Fabrication, characterization, and modeling of comixed films for NXS calibration targets [Fabrication and metrology of the NXS calibration targets

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

Jaquez, Javier; Farrell, Mike; Huang, Haibo

In 2014/2015 at the Omega laser facility, several experiments took place to calibrate the National Ignition Facility (NIF) X-ray spectrometer (NXS), which is used for high-resolution time-resolved spectroscopic experiments at NIF. The spectrometer allows experimentalists to measure the X-ray energy emitted from high-energy targets, which is used to understand key data such as mixing of materials in highly compressed fuel. The purpose of the experiments at Omega was to obtain information on the instrument performance and to deliver an absolute photometric calibration of the NXS before it was deployed at NIF. The X-ray emission sources fabricated for instrument calibration weremore » 1-mm fused silica spheres with precisely known alloy composition coatings of Si/Ag/Mo, Ti/Cr/Ag, Cr/Ni/Zn, and Zn/Zr, which have emission in the 2- to 18-keV range. Critical to the spectrometer calibration is a known atomic composition of elements with low uncertainty for each calibration sphere. This study discusses the setup, fabrication, and precision metrology of these spheres as well as some interesting findings on the ternary magnetron-sputtered alloy structure.« less

Targeting of the Subthalamic Nucleus for Deep Brain Stimulation: A Survey Among Parkinson Disease Specialists.

PubMed

Hamel, Wolfgang; Köppen, Johannes A; Alesch, François; Antonini, Angelo; Barcia, Juan A; Bergman, Hagai; Chabardes, Stephan; Contarino, Maria Fiorella; Cornu, Philippe; Demmel, Walter; Deuschl, Günther; Fasano, Alfonso; Kühn, Andrea A; Limousin, Patricia; McIntyre, Cameron C; Mehdorn, H Maximilian; Pilleri, Manuela; Pollak, Pierre; Rodríguez-Oroz, Maria C; Rumià, Jordi; Samuel, Michael; Timmermann, Lars; Valldeoriola, Francesc; Vesper, Jan; Visser-Vandewalle, Veerle; Volkmann, Jens; Lozano, Andres M

2017-03-01

Deep brain stimulation within or adjacent to the subthalamic nucleus (STN) represents the most common stereotactic procedure performed for Parkinson disease. Better STN imaging is often regarded as a requirement for improving stereotactic targeting. However, it is unclear whether there is consensus about the optimal target. To obtain an expert opinion on the site regarded optimal for "STN stimulation," movement disorder specialists were asked to indicate their preferred position for an active contact on hard copies of the Schaltenbrand and Wahren atlas depicting the STN in all 3 planes. This represented an idealized setting, and it mimicked optimal imaging for direct target definition in a perfectly delineated STN. The suggested targets were heterogeneous, although some clustering was observed in the dorsolateral STN and subthalamic area. In particular, in the anteroposterior direction, the intended targets differed to a great extent. Most of the indicated targets are thought to also result in concomitant stimulation of structures adjacent to the STN, including the zona incerta, fields of Forel, and internal capsule. This survey illustrates that most sites regarded as optimal for STN stimulation are close to each other, but there appears to be no uniform perception of the optimal anatomic target, possibly influencing surgical results. The anatomic sweet zone for STN stimulation needs further specification, as this information is likely to make magnetic resonance imaging-based target definition less variable when applied to individual patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Process for the fabrication of aluminum metallized pyrolytic graphite sputtering targets

DOEpatents

Makowiecki, Daniel M.; Ramsey, Philip B.; Juntz, Robert S.

1995-01-01

An improved method for fabricating pyrolytic graphite sputtering targets with superior heat transfer ability, longer life, and maximum energy transmission. Anisotropic pyrolytic graphite is contoured and/or segmented to match the erosion profile of the sputter target and then oriented such that the graphite's high thermal conductivity planes are in maximum contact with a thermally conductive metal backing. The graphite contact surface is metallized, using high rate physical vapor deposition (HRPVD), with an aluminum coating and the thermally conductive metal backing is joined to the metallized graphite target by one of four low-temperature bonding methods; liquid-metal casting, powder metallurgy compaction, eutectic brazing, and laser welding.

Novel target fabrication using 3D printing developed at University of Michigan

DOE PAGES

Klein, Sallee R.; Deininger, Michael; Gillespie, Robb S.; ...

2016-05-24

The University of Michigan has been fabricating targets for high-energy-density experiments for the past decade. We utilize the technique of machined acrylic bodies and mating components acting as constraints to build repeatable targets. Combining 3D printing with traditional machining, we are able to take advantage of the very best part of both aspects of manufacturing. Furthermore, we present several recent campaigns to act as showcase and introduction of our techniques and our experience with 3D printing, effecting how we utilize 3D printing in our target builds.

Novel target fabrication using 3D printing developed at University of Michigan

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

Klein, Sallee R.; Deininger, Michael; Gillespie, Robb S.

The University of Michigan has been fabricating targets for high-energy-density experiments for the past decade. We utilize the technique of machined acrylic bodies and mating components acting as constraints to build repeatable targets. Combining 3D printing with traditional machining, we are able to take advantage of the very best part of both aspects of manufacturing. Furthermore, we present several recent campaigns to act as showcase and introduction of our techniques and our experience with 3D printing, effecting how we utilize 3D printing in our target builds.

Process for the fabrication of aluminum metallized pyrolytic graphite sputtering targets

DOEpatents

Makowiecki, D.M.; Ramsey, P.B.; Juntz, R.S.

1995-07-04

An improved method is disclosed for fabricating pyrolytic graphite sputtering targets with superior heat transfer ability, longer life, and maximum energy transmission. Anisotropic pyrolytic graphite is contoured and/or segmented to match the erosion profile of the sputter target and then oriented such that the graphite`s high thermal conductivity planes are in maximum contact with a thermally conductive metal backing. The graphite contact surface is metallized, using high rate physical vapor deposition (HRPVD), with an aluminum coating and the thermally conductive metal backing is joined to the metallized graphite target by one of four low-temperature bonding methods; liquid-metal casting, powder metallurgy compaction, eutectic brazing, and laser welding. 11 figs.

Fabrication and characterization of carbon-backed thin 208Pb targets.

PubMed

Thakur, Meenu; Dubey, R; Abhilash, S R; Behera, B R; Mohanty, B P; Kabiraj, D; Ojha, Sunil; Duggal, Heena

2016-01-01

Thin carbon-backed isotopically enriched 208 Pb targets were required for our experiment aimed to study the reaction dynamics for 48 Ti +  208 Pb system, populating the near super-heavy nucleus 256 Rf, through mass-energy correlation of the fission fragments. Purity and thickness of the targets are of utmost importance in such studies as these factors have strong influence on the measurement accuracy of mass and energy distribution of fission fragments. 208 Pb targets with thickness ranging from 60 μg/cm 2 to 250 μg/cm 2 have been fabricated in high vacuum environment using physical vapor deposition method. Important points in the method are as follows: • 208 Pb was deposited using resistive heating method, whereas carbon (backing foil) deposition was performed by using the electron beam bombardment technique.•Different characterization techniques such as Particle Induced X-ray Emission (PIXE), Energy Dispersive X-Ray Fluorescence (EDXRF) and Rutherford Backscattering Spectrometry (RBS) were used to assert the purity and thickness of the targets.•These targets have successfully been used to accomplish our experimental objectives.

Method for fabricating .sup.99 Mo production targets using low enriched uranium, .sup.99 Mo production targets comprising low enriched uranium

DOEpatents

Wiencek, Thomas C.; Matos, James E.; Hofman, Gerard L.

1997-01-01

A radioisotope production target and a method for fabricating a radioisotope production target is provided, wherein the target comprises an inner cylinder, a foil of fissionable material circumferentially contacting the outer surface of the inner cylinder, and an outer hollow cylinder adapted to receive the substantially foil-covered inner cylinder and compress tightly against the foil to provide good mechanical contact therewith. The method for fabricating a primary target for the production of fission products comprises preparing a first substrate to receive a foil of fissionable material so as to allow for later removal of the foil from the first substrate, preparing a second substrate to receive the foil so as to allow for later removal of the foil from the second substrate; attaching the first substrate to the second substrate such that the foil is sandwiched between the first substrate and second substrate to prevent foil exposure to ambient atmosphere, and compressing the exposed surfaces of the first and second substrate to assure snug mechanical contact between the foil, the first substrate and the second substrate.

Method for fabricating {sup 99}Mo production targets using low enriched uranium, {sup 99}Mo production targets comprising low enriched uranium

DOEpatents

Wiencek, T.C.; Matos, J.E.; Hofman, G.L.

1997-03-25

A radioisotope production target and a method for fabricating a radioisotope production target is provided, wherein the target comprises an inner cylinder, a foil of fissionable material circumferentially contacting the outer surface of the inner cylinder, and an outer hollow cylinder adapted to receive the substantially foil-covered inner cylinder and compress tightly against the foil to provide good mechanical contact therewith. The method for fabricating a primary target for the production of fission products comprises preparing a first substrate to receive a foil of fissionable material so as to allow for later removal of the foil from the first substrate, preparing a second substrate to receive the foil so as to allow for later removal of the foil from the second substrate; attaching the first substrate to the second substrate such that the foil is sandwiched between the first substrate and second substrate to prevent foil exposure to ambient atmosphere, and compressing the exposed surfaces of the first and second substrate to assure snug mechanical contact between the foil, the first substrate and the second substrate. 3 figs.

Method for fabricating .sup.99 Mo production targets using low enriched uranium, .sup.99 Mo production targets comprising low enriched uranium

DOEpatents

Wiencek, Thomas C [Orland Park, IL; Matos, James E [Oak Park, IL; Hofman, Gerard L [Downers Grove, IL

2000-12-12

A radioisotope production target and a method for fabricating a radioisotope production target is provided, wherein the target comprises an inner cylinder, a foil of fissionable material circumferentially contacting the outer surface of the inner cylinder, and an outer hollow cylinder adapted to receive the substantially foil-covered inner cylinder and compress tightly against the foil to provide good mechanical contact therewith. The method for fabricating a primary target for the production of fission products comprises preparing a first substrate to receive a foil of fissionable material so as to allow for later removal of the foil from the first substrate, preparing a second substrate to receive the foil so as to allow for later removal of the foil from the second substrate; attaching the first substrate to the second substrate such that the foil is sandwiched between the first substrate and second substrate to prevent foil exposure to ambient atmosphere, and compressing the exposed surfaces of the first and second substrate to assure snug mechanical contact between the foil, the first substrate and the second substrate.

Burns education for non-burn specialist clinicians in Western Australia.

PubMed

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona

2015-03-01

Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care. A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session. Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care. Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Design and Fabrication of Opacity Targets for the National Ignition Facility

DOE PAGES

Cardenas, Tana; Schmidt, Derek William; Dodd, Evan S.; ...

2017-12-22

Accurate models for opacity of partially ionized atoms are important for modeling and understanding stellar interiors and other high-energy-density phenomena such as inertial confinement fusion. Lawrence Livermore National Laboratory is leading a multilaboratory effort to conduct experiments on the National Ignition Facility (NIF) to try to reproduce recent opacity tests at the Sandia National Laboratory Z-facility. Since 2015, the NIF effort has evolved several hohlraum designs that consist of multiple pieces joined together. The target also has three components attached to the main stalk over a long distance with high tolerances that have resulted in several design iterations. The targetmore » has made use of rapid prototyped features to attach a capsule and collimator under the hohlraum while avoiding interference with the beams. Furthermore, this paper discusses the evolution of the hohlraum and overall target design and the challenges involved with fabricating and assembling these targets.« less

Design and Fabrication of Opacity Targets for the National Ignition Facility

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

Cardenas, Tana; Schmidt, Derek William; Dodd, Evan S.

Accurate models for opacity of partially ionized atoms are important for modeling and understanding stellar interiors and other high-energy-density phenomena such as inertial confinement fusion. Lawrence Livermore National Laboratory is leading a multilaboratory effort to conduct experiments on the National Ignition Facility (NIF) to try to reproduce recent opacity tests at the Sandia National Laboratory Z-facility. Since 2015, the NIF effort has evolved several hohlraum designs that consist of multiple pieces joined together. The target also has three components attached to the main stalk over a long distance with high tolerances that have resulted in several design iterations. The targetmore » has made use of rapid prototyped features to attach a capsule and collimator under the hohlraum while avoiding interference with the beams. Furthermore, this paper discusses the evolution of the hohlraum and overall target design and the challenges involved with fabricating and assembling these targets.« less

STS-95 Mission Specialist Duque suits up during TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Pedro Duque of Spain, representing the European Space Agency, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Duque and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

Fabrication of Low-Density Foam Liners in Hohlraums for NIF Targets

DOE PAGES

Bhandarkar, Suhas; Baumann, Ted; Alfonso, Noel; ...

2018-01-15

Low-density foam liners are seen as a means to mitigate hohlraum wall motion that can interfere with the inner set of beams that are pointed toward the middle section of the hohlraum. These liners need to meet several requirements, most notably the material choice and the maximum allowable solid fraction and thickness, which necessitate development of new processing capabilities. In this paper, we discuss our strategy and work on fabrication of a tantalum oxide foam liner and its assembly into targets for the National Ignition Facility (NIF). Finally, in particular, we discuss our approach to finding solutions to the uniquemore » challenges that come up in working with such low-density materials so as to be able establish a viable platform for production of cryogenic targets for NIF with foam-lined hohlraums.« less

Fabrication of Low-Density Foam Liners in Hohlraums for NIF Targets

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

Bhandarkar, Suhas; Baumann, Ted; Alfonso, Noel

Low-density foam liners are seen as a means to mitigate hohlraum wall motion that can interfere with the inner set of beams that are pointed toward the middle section of the hohlraum. These liners need to meet several requirements, most notably the material choice and the maximum allowable solid fraction and thickness, which necessitate development of new processing capabilities. In this paper, we discuss our strategy and work on fabrication of a tantalum oxide foam liner and its assembly into targets for the National Ignition Facility (NIF). Finally, in particular, we discuss our approach to finding solutions to the uniquemore » challenges that come up in working with such low-density materials so as to be able establish a viable platform for production of cryogenic targets for NIF with foam-lined hohlraums.« less

Continuous and scalable polymer capsule processing for inertial fusion energy target shell fabrication using droplet microfluidics.

PubMed

Li, Jin; Lindley-Start, Jack; Porch, Adrian; Barrow, David

2017-07-24

High specification, polymer capsules, to produce inertial fusion energy targets, were continuously fabricated using surfactant-free, inertial centralisation, and ultrafast polymerisation, in a scalable flow reactor. Laser-driven, inertial confinement fusion depends upon the interaction of high-energy lasers and hydrogen isotopes, contained within small, spherical and concentric target shells, causing a nuclear fusion reaction at ~150 M°C. Potentially, targets will be consumed at ~1 M per day per reactor, demanding a 5000x unit cost reduction to ~$0.20, and is a critical, key challenge. Experimentally, double emulsions were used as templates for capsule-shells, and were formed at 20 Hz, on a fluidic chip. Droplets were centralised in a dynamic flow, and their shapes both evaluated, and mathematically modeled, before subsequent shell solidification. The shells were photo-cured individually, on-the-fly, with precisely-actuated, millisecond-length (70 ms), uniform-intensity UV pulses, delivered through eight, radially orchestrated light-pipes. The near 100% yield rate of uniform shells had a minimum 99.0% concentricity and sphericity, and the solidification processing period was significantly reduced, over conventional batch methods. The data suggest the new possibility of a continuous, on-the-fly, IFE target fabrication process, employing sequential processing operations within a continuous enclosed duct system, which may include cryogenic fuel-filling, and shell curing, to produce ready-to-use IFE targets.

Fabrication of 94Zr thin target for recoil distance doppler shift method of lifetime measurement

NASA Astrophysics Data System (ADS)

Gupta, C. K.; Rohilla, Aman; Abhilash, S. R.; Kabiraj, D.; Singh, R. P.; Mehta, D.; Chamoli, S. K.

2014-11-01

A thin isotopic 94Zr target of thickness 520 μg /cm2 has been prepared for recoil distance Doppler shift method (RDM) lifetime measurement by using an electron beam deposition method on tantalum backing of 3.5 mg/cm2 thickness at Inter University Accelerator Center (IUAC), New Delhi. To meet the special requirement of smoothness of surface for RDM lifetime measurement and also to protect the outer layer of 94Zr from peeling off, a very thin layer of gold has been evaporated on a 94Zr target on a specially designed substrate holder. In all, 143 mg of 99.6% enriched 94Zr target material was utilized for the fabrication of 94Zr targets. The target has been successfully used in a recent RDM lifetime measurement experiment at IUAC.

Access to specialist gastroenterology care in Canada: Comparison of wait times and consensus targets

PubMed Central

Leddin, Desmond; Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Paterson, William G

2008-01-01

BACKGROUND: Monitoring wait times and defining targets for care have been advocated to improve health care delivery related to cancer, heart, diagnostic imaging, joint replacements and sight restoration. There are few data on access to care for digestive diseases, although they pose a greater economic burden than cancer or heart disease in Canada. The present study compared wait times for specialist gastroenterology care with recent, evidence-based, consensus-defined benchmark wait times for a range of digestive diseases. METHODS: Total wait times from primary care referral to investigation were measured for seven digestive disease indications by using the Practice Audit in Gastroenterology program, and were benchmarked against consensus recommendations. RESULTS: Total wait times for 1903 patients who were undergoing investigation exceeded targets for those with probable cancer (median 26 days [25th to 75th percentiles eight to 56 days] versus target of two weeks); probable inflammatory bowel disease (101 days [35 to 209 days] versus two weeks); documented iron deficiency anemia (71 days [19 to 142 days] versus two months); positive fecal occult blood test (73 days [36 to 148 days] versus two months); dyspepsia with alarm symptoms (60 days [23 to 140 days] versus two months); refractory dyspepsia without alarm symptoms (126 days [42 to 225 days] versus two months); and chronic constipation and diarrhea (141 days [68 to 264 days] versus two months). A minority of patients were seen within target times: probable cancer (33% [95% CI 20% to 47%]); probable inflammatory bowel disease (12% [95% CI 1% to 23%]); iron deficiency anemia (46% [95% CI 37% to 55%]); positive occult blood test (41% [95% CI 28% to 54%]); dyspepsia with alarm symptoms (51% [95% CI 41% to 60%]); refractory dyspepsia without alarm symptoms (33% [95% CI 19% to 47%]); and chronic constipation and diarrhea (21% [95% CI 14% to 29%]). DISCUSSION: Total wait times for the seven indications exceeded the

STS-95 Mission Specialist Robinson suits up during TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Stephen K. Robinson, with the help of Carlos Gillis, of Lockheed Martin, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Robinson and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

Library Media Specialists: Premier Information Specialists for the Information Age

ERIC Educational Resources Information Center

Neuman, Delia

2011-01-01

The information age has given library media specialists an unprecedented opportunity to play a leading role in helping teachers, administrators, and especially students access and use information intelligently. As the school's premier information specialist; the library media specialist has a unique role to play in helping everyone in the school…

Optimizing the Colour and Fabric of Targets for the Control of the Tsetse Fly Glossina fuscipes fuscipes

PubMed Central

Lindh, Jenny M.; Goswami, Parikshit; Blackburn, Richard S.; Arnold, Sarah E. J.; Vale, Glyn A.; Lehane, Mike J.; Torr, Steve J.

2012-01-01

Background Most cases of human African trypanosomiasis (HAT) start with a bite from one of the subspecies of Glossina fuscipes. Tsetse use a range of olfactory and visual stimuli to locate their hosts and this response can be exploited to lure tsetse to insecticide-treated targets thereby reducing transmission. To provide a rational basis for cost-effective designs of target, we undertook studies to identify the optimal target colour. Methodology/Principal Findings On the Chamaunga islands of Lake Victoria , Kenya, studies were made of the numbers of G. fuscipes fuscipes attracted to targets consisting of a panel (25 cm square) of various coloured fabrics flanked by a panel (also 25 cm square) of fine black netting. Both panels were covered with an electrocuting grid to catch tsetse as they contacted the target. The reflectances of the 37 different-coloured cloth panels utilised in the study were measured spectrophotometrically. Catch was positively correlated with percentage reflectance at the blue (460 nm) wavelength and negatively correlated with reflectance at UV (360 nm) and green (520 nm) wavelengths. The best target was subjectively blue, with percentage reflectances of 3%, 29%, and 20% at 360 nm, 460 nm and 520 nm respectively. The worst target was also, subjectively, blue, but with high reflectances at UV (35% reflectance at 360 nm) wavelengths as well as blue (36% reflectance at 460 nm); the best low UV-reflecting blue caught 3× more tsetse than the high UV-reflecting blue. Conclusions/Significance Insecticide-treated targets to control G. f. fuscipes should be blue with low reflectance in both the UV and green bands of the spectrum. Targets that are subjectively blue will perform poorly if they also reflect UV strongly. The selection of fabrics for targets should be guided by spectral analysis of the cloth across both the spectrum visible to humans and the UV region. PMID:22666511

Using non-specialist observers in 4AFC human observer studies

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2017-03-01

Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

Degradable Magnetic Composites for Minimally Invasive Interventions: Device Fabrication, Targeted Drug Delivery, and Cytotoxicity Tests.

