enrollees. The increased importance of capitated provider organizations within the health system may restrict access in some ways, and expand access in others. CONCLUSIONS: Organizational changes can affect both access to care and its measurement. More research is needed on the effects of these changes on access to care and quality of care. For researchers examining access to care for vulnerable HMO enrollee populations, these changes create challenges to determine the most appropriate measures of access to care, and the most appropriate organizations and organizational characteristics to measure. RELEVANCE TO CLINICAL PRACTICE

  8. 50 CFR 660.316 - Open access fishery-observer requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Open access fishery-observer requirements. 660.316 Section 660.316 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC... West Coast Groundfish-Open Access Fisheries § 660.316 Open access fishery—observer requirements. (a...

  9. 50 CFR 660.316 - Open access fishery-observer requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Open access fishery-observer requirements. 660.316 Section 660.316 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC... West Coast Groundfish-Open Access Fisheries § 660.316 Open access fishery—observer requirements. (a...

  10. 50 CFR 660.316 - Open access fishery-observer requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 13 2013-10-01 2013-10-01 false Open access fishery-observer requirements. 660.316 Section 660.316 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC... West Coast Groundfish-Open Access Fisheries § 660.316 Open access fishery—observer requirements. (a...

  11. 50 CFR 660.316 - Open access fishery-observer requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 13 2012-10-01 2012-10-01 false Open access fishery-observer requirements. 660.316 Section 660.316 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC... West Coast Groundfish-Open Access Fisheries § 660.316 Open access fishery—observer requirements. (a...

  12. 50 CFR 660.316 - Open access fishery-observer requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Open access fishery-observer requirements. 660.316 Section 660.316 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC... West Coast Groundfish-Open Access Fisheries § 660.316 Open access fishery—observer requirements. (a...

  13. Database Quality and Access Issues Relevant to Research Using Anesthesia Information Management System Data.

    PubMed

    Epstein, Richard H; Dexter, Franklin

    2018-07-01

    For this special article, we reviewed the computer code, used to extract the data, and the text of all 47 studies published between January 2006 and August 2017 using anesthesia information management system (AIMS) data from Thomas Jefferson University Hospital (TJUH). Data from this institution were used in the largest number (P = .0007) of papers describing the use of AIMS published in this time frame. The AIMS was replaced in April 2017, making this finite sample finite. The objective of the current article was to identify factors that made TJUH successful in publishing anesthesia informatics studies. We examined the structured query language used for each study to examine the extent to which databases outside of the AIMS were used. We examined data quality from the perspectives of completeness, correctness, concordance, plausibility, and currency. Our results were that most could not have been completed without external database sources (36/47, 76.6%; P = .0003 compared with 50%). The operating room management system was linked to the AIMS and was used significantly more frequently (26/36, 72%) than other external sources. Access to these external data sources was provided, allowing exploration of data quality. The TJUH AIMS used high-resolution timestamps (to the nearest 3 milliseconds) and created audit tables to track changes to clinical documentation. Automatic data were recorded at 1-minute intervals and were not editable; data cleaning occurred during analysis. Few paired events with an expected order were out of sequence. Although most data elements were of high quality, there were notable exceptions, such as frequent missing values for estimated blood loss, height, and weight. Some values were duplicated with different units, and others were stored in varying locations. Our conclusions are that linking the TJUH AIMS to the operating room management system was a critical step in enabling publication of multiple studies using AIMS data. Access to this and

  14. Towards a standard licensing scheme for the access and use of satellite earth observation data for disaster management

    NASA Astrophysics Data System (ADS)

    Clark, Nathan E.

    2017-10-01

    This paper explores from the view of the data recipient and user the complexities of creating a common licensing scheme for the access and use of satellite earth observation (EO) data in international disaster management (DM) activities. EO data contributions in major disaster events often involve numerous data providers with separate licensing mechanisms for controlling the access, uses, and distribution of data by the end users. A lack of standardization among the terminology, wording, and conditions within these licenses creates a complex legal environment for users, and often prevents them from using, sharing and combining datasets in an effective and timely manner. It also creates uncertainty among data providers as to the types of licensing controls that should be applied in disaster scenarios. This paper builds from an ongoing comparative analysis of the common and conflicting conditions among data licenses that must be addressed in order to facilitate easier access and use of EO data within the DM sector and offers recommendations towards the alignment of the structural and technical aspects of licenses among data providers.

  15. Software Health Management: A Short Review of Challenges and Existing Techniques

    NASA Technical Reports Server (NTRS)

    Pipatsrisawat, Knot; Darwiche, Adnan; Mengshoel, Ole J.; Schumann, Johann

    2009-01-01

    Modern spacecraft (as well as most other complex mechanisms like aircraft, automobiles, and chemical plants) rely more and more on software, to a point where software failures have caused severe accidents and loss of missions. Software failures during a manned mission can cause loss of life, so there are severe requirements to make the software as safe and reliable as possible. Typically, verification and validation (V&V) has the task of making sure that all software errors are found before the software is deployed and that it always conforms to the requirements. Experience, however, shows that this gold standard of error-free software cannot be reached in practice. Even if the software alone is free of glitches, its interoperation with the hardware (e.g., with sensors or actuators) can cause problems. Unexpected operational conditions or changes in the environment may ultimately cause a software system to fail. Is there a way to surmount this problem? In most modern aircraft and many automobiles, hardware such as central electrical, mechanical, and hydraulic components are monitored by IVHM (Integrated Vehicle Health Management) systems. These systems can recognize, isolate, and identify faults and failures, both those that already occurred as well as imminent ones. With the help of diagnostics and prognostics, appropriate mitigation strategies can be selected (replacement or repair, switch to redundant systems, etc.). In this short paper, we discuss some challenges and promising techniques for software health management (SWHM). In particular, we identify unique challenges for preventing software failure in systems which involve both software and hardware components. We then present our classifications of techniques related to SWHM. These classifications are performed based on dimensions of interest to both developers and users of the techniques, and hopefully provide a map for dealing with software faults and failures.