PubMed

Peters, Christian; Hoop, Marcus; Pané, Salvador; Nelson, Bradley J; Hierold, Christofer

2016-01-20

Superparamagnetic nanoparticles and a functional, degradable polymer matrix based on poly(ethylene glycol) are combined to enable fully degradable magnetic microdevices for minimally invasive biomedical applications. A bioinspired helical microrobot platform mimicking Escherichia coli bacteria is fabricated and actuated using weak rotating magnetic fields. Locomotion based on corkscrew propulsion, targeted drug delivery, and low-degradation-product cytotoxicity are demonstrated. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Specialist Bibliographic Databases

PubMed Central

2016-01-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls. PMID:27134485

Specialist Bibliographic Databases.

PubMed

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A; Trukhachev, Vladimir I; Kostyukova, Elena I; Gerasimov, Alexey N; Kitas, George D

2016-05-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls.

Fabrication of aerogel capsule, bromine-doped capsule, and modified gold cone in modified target for the Fast Ignition Realization Experiment (FIREX) Project

NASA Astrophysics Data System (ADS)

Nagai, Keiji; Yang, H.; Norimatsu, T.; Azechi, H.; Belkada, F.; Fujimoto, Y.; Fujimura, T.; Fujioka, K.; Fujioka, S.; Homma, H.; Ito, F.; Iwamoto, A.; Jitsuno, T.; Kaneyasu, Y.; Nakai, M.; Nemoto, N.; Saika, H.; Shimoyama, T.; Suzuki, Y.; Yamanaka, K.; Mima, K.

2009-09-01

The development of target fabrication for the Fast Ignition Realization EXperiment (FIREX) Project is described in this paper. For the first stage of the FIREX Project (FIREX-I), the previously designed target has been modified by using a bromine-doped ablator and coating the inner gold cone with a low-density material. A high-quality bromine-doped capsule without vacuoles was fabricated from bromine-doped deuterated polystyrene. The gold surface was coated with a low-density material by electrochemical plating. For the cryogenic fuel target, a brand new type of aerogel material, phloroglucinol/formaldehyde (PF), was investigated and encapsulated to meet the specifications of 500 µm diameter and 20 µm thickness, with 30 nm nanopores. Polystyrene-based low-density materials were investigated and the relationship between the crosslinker content and the nanopore structure was observed.

A Comparison of Selected Supervisory Skills of Content Specialist and Non-Content Specialist University Supervisors

ERIC Educational Resources Information Center

Hunt, Kevin; Mitchell, Murray; Maina, Michael; Griffin, Lisa

2015-01-01

The purpose of this study was to describe and contrast selected approaches to the supervision of student teachers between Content Specialist and Non-Content Specialist university supervisors. Content Specialist supervisors were identified as trained university supervisors with a background in physical education. Non-Content Specialist supervisors…

Targets and processes for fabricating same

DOEpatents

Cowan, Thomas [Dresden, DE; Malekos, Steven [Reno, NV; Korgan, Grant [Reno, NV; Adams, Jesse [Reno, NV; Sentoku, Yasuhiko [Reno, NV; Le Galloudec, Nathalie [Reno, NV; Fuchs, Julien [Paris, FR

2012-07-24

In particular embodiments, the present disclosure provides targets including a metal layer and defining a hollow inner surface. The hollow inner surface has an internal apex. The distance between at least two opposing points of the internal apex is less than about 15 .mu.m. In particular examples, the distance is less than about 1 .mu.m. Particular implementations of the targets are free standing. The targets have a number of disclosed shaped, including cones, pyramids, hemispheres, and capped structures. The present disclosure also provides arrays of such targets. Also provided are methods of forming targets, such as the disclosed targets, using lithographic techniques, such as photolithographic techniques. In particular examples, a target mold is formed from a silicon wafer and then one or more sides of the mold are coated with a target material, such as one or more metals.

Targets and processes for fabricating same

DOEpatents

Adams, Jesse D; Malekos, Steven; Le Galloudec, Nathalie; Korgan, Grant; Cowan, Thomas; Sentoku, Yasuhiko

2016-05-17

In particular embodiments, the present disclosure provides targets including a metal layer and defining a hollow inner surface. The hollow inner surface has an internal apex. The distance between at least two opposing points of the internal apex is less than about 15 .mu.m. In particular examples, the distance is less than about 1 .mu.m. Particular implementations of the targets are free standing. The targets have a number of disclosed shaped, including cones, pyramids, hemispheres, and capped structures. The present disclosure also provides arrays of such targets. Also provided are methods of forming targets, such as the disclosed targets, using lithographic techniques, such as photolithographic techniques. In particular examples, a target mold is formed from a silicon wafer and then one or more sides of the mold are coated with a target material, such as one or more metals.

Targets and processes for fabricating same

DOEpatents

Cowna, Thomas; Malekos, Steven; Korgan, Grant; Adams, Jesse; Sentoku, Yasuhiko; LeGalloudec, Nathalie

2014-06-10

In particular embodiments, the present disclosure provides targets including a metal layer and defining a hollow inner surface. The hollow inner surface has an internal apex. The distance between at least two opposing points of the internal apex is less than about 15 .mu.m. In particular examples, the distance is less than about 1 .mu.m. Particular implementations of the targets are free standing. The targets have a number of disclosed shaped, including cones, pyramids, hemispheres, and capped structures. The present disclosure also provides arrays of such targets. Also provided are methods of forming targets, such as the disclosed targets, using lithographic techniques, such as photolithographic techniques. In particular examples, a target mold is formed from a silicon wafer and then one or more sides of the mold are coated with a target material, such as one or more metals.

Mission Specialist Pedro Duque smiles at camera while at Launch Pad 39B

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA), smiles for the camera from Launch Pad 39B. The STS-95 crew were making final preparations for launch, targeted for liftoff at 2 p.m. on Oct. 29. Other crew members not shown are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialists Scott E. Parazynski, Stephen K. Robinsion, and and Payload Specialists John H. Glenn Jr., senator from Ohio, and Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The STS-95 mission is expected to last 8 days, 21 hours and 49 minutes, returning to KSC at 11:49 a.m. EST on Nov. 7.

Differences in quality standards when prescribing nutritional support: Differences between specialist and non-specialist physicians.

PubMed

Morán López, Jesús Manuel; Piedra León, María; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio

2016-01-01

Adequate nutritional support includes many different aspects, but poor understanding of clinical nutrition by health care professionales often results in an inadequate prescription. A study was conducted to compare enteral and parenteral nutritional support plans prescribed by specialist and non-specialist physicians. Non-specialist physicians recorded anthropometric data from only 13.3% of patients, and none of them performed nutritional assessments. Protein amounts provided by non-specialist physicians were lower than estimated based on ESPEN (10.29g of nitrogen vs 14.62; P<.001). Differences were not statistically significant in the specialist group (14.88g of nitrogen; P=.072). Calorie and glutamine provision and laboratory controls prescribed by specialists were significantly closer to those recommended by clinical guidelines. Nutritional support prescribed by specialists in endocrinology and nutrition at San Pedro de Alcántara Hospital was closer to clinical practice guideline standards and of higher quality as compared to that prescribed by non-specialists. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Large space structures fabrication experiment. [on-orbit fabrication of graphite/thermoplastic beams

NASA Technical Reports Server (NTRS)

1978-01-01

The fabrication machine used for the rolltrusion and on-orbit forming of graphite thermoplastic (CTP) strip material into structural sections is described. The basic process was analytically developed parallel with, and integrated into the conceptual design of, a flight experiment machine for producing a continuous triangular cross section truss. The machine and its associated ancillary equipment are mounted on a Space Lab pallet. Power, thermal control, and instrumentation connections are made during ground installation. Observation, monitoring, caution and warning, and control panels and displays are installed at the payload specialist station in the orbiter. The machine is primed before flight by initiation of beam forming, to include attachment of the first set of cross members and anchoring of the diagonal cords. Control of the experiment will be from the orbiter mission specialist station. Normal operation is by automatic processing control software. Machine operating data are displayed and recorded on the ground. Data is processed and formatted to show progress of the major experiment parameters including stable operation, physical symmetry, joint integrity, and structural properties.

Twelve Scientific Specialists of the Peenemuende Team

NASA Technical Reports Server (NTRS)

2004-01-01

Twelve scientific specialists of the Peenemuende team at the front of Building 4488, Redstone Arsenal, Huntsville, Alabama. They led the Army's space efforts at ABMA before transfer of the team to National Aeronautic and Space Administration (NASA), George C. Marshall Space Flight Center (MSFC). (Left to right) Dr. Ernst Stuhlinger, Director, Research Projects Office; Dr. Helmut Hoelzer, Director, Computation Laboratory: Karl L. Heimburg, Director, Test Laboratory; Dr. Ernst Geissler, Director, Aeroballistics Laboratory; Erich W. Neubert, Director, Systems Analysis Reliability Laboratory; Dr. Walter Haeussermarn, Director, Guidance and Control Laboratory; Dr. Wernher von Braun, Director Development Operations Division; William A. Mrazek, Director, Structures and Mechanics Laboratory; Hans Hueter, Director, System Support Equipment Laboratory;Eberhard Rees, Deputy Director, Development Operations Division; Dr. Kurt Debus, Director Missile Firing Laboratory; Hans H. Maus, Director, Fabrication and Assembly Engineering Laboratory

Biased Target Ion Beam Deposition and Nanoskiving for Fabricating NiTi Alloy Nanowires

NASA Astrophysics Data System (ADS)

Hou, Huilong; Horn, Mark W.; Hamilton, Reginald F.

2016-12-01

Nanoskiving is a novel nanofabrication technique to produce shape memory alloy nanowires. Our previous work was the first to successfully fabricate NiTi alloy nanowires using the top-down approach, which leverages thin film technology and ultramicrotomy for ultra-thin sectioning. For this work, we utilized biased target ion beam deposition technology to fabricate nanoscale (i.e., sub-micrometer) NiTi alloy thin films. In contrast to our previous work, rapid thermal annealing was employed for heat treatment, and the B2 austenite to R-phase martensitic transformation was confirmed using stress-temperature and diffraction measurements. The ultramicrotome was programmable and facilitated sectioning the films to produce nanowires with thickness-to-width ratios ranging from 4:1 to 16:1. Energy dispersive X-ray spectroscopy analysis confirmed the elemental Ni and Ti make-up of the wires. The findings exposed the nanowires exhibited a natural ribbon-like curvature, which depended on the thickness-to-width ratio. The results demonstrate nanoskiving is a potential nanofabrication technique for producing NiTi alloy nanowires that are continuous with an unprecedented length on the order of hundreds of micrometers.

Specialist nectar-yeasts decline with urbanization in Berlin

NASA Astrophysics Data System (ADS)

Wehner, Jeannine; Mittelbach, Moritz; Rillig, Matthias C.; Verbruggen, Erik

2017-03-01

Nectar yeasts are common inhabitants of insect-pollinated flowers but factors determining their distribution are not well understood. We studied the influence of host identity, environmental factors related to pollution/urbanization, and the distance to a target beehive on local distribution of nectar yeasts within Robinia pseudoacacia L. and Tilia tomentosa Moench in Berlin, Germany. Nectar samples of six individuals per species were collected at seven sites in a 2 km radius from each target beehive and plated on YM-Agar to visualise the different morphotypes, which were then identified by sequencing a section of the 26S rDNA gene. Multivariate linear models were used to analyze the effects of all investigated factors on yeast occurrence per tree. Yeast distribution was mainly driven by host identity. The influence of the environmental factors (NO2, height of construction, soil sealing) strongly depended on the radius around the tree, similar to the distance of the sampled beehive. Incidence of specialist nectar-borne yeast species decreased with increasing pollution/urbanization index. Given that specialist yeast species gave way to generalist yeasts that have a reduced dependency on pollinators for between-flower dispersal, our results indicate that increased urbanization may restrict the movement of nectar-specialized yeasts, via limitations of pollinator foraging behavior.

Documentation and Analysis of IAEA (International Atomic Energy Agency) Safeguards Implementation at the Exxon Nuclear Fuel Fabrication Plant.

DTIC Science & Technology

1984-10-01

SAFEGUARDS AT SIMILAR FACILTTIES ASEA -ATOM LEU FUEL FABRICATION PLANT IN VASTERAS, SWEDEN..................B-1 APPENDIX C - EFFECTS OF NONMEASUREMENT ERRORS...second visit was to the ASEA -ATOM’s fuel fabrication plant in Vasteras, Sweden. The safeguards specialists for those plants were interviewed by R...Facilities, ASEA -ATOM LEU Fuel Fabrication Plant in Vasteras, Sweden, by V. Andersson of ASEA -ATOM, Vasteras, Sweden and R. Nilson of Exxon Nuclear

Extension Specialists: A Self-Analysis.

ERIC Educational Resources Information Center

Gerber, John M.

1985-01-01

To document perceived changes in the role of the extension horticulture specialist, a national survey of state horticulture specialists was conducted in 1983. Extension specialists in horticulture appear to be moving away from the traditional activities of farm visits and personal interaction with individual producers. (CT)

STS-82 Mission Specialist Steven L. Smith during TCDT

NASA Technical Reports Server (NTRS)

1997-01-01

STS-82 Mission Specialist Steven L. Smith adjusts the glove of his launch and entry space suit during a practice countdown at KSC. Smith and the other six STS-82 crew members are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT), a dress rehearsal for launch. STS-82 will be the second Hubble Space Telescope servicing mission. Liftoff is targeted for February 11.

Examining the Promotion of Healthy Eating among Exercise Specialists: A Cross-sectional Study.

PubMed

Johnson, Steven T; Cornish, Stephen M; Lytvyak, Ellina; Taylor, Lorian M; Bell, Gordon; Vallance, Jeff; Fraser, Shawn; Murray, Terra

2015-06-01

The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P < 0.05) and promoting healthy eating (P < 0.01). Confidence was higher among those with more professional experience but who did not meet Canada's Food Guide recommendations (P < 0.05). Professional experience, personal dietary practices, and confidence are important characteristics when considering the assessment and promotion of healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.

48 CFR 552.236-72 - Specialist.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 552.236-72... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 552.236-72 Specialist. As prescribed in 536.570-3, insert the following clause: Specialist (APR 1984) The term “Specialist...

Few older people in New Zealand who commit suicide receive specialist psychogeriatric services.

PubMed

Cheung, Gary; Casey, Jane

2014-08-01

Suicide in older people is a growing public health concern in many parts of the world. The literature on this issue is lacking in New Zealand. The aim of this study is to ascertain whether this group is accessing specialist psychogeriatric services. A retrospective case series study of completed suicides in older people (≥65 years) during a three-year period from January 2010 to December 2012 was performed. An online survey detailing demographic and clinical information was completed by psychiatrists in 15 of the 20 District Health Boards in New Zealand. Only about 15% of older people who committed suicide were accessing specialist psychogeriatric services and the group with the highest suicide rate (men≥85 years) did not feature in specialist services. Depression (61%) was the most common diagnosis and nearly half (35%) had had contact with specialist services within three days prior to the suicide. Over half (52%) had a history of past suicide attempt(s). Older people who complete suicide are infrequently accessing specialist services. In those that do, there are questions to be answered regarding suicide prediction and prevention for this high-risk group of vulnerable individuals. More research is required targeting those not accessing specialist services, in particular the high risk group of older men. The role of general practitioner, community care, the assessment and management of depression and whether there is any access issue to specialist psychogeriatric services require elucidation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Small Business Specialists.

DTIC Science & Technology

1997-12-01

located throughout the United States. Each service and agency has an Office of the Director of Small and Disadvantaged Business Utilization. They also...have small business specialists at each of their procurement and contract management offices to assist small businesses , small disadvantaged businesses ...and women-owned small businesses firms in marketing their products and services with the DoD. These specialists provide information and guidance on (1

Fabrication of high-k dielectric Calcium Copper Titanate (CCTO) target by solid state route

NASA Astrophysics Data System (ADS)

Tripathy, N.; Das, K. C.; Ghosh, S. P.; Bose, G.; Kar, J. P.

2016-02-01

CaCu3Ti4O12 (CCTO) ceramic pellet of 10mm diameter has been synthesized by adopting solid state route. The structural and morphological characterization of the ceramics sample was carried out by X-ray diffraction (XRD) and scanning electron microscope (SEM), respectively. XRD pattern revealed the CCTO phase formation, where as SEM micrograph shows the sample consisting of well defined grain and grain boundaries. The room temperature dielectric constant of the sample was found to be ∼ 5000 at 1kHz. After successful preparation of CCTO pellet, a 2 inch diameter CCTO sputtering target is also fabricated in order to deposit CCTO thin films for microelectronic applications.

[The fiscal position of medical specialists].

PubMed

Stevens, S; Moors, M

2013-01-01

Independent medical specialists in the Netherlands are treated as entrepreneurs for tax purposes and therefore enjoy tax benefits. A change in the legal relationship between medical specialists and hospitals is foreseen in 2015. Independent medical specialists will then no longer be considered to be entrepreneurs. This could negatively affect their tax position. The Dutch government has adopted a policy aimed at controlling expenses arising from medical specialists' fees. According to this policy, the formation of regional practices or mega-practices of specialists will be discouraged. In contrast, the current fiscal legislation encourages medical specialists to incorporate their practice into regional practices or mega-practices or to become shareholders of their hospitals. It has been proposed that fiscal benefits be linked to certain aspects of entrepreneurship, such as investing in medical equipment or employing medical personnel.

Fabrication of functional hollow microspheres constructed from MOF shells: Promising drug delivery systems with high loading capacity and targeted transport

PubMed Central

Gao, Xuechuan; Hai, Xiao; Baigude, Huricha; Guan, Weihua; Liu, Zhiliang

2016-01-01

An advanced multifunctional, hollow metal-organic framework (MOF) drug delivery system with a high drug loading level and targeted delivery was designed and fabricated for the first time and applied to inhibit tumour cell growth. This hollow MOF targeting drug delivery system was prepared via a simple post-synthetic surface modification procedure, starting from hollow ZIF-8 successfully obtained for the first time via a mild phase transformation under solvothermal conditions. As a result, the hollow ZIF-8 exhibits a higher loading capacity for the model anticancer drug 5-fluorouracil (5-FU). Subsequently, 5-FU-loaded ZIF-8 was encapsulated into polymer layers (FA-CHI-5-FAM) with three components: a chitosan (CHI) backbone, the imaging agent 5-carboxyfluorescein (5-FAM), and the targeting reagent folic acid (FA). Thus, an advanced drug delivery system, ZIF-8/5-FU@FA-CHI-5-FAM, was fabricated. A cell imaging assay demonstrated that ZIF-8/5-FU@FA-CHI-5-FAM could target and be taken up by MGC-803 cells. Furthermore, the as-prepared ZIF-8/5-FU@FA-CHI-5-FAM exhibited stronger cell growth inhibitory effects on MGC-803 cells because of the release of 5-FU, as confirmed by a cell viability assay. In addition, a drug release experiment in vitro indicated that ZIF-8/5-FU@FA-CHI-5-FAM exhibited high loading capacity (51%) and a sustained drug release behaviour. Therefore, ZIF-8/5-FU@FA-CHI-5-FAM could provide targeted drug transportation, imaging tracking and localized sustained release. PMID:27876876

48 CFR 536.570-3 - Specialist.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 536.570-3... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-3 Specialist. Insert 552.236-72, Specialist, in solicitations and contracts for construction if the technical sections...

Military Curricula for Vocational & Technical Education. Orthopedic Specialist, Classroom Course 10-13.

ERIC Educational Resources Information Center

Brooke Army Medical Center, Fort Sam Houston, TX. Health Care Research Div.

These military-developed curriculum materials for a course for orthopedic specialists are targeted for students from grades 11 through the adult level. The course is designed to provide a working knowledge of the application of casts, traction, and splints to orthopedic patients and the removal of these devices; a working knowledge of assisting in…

Invisible Roles of Doctoral Program Specialists

ERIC Educational Resources Information Center

Bachman, Eva Burns; Grady, Marilyn L.

2016-01-01

The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…

International Halley Watch: Discipline specialists for large scale phenomena

NASA Technical Reports Server (NTRS)

Brandt, J. C.; Niedner, M. B., Jr.

1986-01-01

The largest scale structures of comets, their tails, are extremely interesting from a physical point of view, and some of their properties are among the most spectacular displayed by comets. Because the tail(s) is an important component part of a comet, the Large-Scale Phenomena (L-SP) Discipline was created as one of eight different observational methods in which Halley data would be encouraged and collected from all around the world under the aspices of the International Halley Watch (IHW). The L-SP Discipline Specialist (DS) Team resides at NASA/Goddard Space Flight Center under the leadership of John C. Brandt, Malcolm B. Niedner, and their team of image-processing and computer specialists; Jurgan Rahe at NASA Headquarters completes the formal DS science staff. The team has adopted the study of disconnection events (DE) as its principal science target, and it is because of the rapid changes which occur in connection with DE's that such extensive global coverage was deemed necessary to assemble a complete record.

Adoption, implementation and prioritization of specialist outreach policy in Australia: a national perspective.

PubMed

O'Sullivan, Belinda G; Joyce, Catherine M; McGrail, Matthew R

2014-07-01

The World Health Organization has endorsed the use of outreach to promote: efficient redeployment of the health-care workforce; continuity of care at the local level; and professional support for local, rural, health-care workers. Australia is the only country that has had, since 2000, a sustained national policy on outreach for subsidizing medical specialist outreach to rural areas. This paper describes the adoption, implementation and prioritization of a national specialist outreach policy in Australia. Adoption of the national policy followed a long history of successful outreach, largely driven by the professional interest and personal commitment of the workforce. Initially the policy supported only new outreach services but concerns about the sustainability of existing services resulted in eligibility for funding being extended to all specialist services. The costs of travel, travel time, accommodation, professional support, staff relief at specialists' primary practices and equipment hire were subsidized. Over time, a national political commitment to the equitable treatment of indigenous people resulted in more targeted support for outreach in remote areas. Current priorities are: (i) establishing team-based outreach services; (ii) improving local staff's skills; (iii) achieving local coordination; and (iv) conducting a nationally consistent needs assessment. The absence of subsidies for specialists' clinical work can discourage private specialists from providing services in remote areas where clinical throughput is low. To be successful, outreach policy must harmonize with the interests of the workforce and support professional autonomy. Internationally, the development of outreach policy must take account of the local pay and practice conditions of health workers.

STS-95 Mission Specialist Steve Robinson in white room

NASA Technical Reports Server (NTRS)

1998-01-01

In the environmental chamber known as the white room, STS-95 Mission Specialist Stephen K. Robinson is prepared by white room crew members (left) Danny Wyatt and Dave Law (right) for entry into the Space Shuttle Discovery for his second flight into space. The STS-95 mission, targeted for launch at 2 p.m. EST on Oct. 29, is expected to last 8 days, 21 hours and 49 minutes, and return to KSC at 11:49 a.m. EST on Nov. 7.

Injectable 3-D Fabrication of Medical Electronics at the Target Biological Tissues

NASA Astrophysics Data System (ADS)

Jin, Chao; Zhang, Jie; Li, Xiaokang; Yang, Xueyao; Li, Jingjing; Liu, Jing

2013-12-01

Conventional transplantable biomedical devices generally request sophisticated surgery which however often causes big trauma and serious pain to the patients. Here, we show an alternative way of directly making three-dimensional (3-D) medical electronics inside the biological body through sequential injections of biocompatible packaging material and liquid metal ink. As the most typical electronics, a variety of medical electrodes with different embedded structures were demonstrated to be easily formed at the target tissues. Conceptual in vitro experiments provide strong evidences for the excellent performances of the injectable electrodes. Further in vivo animal experiments disclosed that the formed electrode could serve as both highly efficient ECG (Electrocardiograph) electrode and stimulator electrode. These findings clarified the unique features and practicability of the liquid metal based injectable 3-D fabrication of medical electronics. The present strategy opens the way for directly manufacturing electrophysiological sensors or therapeutic devices in situ via a truly minimally invasive approach.

STS-88 Mission Specialist Currie receives M-113 training during TCDT activities

NASA Technical Reports Server (NTRS)

1998-01-01

STS-88 Mission Specialist Nancy J. Currie prepares to operate an M-113, an armored personnel carrier, as part of emergency egress training under the watchful eye of instructor George Hoggard (left) during Terminal Countdown Demonstration Test (TCDT) activities. The TCDT also provides the crew with simulated countdown exercises and opportunities to inspect their mission payloads in the orbiter's payload bay. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module. Others in the STS-88 crew are Mission Commander Robert D. Cabana; Pilot Frederick W. 'Rick' Sturckow; and Mission Specialists Jerry L. Ross, James H. Newman, and Sergei Konstantinovich Krikalev, a Russian cosmonaut.

Pediatric Specialists

MedlinePlus

... this site from a secured browser on the server. Please enable scripts and reload this page. Turn ... for Referral to Pediatric Surgical Specialists Sports Medicine Professionals What is a Child Abuse Pediatrician? What is ...

Certification of School Media Specialists.

ERIC Educational Resources Information Center

Hawthorne, Dorothy, Ed.

Recommendations for certification requirements for the school media specialist in Texas were the concern of the conference reported here. Two papers presented were: "The Emerging Profession of Media Specialists," and "Certification for Tomorrow," chapter three of the proceedings gives a panel on "Certification" and…

Clinical nurse specialists as entrepreneurs: constrained or liberated.

PubMed

Austin, Lynn; Luker, Karen; Roland, Martin; Ronald, Martin

2006-12-01

This qualitative study explored the experiences of two groups of clinical nurse specialists--continence advisors and tissue viability nurses--working in primary care in the UK. In particular, the study focused on how clinical nurse specialists' relationships with other health-care professionals had an impact on their role. Clinical nurse specialists are recognized worldwide as having expertise in a given field, which they use to develop the practice of others. Additionally, clinical nurse specialists share many of the characteristics of entrepreneurs, which they use to develop services related to their speciality. However, little research has been conducted in relation to clinical nurse specialists' experiences as they attempt to diversify nursing practice. An ethnographic approach was adopted comprising many elements of Glaserian grounded theory. Data were collected via participant observation and face-to-face interviews with 22 clinical nurse specialists. Services provided by clinical nurse specialists were not static, clinical nurse specialists being the main drivers for service developments. However, clinical nurse specialists encountered difficulties when introducing new ideas. Given their role as advisors, clinical nurse specialists lacked authority to bring about change and were dependent on a number of mechanisms to bring about change, including 'cultivating relationships' with more powerful others, most notably the speciality consultant. The UK government has pledged to 'liberate the talents of nurses' so that their skills can be used to progress patient services. This study highlights the fact that a lack of collaborative working practices between health-care professionals led to clinical nurse specialists being constrained. Health-care organizations need to provide an environment in which the entrepreneurial skills of clinical nurse specialists may be capitalized on. In the absence of an outlet for their ideas regarding service developments, clinical

Innovative model uses a new brand of specialist to target the high-risk chronically ill.

PubMed

2002-06-01

Some patients simply can't be taken care of in your typical 15-minute office visit. That's why a Houston-based organization developed a new model--and a new specialist--to deal with the growing number of patients affected by multiple diagnoses and other factors putting them at high risk for hospital utilization. With early success, the approach has now attracted the attention of Medicare and other insurers.

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

Lesion detectability in 2D-mammography and digital breast tomosynthesis using different targets and observers

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2018-05-01

This work investigates the detection performance of specialist and non-specialist observers for different targets in 2D-mammography and digital breast tomosynthesis (DBT) using the OPTIMAM virtual clinical trials (VCT) Toolbox and a 4-alternative forced choice (4AFC) assessment paradigm. Using 2D-mammography and DBT images of virtual breast phantoms, we compare the detection limits of simple uniform spherical targets and irregular solid masses. Target diameters of 4 mm and 6 mm have been chosen to represent target sizes close to the minimum detectable size found in breast screening, across a range of controlled contrast levels. The images were viewed by a set of specialist observers (five medical physicists and six experienced clinical readers) and five non-specialists. Combined results from both observer groups indicate that DBT has a significantly lower detectable threshold contrast than 2D-mammography for small masses (4 mm: 2.1% [DBT] versus 6.9% [2D]; 6 mm: 0.7% [DBT] versus 3.9% [2D]) and spheres (4 mm: 2.9% [DBT] versus 5.3% [2D]; 6 mm: 0.3% [DBT] versus 2.2% [2D]) (p  <  0.0001). Both observer groups found spheres significantly easier to detect than irregular solid masses for both sizes and modalities (p  <  0.0001) (except 4 mm DBT). The detection performances of specialist and non-specialist observers were generally found to be comparable, where each group marginally outperformed the other in particular detection tasks. Within the specialist group, the clinical readers performed better than the medical physicists with irregular masses (p  <  0.0001). The results indicate that using spherical targets in such studies may produce over-optimistic detection thresholds compared to more complex masses, and that the superiority of DBT for detecting masses over 2D-mammography has been quantified. The results also suggest specialist observers may be supplemented by non-specialist observers (with training) in some types of 4AFC studies.

A typology of specialists' clinical roles.

PubMed

Forrest, Christopher B

2009-06-08

High use of specialist physicians and specialized procedures coupled with low exposure to primary care are distinguishing traits of the US health care system. Although the tasks of the primary care medical home are well established, consensus on the normative clinical roles of specialist physicians has not been achieved, which makes it unlikely that the specialist workforce is being used most effectively and efficiently. This article describes a typology of specialists' clinical roles that is based on the conceptual basis for health care specialism and empirical evaluations of the specialty referral process. The report concludes with a discussion on the implications of the typology for improving the effectiveness and efficiency of the primary-specialty care interface.

Nanocarbon materials fabricated using plasmas

NASA Astrophysics Data System (ADS)

Hatakeyama, Rikizo

2017-12-01

Since the discovery of fullerenes more than three decades ago, new kinds of nanoscale materials of carbon allotropes called "nanocarbons" have so far been discovered or synthesized at successive intervals as cases such as carbon nanotubes, carbon nanohorns, graphene, carbon nanowalls, and a carbon nanobelt, while nanodiamonds were actually discovered before then. Their attractively excellent mechanical, physical, and chemical properties have driven researchers to continuously create one of the hottest frontiers in materials science and technology. While plasma states have often been involved in their discovery, on the other hand, plasma-based approaches to this exciting field originally hold promising and enormous potentials for advancing and expanding industrial/biomedical applications of nanocarbons of great diversity. This article provides an extensive overview on plasma-fabricated nanocarbon materials, where the term "fabrication" is defined as synthesis, functionalization, and assembly of devices to cover a wide range of issues associated with the step-by-step plasma processes. Specific attention has been paid to the comparative examination between plasma-based and non-plasma methods for fabricating the nanocarobons with an emphasis on the advantages of plasma processing, such as low-temperature/large-scale fabrication and diversity-carrying structure controllability. The review ends with current challenges and prospects including a ripple effect of the nanocarbon studies on the development of related novel nanomaterials such as transition metal dichalcogenides. It contains not only the latest progress in the field for cutting-edge scientists and engineers, but also the introductory guidance to non-specialists such as lower-class graduate students.

Making Generalists Out of Specialists.

ERIC Educational Resources Information Center

Malinowski, Jon C.

2001-01-01

Most camps use specialists to run activities and cabin leaders to manage campers. However, a generalist model offers greater leadership development opportunities. To implement a more generalist paradigm, have camp leaders express their areas of skill and interest, pair up experienced and inexperienced staff, allow specialists to cover activities…

Clarifying the role of the mental health peer specialist in Massachusetts, USA: insights from peer specialists, supervisors and clients.

PubMed

Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith

2014-01-01

Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated

Elementary Reading Specialists' Perspectives towards Their Work

ERIC Educational Resources Information Center

Bunker, Wendy Woods

2017-01-01

The purpose of this qualitative interview study was to explore the narratives of 22 elementary reading specialists about their work. It asked: What were reading specialists' narratives about their work and their influences? The study looked at reading specialists' day-to-day functioning within an institution and at reading specialists'…

Fabrication of lactobionic-loaded chitosan microcapsules as potential drug carriers targeting the liver.

PubMed

Zhang, Jing; Li, Cao; Xue, Zhi-Yuan; Cheng, Hai-Wei; Huang, Fu-Wei; Zhuo, Ren-Xi; Zhang, Xian-Zheng

2011-04-01

This paper demonstrates a general approach for fabrication of lactobionic chitosan microcapsules using layer-by-layer assembly via click chemistry. Chitosan was selectively modified with either azide (CHI-Az) or alkyne (CHI-Alk) groups. The growth of the CHI-Az/CHI-Alk click multilayer was studied experimentally by multilayer assembly on planar supports. Linear buildup of the film was observed. The chitosan click capsules were also analyzed with confocal laser scanning microscopy and transmission electron microscopy. Capsules were found to have regular spherical shapes. In addition, (CHI-Az/CHI-Alk)-coated particles were modified with fluorescein isothiocyanate to ensure that the particles can be easily post-functionalized. Finally, lactobionic acid was conjugated onto the (CHI-Az/CHI-Alk)-coated particles and the lactobionic particles exhibited hepatoma cell (HepG2) targeting behavior. Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Fabrication and evaluation of tumor-targeted positive MRI contrast agent based on ultrasmall MnO nanoparticles.

PubMed

Huang, Haitao; Yue, Tao; Xu, Ke; Golzarian, Jafar; Yu, Jiahui; Huang, Jin

2015-07-01

Gd(III) chelate is currently used as positive magnetic resonance imaging (MRI) contrast agent in clinical diagnosis, but generally induces the risk of nephrogenic systemic fibrosis (NSF) due to the dissociated Gd(3+) from Gd(III) chelates. To develop a novel positive MRI contrast agent with low toxicity and high sensitivity, ultrasmall MnO nanoparticles were PEGylated via catechol-Mn chelation and conjugated with cRGD as active targeting function to tumor. Particularly, the MnO nanoparticles with a size of ca. 5nm were modified by α,β-poly(aspartic acid)-based graft polymer containing PEG and DOPA moieties and, meanwhile, conjugated with cRGD to produce the contrast agent with a size of ca. 100nm and a longitudinal relaxivity (r1) of 10.2mM(-1)S(-1). Such nanoscaled contrast agent integrated passive- and active-targeting function to tumor, and its efficient accumulation behavior in tumor was verified by in vivo distribution study. At the same time, the PEG moiety played a role of hydrophilic coating to improve the biocompatibility and stability under storing and physiological conditions, and especially might guarantee enough circulation time in blood. Moreover, in vivo MRI revealed a good and long-term effect of enhancing MRI signal for as-fabricated contrast agent while cell viability assay proved its acceptable cytotoxicity for MRI application. On the whole, the as-fabricated PEGylated and cRGD-functionalized contrast agent based on ultrasmall MnO nanoparticles showed a great potential to the T1-weighted MRI diagnosis of tumor. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

Specialist clinics: a better way to care?

PubMed Central

Mutch, W J

1992-01-01

A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents already ran a specialist clinic. The same proportion felt that a Parkinsonism clinic would be useful despite the fact that only 20% stated that they would run one. It is argued that specialist clinics facilitate the effective management of conditions such as Parkinson's disease, especially if supported by a specialist nurse or other appropriate staff. PMID:1564504

STS-95 Mission Specialist Pedro Duque in white room

NASA Technical Reports Server (NTRS)

1998-01-01

In the environmental chamber known as the white room, STS-95 Mission Specialist Pedro Duque of Spain, with the European Space Agency, is prepared by white room crew members Danny Wyatt (left) and Travis Thompson (right) for entry into the Space Shuttle Discovery for his first flight into space. The STS-95 mission, targeted for launch at 2 p.m. EST on Oct. 29, is expected to last 8 days, 21 hours and 49 minutes, and return to KSC at 11:49 a.m. EST on Nov. 7.

What Is an Adolescent Health Specialist?

MedlinePlus

... Health Specialists — The Best Care For Teens And Young Adults Adolescents have unique and important health care ... know how to communicate effectively with teens and young adults. Adolescent health specialists are also specially trained ...

STS-88 Mission Specialist Nancy Currie arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-88 Mission Specialist Nancy J. Currie climbs out of a T-38 jet aircraft in which she arrived after dark at the Shuttle Landing Facility in order to take part in Terminal Countdown Demonstration Test (TCDT) activities. The TCDT provides the crew with simulated countdown exercises, emergency egress training, and opportunities to inspect their mission payloads in the orbiter's payload bay. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module. Others in the STS-88 crew are Mission Commander Robert D. Cabana, Pilot Frederick W. 'Rick' Sturckow, Mission Specialists Jerry L. Ross, James H. Newman and Sergei Krikalev, a Russian cosmonaut. Ross and Newman will make three spacewalks to connect power, data and utility lines and install exterior equipment.

E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course.

PubMed

Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M; Biermann, Martin

2017-07-01

While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. To assess the potential of e-learning in specialist education in medical imaging. An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs.

Indium oxide co-doped with tin and zinc: A simple route to highly conducting high density targets for TCO thin-film fabrication

NASA Astrophysics Data System (ADS)

Saadeddin, I.; Hilal, H. S.; Decourt, R.; Campet, G.; Pecquenard, B.

2012-07-01

Indium oxide co-doped with tin and zinc (ITZO) ceramics have been successfully prepared by direct sintering of the powders mixture at 1300 °C. This allowed us to easily fabricate large highly dense target suitable for sputtering transparent conducting oxide (TCO) films, without using any cold or hot pressing techniques. Hence, the optimized ITZO ceramic reaches a high relative bulk density (˜ 92% of In2O3 theoretical density) and higher than the well-known indium oxide doped with tin (ITO) prepared under similar conditions. All X-ray diagrams obtained for ITZO ceramics confirms a bixbyte structure typical for In2O3 only. This indicates a higher solubility limit of Sn and Zn when they are co-doped into In2O3 forming a solid-solution. A very low value of electrical resistivity is obtained for [In2O3:Sn0.10]:Zn0.10 (1.7 × 10-3 Ω cm, lower than ITO counterpart) which could be fabricated to high dense ceramic target suing pressure-less sintering.

Laser targets compensate for limitations in inertial confinement fusion drivers

NASA Astrophysics Data System (ADS)

Kilkenny, J. D.; Alexander, N. B.; Nikroo, A.; Steinman, D. A.; Nobile, A.; Bernat, T.; Cook, R.; Letts, S.; Takagi, M.; Harding, D.

2005-10-01

Success in inertial confinement fusion (ICF) requires sophisticated, characterized targets. The increasing fidelity of three-dimensional (3D), radiation hydrodynamic computer codes has made it possible to design targets for ICF which can compensate for limitations in the existing single shot laser and Z pinch ICF drivers. Developments in ICF target fabrication technology allow more esoteric target designs to be fabricated. At present, requirements require new deterministic nano-material fabrication on micro scale.

Attitudes regarding specialist referrals in periodontics.

PubMed

Sharpe, G; Durham, J A; Preshaw, P M

2007-02-24

To examine the attitudes of dental practitioners towards specialist periodontal referral in the North East of England. Semi-structured interviews were conducted with a purposive sample of 10 practitioners. Interviews continued until data saturation occurred. The data were organised using a framework and analysed by two researchers working independently. Perceptions of periodontal disease and treatment appear to be heavily influenced by the NHS remuneration system. Treatment in general practice was limited to simple scaling and there was an apparent reluctance to treat advanced periodontitis. Such cases were commonly referred to specialists, confirming the demand for a referral service in periodontics. The perceived potential for medico-legal consequences was a strong driver of referrals. Distance to the referral centre and the perceived costs of treatment were significant barriers to referral. Dentists valued the specialist's personal reputation and clinical skills more highly than academic status. Deficiencies in communication between primary and secondary care were highlighted. Increased resources are required to manage periodontal diseases within the NHS. There is a need for a periodontal referral service in the North East of England to improve accessibility to specialist care. This would appear to be most appropriately delivered by increased numbers of specialist practitioners.

Simulation-Based Assessment of ECMO Clinical Specialists.

PubMed

Fehr, James J; Shepard, Mark; McBride, Mary E; Mehegan, Mary; Reddy, Kavya; Murray, David J; Boulet, John R

2016-06-01

The aims of the study were (1) to create multiple scenarios that simulate a range of urgent and emergent extracorporeal membrane oxygenation (ECMO) events and (2) to determine whether these scenarios can provide reliable and valid measures of a specialist's advanced skill in managing ECMO emergencies. Multiscenario simulation-based performance assessment was performed. The study was conducted in the Saigh Pediatric Simulation Center at St. Louis Children's Hospital. ECMO clinical specialists participated in the study. Twenty-five ECMO specialists completed 8 scenarios presenting acute events in simulated ECMO patients. Participants were evaluated by 2 separate reviewers for completion of key actions and for global performance. The scores were highest for the hemodilution scenario, whereas the air entrainment scenario had the lowest scores. Psychometric analysis demonstrated that ECMO specialists with more than 1 year of experience outperformed the specialists with less than 1 year of experience. Participants endorsed these sessions as important and representative of events that might be encountered in practice. The scenarios could serve as a component of an ECMO education curriculum and be used to assess clinical specialists' readiness to manage ECMO emergencies.

Information specialist for a coming age (1)

NASA Astrophysics Data System (ADS)

Fujii, Kunihiko

It is said that a drastic progress is being made in information service today. Author guesses what talent and quality will be needed for future information specialist, on the assumption of image of the future information service. In the highly computerized society, information specialist will be required to make a quick delivery of high quality information. To meet such a high level request from researchers, information specialist will have to acquire much more information technology than ever. In the coming age of SIS, information specialist should have a qualification for librarian and researcher, and try to offer the active service with the enhanced technology.

Fabrication of high specificity hollow mesoporous silica nanoparticles assisted by Eudragit for targeted drug delivery.

PubMed

She, Xiaodong; Chen, Lijue; Velleman, Leonora; Li, Chengpeng; Zhu, Haijin; He, Canzhong; Wang, Tao; Shigdar, Sarah; Duan, Wei; Kong, Lingxue

2015-05-01

Hollow mesoporous silica nanoparticles (HMSNs) are one of the most promising carriers for effective drug delivery due to their large surface area, high volume for drug loading and excellent biocompatibility. However, the non-ionic surfactant templated HMSNs often have a broad size distribution and a defective mesoporous structure because of the difficulties involved in controlling the formation and organization of micelles for the growth of silica framework. In this paper, a novel "Eudragit assisted" strategy has been developed to fabricate HMSNs by utilising the Eudragit nanoparticles as cores and to assist in the self-assembly of micelle organisation. Highly dispersed mesoporous silica spheres with intact hollow interiors and through pores on the shell were fabricated. The HMSNs have a high surface area (670 m(2)/g), small diameter (120 nm) and uniform pore size (2.5 nm) that facilitated the effective encapsulation of 5-fluorouracil within HMSNs, achieving a high loading capacity of 194.5 mg(5-FU)/g(HMSNs). The HMSNs were non-cytotoxic to colorectal cancer cells SW480 and can be bioconjugated with Epidermal Growth Factor (EGF) for efficient and specific cell internalization. The high specificity and excellent targeting performance of EGF grafted HMSNs have demonstrated that they can become potential intracellular drug delivery vehicles for colorectal cancers via EGF-EGFR interaction. Copyright © 2014 Elsevier Inc. All rights reserved.