  16. Three-Dimensional Printing: An Aid to Epidural Access for Neuromodulation.

    PubMed

    Taverner, Murray G; Monagle, John P

    2017-08-01

    The case report details to use of three-dimensional (3D) printing as an aid to neuromodulation. A patient is described in whom previous attempts at spinal neuromodulation had failed due to lack of epidural or intrathecal access, and the use of a 3D printed model allowed for improved planning and ultimately, success. Successful spinal cord stimulation was achieved with the plan developed by access to a 3D model of the patient's spine. Neuromodulation techniques can provide the optimal analgesic techniques for individual patients. At times these can fail due to lack of access to the site for intervention, in this case epidural access. 3D printing may provide additional information to improve the likelihood of access when anatomy is distorted and standard approaches prove difficult. © 2017 International Neuromodulation Society.

  17. Scientific or rule-of-thumb techniques of ground-water management--Which will prevail?

    USGS Publications Warehouse

    McGuinness, Charles Lee

    1969-01-01

    Emphasis in ground-water development, once directed largely to quantitatively minor (but sociologically vital) service of human and stock needs, is shifting: aquifers are treated as possible regulating reservoirs managed conjunctively with surface water. Too, emphasis on reducing stream pollution is stimulating interest in aquifers as possible waste-storage media. Such management of aquifers requires vast amounts of data plus a much better understanding of aquifer-system behavior than now exists. Implicit in this deficiency of knowledge is a need for much new research, lest aquifers be managed according to ineffective rule-of-thumb standards, or even abandoned as unmanageable. The geohydrologist's task is to define both internal and boundary characteristics of aquifer systems. Stratigraphy is a primary determinant of these characteristics, but stratigraphically minor features may make aquifers transcend stratigraphic boundaries. For example, a structurally insignificant fracture may carry more water than a major fault; a minor stratigraphic discontinuity may be a major hydrologic boundary. Hence, there is a need for ways of defining aquifer boundaries and quantifying aquifer and confining-bed characteristics that are very different from ordinary stratigraphic techniques. Among critical needs are techniques for measuring crossbed permeability; for extrapolating and interpolating point data on direction and magnitude of permeability in defining aquifer geometry; and for accurately measuring geochemical properties of water and aquifer material, and interpreting those measurements in terms of source of water, rate of movement, and waste-sorbing capacities of aquifers and of confining beds--in general, techniques adequate for predicting aquifer response to imposed forces whether static, hydraulic, thermal, or chemical. Only when such predictions can be made routinely can aquifer characteristics be inserted into a master model that incorporates both the hydrologic and

  18. Research on Self-Management Techniques Used by Students with Disabilities in General Education Settings: A Promise Fulfilled?

    ERIC Educational Resources Information Center

    McDougall, Dennis; Skouge, Jim; Farrell, Anthony; Hoff, Kathy

    2006-01-01

    This comprehensive review synthesizes findings from 43 studies in which students with disabilities utilized behavioral self-management (BSM) techniques in general education settings. Findings suggest that the long-standing promise of BSM as an inclusive technique has been partially fulfilled. The review identifies strengths and limitations of BSM…

  19. 50 CFR 648.60 - Sea scallop access area program requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  20. 50 CFR 648.60 - Sea scallop access area program requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  1. 50 CFR 648.60 - Sea scallop area access program requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Sea scallop area access program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  2. 50 CFR 648.60 - Sea scallop access area program requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  3. 50 CFR 648.60 - Sea scallop area access program requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Sea scallop area access program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  4. An effective and secure key-management scheme for hierarchical access control in E-medicine system.

    PubMed

    Odelu, Vanga; Das, Ashok Kumar; Goswami, Adrijit

    2013-04-01

    Recently several hierarchical access control schemes are proposed in the literature to provide security of e-medicine systems. However, most of them are either insecure against 'man-in-the-middle attack' or they require high storage and computational overheads. Wu and Chen proposed a key management method to solve dynamic access control problems in a user hierarchy based on hybrid cryptosystem. Though their scheme improves computational efficiency over Nikooghadam et al.'s approach, it suffers from large storage space for public parameters in public domain and computational inefficiency due to costly elliptic curve point multiplication. Recently, Nikooghadam and Zakerolhosseini showed that Wu-Chen's scheme is vulnerable to man-in-the-middle attack. In order to remedy this security weakness in Wu-Chen's scheme, they proposed a secure scheme which is again based on ECC (elliptic curve cryptography) and efficient one-way hash function. However, their scheme incurs huge computational cost for providing verification of public information in the public domain as their scheme uses ECC digital signature which is costly when compared to symmetric-key cryptosystem. In this paper, we propose an effective access control scheme in user hierarchy which is only based on symmetric-key cryptosystem and efficient one-way hash function. We show that our scheme reduces significantly the storage space for both public and private domains, and computational complexity when compared to Wu-Chen's scheme, Nikooghadam-Zakerolhosseini's scheme, and other related schemes. Through the informal and formal security analysis, we further show that our scheme is secure against different attacks and also man-in-the-middle attack. Moreover, dynamic access control problems in our scheme are also solved efficiently compared to other related schemes, making our scheme is much suitable for practical applications of e-medicine systems.

  5. 50 CFR 648.88 - Multispecies open access permit restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Multispecies open access permit... Management Measures for the NE Multispecies and Monkfish Fisheries § 648.88 Multispecies open access permit restrictions. (a) Handgear permit. A vessel issued a valid open access NE multispecies Handgear permit is...

  6. 50 CFR 648.88 - Multispecies open access permit restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Multispecies open access permit... Management Measures for the NE Multispecies and Monkfish Fisheries § 648.88 Multispecies open access permit restrictions. (a) Handgear permit. A vessel issued a valid open access NE multispecies Handgear permit is...

  7. 50 CFR 648.88 - Multispecies open access permit restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Multispecies open access permit... Management Measures for the NE Multispecies and Monkfish Fisheries § 648.88 Multispecies open access permit restrictions. (a) Handgear permit. A vessel issued a valid open access NE multispecies Handgear permit is...

  8. 50 CFR 648.88 - Multispecies open access permit restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Multispecies open access permit... Management Measures for the NE Multispecies and Monkfish Fisheries § 648.88 Multispecies open access permit restrictions. (a) Handgear permit. A vessel issued a valid open access NE multispecies Handgear permit is...

  9. 50 CFR 648.88 - Multispecies open access permit restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Multispecies open access permit... Management Measures for the NE Multispecies and Monkfish Fisheries § 648.88 Multispecies open access permit restrictions. (a) Handgear permit. A vessel issued a valid open access NE multispecies Handgear permit is...

  10. Vortical flow management techniques

    NASA Technical Reports Server (NTRS)

    Rao, Dhanvada M.; Campbell, James F.

    1987-01-01

    The aerodynamic performance and controllability of advanced, highly maneuverable supersonic aircraft can be enhanced by means of 'vortex management', which refers to the purposeful manipulation and reordering of stable and concentrated vortical structures due to flow separations from highly swept leading edges and slender forebodies at moderate-to-high angles-of-attack. Attention is presently given to a variety of results obtained in the course of experiments on generic research models at NASA Langley, clarifying their underlying aerodynamics and evaluating their performance-improvement potential. The vortex-management concepts discussed encompass aerodynamic compartmentation of highly swept leading edges, vortex lift augmentation and modulation, and forebody vortex manipulation.

  11. Stress management techniques in the prison setting.

    PubMed

    Kristofersson, Gisli Kort; Kaas, Merrie J

    2013-01-01

    The percentage of incarcerated individuals in the United States is currently close to an all time high, and more stressful places than prisons are hard to find. Because registered nurses and advance practice nurses are often the only healthcare providers readily available to prison inmates, nurses need a repertoire of effective strategies to minimize prisoners' stress-related symptoms and behaviors. The purpose of this critical literature review was to identify the state of knowledge about using stress management techniques (SMTs) in the prison setting for reducing psychological problems and/or behavioral problems in male and female adult prison populations. A comprehensive, systematic integrated literature search was performed using multiple relevant databases to identify studies using various SMTs for incarcerated adults. Although clinical practice recommendations for the use of SMTs in the prison setting cannot be made with strong certainty, nurses working in the prison setting should continue to incorporate muscle relaxation, Transcendental Meditation, and certain Eastern meditative practices in the care of their clients because of the safety and possible positive impacts and practicality these methods have in this setting.

  12. Modern techniques and technologies for unbundled access in the local loop

    NASA Astrophysics Data System (ADS)

    Bacis Vasile, Irina Bristena; Schiopu, Paul; Marghescu, Cristina

    2015-02-01

    The efficient and unbundled use of the existing telecommunications infrastructure represents a major goal for the development of the services offered by telecommunications providers. A major telecommunications operator can provide services to a subscriber using a copper wire pair or part of the frequency spectrum of a copper wire pair, together with other operators, through a process of unbundling access in the local loop. Since access to the vocal band is an already solved problem, concerns turn to the broadband access with xDSL service delivery on ungrouped subscriber loops; besides the legal and economic aspects involved this has become an engineering problem also. The local loop unbundling methods have a substantial technical impact. This impact should be taken into account right from the design stage and then in the standardization stage of broadband systems intended to operate on copper wire pairs in the local loop. These systems are known under the generic term of xDSL and began to be analyzed in the late 90s. xDSL became the dominant solution for providing Internet at a reasonable price for both residential and business subscribers. In this massive development scenario, certain problems will arise from the early stages of deployment, and another type of problems will occur later on when a large number of systems will be installed in a single beam.