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

Parts Specialist.

ERIC Educational Resources Information Center

Fuqua, Lou; Fuqua, Debbie

Designed to address the skills that an auto parts specialist must master in order to be effective in the market place, this manual consists of 13 units of instruction. Covered in the units are orientation; human relations; communications; safety; parts and systems identification; stocking, shipping, and receiving; inventory control; cataloging and…

ATTITUDE OF CLEFT CARE SPECIALISTS IN AFRICA TOWARDS PRESURGICAL ORTHOPAEDICS.

PubMed

Adeyemi, A T; Bankole, O O

2012-12-01

To determine the attitude of cleft care specialists working in Africa towards pre-surgical orthopaedics. A cross sectional study. Pan-African conference on cleft lip and palate in Nigeria. Sixty cleft care specialists working in Africa. The general attitude towards pre-surgicalorthopaedics was positive. Majority of the specialists employ pre-surgical orthopaedics before surgical repair. Fifty four (91%) of the specialists use plaster strapping for cases of bilateral cleft, five (8.3%) use nasoalveolar molding and one (2%) use feeding plate. Half of the specialists (50%) felt that pre-surgical orthopaedics is to be managed by orthodontists alone. There were significant difference in attitude towards pre-surgical orthopaedics between providers (p < 0.05). Orthodontists had a strong positive attitude towards pre-surgical orthopaedics than other specialists. Younger specialists had a more positive attitude towards pre-surgical orthopaedics than older specialists. Cleft care specialists in Africa have a positive attitude towards pre-surgical orthopaedics. Majority of them use plaster strapping technique. Younger specialists have a more favorable attitude towards pre-surgical orthopaedics than older specialists.

E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course

PubMed Central

Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M

2017-01-01

Background While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. Purpose To assess the potential of e-learning in specialist education in medical imaging. Material and Methods An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Results Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. Conclusion E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs. PMID:28804642

Are peer specialists happy on the job?

PubMed

Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina

2018-03-01

This study was designed to examine the impact of role clarity and job training on job satisfaction among peer specialists. A 3-part survey assessing job training, job satisfaction, and role clarity was administered online to 195 peer specialists who are members of the International Association of Peer Specialists. Data was analyzed using descriptive statistics, correlational analyses to include multiple linear regressions and analysis of variance. Self-study and online training methods were negatively correlated with job satisfaction while job shadowing was positively correlated with job satisfaction. Role clarity was positively correlated with job satisfaction and job training satisfaction as well as job shadowing and one-on-one training. The use of self-study and online training for peer specialists is contraindicated by current findings, which suggest the need to utilize job shadowing or training methods that allow for personal interaction between peer specialists and their colleagues. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Behavior medicine specialist.

PubMed

Tuso, Phillip

2014-01-01

Total Health is a vision for the future and a strategy to prevent preventable disease, save lives, and make health care more affordable. Total Health means health of mind (behavior health) and health of body (physical health). To achieve Total Health we need healthy people in healthy communities. A behavior medicine specialist is a psychologist who works in the medical home with the primary care physician instead of in the Mental Health Department with a psychiatrist. The key to achieving Total Health will be to transform our current health care system from a focus on treating disease to a focus on preventing disease. This transformation will require complex behavior change interventions and services not usually provided in the medical home. The behavior medicine specialist will bring the knowledge and experience used to treat mental illness into the medical home to help the primary care physician improve the care of all patients in the medical home. The behavior medicine specialist will help improve outcomes in synergy with the primary care physician by universal screening of high-risk diseases, stepped care protocols, and efficient use of all resources available to care for patients in the medical home (health education classes, wellness coaches, and online social networking lifestyle management programs). These interventions should increase patient satisfaction, increase access to specialty care (psychiatry), and help us achieve Total Health.

Identification of gunshot residues in fabric targets using sector field inductively coupled plasma mass spectrometry technique and ternary graphs.

PubMed

Freitas, João Carlos D; Sarkis, Jorge E Souza; Negrini Neto, Osvaldo; Viebig, Sônia Bocamino

2012-03-01

During criminal investigations involving firearms, the detection of gunshot residues (GSRs) is one of the most important evidences. In the present study, a new method to identify trace evidences of GSRs, deposited around the bullet entrance hole, in different types of fabrics used as targets, is described. The experiments were carried out using a 0.38-inch caliber revolver, and 9-mm and 0.40-inch caliber pistols. Testimonies of 2.25 cm(2) of the fabrics were cut around the bullet entrance and digested with 10% nitric acid. Antimony, barium, and lead were analyzed in the remaining solution using a sector field inductively coupled plasma mass spectrometer. The concentrations of the elements were detected at levels up to few microgram per square centimeter. The use of ternary graphics allowed us to identify specific patterns of distribution for blank samples and the clear distinction between the revolver and pistols used. © 2011 American Academy of Forensic Sciences.

Telecommunications Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 17 subjects appropriate for use in a competency list for the occupation of telecommunications specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 17 units are as…

Learning Opportunities for Library Media Specialists

ERIC Educational Resources Information Center

Newton, Jennifer W.

2008-01-01

To address the varying needs of media specialists, area Educational Technology Training Centers, Regional Educational Service Agencies (RESA), and larger school systems are forming professional development communities or consortia that cater specifically to the continuing education needs of library media specialists. In addition to academic and…

Brazilian infectious diseases specialists: who and where are they?

PubMed

Cassenote, Alex Jones Flores; Scheffer, Mario César; Segurado, Aluísio Augusto Cotrim

2016-01-01

The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3-58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7yrs; 95% CI 7.9-9.5) than physicians trained elsewhere in the country (13.6yrs: 95% CI 11.8-15.5). Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in

It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills

STS-47 Payload Specialist Mohri conducts visual stability experiment in SLJ

NASA Image and Video Library

1992-09-20

STS047-204-006 (12 - 20 Sept 1992) --- Dr. Mamoru Mohri, payload specialist representing Japan's National Space Development Agency (NASDA), participates in an experiment designed to learn more about Space Adaptation Syndrome (SAS). The experiment is titled, "Comparative Measurement of Visual Stability in Earth and Cosmic Space." During the experiment, Dr. Mohri tracked a flickering light target while eye movements and neck muscle tension were measured. This 45-degree angle position was one of four studied during the eight-day Spacelab-J mission.

14 CFR § 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialist responsibilities. § 1214.305 Section § 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

Accounting Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication identifies 20 subjects appropriate for use in a competency list for the occupation of accounting specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 20 units are as follows:…

Guidelines for Certification of Media Specialists.

ERIC Educational Resources Information Center

Galey, Minaruth; Grady, William F.

This certification model, which is a refined version of the 1974 AECT Certification Model, is directed to the needs of educational media specialists, their employers and educators, and to certifying and accrediting agencies that approve programs preparing educational media specialists. Included in the document are reports on accreditation and…

Extending specialist palliative care to all?

PubMed

Field, D; Addington-Hall, J

1999-05-01

How to extend palliative care services to all patients needing them is an issue currently exercising a range of bodies in contemporary Britain. This paper first considers the evidence regarding the needs of dying patients with long term conditions other than cancer and concludes that there is evidence to support their presumed need for palliative care. It then considers five potential barriers to extending specialist palliative care services to non-cancer patients in Britain. These are the skill base of current specialists in palliative care, difficulties in identifying candidates for specialist palliative care, the views of potential users of these services, resource implications and vested interests in present health service arrangements.

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Clinical nurse specialists' services. 410.76... § 410.76 Clinical nurse specialists' services. (a) Definition. As used in this section, the term...) Qualifications. For Medicare Part B coverage of his or her services, a clinical nurse specialist must— (1) Be a...

Organizing uninsured safety-net access to specialist physician services.

PubMed

Hall, Mark A

2013-05-01

Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.

Preparing Elementary Mathematics-Science Teaching Specialists.

ERIC Educational Resources Information Center

Miller, L. Diane

1992-01-01

Describes a professional development program to train math/science specialists for the upper elementary school grades. Using results from an interest survey, 30 teachers were chosen to participate in a 3-year program to become math/science specialists. Presents the teaching model used and the advantages for teachers and students in having subject…

STS-107 Mission Specialist Laurel Clark at SPACEHAB

NASA Technical Reports Server (NTRS)

2000-01-01

KENNEDY SPACE CENTER, FLA. -- At SPACEHAB, STS-107 Mission Specialist Laurel Clark gets hands-on experience with equipment that will be on the mission. Watching in the left foreground is Mission Specialist Kalpana Chawla; next to her at left is Mission Specialist Michael Anderson. Identified as a research mission, STS-107 is scheduled for launch July 19, 2001

[New business model for medical specialists].

PubMed

Houwen, L G H J Louis

2013-01-01

The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

A combination of process of care and clinical target among type 2 diabetes mellitus patients in general medical clinics and specialist diabetes clinics at hospital levels.

PubMed

Sieng, Sokha; Hurst, Cameron

2017-08-07

This study compares a combination of processes of care and clinical targets among patients with type 2 diabetes mellitus (T2DM) between specialist diabetes clinics (SDCs) and general medical clinics (GMCs), and how differences between these two types of clinics differ with hospital type (community, provincial and regional). Type 2 diabetes mellitus patient medical records were collected from 595 hospitals (499 community, 70 provincial, 26 regional) in Thailand between April 1 to June 30, 2012 resulting in a cross-sectional sample of 26,860 patients. Generalized linear mixed modeling was conducted to examine associations between clinic type and quality of care. The outcome variables of interest were split into clinical targets and process of care. A subsequent subgroup analysis was conducted to examine if the nature of clinical target and process of care differences between GMCs and SDCs varied with hospital type (regional, provincial, community). Regardless of the types of hospitals (regional, provincial, or community) patients attending SDCs were considerably more likely to have eye and foot exam. In terms of larger hospitals (regional and provincial) patients attending SDCs were more likely to achieve HbA1c exam, All FACE exam, BP target, and the Num7Q. Interestingly, SDCs performed better than GMCs at only provincial hospitals for LDL-C target and the All7Q. Finally, patients with T2DM who attended community hospital-GMCs had a better chance of achieving the blood pressure target than patients who attended community hospital-SDCs. Specialized diabetes clinics outperform general medical clinics for both regional and provincial hospitals for all quality of care indicators and the number of quality of care indicators achieved was never lower. However, this better performance of SDC was not observed in community hospital. Indeed, GMCs outperformed SDCs for some quality of care indicators in the community level setting.

Fabrication of 14 different RNA nanoparticles for specific tumor targeting without accumulation in normal organs

PubMed Central

Shu, Yi; Haque, Farzin; Shu, Dan; Li, Wei; Zhu, Zhenqi; Kotb, Malak; Lyubchenko, Yuri; Guo, Peixuan

2013-01-01

Due to structural flexibility, RNase sensitivity, and serum instability, RNA nanoparticles with concrete shapes for in vivo application remain challenging to construct. Here we report the construction of 14 RNA nanoparticles with solid shapes for targeting cancers specifically. These RNA nanoparticles were resistant to RNase degradation, stable in serum for >36 h, and stable in vivo after systemic injection. By applying RNA nanotechnology and exemplifying with these 14 RNA nanoparticles, we have established the technology and developed “toolkits” utilizing a variety of principles to construct RNA architectures with diverse shapes and angles. The structure elements of phi29 motor pRNA were utilized for fabrication of dimers, twins, trimers, triplets, tetramers, quadruplets, pentamers, hexamers, heptamers, and other higher-order oligomers, as well as branched diverse architectures via hand-in-hand, foot-to-foot, and arm-on-arm interactions. These novel RNA nanostructures harbor resourceful functionalities for numerous applications in nanotechnology and medicine. It was found that all incorporated functional modules, such as siRNA, ribozymes, aptamers, and other functionalities, folded correctly and functioned independently within the nanoparticles. The incorporation of all functionalities was achieved prior, but not subsequent, to the assembly of the RNA nanoparticles, thus ensuring the production of homogeneous therapeutic nanoparticles. More importantly, upon systemic injection, these RNA nanoparticles targeted cancer exclusively in vivo without accumulation in normal organs and tissues. These findings open a new territory for cancer targeting and treatment. The versatility and diversity in structure and function derived from one biological RNA molecule implies immense potential concealed within the RNA nanotechnology field. PMID:23604636

STS-86 Mission Specialist Wolf at SLF for TCDT

NASA Technical Reports Server (NTRS)

1997-01-01

STS-86 Mission Specialist David A. Wolf arrives in a T-38 jet at KSCs Shuttle Landing Facility for the Terminal Countdown Demonstration Test (TCDT), a dress rehearsal for launch. STS-86 will be the seventh docking of the Space Shuttle with the Russian Space Station Mir. During the mission, Wolf will transfer to the Mir 24 crew, replacing astronaut C. Michael Foale, who will return to Earth with the rest of the STS-86 crew. Wolf is scheduled to remain on the Mir until his replacement arrives on the STS-89 mission in January. STS-86 is targeted for a Sept. 25 launch aboard the Space Shuttle Atlantis.

STS-88 Mission Specialists Currie and Ross inside Endeavour

NASA Technical Reports Server (NTRS)

1998-01-01

STS-88 Mission Specialists Nancy J. Currie, Ph.D., (back) and Jerry L. Ross (front) check over equipment inside orbiter Endeavour during Terminal Countdown Demonstration Activities (TCDT). The TCDT includes mission familiarization activities, emergency egress training, and the simulated main engine cut-off exercise. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module. Unity will be mated with the already orbiting Russian-built Zarya control module. The 12-day mission includes three planned spacewalks to connect power, data and utility lines and install exterior equipment.

Media Specialist's Corner.

ERIC Educational Resources Information Center

Parrini, Michelle; Kittlaus, Jennifer

2002-01-01

Presents an annotated bibliography of resources for students, teachers, and school library media specialists related to the topic, "Youth, Rights, and the Constitution," found in this issue of "Insights on Law and Society." Includes books and primary sources for students. (CMK)

An audit of management of differentiated thyroid cancer in specialist and non-specialist clinic settings.

PubMed

Kumar, H; Daykin, J; Holder, R; Watkinson, J C; Sheppard, M C; Franklyn, J A

2001-06-01

Thyroid cancer is the most common endocrine malignancy but is none the less rare. Some aspects of its management remain controversial. Previous audits of patient management in the United Kingdom have revealed deficiencies, especially in communication between specialists. We have audited patient management in a large university-associated teaching hospital, assessing points of good practice identified from published guidelines and reviews, and have compared findings in groups of patients managed jointly by specialists with an interest in thyroid cancer (including surgeon, endocrinologist and oncologist) with a group managed by other clinicians outside that setting. Retrospective case-note review of 205 patients with differentiated (papillary or follicular) cancer including group A (n = 134; managed in a specialist multi-disciplinary clinic setting) and group B (n = 71; managed in other clinic settings). Points of good practice investigated were adequacy of surgery, surgical complications, prescription and adequacy of T4 treatment, adequacy of monitoring by measurement of serum thyroglobulin and action taken and appropriate administration of ablative radioiodine. Deficiencies in management of the cohort as a whole were identified, including inadequate surgery and inadequate TSH suppression in approximately one-fifth of the cases. Monitoring with thyroglobulin measurements and action when serum thyroglobulin was high were also inadequate in some cases and ablative radioiodine was not given, despite being indicated in 11.7% of the cohort. Inadequate surgery and failure to administer radioiodine were less common in those managed in a specialist clinic setting than in those managed in other clinic settings. The findings highlight the need for locally agreed protocols in managing relatively rare endocrine disorders such as thyroid cancer and argue in favour of centralization of expertise and patient management in multi-disciplinary specialist clinic settings.

The need for PGY2-trained clinical pharmacy specialists.

PubMed

Ragucci, Kelly R; O'Bryant, Cindy L; Campbell, Kristin Bova; Buck, Marcia L; Dager, William E; Donovan, Jennifer L; Emerson, Kayleigh; Gubbins, Paul O; Haight, Robert J; Jackevicius, Cynthia; Murphy, John E; Prohaska, Emily

2014-06-01

The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level. © 2014 Pharmacotherapy Publications, Inc.

Academic learning for specialist nurses: a grounded theory study.

PubMed

Millberg, Lena German; Berg, Linda; Brämberg, Elisabeth Björk; Nordström, Gun; Ohlén, Joakim

2014-11-01

The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful. Copyright © 2014 Elsevier Ltd. All rights reserved.

Role Transition After Clinical Nurse Specialist Education.

PubMed

Ares, Terri L

This study explored the transition of clinical nurse specialists into new roles after completion of their graduate education. A quantitative longitudinal survey was used to measure certification, employment, career commitment, and the imposter phenomenon. An online survey was sent to 113 participants from a previous national study that agreed to follow-up. The Student Nurse Anesthetist Experience Questionnaire and Clance Imposter Phenomenon Scale instruments were used. Each case (N = 68) was matched with data from the primary study, and 2 comparison groups were formed based on employment status as a clinical nurse specialist. The advanced practice certification rate was 66.7%, and 48.5% were employed as a clinical nurse specialist. The employed group perceived more autonomy, a more positive view of the clinical nurse specialist lifestyle, and upset life plans if not able to practice in the role when compared with the not-employed group. Self-image was significantly different based on employment, but career commitment was not particularly strong regardless of employment status. The prevalence of imposter phenomenon experiences was 74.6% in this sample. Recent graduates are struggling with their transition into practice as clinical nurse specialists.

Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

PubMed

Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

2010-01-01

The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic

Adoption, implementation and prioritization of specialist outreach policy in Australia: a national perspective

PubMed Central

Joyce, Catherine M; McGrail, Matthew R

2014-01-01

Abstract The World Health Organization has endorsed the use of outreach to promote: efficient redeployment of the health-care workforce; continuity of care at the local level; and professional support for local, rural, health-care workers. Australia is the only country that has had, since 2000, a sustained national policy on outreach for subsidizing medical specialist outreach to rural areas. This paper describes the adoption, implementation and prioritization of a national specialist outreach policy in Australia. Adoption of the national policy followed a long history of successful outreach, largely driven by the professional interest and personal commitment of the workforce. Initially the policy supported only new outreach services but concerns about the sustainability of existing services resulted in eligibility for funding being extended to all specialist services. The costs of travel, travel time, accommodation, professional support, staff relief at specialists’ primary practices and equipment hire were subsidized. Over time, a national political commitment to the equitable treatment of indigenous people resulted in more targeted support for outreach in remote areas. Current priorities are: (i) establishing team-based outreach services; (ii) improving local staff’s skills; (iii) achieving local coordination; and (iv) conducting a nationally consistent needs assessment. The absence of subsidies for specialists’ clinical work can discourage private specialists from providing services in remote areas where clinical throughput is low. To be successful, outreach policy must harmonize with the interests of the workforce and support professional autonomy. Internationally, the development of outreach policy must take account of the local pay and practice conditions of health workers. PMID:25110376

Enabling factors for specialist outreach in western KwaZulu-Natal

PubMed Central

2018-01-01

Background There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa. Aim This study attempts to uncover some of the factors that enable good multifaceted specialist outreach. Setting The study was conducted in hospitals in western KwaZulu-Natal province. This health area is served by a tertiary hospital and 20 peripheral hospitals; three of these are regional level and the majority are district level hospitals. Specialist outreach emanates from the tertiary hospital. Methods Specialists providing outreach services from the tertiary hospital and medical officers at seven receiving hospitals were interviewed to explore perceptions regarding factors that might enable successful specialist outreach. Framework analysis on the transcribed interviews was carried out using NVivo version 11. Results A major positive finding concerns the relationships formed between outreach specialists and doctors at the recipient hospitals. The management of the programme with respect to structure, dependability, data management, transport provision, communication technology and public health systems was also seen as beneficial in specialist outreach. Conclusion Specialist outreach plays an essential role in providing equality in health care. To enable effectiveness, it is important to make full use of the multifaceted nature of this intervention. PMID:29781691

Administrative Assistant and Correspondence Specialist: Task List Competency Record.

ERIC Educational Resources Information Center

Minnesota Instructional Materials Center, White Bear Lake.

One of a series of 12 in the secretarial/clerical area, this booklet for the vocational instructor contains job descriptions for two word processing occupations, the non-typing administrative assistant and the correspondence specialist (also called word processing correspondence specialist, magnetic keyboard specialist, or word processing…

Heating Systems Specialist.

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

This instructional package is intended for use in training Air Force personnel enrolled in a program for apprentice heating systems specialists. Training includes instruction in fundamentals and pipefitting; basic electricity; controls, troubleshooting, and oil burners; solid and gas fuel burners and warm air distribution systems; hot water…

14 CFR § 1214.812 - Payload specialists.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialists. § 1214.812 Section § 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

CSHCN in Texas: meeting the need for specialist care.