  13. Spatiotemporal Access Model Based on Reputation for the Sensing Layer of the IoT

    PubMed Central

    Guo, Yunchuan; Yin, Lihua; Li, Chao

    2014-01-01

    Access control is a key technology in providing security in the Internet of Things (IoT). The mainstream security approach proposed for the sensing layer of the IoT concentrates only on authentication while ignoring the more general models. Unreliable communications and resource constraints make the traditional access control techniques barely meet the requirements of the sensing layer of the IoT. In this paper, we propose a model that combines space and time with reputation to control access to the information within the sensing layer of the IoT. This model is called spatiotemporal access control based on reputation (STRAC). STRAC uses a lattice-based approach to decrease the size of policy bases. To solve the problem caused by unreliable communications, we propose both nondeterministic authorizations and stochastic authorizations. To more precisely manage the reputation of nodes, we propose two new mechanisms to update the reputation of nodes. These new approaches are the authority-based update mechanism (AUM) and the election-based update mechanism (EUM). We show how the model checker UPPAAL can be used to analyze the spatiotemporal access control model of an application. Finally, we also implement a prototype system to demonstrate the efficiency of our model. PMID:25177731

  14. Spatiotemporal access model based on reputation for the sensing layer of the IoT.

    PubMed

    Guo, Yunchuan; Yin, Lihua; Li, Chao; Qian, Junyan

    2014-01-01

    Access control is a key technology in providing security in the Internet of Things (IoT). The mainstream security approach proposed for the sensing layer of the IoT concentrates only on authentication while ignoring the more general models. Unreliable communications and resource constraints make the traditional access control techniques barely meet the requirements of the sensing layer of the IoT. In this paper, we propose a model that combines space and time with reputation to control access to the information within the sensing layer of the IoT. This model is called spatiotemporal access control based on reputation (STRAC). STRAC uses a lattice-based approach to decrease the size of policy bases. To solve the problem caused by unreliable communications, we propose both nondeterministic authorizations and stochastic authorizations. To more precisely manage the reputation of nodes, we propose two new mechanisms to update the reputation of nodes. These new approaches are the authority-based update mechanism (AUM) and the election-based update mechanism (EUM). We show how the model checker UPPAAL can be used to analyze the spatiotemporal access control model of an application. Finally, we also implement a prototype system to demonstrate the efficiency of our model.

  15. Effective Management Techniques in Tertiary Administration: A Risk Management Framework.

    ERIC Educational Resources Information Center

    McNamara, R. P.; Booth, P.

    1984-01-01

    A management strategy that is potentially more fruitful for the nonprofit sector than traditional management toward a primary objective is a risk management approach to organizational effectiveness. The organization's effectiveness, its survival, can be analyzed by categorizing the risks facing it and assessing its performance in managing these…

  16. A novel approach to early sickness absence management: The EASY (Early Access to Support for You) way

    PubMed Central

    Demou, Evangelia; Brown, Judith; Sanati, Kaveh; Kennedy, Mark; Murray, Keith; Macdonald, Ewan B.

    2015-01-01

    BACKGROUND: Sickness absence (SA) is multi-causal and remains a significant problem for employees, employers and society. This makes it necessary to concurrently manage a particular disabling condition and consider the working environment and employee-employer relationship. OBJECTIVE: To describe and examine the components of a novel SA management service Early Access to Support for You (EASY) and discuss their potential influence on the intervention. METHODS: A new sickness absence model, starting from day one of absence, was created called EASY. EASY is planned to support both employees and managers and comprises elements already found to be associated with reduction of SA, such as maintaining regular contact; early biopsychosocial case-management; physiotherapy; mental-health counselling; work modification; phased return-to-work; and health promotion activities. RESULTS: During the EASY implementation period, the SA rate at a health board reversed its trend of being one of the highest rates in the Scottish National Health Service (NHS) and EASY was considered helpful by both managers and employees. CONCLUSIONS: This paper describes an innovative occupational health intervention to sickness absence management based on the bio-psychosocial model to provide early intervention, and discusses the pros and cons of applying cognitive behavioural principles at an early stage in sickness-absence events, in order to improve return-to-work outcomes. PMID:26409380

  17. [Management of open access gastrointestinal endoscopy and quality of care: collaboration between an improvement team and primary care].

    PubMed

    Sebastián Domingo, Juan José; Sánchez Sánchez, Clara; Galve Royo, Eugenio; Mendi Metola, Carolina; Valdepérez Torrubia, Javier

    2012-02-01

    To create an improvement team within a healthcare quality improvement project of the Government of Aragon (Spain), aimed at increasing the quality of care and suitability of the indications of gastrointestinal endoscopy in the open access endoscopy system of a secondary hospital in Aragon. The team developed a consensus document indicating how to use oral endoscopy and colonoscopy correctly, and held information and training sessions with all the primary care physicians involved in this area. Sector I health centers and Royo Villanova Hospital, in Zaragoza. The team consisted of a gastroenterologist and three primary care physicians and, from the outset received the support of the primary care administration and management in the health area. Inappropriate use of endoscopy, particularly colonoscopy, was reduced from 20% to 11.6%. Significant savings were achieved in health costs. The endoscopy waiting list was reduced. The quality of care and the safety of patients undergoing these examinations improved. Training of primary care physicians in these procedures was enhanced, and coordination between primary and specialized was implemented. To ensure efficient running of an open access gastrointestinal endoscopy system, an interdisciplinary improvement team and the full involvement of the primary care staff managing this resource are required. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  18. Secure Web-Site Access with Tickets and Message-Dependent Digests

    USGS Publications Warehouse

    Donato, David I.

    2008-01-01

    Although there are various methods for restricting access to documents stored on a World Wide Web (WWW) site (a Web site), none of the widely used methods is completely suitable for restricting access to Web applications hosted on an otherwise publicly accessible Web site. A new technique, however, provides a mix of features well suited for restricting Web-site or Web-application access to authorized users, including the following: secure user authentication, tamper-resistant sessions, simple access to user state variables by server-side applications, and clean session terminations. This technique, called message-dependent digests with tickets, or MDDT, maintains secure user sessions by passing single-use nonces (tickets) and message-dependent digests of user credentials back and forth between client and server. Appendix 2 provides a working implementation of MDDT with PHP server-side code and JavaScript client-side code.

  19. Strategies of arteriovenous dialysis access.

    PubMed

    Weiswasser, Jonathan M; Kellicut, Dwight; Arora, Subodh; Sidawy, Anton N

    2004-03-01

    Surgical management of the patient who requires hemodialysis access, while continuing to demand more attention from the vascular surgeon, suffers from discrepancies of approach and strategy. With the increase in incidence of dialysis dependent renal failure among our population, many have attempted to present a uniform, logical strategy with which the vascular surgeon can most effectively treat the hemodialysis patient in the long term. Most notably, the multidisciplinary Dialysis Outcomes Quality Initiative (DOQI) guidelines present the surgeon with a rough outline of hemodialysis access insertion strategy, and it has become nationally recognized as an acceptable summary of treatment strategy and goals. The decision as to the most appropriate surgical access to offer a patient depends on immediate need for hemodialysis, history and physical examination findings, and suitability of available veins in the extremity. While percutaneous, catheter based access affords the luxury of immediate access, these devices suffer from several complicating factors, such as infection, and damage to large, proximal veins. For long-term access, the autogenous access, while perhaps less successful in the immediate short term, is always the preferred access type given its favorable longevity. The surgeons should focus on sites distally on the extremity, reserving proximal sites for potential future access insertions should the primary access fail. In the absence of suitable vein, prosthetic access may be considered. When both the upper and lower aspects of both upper extremities have been exhausted, the surgeon should consider access insertion elsewhere, such as the lower extremity.

  20. IceBridge Data Management and Access Strategies at NSIDC

    NASA Astrophysics Data System (ADS)

    Oldenburg, J.; Tanner, S.; Collins, J. A.; Lewis, S.; FitzGerrell, A.

    2013-12-01

    NASA's Operation IceBridge (OIB) mission, initiated in 2009, collects airborne remote sensing measurements over the polar regions to bridge the gap between NASA's Ice, Cloud and Land Elevation satellite (ICESat) mission and the upcoming ICESat-2 mission in 2016. OIB combines an evolving mix of instruments to gather data on topography, ice and snow thickness, high-resolution photography, and other properties that are more difficult or impossible to measure via satellite. Once collected, these data are stored and made available at the National Snow and Ice Data Center (NSIDC) in Boulder, Colorado. To date, there are nearly 90 terabytes of data available, and there are about three more years of data collection left. The main challenges faced in data management at NSIDC are derived from the quantity and heterogeneity of the data. To deal with the quantity of data, the technical teams at NSIDC have significantly automated the data ingest, metadata generation, and other required data management steps. Heterogeneity of data and the evolution of the Operation over time make technical automation complex. To limit complexity, the IceBridge team has agreed to such practices as using specific data file formats, limiting file sizes, using specific filename templates, etc. These agreements evolve as Operation IceBridge moves forward. The metadata generated about the flights and the data collected thereon make the storage of the data more robust, and enable data discoverability. With so much metadata, users can search the vast collection with ease using specific parameters about the data they seek. An example of this in action is the IceBridge data portal developed at NSIDC, http://nsidc.org/icebridge/portal/. This portal uses the GPS data from the flights projected onto maps as well as other flight and instrument metadata to help the user find the exact data file they seek. This implementation is only possible with dependable data management beneath the surface. The data files

  1. A SMART groundwater portal: An OGC web services orchestration framework for hydrology to improve data access and visualisation in New Zealand

    NASA Astrophysics Data System (ADS)

    Klug, Hermann; Kmoch, Alexander

    2014-08-01

    Transboundary and cross-catchment access to hydrological data is the key to designing successful environmental policies and activities. Electronic maps based on distributed databases are fundamental for planning and decision making in all regions and for all spatial and temporal scales. Freshwater is an essential asset in New Zealand (and globally) and the availability as well as accessibility of hydrological information held by or held for public authorities and businesses are becoming a crucial management factor. Access to and visual representation of environmental information for the public is essential for attracting greater awareness of water quality and quantity matters. Detailed interdisciplinary knowledge about the environment is required to ensure that the environmental policy-making community of New Zealand considers regional and local differences of hydrological statuses, while assessing the overall national situation. However, cross-regional and inter-agency sharing of environmental spatial data is complex and challenging. In this article, we firstly provide an overview of the state of the art standard compliant techniques and methodologies for the practical implementation of simple, measurable, achievable, repeatable, and time-based (SMART) hydrological data management principles. Secondly, we contrast international state of the art data management developments with the present status for groundwater information in New Zealand. Finally, for the topics (i) data access and harmonisation, (ii) sensor web enablement and (iii) metadata, we summarise our findings, provide recommendations on future developments and highlight the specific advantages resulting from a seamless view, discovery, access, and analysis of interoperable hydrological information and metadata for decision making.