PubMed

Young, M Cherilyn; Drayton, Vonna L C; Menon, Ramdas; Walker, Lesa R; Parker, Colleen M; Cooper, Sam B; Bultman, Linda L

2005-06-01

Assuring the sufficiency and suitability of systems of care and services for children with special health care needs (CSHCN) presents a challenge to Texas providers, agencies, and state Title V programs. To meet the need for specialist care, referrals from primary care doctors are often necessary. The objective of this study was to describe the factors associated with the need for specialist care and problems associated with obtaining referrals in Texas. Bivariate and multivariate analyses were performed using the National Survey of Children with Special Health Care Needs (NS-CSHCN) weighted sample for Texas (n = 719,014) to identify variables associated with the need for specialist care and problems obtaining referrals for specialist care. Medical need of the CSHCN and sensitivity to family values/customs was associated with greater need for specialist care, and Hispanic ethnicity and lower maternal education were associated with less need. Medical need, amount of time spent with doctors and sensitivity to values/customs, living in a large metropolitan statistical area, and lack of medical information were associated with problems obtaining a specialist care referral. Findings revealed some similarities and differences with meeting the need for specialist care when comparing Texas results to other studies. In Texas, aspects of customer satisfaction variables, especially doctors' sensitivity to family values/customs and parents' not receiving enough information on medical problems, were significantly associated with problems obtaining specialist referrals. Findings indicate a need to further research relationships and communication among doctors, CSHCN, and their families.

Diet Therapy Specialist.

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

This four-volume student text is intended for use in training Air Force diet therapy specialists. The first volume, a study guide and workbook for self-directed instruction, covers nutrition, food processing and preparation, therapeutic diets, security precautions in medical food service, procedures for ordering equipment and supplies, food…

Fabrication and Calibration of FORTIS

NASA Technical Reports Server (NTRS)

Fleming, Brian T.; McCandliss, Stephan R.; Kaiser, Mary Elizabeth; Kruk, Jeffery; Feldman, Paul D.; Kutyrev, Alexander S.; Li, Mary J.; Rapchun, David A.; Lyness, Eric; Moseley, S. H.;

Fabrication and calibration of FORTIS

NASA Astrophysics Data System (ADS)

Fleming, Brian T.; McCandliss, Stephan R.; Kaiser, Mary Elizabeth; Kruk, Jeffery; Feldman, Paul D.; Kutyrev, Alexander S.; Li, Mary J.; Rapchun, David A.; Lyness, Eric; Moseley, S. H.; Siegmund, Oswald; Vallerga, John; Martin, Adrian

2011-09-01

The Johns Hopkins University sounding rocket group is entering the final fabrication phase of the Far-ultraviolet Off Rowland-circle Telescope for Imaging and Spectroscopy (FORTIS); a sounding rocket borne multi-object spectro-telescope designed to provide spectral coverage of 43 separate targets in the 900 - 1800 Angstrom bandpass over a 30' x 30' field-of- view. Using "on-the-fly" target acquisition and spectral multiplexing enabled by a GSFC microshutter array, FORTIS will be capable of observing the brightest regions in the far-UV of nearby low redshift (z ~ 0.002 - 0.02) star forming galaxies to search for Lyman alpha escape, and to measure the local gas-to-dust ratio. A large area (~ 45 mm x 170 mm) microchannel plate detector built by Sensor Sciences provides an imaging channel for targeting flanked by two redundant spectral outrigger channels. The grating is ruled directly onto the secondary mirror to increase efficiency. In this paper, we discuss the recent progress made in the development and fabrication of FORTIS, as well as the results of early calibration and characterization of our hardware, including mirror/grating measurements, detector performance, and early operational tests of the microshutter arrays.

17 CFR 240.11b-1 - Regulation of specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Regulation of specialists. 240... Securities Exchange Act of 1934 Adoption of Regulation on Conduct of Specialists § 240.11b-1 Regulation of specialists. (a)(1) The rules of a national securities exchange may permit a member of such exchange to...

Sports Medicine: What is a Sports Medicine Specialist?

MedlinePlus

What is a Sports Medicine Specialist? A physician with significant specialized training in both the treatment and prevention of illness and injury. The Sports Medicine Specialist helps patients maximize function and minimize ...

Fabrication and bioconjugation of BIII and CrIII co-doped ZnGa2O4 persistent luminescent nanoparticles for dual-targeted cancer bioimaging.

PubMed

Zhao, Huai-Xin; Yang, Cheng-Xiong; Yan, Xiu-Ping

2016-12-07

Persistent luminescent nanoparticles (PLNPs) show great potential in realizing precision imaging due to the absence of in situ excitation and no background interference. However, the current PLNP-based tumour imaging is usually achieved by single targeting or passive targeting strategies, and thus it lacks high specificity and affinity for efficient persistent luminescence imaging in vivo. Herein we report the bioconjugation of multiple targeting ligands on the surface of PLNPs for dual-targeted bioimaging to improve the specificity and affinity of the PLNP nanoprobe for in vitro and in vivo bioimaging. The PLNPs were prepared by co-doping Cr III and B III into ZnGa 2 O 4 via a hydrothermal-calcination method. While Cr III doped ZnGa 2 O 4 PLNPs possess excellent near-infrared luminescence along with long afterglow and red light renewable near-infrared luminescence, doping of B III into the PLNPs further improves the persistent luminescence. Conjugation of two targeting ligands, hyaluronic acid and folic acid, which have specificity toward the cluster determinant 44 receptor and folic acid receptor in tumour cells, respectively, provides synergistic targeting effects to enhance the specificity and affinity toward tumour cells. This work provides a dual-targeting strategy for fabricating PLNP-based nanoprobes to realize precision tumour-targeted bioimaging.

Corrigendum to: It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills

Portrait view of ESA Spacelab Specialists

NASA Technical Reports Server (NTRS)

1978-01-01

Portrait view of European Space Agency (ESA) Spacelab Specialist Byron K. Lichtenberg in civilian clothes standing in front of a display case. The photo was taken at the Marshall Space Flight Center (MSFC), Huntsville, Alabama (31779); portrait view of ESA Spacelab Specialist Michael L. Lampton, also in civilian clothes in front of display at MSFC (31780); portrait view of Wubbo Ockels, also in civilian clothes in front of display at MSFC (31781).

Rapid fabrication of carbon quantum dots as multifunctional nanovehicles for dual-modal targeted imaging and chemotherapy.

PubMed

Chiu, Sheng-Hui; Gedda, Gangaraju; Girma, Wubshet Mekonnen; Chen, Jem-Kun; Ling, Yong-Chien; Ghule, Anil V; Ou, Keng-Liang; Chang, Jia-Yaw

2016-12-01

Herein, we synthesized an S, N, and Gd tri-element doped magnetofluorescent carbon quantum dots (GdNS@CQDs) within 10min by using a one-pot microwave method. Our results showed that these magnetofluorescent GdNS@CQDs have excellent fluorescent and magnetic properties. Moreover, GdNS@CQDs exhibited high stability at physiological conditions and ionic strength. These magnetofluorescent GdNS@CQDs were conjugated with a folic acid, denoted as FA-GdNS@CQDs, for targeting dual modal fluorescence/magnetic resonance (MR) imaging. The in vitro and in vivo studies confirmed the high biocompatibility and low toxicity of FA-GdNS@CQDs. FA-GdNS@CQDs enhanced the MR response as compared to that for commercial Gd-DTPA. The targeting capabilities of FA-GdNS@CQDs were confirmed in HeLa and HepG2 cells using in vitro fluorescence and MR dual modality imaging. Additionally, an anticancer drug, doxorubicin, was incorporated into the FA-GdNS@CQDs forming FA-GdNS@CQDs-DOX, which enables targeted drug delivery. Importantly, the prepared FA-GdNS@CQDs-DOX showed a high quantity of doxorubicin loading capacity (about 80%) and pH-sensitive drug release. The uptake into cancer cells and the intracellular location of the FA-GdNS@CQDs were observed by confocal laser scanning microscopy. We also successfully demonstrated in vivo fluorescence bio imaging of the FA-GdNS@CQDs, using zebrafish as an animal model. In this manuscript, we reported a facial, rapid, and environmental friendly method to fabricate hetero atoms including gadolinium, nitrogen, and sulfur doped multi-functional magnetofluorescent carbon quantum dots (GdNS@CQDs) nanocomposite. These multifunctional GdNS@CQDs were conjugated with a folic acid for targeting dual modal fluorescence/magnetic resonance imaging. Additionally, an anticancer drug, doxorubicin, was incorporated into the nanocomposite forming FA-GdNS@CQDs-DOX, which enables targeted drug delivery. We have developed GdNS@CQDs with integrated functions for simultaneous in

STS-90 Mission Specialist Williams arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-90 Mission Specialist Dafydd (Dave) Williams with the Canadian Space Agency poses in the cockpit of his T-38 jet trainer aircraft after arriving at the KSC Shuttle Landing Facility along with other members of the crew from NASAs Johnson Space Center to begin Terminal Countdown Demonstration Test (TCDT) activities. The TCDT is held at KSC prior to each Space Shuttle flight to provide crews with the opportunity to participate in simulated countdown activities. Columbia is targeted for launch of STS-90 on April 16 at 2:19 p.m. EST and will be the second mission of 1998. The mission is scheduled to last nearly 17 days.

Information Support Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 22 subjects appropriate for use in a competency list for the occupation of information support specialist, 1 of occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 22 units are as…

Microcomputer Applications Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 16 subjects appropriate for use in a competency list for the occupation of microcomputer applications specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 16 units are…

STS-87 Mission Specialist Scott in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Winston Scott is assisted with his ascent and re-entry flight suit in the white room at Launch Pad 39B by Danny Wyatt, NASA quality assurance specialist. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. Scott is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, during STS-87. Scott also performed a spacewalk on the STS-72 mission.

[History in the public communication of specialist scientific societies: history marketing].

PubMed

Moll, F H; Halling, T; Rathert, P; Fangerau, H

2014-10-01

History is nowadays used as an economic factor. The past is therefore specifically targeted and cultivated, which for specialist scientific associations and societies often fullfils totally different functions in comparison to the open market, although the techniques and requirements are similar. Within medical specialties these facts are often still unknown. Museums and archives as well as the historians and curators working in them are very familiar with the special cultures of communication within these scientific communities and they play a major role in the establishment and development of history as a modern part of public relations and public identity.

Management Information Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 19 subjects appropriate for use in a competency list for the occupation of management information specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 19 units are as…

Value, Challenges, and Satisfaction of Certification for Multiple Sclerosis Specialists

PubMed Central

Halper, June

2014-01-01

Background: Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. Methods: A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Results: Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS specialists perceived significantly greater value and satisfaction than lapsed-certification MS specialists in terms of employer and peer recognition, validation of MS knowledge, and empowering MS patients. Lapsed-certification MS specialists reported increased confidence and caring for MS patients using evidence-based practice. Both currently certified and lapsed-certification groups reported dissatisfaction with MSCS recognition and pay/salary rewards. Conclusions: The results of this study can be used in efforts to encourage initial certification and recertification of interdisciplinary MS team members. PMID:25061432

Addressing the unequal geographic distribution of specialist doctors in indonesia: the role of the private sector and effectiveness of current regulations.

PubMed

Meliala, Andreasta; Hort, Krishna; Trisnantoro, Laksono

2013-04-01

As in many countries, the geographic distribution of the health workforce in Indonesia is unequal, with a concentration in urban and more developed areas, and a scarcity in rural and remote areas. There is less information on the distribution of specialist doctors, yet inequalities in their distribution could compromise efforts to achieve universal coverage by 2014. This paper uses data from 2007 and 2008 to describe the geographic distribution of specialist doctors in Indonesia, and to examine two key factors that influence the distribution and are targets of current policies: sources of income for specialist doctors, and specialist doctor engagement in private practice. The data demonstrates large differences in the ratio of specialist doctors to population among the provinces of Indonesia, with higher ratios on the provinces of the islands of Java, and much lower ratios on the more remote provinces in eastern Indonesia. Between 65% and 80% of specialist doctors' income derives from private practice in non-state hospitals or private clinics. Despite regulations limiting practice locations to three, most specialists studied in a provincial capital city were working in more than three locations, with some working in up to 7 locations, and spending only a few hours per week in their government hospital practice. Our study demonstrates that the current regulatory policies and financial incentives have not been effective in addressing the maldistribution of specialist doctors in a context of a growing private sector and predominance of doctors' income from private sources. A broader and more integrated policy approach, including more innovative service delivery strategies for rural and remote areas, is recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Databases for surgical specialists in Cancún, Quintana Roo].

PubMed

Contla-Hosking, Jorge Eduardo; Ceballos-Martínez, Zoila Inés; Peralta-Bahena, Mónica Esther

2004-01-01

Our aim was to identify the level of knowledge of surgical health-area specialists in Cancún, Quintana Roo, Mexico, from the personal productivity database. We carried out an investigation of 37 surgical specialists: 24 belonged to the Mexican Social Security Institute (IMSS), while 13 belonged to the Mexican Health Secretariat (SSA). In our research, we found that 61% of surgical health-area specialist physicians were familiar with some aspects of the institutional surgical registry, including the following: 54% knew of the existence of a personal registry of surgeries carried out, and 43% keep a record of their personal activities. From the latter percentage, 69% of surgical health-area specialist physicians mentioned keeping their records manually, while 44% used the computer. Results of the research suggest that these physicians would like to have some kind of record of the surgeries carried out by each. An important percentage of these specialists do not keep a personal record on a database; due to this lack of knowledge, we obtain incorrect information in institutional records of the reality of what is actually done. We consider it important to inform surgical specialists concerning the existence of personal institutional records in database form or even of record done manually, as well as correct terminology for the International Codification (CIE-9 & 10). We inform here of the need to encourage a culture in records and databases in the formative stage of surgeon specialists.

The evolution of resource adaptation: how generalist and specialist consumers evolve.

PubMed

Ma, Junling; Levin, Simon A

2006-07-01

Why and how specialist and generalist strategies evolve are important questions in evolutionary ecology. In this paper, with the method of adaptive dynamics and evolutionary branching, we identify conditions that select for specialist and generalist strategies. Generally, generalist strategies evolve if there is a switching benefit; specialists evolve if there is a switching cost. If the switching cost is large, specialists always evolve. If the switching cost is small, even though the consumer will first evolve toward a generalist strategy, it will eventually branch into two specialists.

STS-89 Mission Specialist Andrew Thomas arrives for TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-89 Mission Specialist Andrew Thomas, Ph.D., poses in his T-38 jet trainer after landing with other members of the flight crew at KSCs Shuttle Landing Facility from NASAs Johnson Space Center to begin Terminal Countdown Demonstration Test (TCDT) activities. The TCDT is held at KSC prior to each Space Shuttle flight to provide crews with the opportunity to participate in simulated countdown activities. Endeavour is targeted for launch of STS-89 on Jan. 22 at 9:48 p.m. EST., which will be the first mission of 1998 and the eighth to dock with Russias Mir Space Station, where Thomas will succeed David Wolf, M.D., who has been on Mir since September 28. The STS-89 mission is scheduled to last nine days.

Does the specialist nurse enhance or deskill the general nurse?

PubMed

Marshall, Z; Luffingham, N

Much conflict and confusion surrounds the title and role of the specialist nurse, leading in some instances to disharmony between general and specialist nurses. It has been suggested that too many highly specialized nurses in a general area may lead to a deskilled workforce and fragmented care. Attempts to define the key concepts of specialist practice as described by the UKCC has resulted in elitism, conflict and abuse of the title. One suggestion to eliminate this conflict is for specialist nurses to achieve key competencies that encompass the role of the clinical expert. These key competencies should be devised by specialist nurses, in the absence of national guidelines, and be agreed by employers. They should incorporate the key roles of: change agent, expert clinician, educator, researcher and coordinator. It is contended that if all concerned have a clearer definition of the title, role and what is expected from the specialist nurse then this will result in reduced conflict and improved quality of care.

Developing a speciality: regearing the specialist public health workforce.

PubMed

Chapman, J; Abbott, S; Carter, Y H

2005-03-01

To identify issues surrounding the future training needs of the specialist public health workforce following the most recent restructuring of the National Health Service (NHS) in England. All directors of public health (DsPH) based in strategic health authorities and nine senior staff working in public health at the regional level were invited to participate in a semi-structured telephone interview. Twenty-six people were interviewed. Many interviewees expressed concern that because consultants and specialists in public health will be working in much smaller teams than hitherto, they will have to generalize their skills to cover a much wider range of functions (including board-level duties). This may result in a loss of specialist expertise. Successful public health practice in the new structures will require new ways of interorganizational working that will add an administrative burden to specialists in public health. Also, the creation of a board-level post in each primary care trust (PCT) has resulted in more time spent on corporate responsibilities and less on public health for DsPH, who are often the only fully trained specialist in public health in their PCT. Furthermore, interviewees expressed their anxiety about the lack of diversity in the posts available to specialists in public health and particularly to those newly completing their specialist training. Generally, interviewees felt that traditional public health roles and responsibilities were being eclipsed by corporate and managerial ones. Professional development activities were being carried out, but in a rather ad-hoc fashion. Interviewees were hopeful that public health networks would lead professional development initiatives once they were more established. It is important that excellence in public health is maintained through a set of accreditable standards, whilst corporate skills, essential to successful public health practice in the new UK NHS, are developed among specialists in public health.

Overview of Target Fabrication in Support of Sandia National Laboratories

NASA Astrophysics Data System (ADS)

Schroen, Diana; Breden, Eric; Florio, Joseph; Grine-Jones, Suzi; Holt, Randy; Krych, Wojtek; Metzler, James; Russell, Chris; Stolp, Justin; Streit, Jonathan; Youngblood, Kelly

2004-11-01

Sandia National Laboratories has succeeded in making its pulsed power driver, the Z machine, a valuable testbed for a great variety of experiments. These experiments include ICF, weapon physics, Equation of State and astrophysics. There are four main target types: Dynamic Hohlraum, Double Pinch, Fast Igniter and EOS. The target sizes are comparable to projected NIF sizes. For example, capsules up to 5 mm have been fielded. This talk will focus on the assembly challenges and the use of foams to create these targets. For many targets, diagnostics and capsules are embedded in the foams, and foam dopants have been added. It is the 14 mg/cc foam target with an embedded capsule (containing deuterium) that has reproducibly produced thermonuclear neutrons. For all target types, the characterization and documentation has had to develop to ensure understanding of target performance. To achieve the required resolution we are using a Nikon automated microscope and a custom OMEGA/NIF target assembly system. Our drive for quality has lead us develop a management system that been registered to ISO 9001.

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

ERIC Educational Resources Information Center

McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

2009-01-01

This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

Art Appreciation as a Learned Competence: A Museum-Based Qualitative Study of Adult Art Specialist and Art Non-Specialist Visitors

ERIC Educational Resources Information Center

Bracun Sova, Rajka

2015-01-01

Since Bourdieu, it has been argued that art appreciation requires "knowledge". The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three…

The Search for Specialists and Managers. Staff Shortage in Germany.

ERIC Educational Resources Information Center

Stahl, Klaus, Ed.

1999-01-01

Despite its high unemployment level, Germany is experiencing a shortage of specialists and managers. Germany's need for highly qualified information technology (IT) workers and engineers is particularly great. Approximately 10,000 posts for computer scientists and IT specialists remained vacant in 1998. Because of the shortage of such specialists,…

STS-87 Mission Specialist Doi in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, is assisted with his ascent and re- entry flight suit by Dave Law, USA mechanical technician, in the white room at Launch Pad 39B as Dr. Doi prepares to enter the Space Shuttle orbiter Columbia on launch day. At right wearing glasses is Danny Wyatt, NASA quality assurance specialist. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. The 16-day mission will include a spacewalk by Dr. Doi and Mission Specialist Winston Scott.

STS-55 German payload specialists (and backups) in LESs during JSC training

NASA Technical Reports Server (NTRS)

1992-01-01

STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists and backup (alternate) payload specialists, wearing launch and entry suits (LESs), pose for group portrait outside mockup side hatch in JSC's Mockup and Integration Laboratory (MAIL) Bldg 9NE. These payload specialists will support the STS-55 Spacelab Deutsche 2 (SL-D2) mission. It is the second dedicated German (Deutsche) Spacelab flight. Left to right are backup Payload Specialists Renate Brummer and Dr. P. Gerhard Thiele, Payload Specialist 1 Ulrich Walter, and Payload Specialist 2 Hans Schlegel.

Understanding practice patterns of glaucoma sub-specialists in India

PubMed Central

Choudhari, Nikhil S.; Pathak-Ray, Vanita; Kaushik, Sushmita; Vyas, Prateep; George, Ronnie

2017-01-01

AIM To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI) were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57%) had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%). Goldmann applanation tonometry was preferred by 103 (72%) specialists whilst n=25 (17.4%) used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66%) whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively). Nearly three quarter specialists (n=96; 72%) preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93%) and medical management (prostaglandin analogue, n=104; 78%), respectively. Approximately only a third of the specialists surveyed (n=37; 28%) were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47%) were not operating on congenital glaucoma at all. CONCLUSION This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies. PMID:29062779

Exploring the situational motivation of medical specialists: a qualitative study.

PubMed

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M

2018-02-26

The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... master's degree in a defined clinical area of nursing from an accredited educational institution or a Doctor of Nursing Practice (DNP) doctoral degree; and (3) Be certified as a clinical nurse specialist by....26 are met. (e) Professional services. Clinical nurse specialists can be paid for professional...

Mission Specialist (MS) Ride on middeck

NASA Image and Video Library

1992-06-24

STS007-02-020 (21 June 1983) --- Astronaut Sally K. Ride, STS-7 mission specialist, STS-7 mission specialist, stands in the mid deck of the orbiting Space Shuttle Challenger near one of the experiment with which she has devoted a great deal of time. The continuous flow electrophoresis system (CFES) experiment, about the size of a household refrigerator, stands nearby. One of her fellow crewmembers moves partially out of frame in the background. The tube on her face is part of a communications system linking Dr. Ride to ground controllers in Houston.

STS-86 Mission Specialist David Wolf in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-86 Mission Specialist David A. Wolf, at center facing camera, prepares to enter the Space Shuttle Atlantis at Launch Pad 39A, with the assistance of Rick Welty, in foreground at center, United Space Alliance (USA) orbiter vehicle closeout chief; and closeout team members, in background from left, Jim Davis, NASA quality assurance specialist; and George Schramm, USA mechanical technician. STS-86 Mission Specialist Vladimir Georgievich Titov, in foreground at far left, is awaiting his turn.

A descriptive study of employment patterns and work environment outcomes of specialist nurses in Canada.

PubMed

Doran, Diane; Duffield, Christine; Rizk, Paul; Nahm, Sang; Chu, Charlene H

2014-01-01

registered as general staff nurses. Analysis involved descriptive summaries, mean comparisons with independent-samples t test, and χ(2) tests for categorical data. Exit rates from direct practice were highest for APN-other (7.6%) and CNS (6.2%) and lowest for RN(EC) (1.0%) and staff nurses (1.2%). χ(2) Tests indicated yearly exit rates of both APN-other and CNS nurse groups were significantly higher than those of staff nurses in all years evaluated (α = .025). Every specialist employment group scored significantly higher than staff nurses on measures of work environment and satisfaction outcomes. We provided a description of specialist nurses in Ontario and examined the relationship between specialization and employment patterns of nurses to inform nurse retention strategies in the future. Employment in specialist nursing positions is significantly associated with differences in transitions or exits from nursing among the specialist and nonspecialist groups. Registered nurses (EC) displayed improved retention characteristics compared with staff nurses. Advanced practice nurse-other and APN-CNS exit rates from nursing practice in Ontario were comparable to staff nurses, but exit rates from direct clinical practice roles were higher than those of staff nurses. Targeted strategies are required to retain CNS and APN-other in direct clinical practice roles.

Higher Education Institutions and Specialist Schools: Potential Partnerships

ERIC Educational Resources Information Center

Penney, Dawn; Houlihan, Barrie

2003-01-01

This paper argues that the development and growth in numbers of Specialist Schools in England raises a number of key questions about the relationships between higher education institutions (HEIs) involved in initial teacher training (ITT) and continuing professional development (CPD) work, and schools now designated as Specialist Schools. It…

Sports medicine and the accident and emergency medicine specialist.

PubMed

Abernethy, L; McNally, O; MacAuley, D; O'Neill, S

2002-05-01

Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training. To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine. A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements). VALUE OF RESEARCH: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

STS-88 Mission Specialist Nancy J. Currie suits up for TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-88 Mission Specialist Nancy J. Currie suits up in the Operations and Checkout Building, as part of flight crew equipment fit check, prior to her trip to Launch Pad 39A. She is helped by suit tech Drew Billingsley. The crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and the simulated main engine cut-off exercise. This is Currie's third space flight. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module.

Early stages of development of a peer specialist fidelity measure

PubMed Central

Chinman, Matthew; McCarthy, Sharon; Mitchell-Miland, Chantele; Daniels, Karin; Youk, Ada; Edelen, Maria

2017-01-01

OBJECTIVE Research on peer specialists (individuals with serious mental illness supporting others with serious mental illness in clinical and other settings), has not yet included the measurement of fidelity. Without measuring fidelity, it’s unclear if the absence of impact in some studies is attributable to ineffective peer specialist services or because the services were not true to the intended role. This paper describes the initial development of a peer specialist fidelity measure for two content areas: services provided by peer specialists and factors that either support or hamper the performance of those services. METHODS A literature search identified 40 domains; an expert panel narrowed the number of domains and helped generate and then review survey items to operationalize those domains. Twelve peer specialists, individuals with whom they work, and their supervisors participated in a pilot test and cognitive interviews regarding item content. RESULTS Peer specialists tended to rate themselves as having engaged in various peer service activities more than supervisors and individuals with whom they work. A subset of items tapping peer specialist services “core” to the role regardless of setting had higher ratings. Participants stated the measure was clear, appropriate, and could be useful in performance improvement. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although preliminary, findings were consistent with organizational research on performance ratings of supervisors and employees made in the workplace. Several changes in survey content and administration were identified. With continued work, the measure could crystalize the role of peer specialists and aid in research and clinical administration. PMID:27618462

Specialist training of Emergency Medicine in Finland.

PubMed

Naskali, Jarno; Lehtonen, Jarmo; Palomäki, Ari

Emergency Medicine with a six-year specialist training became a main specialty in Finland in the beginning of 2013. Specialist training has developed very quickly over just a few years. In the frontline clinics, the clinical results have already reached high international quality. When developing a new specialty, not only active research and high-quality training but also good co-operation with other specialties are of utmost importance.

Specialist participation in healthcare delivery transformation: influence of patient self-referral.

PubMed

Aliu, Oluseyi; Sun, Gordon; Burke, James; Chung, Kevin C; Davis, Matthew M

2014-01-01

Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base. To examine recent national trends in self-referred new visits to specialists. A descriptive cross-sectional study of new ambulatory visits to specialists from 2000 to 2009 using data from the National Ambulatory Medical Care Survey. We calculated nationally representative estimates of the proportion of new specialist visits through self-referrals among Medicare and private insurance beneficiaries. We also estimated the nationally representative absolute number of self-referred new specialist visits among both groups of beneficiaries. Among Medicare and private insurance beneficiaries, self-referred visits declined from 32.2% (95% confidence interval [CI], 24.0%-40.4%) to 19.6% (95% CI, 13.9%-23.3%) and from 32.4% (95% CI, 27.9%-36.8%) to 24.1% (95% CI,18.8%-29.4%), respectively. Hence, at least 1 in 5 and 1 in 4 new visits to specialists among Medicare and private insurance beneficiaries, respectively, are self-referred. The current considerable rate of self-referred new specialist visits among both Medicare and private insurance beneficiaries may have adverse implications for organizations attempting to transform healthcare delivery with improved care coordination.

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the statutory exclusions; and (3) Performs them while working in collaboration with a physician. (i) Collaboration is a process in which a clinical nurse specialist works with one or more physicians to deliver... collaboration, collaboration is a process in which a clinical nurse specialist has a relationship with one or...

Optometry Specialist (AFSC 91255).

ERIC Educational Resources Information Center

Kille, Michael O.

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for optometry specialists. Covered in the individual volumes are optometry clinic administration (optometry career and field training, ethical relationships and professionalism, eligibility for optometric care and appointment…

A qualitative evaluation of the Scottish Staff and Associate Specialist Development Programme.

PubMed

Cleland, Jennifer; Burr, Jacqueline; Johnston, Peter

2016-05-01

The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances. An inductive and data-driven thematic analysis was carried out and then the realist framework was applied to the data. We interviewed 22 key stakeholders: staff and associate specialist doctors, staff and associate specialist educational advisors, programme architects and clinical directors, between end February and May 2014. The resultant data indicated five broad themes: organisational barriers to continued professional development for staff and associate specialist doctors, the purpose of funding, gains from funding, the need for better communication about the staff and associate specialist Programme Development Fund, and the interplay between individual and systems factors. The staff and associate specialist Programme Development Fund has changed the opportunities available to staff and associate specialist doctors in Scotland and, in that sense, has changed the context for this group - or at least those who have realised the opportunities. © The Author(s) 2016.

48 CFR 1519.201-72 - Small and disadvantaged business utilization specialists.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prescribed from time to time in furtherance of overall small and small disadvantaged business utilization... business utilization specialists. 1519.201-72 Section 1519.201-72 Federal Acquisition Regulations System... disadvantaged business utilization specialists. (a) Small Business Specialists (SBS) shall be appointed in...

Management Matters: The Library Media Specialist's Management Toolbox

ERIC Educational Resources Information Center

Pappas, Marjorie L.

2004-01-01

Library media specialists need tools to help them manage the school library media program. The Internet includes a vast array of tools that a library media specialist might find useful. The websites and electronic resources included in this article are only a representative sample and future columns may explore additional tools. All the tools are…

Weather Specialist (AFSC 25120).

ERIC Educational Resources Information Center

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This correspondence course is designed for self-study to help military personnel to attain the rating of weather specialist. The course is organized in three volumes. The first volume, containing seven chapters, covers background knowledge, meteorology, and climatology. In the second volume, which also contains seven chapters, surface…

The clinical nurse specialist: leadership in quality improvement.

PubMed

Finkelman, Anita

2013-01-01

Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

generated a modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will...adenocarcinoma - - - Figure 2. Validation of CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti...execution, and interpretation of CRISPR experiments Morgan Diolaiti Specialist UCSF PH.D. Experimental planning and reporting Jefferson Woods SRA

A Simulation Tool for the Duties of Computer Specialist Non-Commissioned Officers on a Turkish Air Force Base

DTIC Science & Technology

2009-09-01

Interface IFR Instrument Flight Rules LANTIRN Low-Altitude Navigation and Targeting Infrared for Night MANTIRN Medium Altitude Navigation and...MANTIRN categories, and IFR weather categories. Aside from the category of personnel (computer specialist NCOs rather than pilots), the main...of the node, (2) Adding a description, (3) Implementing event arguments , local variables, and state transitions, (4) Implementing a code that is

Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

ERIC Educational Resources Information Center

Domina, Thurston; Lewis, Ryan; Agarwal, Priyanka; Hanselman, Paul

2015-01-01

This brief documents the expansion of instructional specialist staffing in U.S. public school districts. We use data from the National Center of Education Statistics' annual Common Core of Data to chart staffing trends in public school districts between 1997-98 and 2012-13. The number of instructional specialists per 1,000 U.S students doubled…

Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

ERIC Educational Resources Information Center

Domina, Thurston; Lewis, Ryan; Agarwal, Priyanka; Hanselman, Paul

2015-01-01

This brief documents the expansion of instructional specialist staffing in U.S. public school districts. We use data from the National Center of Education Statistics' annual Common Core of Data to chart staffing trends in public school districts between 1997-1998 and 2012-2013. The number of instructional specialists per 1,000 U.S students doubled…

Of Specialists and Generalists.

ERIC Educational Resources Information Center

DeVore, Paul W.

The issues involving the role and impact of specialists and generalists in society are critically examined in this paper. Currently held views on specialization are analyzed and challenged. Perspectives on this dilemma are developed in the following areas: (1) limitations of experts (casts doubt on the assumption that ordinary citizens are…

Documenting coordination of cancer care between primary care providers and oncology specialists in Canada.

PubMed

Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret

2016-10-01

To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and

Nursing home organizational change: the "Culture Change" movement as viewed by long-term care specialists.

PubMed

Miller, Susan C; Miller, Edward Alan; Jung, Hye-Young; Sterns, Samantha; Clark, Melissa; Mor, Vincent

2010-08-01

A decade-long grassroots movement aims to deinstitutionalize nursing home (NH) environments and individualize care. Coined "NH Culture Change" the movement is often described by its resident-centered/directed care focus. While empirical data of "culture change's" costs and benefits are limited, it is broadly viewed as beneficial and widely promoted. Still, debate abounds regarding barriers to its adoption. We used data from a Web-based survey of 1,147 long-term care specialists (including NH and other providers, consumers/advocates, state and federal government officials, university/academic, researchers/consultants, and others) to better understand factors associated with perceived barriers. Long-term care specialists view the number-one barrier to adoption differently depending on their employment, familiarity with culture change, and their underlying policy views. To promote adoption, research and broad-based educational efforts are needed to influence views and perceptions. Fundamental changes in the regulatory process together with targeted regulatory changes and payment incentives may also be needed.

Careers in the U.S. Department of Education: Education Program Specialist.

ERIC Educational Resources Information Center

Horace Mann Learning Center (ED), Washington, DC.

Education program specialists in the United States Department of Education establish and lead the education program, policies, and activities for which the Department of Education is responsible under law. This brochure provides information about the job of education program specialist, describing how the specialists fit into the department's…

Host specialist clownfishes are environmental niche generalists.

PubMed

Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas

2014-11-22

Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Host specialist clownfishes are environmental niche generalists

PubMed Central

Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas

2014-01-01

Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. PMID:25274370

Inertial Confinement fusion targets

NASA Technical Reports Server (NTRS)

Hendricks, C. D.

1982-01-01

Inertial confinement fusion (ICF) targets are made as simple flat discs, as hollow shells or as complicated multilayer structures. Many techniques were devised for producing the targets. Glass and metal shells are made by using drop and bubble techniques. Solid hydrogen shells are also produced by adapting old methods to the solution of modern problems. Some of these techniques, problems, and solutions are discussed. In addition, the applications of many of the techniques to fabrication of ICF targets is presented.

National Ignition Facility Target Chamber

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

Wavrik, R W; Cox, J R; Fleming, P J

2000-10-05

On June 11, 1999 the Department of Energy dedicated the single largest piece of the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL) in Livermore, California. The ten (10) meter diameter aluminum target high vacuum chamber will serve as the working end of the largest laser in the world. The output of 192 laser beams will converge at the precise center of the chamber. The laser beams will enter the chamber in two by two arrays to illuminate 10 millimeter long gold cylinders called hohlraums enclosing 2 millimeter capsule containing deuterium, tritium and isotopes of hydrogen. The twomore » isotopes will fuse, thereby creating temperatures and pressures resembling those found only inside stars and in detonated nuclear weapons, but on a minute scale. The NIF Project will serve as an essential facility to insure safety and reliability of our nation's nuclear arsenal as well as demonstrating inertial fusion's contribution to creating electrical power. The paper will discuss the requirements that had to be addressed during the design, fabrication and testing of the target chamber. A team from Sandia National Laboratories (SNL) and LLNL with input from industry performed the configuration and basic design of the target chamber. The method of fabrication and construction of the aluminum target chamber was devised by Pitt-Des Moines, Inc. (PDM). PDM also participated in the design of the chamber in areas such as the Target Chamber Realignment and Adjustment System, which would allow realignment of the sphere laser beams in the event of earth settlement or movement from a seismic event. During the fabrication of the target chamber the sphericity tolerances had to be addressed for the individual plates. Procedures were developed for forming, edge preparation and welding of individual plates. Construction plans were developed to allow the field construction of the target chamber to occur parallel to other NIF construction activities. This was

Specialist outreach clinics in primary care and rural hospital settings.

PubMed

Gruen, R L; Weeramanthri, T S; Knight, S E; Bailie, R S

2004-01-01

Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. To undertake a descriptive overview of studies of specialist outreach clinics and to assess the effectiveness of specialist outreach clinics on access, quality, health outcomes, patient satisfaction, use of services, and costs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) specialised register (March 2002), the Cochrane Controlled Trials Register (CCTR) (Cochrane Library Issue 1, 2002), MEDLINE (including HealthStar) (1966 to May 2002), EMBASE (1988 to March 2002), CINAHL (1982 to March 2002), the Primary-Secondary Care Database previously maintained by the Centre for Primary Care Research in the Department of General Practice at the University of Manchester, a collection of studies from the UK collated in "Specialist Outreach Clinics in General Practice" (Roland 1998), and the reference lists of all retrieved articles. Randomised trials, controlled before and after studies and interrupted time series analyses of visiting specialist outreach clinics in primary care or rural hospital settings, either providing simple consultations or as part of complex multifaceted interventions. The participants were patients, specialists, and primary care providers. The outcomes included objective measures of access, quality, health outcomes, satisfaction, service use, and cost. Four reviewers working in pairs independently extracted data and assessed study quality. 73 outreach interventions were identified covering many specialties, countries and settings. Nine studies met the inclusion criteria. Most comparative studies came from urban non-disadvantaged populations in developed countries. Simple 'shifted outpatients

An organization for academic specialists: the time has come.

PubMed

Thompson, L Chesney; Chelmow, David; Hitt, Wilbur; Learman, Lee A; Ogburn, Tony

2014-07-01

The Society for Academic Specialists in General Obstetrics and Gynecology was recently formed to meet the professional needs of general obstetrician-gynecologists (ob-gyns) in academic settings. Historically there has been little communication and poor networking among this group, largely as a result of lack of infrastructure. Until the Society for Academic Specialists in General Obstetrics and Gynecology, there has been no common venue to unite academic specialists nor a means to identify colleagues and develop professional relationships. The Society is creating avenues for communication and collaboration among general ob-gyn faculty across institutions. The Society for Academic Specialists in General Obstetrics and Gynecology is hosting national meetings, conducting workshops and webinars, and developing other media to promote research training, share administrative skills, and help members to become more effective educators. One major focus of the new organization is to provide resources to facilitate faculty development. Formation of the Society for Academic Specialists in General Obstetrics and Gynecology is particularly timely given that ob-gyns, without subspecialty fellowship training, have assumed major roles in academic departments. Their contribution to educational, scholarly, and clinical responsibilities is a significant benefit to the well-being of the departments of obstetrics and gynecology. In turn, the role of educator and scholar is of value to the general academic ob-gyn. The Society for Academic Specialists in General Obstetrics and Gynecology will help academic faculty and their institutions by filling current gaps in professional and career development, which should improve scholarship, enhance retention, and improve the ability for academic departments to fulfill their educational and clinical missions.

The visiting specialist model of rural health care delivery: a survey in Massachusetts.

PubMed

Drew, Jacob; Cashman, Suzanne B; Savageau, Judith A; Stenger, Joseph

2006-01-01

Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of satisfaction and intention to continue the visiting arrangement. Visiting specialists at 11 rural hospitals were asked to complete a mailed survey. Visiting specialists were almost evenly split between the medical (54%) and surgical (46%) specialties, with ophthalmology, nephrology, and obstetrics/gynecology the most common specialties reported. A higher proportion of visiting specialists than specialists statewide were male (P = .001). Supplementing their patient base and income were the most important reasons visiting specialists reported for having initiated an ancillary clinic. There was a significant negative correlation between a hospital's number of staffed beds and the total number of visiting specialists it hosted (r =-0.573, P = .032); study hospitals ranged in bed size from 15 to 129. The goal of matching supply of health care services with demand has been elusive. Visiting specialist clinics may represent an element of a market structure that expands access to needed services in rural areas. They should be included in any enumeration of physician availability.

Clinical nurse specialists: essential resource for an effective NHS.

PubMed

Vidall, Cheryl; Barlow, Helen; Crowe, Maggie; Harrison, Isabel; Young, Annie

Despite emerging evidence for the clinical and financial efficacy of the clinical nurse specialist (CNS), the provision of this role is patchy across the country. There is also a risk that incumbent CNS' may be redirected to less specialist work in trusts that do not appreciate the full value of the service that these nurses provide. Optimal and equitable patient access to CNS care will require the development of a strong evidence base showing that specialist nurses not only deliver patient-focused care, but that they can also help to meet healthcare managers' objectives of streamlined, cost-effective clinical services.

The effect of intermediate clothing targets on shotgun ballistics.

PubMed

Cail, Kenneth; Klatt, Edward

2013-12-01

The ballistic properties of shotgun shells are complex because of multiple projectiles fired simultaneously that interact and spread out to affect their energy relayed to a human target. Intermediate targets such as clothing can affect penetration into tissues. We studied the effect of common clothing fabrics as intermediate targets on penetration of shotgun shell pellets, using ordnance gelatin to simulate soft tissue and thin cowhide to simulate skin. A standard 12-gauge shotgun with modified choke was used with no. 8 shot ammunition. We found that protection afforded by fabrics to reduce penetration of shotgun pellets into tissues was greater at increasing distance from the muzzle beyond 40 yd (36.6 m). The thicker denim and cotton fabrics provided slightly greater protection than polyester. This study demonstrates that clothing modifies the potential wound patterns to victims of shotgun injuries.

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

inhibitors. We also generated a modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening...Figure 2. Validation of CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti-CD55 antibody. Data shown...interpretation of CRISPR experiments Morgan Diolaiti Specialist UCSF PH.D. Experimental planning and reporting Jefferson Woods SRA UCSF B.S. Perform drug

Redefining "Community" through Collaboration and Co-Teaching: A Case Study of an ESOL Specialist, a Literacy Specialist, and a Fifth-Grade Teacher

ERIC Educational Resources Information Center

Ahmed Hersi, Afra; Horan, Deborah A.; Lewis, Mark A.

2016-01-01

This article explores the development of a professional learning community through a case study of three teachers--an ESOL specialist, a literacy specialist, and a fifth-grade teacher--who engaged in co-teaching and collaboration. The emerging community of practice offered these teachers a space to learn and problem-solve by utilizing their…

The School Librarian as Information Specialist: A Vibrant Species

ERIC Educational Resources Information Center

Harris, Frances Jacobson

2011-01-01

In this article, the author talks about the school librarian as information specialist. She stresses that the school librarian's information specialist role is more important than ever. She offers her personal toolkit that consists of four strategies in helping and teaching students to use content responsibly.