  2. Unique Access to Learning

    ERIC Educational Resources Information Center

    Goble, Don

    2009-01-01

    This article describes the many learning opportunities that broadcast technology students at Ladue Horton Watkins High School in St. Louis, Missouri, experience because of their unique access to technology and methods of learning. Through scaffolding, stepladder techniques, and trial by fire, students learn to produce multiple television programs,…

  3. Automated Computer Access Request System

    NASA Technical Reports Server (NTRS)

    Snook, Bryan E.

    2010-01-01

    The Automated Computer Access Request (AutoCAR) system is a Web-based account provisioning application that replaces the time-consuming paper-based computer-access request process at Johnson Space Center (JSC). Auto- CAR combines rules-based and role-based functionality in one application to provide a centralized system that is easily and widely accessible. The system features a work-flow engine that facilitates request routing, a user registration directory containing contact information and user metadata, an access request submission and tracking process, and a system administrator account management component. This provides full, end-to-end disposition approval chain accountability from the moment a request is submitted. By blending both rules-based and rolebased functionality, AutoCAR has the flexibility to route requests based on a user s nationality, JSC affiliation status, and other export-control requirements, while ensuring a user s request is addressed by either a primary or backup approver. All user accounts that are tracked in AutoCAR are recorded and mapped to the native operating system schema on the target platform where user accounts reside. This allows for future extensibility for supporting creation, deletion, and account management directly on the target platforms by way of AutoCAR. The system s directory-based lookup and day-today change analysis of directory information determines personnel moves, deletions, and additions, and automatically notifies a user via e-mail to revalidate his/her account access as a result of such changes. AutoCAR is a Microsoft classic active server page (ASP) application hosted on a Microsoft Internet Information Server (IIS).

  4. Access to Electronic Personal Health Records Among Patients With Multiple Chronic Conditions: A Secondary Data Analysis

    PubMed Central

    Falisi, Angela L; Finney Rutten, Lila J; Chou, Wen-Ying Sylvia; Patel, Vaishali; Moser, Richard P; Hesse, Bradford W

    2017-01-01

    Background In the United States, national incentives for offering access to electronic personal health records (ePHRs) through electronic means are geared toward creating a culture of patient engagement. One group of patients who stand to benefit from online access to ePHRs is the growing population with multiple chronic conditions (MCC). However, little is known about the current availability and use of ePHRs and patient portals among those managing MCC. Objective The aim was to determine the associations between number of chronic conditions and sociodemographic characteristics and usage of ePHRs, and to assess how the public’s use of ePHRs varies across subpopulations, including those with MCC. Methods This study used data collected from the 2014 Health Information National Trends Survey (HINTS), and assessed differences in use of ePHRs between those with and without MCC (N=3497) using multiple logistic regression techniques. Variables associated with health care systems (insurance status, having a regular provider) and patient-reported self-efficacy were included in the statistical models. Results Those with MCC (n=1555) had significantly higher odds of accessing their records three or more times in the past year compared to those reporting no chronic conditions (n=1050; OR 2.46, 95% CI 1.37-4.45), but the overall percentage of those with MCC using ePHRs remained low (371 of 1529 item respondents, 25.63% weighted). No difference in odds of accessing their records was found between those reporting one chronic condition (n=892) and those reporting none (n=1050; OR 1.02, 95% CI 0.66-1.58). Significant differences in odds of accessing ePHRs were seen between income and age groups (P<.001 and P=.05, respectively), and by whether respondents had a regular provider (P=.03). Conclusions We conclude that ePHRs provide a unique opportunity to enhance MCC patient self-management, but additional effort is needed to ensure that these patients are able to access their e

  5. Laparoscopic Heller Myotomy and Dor Fundoplication for Esophageal Achalasia: Technique and Perioperative Management.

    PubMed

    Andolfi, Ciro; Fisichella, P Marco

    2016-11-01

    Surgical correction of achalasia using laparoscopic Heller myotomy with Dor fundoplication is argued to be the gold standard treatment for patients with achalasia. The goal of this technical report is to illustrate our preferred approach to patients with achalasia and to provide the reader with a detailed description of our operative technique, its rationale, and our pre and postoperative management.

  6. Empowering Learners with Mobile Open-Access Learning Initiatives

    ERIC Educational Resources Information Center

    Mills, Michael, Ed.; Wake, Donna, Ed.

    2017-01-01

    Education has been progressing at a rapid pace ever since educators have been able to harness the power of mobile technology. Open-access learning techniques provide more students with the opportunity to engage in educational opportunities that may have been previously restricted. "Empowering Learners with Mobile Open-Access Learning…

  7. Proceedings of the National Conference on Energy Resource Management. Volume 1: Techniques, Procedures and Data Bases

    NASA Technical Reports Server (NTRS)

    Brumfield, J. O. (Editor); Schiffman, Y. M. (Editor)

    1982-01-01

    Topics dealing with the integration of remotely sensed data with geographic information system for application in energy resources management are discussed. Associated remote sensing and image analysis techniques are also addressed.