Payload specialist Merbold performing experiment in Spacelab

NASA Image and Video Library

1983-11-28

STS009-13-699 (28 Nov - 8 Dec 1983) --? Ulf Merbold, Spacelab 1 payload specialist, carries out one of the experiments using the gradient heating facility on the materials science double rack facility in the busy science module aboard the Earth-orbiting Space Shuttle Columbia. Representing the European Space Agency, Dr. Merbold comes from Max-Planck Institute in Stuttgart, the Federal Republic of Germany. He is a specialist in crystal lattice defects and low temperature physics. The photograph was made with a 35mm camera.

Specialist payment schemes and patient selection in private and public hospitals.

PubMed

Wright, Donald J

2007-09-01

It has been observed that specialist physicians who work in private hospitals are usually paid by fee-for-service while specialist physicians who work in public hospitals are usually paid by salary. This paper provides an explanation for this observation. Essentially, fee-for-service aligns the interests of income preferring specialists with profit maximizing private hospitals and results in private hospitals treating a high proportion of short stay patients. On the other hand, salary aligns the interests of fairness preferring specialists with benevolent public hospitals that commit to admit all patients irrespective of their expected length of stay.

STS-47 Japanese Payload Specialist Mohri and backups during Homestead training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Japanese Payload Specialist Mamoru Mohri (far left), backup Payload Specialist Takao Doi (center), and backup Payload Specialist Chiaki Mukai (right) participate in water survival training at Homestead Air Force Base, Florida. Dockside, Mohri and Mukai wash the salt water from their personalized helmets after a water exercise. The three-day course was attended by the STS-47 prime and alternate payload specialists shortly after they were announced for the scheduled summer of 1992 Spacelab Japan (SLJ) mission. Mohri, Doi, and Mukai all represent the National Space Development Agency of Japan (NASDA).

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

Becoming a Specialist Nurse in Psychiatric Mental Health Care

ERIC Educational Resources Information Center

Södergren, Ulrika; Benjaminson, Carin; Mattsson, Janet

2017-01-01

Background: Specialist nurse students are upon graduation certified to have increased their professional competence to an advanced level. But how do specialist nurse students themselves experience and understand their professional competence and its development upon graduation? This is what this study aims at describing. Method: This study has a…

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

An empirical investigation of differences between mathematics specialists and non-specialists at the high school level in Cyprus: A Logistic regression Approach

NASA Astrophysics Data System (ADS)

Papanastasiou, Elena C.; Zembylas, Michalinos

2006-12-01

AN EMPIRICAL INVESTIGATION OF DIFFERENCES BETWEEN MATHEMATICS SPECIALISTS AND NON-SPECIALISTS AT THE HIGH-SCHOOL LEVEL in Cyprus - The data obtained from high-school seniors for the Third International Mathematics and Science Study (TIMSS) for the country of Cyprus appear to be contradictory. Although Cypriot students did not perform well in mathematics in elementary school, middle school, and in the non-advanced sectors of high school, students in advanced mathematics courses in high school managed to perform exceptionally well. In seeking to account for this apparent disparity, the present study examines the differences between mathematics specialists and non-specialists at the high-school level and discusses the implications that these have for teaching practice. It shows how students educated in an environment that might not be optimal for producing high-achieving students in mathematics and science in elementary and middle school (according to the TIMSS) might nonetheless manage to excel in these fields at the end of their schooling. In conclusion, the authors address the implications of their study for similar educational systems in other developing countries.

Polish Code of Ethics of a Medical Laboratory Specialist.

PubMed

Elżbieta, Puacz; Waldemar, Glusiec; Barbara, Madej-Czerwonka

2014-09-01

Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists' identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world.

An analysis of specialist and non-specialist user requirements for geographic climate change information.

PubMed

Maguire, Martin C

2013-11-01

The EU EuroClim project developed a system to monitor and record climate change indicator data based on satellite observations of snow cover, sea ice and glaciers in Northern Europe and the Arctic. It also contained projection data for temperature, rainfall and average wind speed for Europe. These were all stored as data sets in a GIS database for users to download. The process of gathering requirements for a user population including scientists, researchers, policy makers, educationalists and the general public is described. Using an iterative design methodology, a user survey was administered to obtain initial feedback on the system concept followed by panel sessions where users were presented with the system concept and a demonstrator to interact with it. The requirements of both specialist and non-specialist users is summarised together with strategies for the effective communication of geographic climate change information. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Fabricated Elastin.

PubMed

Yeo, Giselle C; Aghaei-Ghareh-Bolagh, Behnaz; Brackenreg, Edwin P; Hiob, Matti A; Lee, Pearl; Weiss, Anthony S

2015-11-18

The mechanical stability, elasticity, inherent bioactivity, and self-assembly properties of elastin make it a highly attractive candidate for the fabrication of versatile biomaterials. The ability to engineer specific peptide sequences derived from elastin allows the precise control of these physicochemical and organizational characteristics, and further broadens the diversity of elastin-based applications. Elastin and elastin-like peptides can also be modified or blended with other natural or synthetic moieties, including peptides, proteins, polysaccharides, and polymers, to augment existing capabilities or confer additional architectural and biofunctional features to compositionally pure materials. Elastin and elastin-based composites have been subjected to diverse fabrication processes, including heating, electrospinning, wet spinning, solvent casting, freeze-drying, and cross-linking, for the manufacture of particles, fibers, gels, tubes, sheets and films. The resulting materials can be tailored to possess specific strength, elasticity, morphology, topography, porosity, wettability, surface charge, and bioactivity. This extraordinary tunability of elastin-based constructs enables their use in a range of biomedical and tissue engineering applications such as targeted drug delivery, cell encapsulation, vascular repair, nerve regeneration, wound healing, and dermal, cartilage, bone, and dental replacement. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Fabricated elastin

PubMed Central

Yeo, Giselle C.; Weiss, Anthony S.

2015-01-01

The mechanical stability, elasticity, inherent bioactivity, and self-assembly properties of elastin make it a highly attractive candidate for the fabrication of versatile biomaterials. The ability to engineer specific peptide sequences derived from elastin allows for precise control of these physicochemical and organizational characteristics, and further broadens the diversity of elastin-based applications. Elastin and elastin-like peptides can also be modified or blended with other natural or synthetic moieties, including peptides, proteins, polysaccharides and polymers, to augment existing capabilities or confer additional architectural and biofunctional features to compositionally pure materials. Elastin and elastin-based composites have been subjected to diverse fabrication processes, including heating, electrospinning, wet spinning, solvent casting, freeze-drying, and cross-linking, for the manufacture of particles, fibers, gels, tubes, sheets and films. The resulting materials can be tailored to possess specific strength, elasticity, morphology, topography, porosity, wettability, surface charge and bioactivity. This extraordinary tunability of elastin-based constructs enables their use in a range of biomedical and tissue engineering applications such as targeted drug delivery, cell encapsulation, vascular repair, nerve regeneration, wound healing, and dermal, cartilage, bone and dental replacement. PMID:25771993

On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists.

PubMed

Zambrano, Sofia Carolina; Chur-Hansen, Anna; Crawford, Gregory B

2012-09-01

This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. Thirty-three semi-structured individual interviews were analysed using thematic analysis. One of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies. Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.

Specialist Schools and Academies Trust Annual Report, 2008-2009

ERIC Educational Resources Information Center

Specialist Schools and Academies Trust, 2010

2010-01-01

This paper presents the annual activities of the Specialist Schools and Academies Trust (SSAT) during 2008-2009. SSAT's activities this year have reflected its commitment to the priorities of the Government's Children's Plan. Its active and expert support of specialist schools, academies and trust schools continued to develop and enrich the…

STS-95 Mission Specialist Stephen Robinson suits up for launch

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Stephen K. Robinson gives a thumbs up as he dons his flight suit in the Operations and Checkout Building with the help of suit tech George Brittingham (lower right). The final fitting takes place prior to the crew walkout and transport to Launch Pad 39B. Targeted for launch at 2 p.m. EST on Oct. 29, the mission is expected to last 8 days, 21 hours and 49 minutes, and return to KSC at 11:49 a.m. EST on Nov. 7. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

New study program: Interdisciplinary Postgraduate Specialist Study in Medical Informatics.

PubMed

Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra

2014-01-01

Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.

STS-95 Mission Specialist Pedro Duque suits up for launch

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Pedro Duque of Spain, with the European Space Agency, is helped with his flight suit by suit tech Tommy McDonald in the Operations and Checkout Building. The final fitting takes place prior to the crew walkout and transport to Launch Pad 39B. Targeted for launch at 2 p.m. EST on Oct. 29, the mission is expected to last 8 days, 21 hours and 49 minutes, and return to KSC at 11:49 a.m. EST on Nov. 7. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Nursing Home Organizational Change: The “Culture Change” Movement as Viewed by Long-Term Care Specialists

PubMed Central

Miller, Susan C.; Miller, Edward Alan; Jung, Hye-Young; Sterns, Samantha; Clark, Melissa; Mor, Vincent

2017-01-01

A decade-long grassroots movement aims to deinstitutionalize nursing home (NH) environments and individualize care. Coined “NH Culture Change” the movement is often described by its resident-centered/directed care focus. While empirical data of “culture change’s” costs and benefits are limited, it is broadly viewed as beneficial and widely promoted. Still, debate abounds regarding barriers to its adoption. We used data from a Web-based survey of 1,147 long-term care specialists (including NH and other providers, consumers/advocates, state and federal government officials, university/academic, researchers/consultants, and others) to better understand factors associated with perceived barriers. Long-term care specialists view the number-one barrier to adoption differently depending on their employment, familiarity with culture change, and their underlying policy views. To promote adoption, research and broad-based educational efforts are needed to influence views and perceptions. Fundamental changes in the regulatory process together with targeted regulatory changes and payment incentives may also be needed. PMID:20435790

22 CFR 62.26 - Specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., international educational exchange, museum exhibitions, labor law, public administration, and library science... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Specialists. 62.26 Section 62.26 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program...

Certification of School Media Specialists.

ERIC Educational Resources Information Center

Penland, Patrick R.

1982-01-01

Professional organizations, such as the American Association of School Librarians and the Association for Educational Communications and Technology, have established guidelines and standards for certification of school media specialists and have identified necessary professional competencies. Issues and problems concerning state certification and…

[Integral financing stifles innovation: consequences of the new form of financing for specialists].

PubMed

Berden, H J J M Bart; Keuzenkamp, Hugo A

2015-01-01

Of the 22,800 Dutch medical specialists, 43% are self-employed, which involves various tax benefits. In 2015 an important change took place. In the past, specialists declared their services independently from the hospital, which impeded process adjustments. Although this gives the impression of improvement, it is not, mainly because specialists are organized separately from the hospital organization. In addition, specialists are not entrepreneurs, which means that they avoid risks and uncertainty. The complex situation that has arisen is further complicated by fuzzy implementation that lacks an overall plan. For the individual specialist, the situation is unclear. The specialists consider necessary renewals and innovations to be irresponsible risks. This creates a cautious attitude and inertia. To achieve improvement, government and policy-makers should set clear rules and health insurers should value good governance. This protection would allow specialists and hospital boards to balance medical content and finance.

STS-47 Payload Specialist Mohri adjusts life vest during Homestead training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Payload Specialist Mamoru Mohri adjusts his life jacket with a training instructor's assistance as backup (alternate) payload specialist Takao Doi looks on. The STS-47 prime and alternate payload specialists are participating in a special water survival training course hosted by Homestead Air Force Base in Florida. Mohri and Doi represent the National Space Development Agency of Japan (NASDA).

Payload specialist Reinhard Furrer show evidence of previous blood sampling

NASA Technical Reports Server (NTRS)

1985-01-01

Payload specialist Reinhard Furrer shows evidence of previous blood sampling while Wubbo J. Ockels, Dutch payload specialist (only partially visible), extends his right arm after a sample has been taken. Both men show bruises on their arms.

A Comparative Study of Directly Selected, In-Service Promoted and Online Selected Subject Specialists Regarding Teaching Effectiveness in Kohat Division, Pakistan

ERIC Educational Resources Information Center

Suleman, Qaiser; Gul, Rizwana

2015-01-01

The main objective of the study was to compare the teaching effectiveness of directly selected, in-service promoted and online selected subject specialists teaching at higher secondary school level in Kohat Division, Pakistan. The target population of the study was the higher secondary school students in Kohat Division, Pakistan. A sample of 600…

Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists.

PubMed

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Wilschut, Janneke A; Tjin A Tsoi, Sharon L N M; Croiset, Gerda; Peerdeman, Saskia M

2018-05-22

Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work

Addressing cultural diversity: the hepatitis B clinical specialist perspective.

PubMed

Wallace, Jack; Smith, Elizabeth; Hajarizadeh, Behzad; Richmond, Jacqueline; Lucke, Jayne

2017-08-31

Hepatitis B is a viral infection primarily affecting people from culturally diverse communities in Australia. While vaccination prevents infection, there is increasing mortality resulting from liver damage associated with chronic infection. Deficits in the national policy and clinical response to hepatitis B result in a low diagnosis rate, inadequate testing and diagnosis processes, and poor access to hepatitis B treatment services. While research identifies inadequate hepatitis B knowledge among people with the virus and primary health care workers, this project sought to identify how specialist clinicians in Australia negotiate cultural diversity, and provide often complex clinical information to people with hepatitis B. A vignette was developed and presented to thirteen viral hepatitis specialist clinicians prior to an electronically recorded interview. Recruitment continued until saturation of themes was reached. Data were thematically coded into themes outlined in the interview schedule. Ethical approval for the research was provided by the La Trobe University Human Research Ethics Committee. Key messages provided to patients with hepatitis B by clinical specialists were identified. These messages were not consistently provided to all patients with hepatitis B, but were determined on perceptions of patient knowledge, age and highest educational level. While the vignette stated that English was not an issue for the patient, most specialists identified the need for an interpreter. Combating stigma related to hepatitis B was seen as important by the specialists and this was done through normalising the virus. Having an awareness of different cultural understandings about hepatitis B specifically, and health and well-being generally, was noted as a communication strategy. Key core competencies need to be developed to deliver educational messages to people with hepatitis B within clinical encounters. The provision of adequate resources to specialist clinics will

Comparing Clinical Nurse Specialist Students' Socialization Based on Magnet Employment.

PubMed

Ares, Terri L

The purpose of this study is to ascertain if clinical nurse specialist students differed on measures of professional socialization based on employment in a Magnet-oriented hospital. A secondary analysis of data from a previous national study of the socialization of clinical nurse specialist students was used. Anticipatory socialization variables (nursing leadership, workplace exposure to the role, and preconceived impression of the role), mentorship by a clinical nurse specialist, and socialization outcomes (self-concept, perceived preparedness for practice, and nursing specialty certification) were explored. Data were divided into 2 groups: Magnet (n = 106) and non-Magnet (n = 119). Comparisons between the groups on researcher-designed items and the Professionalism and Work Ethic subscales of the Nurses Self-Description Form were analyzed. The Magnet group was more likely to be exposed to the clinical nurse specialist role in the workplace. Overall, there were no group differences in socialization outcome measures; but in the subset of students with workplace exposure to the role, those with Magnet experience had higher professionalism self-concept scores. Magnet employment was not a significant socializing factor for nurses pursuing clinical nurse specialist education. The graduate program is likely the primary socializing agent for these students.

Perceptions of Information Technology Specialists Regarding Securing Re-Employment after Offshoring Displacement

ERIC Educational Resources Information Center

Gallaway, Ricky A.

2015-01-01

The purpose of this qualitative exploratory case study was to explore why some IT specialists, after experiencing unemployment because of corporate offshoring, acquired gainful re-employment, whereas other similarly unemployed IT specialists had not. To effectively address this case study, two cases were studied: (a) displaced IT specialists who…

Payload specialists Millie Hughes-Fulford in Body Mass Measurement Device

NASA Image and Video Library

1985-02-01

S85-26553 (Feb 1985) --- STS-40/SLS-1 payload specialist Millie Hughes-Fulford sits strapped in the special device scientists have developed for determining mass on orbit. As the chair swings back and forth, a timer records how much the crewmember's mass retards the chair's movement. Dr. Hughes-Fulford will be joined by three mission specialists, the mission commander, the pilot and a second payload specialist for the scheduled 10-day Spacelab Life Sciences-1 (SLS-1) mission. The flight is totally dedicated to biological and medical experimentation.

Balanced scorecards for specialists: a tool for quality improvement.

PubMed

Marr, Thomas J; Mullen, Deborah M

2004-04-01

This article describes a program that HealthPartners uses to assess and compare the performance of specialists that serve its members. HealthPartners' Balanced Scorecards program focuses on cardiologist and orthopedist practices in the Minneapolis/St. Paul metro area and St. Cloud, Minnesota. The scorecards assess the clinical and business processes of specialist practices, their use of resources, the degree to which patients and referring physicians are satisfied with their performance, and their patient outcomes. Unblinded comparative data is made available to referring physicians, employers, and consumers only after each individual specialist group has had the opportunity to review its own data against blinded results, discuss the methodology, and comment on the results.

Evolution of Magnetized Liner Inertial Fusion (MagLIF) Targets

DOE PAGES

Fooks, J. A.; Carlson, L. C.; Fitzsimmons, P.; ...

2017-12-19

Here, the magnetized liner inertial fusion (MagLIF) experimental campaign conducted at the University of Rochester’s Laboratory for Laser Energetics (LLE) has evolved significantly since its start in 2014. Scientific requirements and OMEGA EP system technology both have progressed, resulting in necessary and available updates to the target design. These include, but are not limited to: optimizing target dimensions and aspect ratios to maximize survival at desired pressures; coating target components to enhance physics diagnosis; precision-machining diagnostic windows along the axis of the target; improving fiducial placement reproducibility and reducing subsequent assembly time by 50%; and implementing gas-pressure transducers on themore » targets. In addition, target fabrication techniques have changed and improved, allowing for simpler target reproducibility and decreased assembly time. To date, eleven variations of targets have been fabricated, with successful target fielding ranging from 1 to 20atm internal pressure and a maximum survivability of 33atm.« less

Evolution of Magnetized Liner Inertial Fusion (MagLIF) Targets

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

Fooks, J. A.; Carlson, L. C.; Fitzsimmons, P.

Here, the magnetized liner inertial fusion (MagLIF) experimental campaign conducted at the University of Rochester’s Laboratory for Laser Energetics (LLE) has evolved significantly since its start in 2014. Scientific requirements and OMEGA EP system technology both have progressed, resulting in necessary and available updates to the target design. These include, but are not limited to: optimizing target dimensions and aspect ratios to maximize survival at desired pressures; coating target components to enhance physics diagnosis; precision-machining diagnostic windows along the axis of the target; improving fiducial placement reproducibility and reducing subsequent assembly time by 50%; and implementing gas-pressure transducers on themore » targets. In addition, target fabrication techniques have changed and improved, allowing for simpler target reproducibility and decreased assembly time. To date, eleven variations of targets have been fabricated, with successful target fielding ranging from 1 to 20atm internal pressure and a maximum survivability of 33atm.« less

Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-01-07

The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

Wearable carbon nanotube-based fabric sensors for monitoring human physiological performance

NASA Astrophysics Data System (ADS)

Wang, Long; Loh, Kenneth J.

2017-05-01

A target application of wearable sensors is to detect human motion and to monitor physical activity for improving athletic performance and for delivering better physical therapy. In addition, measuring human vital signals (e.g., respiration rate and body temperature) provides rich information that can be used to assess a subject’s physiological or psychological condition. This study aims to design a multifunctional, wearable, fabric-based sensing system. First, carbon nanotube (CNT)-based thin films were fabricated by spraying. Second, the thin films were integrated with stretchable fabrics to form the fabric sensors. Third, the strain and temperature sensing properties of sensors fabricated using different CNT concentrations were characterized. Furthermore, the sensors were demonstrated to detect human finger bending motions, so as to validate their practical strain sensing performance. Finally, to monitor human respiration, the fabric sensors were integrated with a chest band, which was directly worn by a human subject. Quantification of respiration rates were successfully achieved. Overall, the fabric sensors were characterized by advantages such as flexibility, ease of fabrication, lightweight, low-cost, noninvasiveness, and user comfort.

22 CFR 41.54 - Intracompany transferees (executives, managers, and specialists).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Intracompany transferees (executives, managers, and specialists). 41.54 Section 41.54 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION....54 Intracompany transferees (executives, managers, and specialists). (a) Requirements for L...

STS-9 payload specialists and backup in training session

NASA Technical Reports Server (NTRS)

1983-01-01

Two Spacelab 1 payload specialists and a backup for that flight prepare for a training session in the JSC mockup and integration laboratory. Fully decked out in the Shuttle constant wear garments (foreground) are Ulf Merbold, left, and Byron K. Licktenberg, prime crewmembers on the STS-9 team. In civilian clothes is payload specialist backup Michael L. Lampton.