  8. IP access networks with QoS support

    NASA Astrophysics Data System (ADS)

    Sargento, Susana; Valadas, Rui J. M. T.; Goncalves, Jorge; Sousa, Henrique

    2001-07-01

    The increasing demand of new services and applications is pushing for drastic changes on the design of access networks targeted mainly for residential and SOHO users. Future access networks will provide full service integration (including multimedia), resource sharing at the packet level and QoS support. It is expected that using IP as the base technology, the ideal plug-and-play scenario, where the management actions of the access network operator are kept to a minimum, will be achieved easily. This paper proposes an architecture for access networks based on layer 2 or layer 3 multiplexers that allows a number of simplifications in the network elements and protocols (e.g. in the routing and addressing functions). We discuss two possible steps in the evolution of access networks towards a more efficient support of IP based services. The first one still provides no QoS support and was designed with the goal of reusing as much as possible current technologies; it is based on tunneling to transport PPP sessions. The second one introduces QoS support through the use of emerging technologies and protocols. We illustrate the different phases of a multimedia Internet access session, when using SIP for session initiation, COPS for the management of QoS policies including the AAA functions and RSVP for resource reservation.

  9. Minimal access treatment of pectus carinatum: a preliminary report.

    PubMed

    Hock, András

    2009-04-01

    Unlike the minimal access repair of pectus excavatum (PE), a minimal access repair of pectus carinatum (PC) has not been established. This initial experience reports the correction of PC using a minimal access technique in five patients. The procedure was performed by insertion of a pectus bar through either bilateral or only left midaxillary incision. The pectus bar was placed so that the elevated sternum could be depressed. Thoracoscopy was not employed during the procedures and no stabiliser plates were used. On completion of the procedure, a chest tube was inserted into the thoracic cavity to evacuate the air from the thoracic cavity followed by wound closure. The operation time ranged from 75 to 110 min. The chest tube was removed on the second postoperative day and the patients were discharged between the fifth and seventh postoperative day. There was one dislocation in which the bar was finally removed, and in three patients a prolapse of the end of the strut through intercostal space necessitated refixation using wires. Despite a small series, this method offers a minimal access repair of PC, which is comparable to the technique used for PE. The invasiveness of our method is obviously far less, than of those different open surgical techniques performed worldwide presently. Our postoperative results warrant the application of this technique in patients with PC.

  10. A theoretical and empirical review of the death-thought accessibility concept in terror management research.

    PubMed

    Hayes, Joseph; Schimel, Jeff; Arndt, Jamie; Faucher, Erik H

    2010-09-01

    Terror management theory (TMT) highlights the motivational impact of thoughts of death in various aspects of everyday life. Since its inception in 1986, research on TMT has undergone a slight but significant shift from an almost exclusive focus on the manipulation of thoughts of death to a marked increase in studies that measure the accessibility of death-related cognition. Indeed, the number of death-thought accessibility (DTA) studies in the published literature has grown substantially in recent years. In light of this increasing reliance on the DTA concept, the present article is meant to provide a comprehensive theoretical and empirical review of the literature employing this concept. After discussing the roots of DTA, the authors outline the theoretical refinements to TMT that have accompanied significant research findings associated with the DTA concept. Four distinct categories (mortality salience, death association, anxiety-buffer threat, and dispositional) are derived to organize the reviewed DTA studies, and the theoretical implications of each category are discussed. Finally, a number of lingering empirical and theoretical issues in the DTA literature are discussed with the aim of stimulating and focusing future research on DTA specifically and TMT in general.

  11. Superior Recess Access of the Lumbar Facet Joint.

    PubMed

    Demir-Deviren, Sibel; Singh, Sukhminder; Hanelin, Joshua

    2017-04-01

    Descriptive approach to accessing the lumbar facet joint by superior recess. This study is aimed to describe an approach to accessing the lumbar facet joint through targeting the superior recess during lumbar facet joint injections. Lumbar facet joint injections are routinely performed for both the diagnosis and treatment of chronic low back pain. Previous studies either did not specify which part of the joint to target, or recommended targeting the inferior aspect of the joint to access the inferior recess. One study did mention the superior recess as an alternative to injecting the inferior recess, but none has focused on description of the technique. This is the first time this technique has been described. The records and fluoroscopic images were reviewed for all patients over a period of 9 months (January-September 2012) using the proposed technique. This resulted in a total of 48 patients; 15 men, 29 women, and a total of 117 facet joint intra-articular injections. Among these 48 patients, injections were repeated in total of 4 cases. The average time of injections among 4 repeat cases was 121 days. The success of the procedure was confirmed with an arthrogram demonstrating contrast flowing from the superior recess inferiorly through the joint space. Successful access of the lumbar facet joint through puncture of the superior recess was seen in 114 cases, with 3 unsuccessful attempts to enter facet joints due to osteophytes at involved levels. There were no complications observed during the procedure. We find this approach to be highly successful, safe, and well tolerated by the patient and recommend it as a technique for access of the lumbar facet joint in those patients in whom direct puncture of the inferior recess is difficult.

  12. Cultural Variations in Mothers' Acceptance of and Intent to Use Behavioral Child Management Techniques

    ERIC Educational Resources Information Center

    Mah, Janet W. T.; Johnston, Charlotte

    2012-01-01

    We examined cultural differences in mothers' acceptance of and intent to use behavioral parenting techniques for managing disruptive child behavior, and the possible roles of parenting styles and implicit theories in explaining these cultural differences. A community sample of 117 Euro-Canadian and Chinese-immigrant mothers of boys aged 4- to…

  13. Upgrading of the micro-marsupialisation technique for the management of mucus extravasation or retention phenomena.

    PubMed

    Amaral, M B F; de Freitas, J B; Mesquita, R A

    2012-12-01

    This study evaluated the performance of an upgrading of the micro-marsupialisation technique for the management of mucus extravasation or retention phenomena. This study presents a prospective case series of management of ranulas and mucoceles, with a follow-up ranging from 6 to 18 months. Data included the age and gender of patients, as well as the type, size, and site of lesions, and number of punctures. The treatment performance was evaluated according to: postoperative pain, oedema, secondary infection, clinical healing, retreatment, and recurrence of the lesions. All patients showed clinical healing of the lesions within 30 days after the micro-marsupialisation technique. None of patients presented a recurrence or required retreatment, there was no oedema or infection. No pain, or mild pain was reported by the majority of patients (58.81%). Micro-marsupialisation proved to be a simple, low cost, relatively non-invasive, painless, effective, and low recurrence technique to treat mucus extravasation or retention phenomena. Micro-marsupialisation can be recommended primarily to treat oral ranulas and selected mucoceles. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Access control and privilege management in electronic health record: a systematic literature review.

    PubMed

    Jayabalan, Manoj; O'Daniel, Thomas

    2016-12-01

    This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.

  15. An easy access to retrieve dental implants displaced into the maxillary sinus: the bony window technique.

    PubMed

    Biglioli, Federico; Chiapasco, Matteo

    2014-12-01

    To present the authors' experience concerning the removal of dental implants displaced in the maxillary sinus via an intraoral approach consisting of the creation of a bony window pedicled to the maxillary sinus membrane. Thirty-six systemically healthy patients, presenting with oral implants displaced into the maxillary sinus, but with no signs of acute or chronic sinusitis, were consecutively treated between 2002 and 2012 via an intraoral approach with the bony window technique. Removal of oral implants from the maxillary sinus was achieved in all patients, and postoperative recovery was uneventful in all of them. Computed tomographies performed after surgery showed no signs of residual sinus infection in all patients and a complete ossification of the bony window margins. Twelve of the 36 treated patients were treated with a sinus grafting procedure 12-18 months after in the same areas previously treated with the bone lid technique. Seventeen implants were placed in the grafted areas 6-9 months later and, after a further waiting period needed for osseointegration, the treated patients were rehabilitated with implant-supported prostheses. The survival rate of implants was 100%, and no complications related to the sinuses and implants were recorded. Results from this study seem to demonstrate that the bony window technique is a safe and easy way to remove oral implants from the maxillary sinus under local anesthesia. The surgical access is hardly visible 6-12 months after surgery, and maxillary sinuses appeared free from residual pathology in all treated patients. Finally, this procedure allows a second-stage sinus grafting procedure via a lateral approach as in a previously untreated maxillary sinus, thus allowing an implant-supported prosthetic restoration. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. 43 CFR 3802.4-2 - Access.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS UNDER THE GENERAL MINING LAWS Exploration... specify the location of the access route, the design, construction, operation and maintenance standards...

  17. 43 CFR 3802.4-2 - Access.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF THE INTERIOR MINERALS MANAGEMENT (3000) MINING CLAIMS UNDER THE GENERAL MINING LAWS Exploration... specify the location of the access route, the design, construction, operation and maintenance standards...

  18. 41 CFR 105-8.154 - Program accessibility: Exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Program accessibility: Exceptions. 105-8.154 Section 105-8.154 Public Contracts and Property Management Federal Property Management... any action that it can demonstrate would result in a fundamental alteration in the nature of a program...

  19. Testing, Testing...Managing Electronic Access in Disparate Times.

    ERIC Educational Resources Information Center

    Carrington, Bessie M.

    1996-01-01

    Duke University's Perkins Library (North Carolina) tests electronic resources and services for remote accessibility by examining capabilities on various platforms, operating systems, communications software, and World Wide Web browsers. Problems occur in establishing connections, screen display, navigation or retrieval, keyboard variations, and in…

  20. A New Technique in Surgical Management of the Giant Cerebral Hydatid Cysts.

    PubMed

    Aydin, Mehmet Dumlu; Karaavci, Nuh Cagri; Akyuz, Mehmet Emin; Sahin, Mehmet Hakan; Zeynal, Mete; Kanat, Ayhan; Altinors, Mehmet Nur

    2018-05-01

    In hydatid disease, the central nervous system is affected approximately in 2% to 3% of patients. Surgical management in these patients is important. To develop a surgical technique to avoid the formation of great volume of cavity after hydatid cyst removal and prevent complications associated with brain collapse and cortical convolution. In 2 patients, hydatid cysts were delivered by this new technique. A balloon filled with 150 cc of sterile air/distilled water was placed in the cavity until the balloon filled the entire cavity. Air/distilled water evacuation was continued at a rate of 20 cc/d and, after a week, eventually, the balloons were removed RESULTS:: All cysts were delivered without rupture. Neurologic outcomes were good. No complications were observed related to usage of the system such as balloon rupture, evacuation problems, and infection. The authors believe that the balloon insertion technique may be a useful method to prevent brain collapse, cortical convolution, and complications associated with this condition. Further technical refinements of the system are needed for better results.