Laser ``M'egajoule'' cryogenic target program: from target fabrication to conformation of the deuterium-tritium ice layer

NASA Astrophysics Data System (ADS)

Collier, Rémy; Durut, Frédéric; Reneaume, Benoît; Chicane, Cédric; Théobald, Marc; Breton, Olivier; Martin, Michel; Fleury, Emmanuel; Vincent-Viry, Olivier; Bachelet, Franck; Jeannot, Laurent; Geoffray, Isabelle; Botrel, Ronan; Dauteuil, Christophe; Hermerel, Cyril; Choux, Alexandre; Bednarczyk, Sophie; Legaie, Olivier

2008-11-01

For the French inertial confinement fusion (ICF) experiments, cryogenic target assemblies (CTAs) for the LMJ program are manufactured and filled at CEA Valduc (Dijon) in the cryogenic targets filling station (IRCC). They will be moved at about 20 K into a transport cryostat for cryogenic targets and will be driven from CEA/Valduc to CEA/CESTA (Bordeaux). Cryogenic targets will then be transferred by several cryogenic grippers on the cryogenic target positioner before shots. The CTA has to meet severe specifications and involves a lot of challenging tasks for its manufacture. To fill CTAs by permeation with deuterium-tritium (DT), the IRCC need to meet strict thermal, mechanical and dimensional specifications. To obtain a good combustion yield, a very homogenous DT ice layer and very smooth roughness at 1.5 K below the DT triple point are also required. This paper deals with the up to date main issues in the different fields of the LMJ cryogenic target program.

How much does the specialist know about cardiogastroenterology?

PubMed

Aguilar-Nájera, O; Valdovinos-García, L R; Tepox-Padrón, A; Valdovinos-Díaz, M A

Cardiovascular disease is a growing public health problem. Forty percent of the general population will suffer from the disease by 2030, consequently requiring antithrombotic therapy. Cardiogastroenterology is a new area of knowledge that evaluates the gastrointestinal effects and complications of antithrombotic therapy. Our aim was to evaluate, through a validated questionnaire, the knowledge held by a group of specialists and residents in the areas of gastroenterology and internal medicine, about pharmacology and drug prescription, as well as gastrointestinal risks and complications, in relation to antithrombotic therapy. A validated questionnaire composed of 30 items was applied to a group of specialists and residents in the areas of gastroenterology and internal medicine. The questions were on indications, pharmacology, evaluation of risks for gastrointestinal bleeding and thromboembolic events, and use of antithrombotic therapy during endoscopic procedures. Sufficient knowledge was defined as 18 or more (≥ 60%) correct answers. The questionnaire was answered by 194 physicians: 82 (42%) internal medicine residents and gastroenterology residents and 112 (58%) specialists. Only 40 (20.6%) of the participants had sufficient knowledge of cardiogastroenterology. Residents had a higher number of correct answers than specialists (53 vs. 36%, P<.0001). The gastroenterology residents had more correct answers than the internal medicine residents, gastroenterologists, and internists (70 vs. 53, 40, and 46%, respectively, P<.001). Only residents had sufficient knowledge regarding pharmacology and the use of antithrombotic therapy in endoscopy (P<.0001). All groups had insufficient knowledge in evaluating the risk for gastrointestinal bleeding and thrombosis. Knowledge of cardiogastroenterology was insufficient in the group of residents and specialists surveyed. There is a need for medical education programs on the appropriate use of antithrombotic therapy. Copyright �

Fabrication High Resolution Metrology Target By Step And Repeat Method

NASA Astrophysics Data System (ADS)

Dusa, Mircea

1983-10-01

Based on the photolithography process generally used to generate high resolution masks for semiconductor I.C.S, we found a very useful industrial application of laser technology.First, we have generated high resolution metrology targets which are used in industrial measurement laser interferometers as difra.ction gratings. Secondi we have generated these targets using step and repeat machine, with He-Ne laser interferometer controlled state, as a pattern generator, due to suitable computer programming.Actually, high resolution metrology target, means two chromium plates, one of which is called the" rule" the other one the "vernier". In Fig.1 we have the configuration of the rule and the vernier. The rule has a succesion of 3 μM lines generated as a difraction grating on a 4 x 4 inch chromium blank. The vernier has several exposed fields( areas) having 3 - 15 μm lines, fields placed on very precise position on the chromium blank surface. High degree of uniformity, tight CD tolerances, low defect density required by the targets, creates specialised problems during processing. Details of the processing, together with experimental results will be presented. Before we start to enter into process details, we have to point out that the dimensional requirements of the reticle target, are quite similar or perhaps more strict than LSI master casks. These requirements presented in Fig.2.

Inequalities in Specialist Hand Surgeon Distribution across the United States.

PubMed

Rios-Diaz, Arturo J; Metcalfe, David; Singh, Mansher; Zogg, Cheryl K; Olufajo, Olubode A; Ramos, Margarita S; Caterson, Edward J; Talbot, Simon G

2016-05-01

Unequal access to hospital specialists for emergency care is an issue in the United States. The authors sought to describe the geographic distribution of specialist hand surgeons and associated factors in the United States. Geographic distributions of surgeons holding a Subspecialty Certificate in Surgery of the Hand and hand surgery fellowship positions were identified from the American Board of Medical Specialties Database and the literature (2013), respectively. State-level population and per capita income were ascertained using U.S. Census data. Variations in hand trauma admissions were determined using Healthcare Cost and Utilization Project national/state inpatient databases. Risk-adjusted generalized linear models were used to assess independent association between hand surgeon density and hand trauma admission density, fellowship position density, and per capita income. Among 2019 specialist hand surgeons identified, 72.1 percent were orthopedic surgeons, 18.3 percent were plastic surgeons, and 9.6 percent were general surgeons. There were 157 hand surgery fellowship positions nationwide. There were 149,295 annual hand trauma admissions. The national density of specialist hand surgeons and density of trauma admission were 0.6 and 47.6, respectively. The density of specialist hand surgeons varied significantly between states. State-level variations in density of surgeons were independent and significantly associated with median per capita income (p < 0.001) and with density of fellowships (p = 0.014). Specialist hand surgeons are distributed unevenly across the United States. State-level analyses suggest that states with lower per capita incomes may be particularly underserved, which may contribute to regional disparities in access to emergency hand trauma care.

Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

PubMed

Gruen, Russell; Bailie, Ross

2004-10-01

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

Pest Management Specialist (AFSC 56650).

ERIC Educational Resources Information Center

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This eight-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for pest management specialists. Covered in the individual volumes are civil engineering; pest management (entomology, pest management planning and coordination, and safety and protective equipment); pest management chemicals and…

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

20 CFR 702.408 - Evaluation of medical questions; impartial specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Evaluation of medical questions; impartial specialists. 702.408 Section 702.408 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF... PROCEDURE Medical Care and Supervision § 702.408 Evaluation of medical questions; impartial specialists. In...

STS-75 Payload Specialist Umberto Guidoni suits up

NASA Technical Reports Server (NTRS)

1996-01-01

STS-75 Payload Specialist Umberto Guidoni (right) chats with fellow crew member Mission Specialist Claude Nicollier during suitup activities in the Operations and Checkout Building. Guidoni represents the Italian Space Agency and is one of three international crew members assigned to STS-75. He and six fellow crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff during a two-and-a-half- hour launch window opening at 3:18 p.m. EST.

Payload specialist Robert Cenker after adjusting DSO equipment

NASA Image and Video Library

1986-01-12

61C-05-035 (12-17 Jan 1986) --- Robert J. Cenker, 61-C payload specialist representing RCA, returns a tiny tool to its stowage position after adjusting the inner workings of a device used in one of a number of detailed supplementary objective (DSO) studies for NASA's Space Biomedical Research Institute. The device is a pair of ocular counter-rolling goggles used by U.S. Rep. Bill Nelson (D., Florida), 61-C's other payload specialist aboard the Columbia for this five-day flight.

STS-87 Mission Specialist Takao Doi suits up

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, gives a thumbs up in his launch and entry suit in the Operations and Checkout Building. He and the five other crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff on a 16-day mission to perform microgravity and solar research. Dr. Doi is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Winston Scott during STS-87.

Portrait view of ESA Spacelab Specialists

NASA Technical Reports Server (NTRS)

1978-01-01

Portrait view of European Space Agency (ESA) Spacelab Specialist Ulf Merbold in civilian clothes standing in front of a display case. The photo was taken at the Marshall Space Flight Center (MSFC), Huntsville, Alabama.

[Smoking among patients of selected specialist clinics of Miedzylesie Specialist Hospital in Warsaw].

PubMed

Pytka, Dorota; Doboszyńska, Anna

2011-01-01

The purpose of the study is to examine the issue of smoking among patients of selected clinics of the Miedzylesie Specialist Hospital in Warsaw, assessment of nicotine addiction of smokers and motivation to give up smoking. The survey was carried out in June and July 2009 after obtaining the consent of the Director of Miedzylesie Specialist Hospital in Warsaw. The survey was participated in by 100 patients of selected specialist clinics. The survey was carried out on the basis of a questionnaire consisting of 7 questions. Furthermore, the "Test of motivation to give up smoking" (Schneider's test) and the "Assessment of nicotine addiction level" (Fagerström's test), published in the "Consensus regarding recognition and treatment of nicotine addiction", were used. When processing data, the descriptive statistics were applied. Those surveyed included 53 former cigarette smokers 47 active smokers and. In the group of former smokers, 19 people still were exposed to passive smoking. In the past, the problem regarded 41 people. Thirty former smokers smoked cigarettes among non-smokers, including young children (18 people) and when pregnant and breastfeeding (2 people). Also 30 respondents smoked despite medical contraindications and bad conscience. For 27 people, expenditures on cigarettes constituted a considerable burden of their respective household budgets, and 20 said that it was a significant item in their expenditures. Smokers have been smoking cigarettes for 30 years, on average 20 cigarettes a day. Those patients began to smoke at the age of 20. Thirty one active smokers exposed other people to passive smoking and 38 respondents smoked cigarettes despite medical contraindications and with bad conscience. For 22 people, expenditures related to smoking are a considerable burden of the household budget and for 21 people, it is a significant expenditure. Almost one half of the patients smoke cigarettes although they should brake off smoking for medical reasons. Most

Establishing a Research Agenda for Understanding the Role and Impact of Mental Health Peer Specialists.

PubMed

Chinman, Matthew; McInnes, D Keith; Eisen, Susan; Ellison, Marsha; Farkas, Marianne; Armstrong, Moe; Resnick, Sandra G

2017-09-01

Mental health peer specialists are individuals with serious mental illnesses who receive training to use their lived experiences to help others with serious mental illnesses in clinical settings. This Open Forum discusses the state of the research for mental health peer specialists and suggests a research agenda to advance the field. Studies have suggested that peer specialists vary widely in their roles, settings, and theoretical orientations. Theories of action have been proposed, but none have been tested. Outcome studies have shown benefits of peer specialists; however, many studies have methodological shortcomings. Qualitative descriptions of peer specialists are plentiful but lack grounding in implementation science frameworks. A research agenda advancing the field could include empirically testing theoretical mechanisms of peer specialists, developing a measure of peer specialist fidelity, conducting more rigorous outcomes studies, involving peer specialists in executing the research, and assessing various factors that influence implementing peer specialist services and testing strategies that could address those factors.

Are Specialist Certification Examinations a Reliable Measure of Physician Competence?

ERIC Educational Resources Information Center

Burch, V. C.; Norman, G. R.; Schmidt, H. G.; van der Vleuten, C. P. M.

2008-01-01

High stakes postgraduate specialist certification examinations have considerable implications for the future careers of examinees. Medical colleges and professional boards have a social and professional responsibility to ensure their fitness for purpose. To date there is a paucity of published data about the reliability of specialist certification…

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

Understanding specialist sharing: A mixed-method exploration in an increasingly price-competitive hospital market.

PubMed

Westra, Daan; Angeli, Federica; Jatautaitė, Evelina; Carree, Martin; Ruwaard, Dirk

2016-08-01

Medical specialists seem to increasingly work in- and be affiliated to- multiple organizations. We define this phenomenon as specialist sharing. This form of inter-organizational cooperation has received scant scholarly attention. We investigate the extent of- and motives behind- specialist sharing, in the price-competitive hospital market of the Netherlands. A mixed-method was adopted. Social network analysis was used to quantitatively examine the extent of the phenomenon. The affiliations of more than 15,000 medical specialists to any Dutch hospital were transformed into 27 inter-hospital networks, one for each medical specialty, in 2013 and in 2015. Between February 2014 and February 2016, 24 semi-structured interviews with 20 specialists from 13 medical specialties and four hospital executives were conducted to provide in-depth qualitative insights regarding the personal and organizational motives behind the phenomenon. Roughly, 20% of all medical specialists are affiliated to multiple hospitals. The phenomenon occurs in all medical specialties and all Dutch hospitals share medical specialists. Rates of specialist sharing have increased significantly between 2013 and 2015 in 14 of the 27 specialties. Personal motives predominantly include learning, efficiency, and financial benefits. Increased workload and discontinuity of care are perceived as potential drawbacks. Hospitals possess the final authority to decide whether and which specialists are shared. Adhering to volume norms and strategic considerations are seen as their main drivers to share specialists. We conclude that specialist sharing should be interpreted as a form of inter-organizational cooperation between healthcare organizations, facilitating knowledge flow between them. Although quality improvement is an important perceived factor underpinning specialist sharing, evidence of enhanced quality of care is anecdotal. Additionally, the widespread occurrence of the phenomenon and the underlying

Neurofibromatosis and the role of the specialist adviser.

PubMed

Redman, Carolyn

2017-09-11

Neurofibromatosis (NF) is a genetic condition that mainly involves the nervous system. There are two types: NF1 affects about one in 2,500 of the population worldwide and NF2 affects one in 35,000. Both types result in complex health problems for patients and can pose significant challenges for all those involved in their management. Established in 1981, The Neuro Foundation is a patient-focused charity that funds a network of specialist advisers who work in partnership with the NHS to offer support and advice for families affected by NF and the professionals who care for them. With a significant level of autonomy, the specialist adviser role is flexible in matching the needs of those affected while working cooperatively alongside the national specialist services for NF1 and NF2. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

One Point of View: Elementary School Mathematics Specialists: Where Are They?

ERIC Educational Resources Information Center

Dossey, John A.

1984-01-01

A plea is made for the mathematics education community to support the need for elementary school mathematics specialists. Roles of such specialists in primary as well as intermediate grades are listed. (MNS)

Internet for Library Media Specialists.

ERIC Educational Resources Information Center

Simpson, Carol Mann

This guide introduces the library media specialist to the Internet, its history and features, and provides information on specific uses of the Internet in school libraries and specific areas. Section 1, "What is the Internet?" introduces the reader to the Internet; electronic mail; telnet; file transfer protocol (FTP); wide area…

Dental Assistant Specialist. (AFSC 98150).

ERIC Educational Resources Information Center

Eling, David R.

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for dental assistant specialists. Covered in the individual volumes are an introduction to dental services (the mission and organization of medical/dental service, career ladder progressions, medical readiness/wartime training, and…

Environmental Medicine Specialist (AFSC 90850).

ERIC Educational Resources Information Center

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This five-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for environmental medical specialists. Covered in the individual volumes are (1) control of communicable diseases (principles of epidemiology and biology; food, waterborne, airborne, and sexually transmitted diseases; medical zoology;…

Layered Metals Fabrication Technology Development for Support of Lunar Exploration at NASA/MSFC

NASA Technical Reports Server (NTRS)

Cooper, Kenneth G.; Good, James E.; Gilley, Scott D.

2007-01-01

NASA's human exploration initiative poses great opportunity and risk for missions to the Moon and beyond. In support of these missions, engineers and scientists at the Marshall Space Flight Center are developing technologies for ground-based and in-situ fabrication capabilities utilizing provisioned and locally-refined materials. Development efforts are pushing state-of-the art fabrication technologies to support habitat structure development, tools and mechanical part fabrication, as well as repair and replacement of ground support and space mission hardware such as life support items, launch vehicle components and crew exercise equipment. This paper addresses current fabrication technologies relative to meeting targeted capabilities, near term advancement goals, and process certification of fabrication methods.

Assessing the economic burden of Alzheimer's disease patients first diagnosed by specialists.

PubMed

Kirson, Noam Y; Desai, Urvi; Ristovska, Ljubica; Cummings, Alice Kate G; Birnbaum, Howard G; Ye, Wenyu; Andrews, J Scott; Ball, Daniel; Kahle-Wrobleski, Kristin

2016-07-11

It is not known if there is a differential impact on Alzheimer's disease (AD) diagnosis and outcomes if/when patients are diagnosed with cognitive decline by specialists versus non-specialists. This study examined the cost trajectories of Medicare beneficiaries initially diagnosed by specialists compared to similar patients who received their diagnosis in primary care settings. Patients with ≥2 claims for AD were selected from de-identified administrative claims data for US Medicare beneficiaries (5 % random sample). The earliest observed diagnosis of cognitive decline served as the index date. Patients were required to have continuous Medicare coverage for ≥12 months pre-index (baseline) and ≥12 months following the first AD diagnosis, allowing for up to 3 years from index to AD diagnosis. Time from index date to AD diagnosis was compared between those diagnosed by specialists (i.e., neurologist, psychiatrist, or geriatrician) versus non-specialists using Kaplan-Meier analyses with log-rank tests. Patient demographics, Charlson Comorbidity Index (CCI) during baseline, and annual all-cause medical costs (reimbursed by Medicare) in baseline and follow-up periods were compared across propensity-score matched cohorts. Patients first diagnosed with cognitive decline by specialists (n = 2593) were younger (78.8 versus 80.8 years old), more likely to be male (40 % versus 34 %), and had higher CCI scores and higher medical costs at baseline than those diagnosed by non-specialists (n = 13,961). However, patients diagnosed by specialists had a significantly shorter time to AD diagnosis, both before and after matching (mean [after matching]: 3.5 versus 4.6 months, p < 0.0001). In addition, patients diagnosed by specialists had significantly lower average total all-cause medical costs in the first 12 months after their index date, a finding that persisted after matching ($19,824 versus $25,863, p < 0.0001). Total per-patient annual medical costs

Peculiarities of Future Social Sphere Specialists' Professional Training in Poland

ERIC Educational Resources Information Center

Zieba, Beata

2016-01-01

The article reviews certain aspects of organising the process of professional training of future specialists in social sphere. It identifies, considers and analyzes the main definitions of scientific research, the object of which is to make specialists in social sphere ready for professional activity. The article highlights peculiarities of…

Structure and properties of nanoparticles fabricated by laser ablation of Zn metal targets in water and ethanol

NASA Astrophysics Data System (ADS)

Svetlichnyi, V. A.; Lapin, I. N.

2013-10-01

Size characteristics, structure, and spectral and luminescent properties of nanoparticles fabricated by laser ablation of zinc metal targets in water and ethanol are experimentally investigated upon excitation by Nd:YAG-laser radiation (1064 nm, 7 ns, and 15 Hz). It is demonstrated that zinc oxide nanoparticles with average sizes of 10 nm (in water) and 16 nm (in ethanol) are formed in the initial stage as a result of ablation. The kinetics of the absorption and luminescence spectra, transmission electron microscopy, and x-ray structural analysis demonstrate that during long storage of water dispersions and their drying, nanoparticles efficiently interact with carbon dioxide gas of air that leads to the formation of water-soluble Zn(CO3)2(OH)6. In ethanol, Zn oxidation leads to the formation of stable dispersions of ZnO nanoparticles with 99% of the wurtzite phase; in this case, the fluorescence spectra of ZnO nanoparticles change with time, shifting toward longer wavelength region from 550 to 620 nm, which is caused by the changed nature of defects.

Payload Specialist Gregory T. Linteris

NASA Technical Reports Server (NTRS)

1997-01-01

KENNEDY SPACE CENTER, FLA. -- STS-83 Payload Specialist Gregory T. Linteris chats with white room closeout crew members as he prepares to enter the Space Shuttle Columbia at Launch Pad 39A. Closeout crew workers Max Kandler (second from right) and Bob Saulnier wait to assist Linteris with his ascent/reentry suit.

The Changing Role of the Reading Specialist: A Case Study

ERIC Educational Resources Information Center

Ginsburg, Victoria Elaine

2012-01-01

This descriptive qualitative case study explored the changing role of the reading specialist through various perceptions of professionals in the Neon Shadow School District. The purpose of the study was to explore what, how, and why the duties and responsibilities of the reading specialist have changed since first employed as an…

STS-93 Mission Specialist Coleman takes part in emergency egress training

NASA Technical Reports Server (NTRS)

1999-01-01

STS-93 Mission Specialist Catherine G. Coleman (Ph.D.) smiles for the photographer before climbing into an M-113 armored personnel carrier at the launch pad to take part in emergency egress training. In preparation for their mission, the STS-93 crew are participating in Terminal Countdown Demonstration Test activities that also include a launch-day dress rehearsal culminating with a simulated main engine cut-off. Others in the crew are Commander Eileen M. Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Steven A. Hawley (Ph.D.) and Michel Tognini of France, who represents the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as a mission commander. The primary mission of STS-93 is the release of the Chandra X-ray Observatory, which will allow scientists from around the world to obtain unprecedented X-ray images of exotic environments in space to help understand the structure and evolution of the universe. Chandra is expected to provide unique and crucial information on the nature of objects ranging from comets in our solar system to quasars at the edge of the observable universe. Since X-rays are absorbed by the Earth's atmosphere, space-based observatories are necessary to study these phenomena and allow scientists to analyze some of the greatest mysteries of the universe. The targeted launch date for STS-93 is no earlier than July 20 at 12:36 a.m. EDT from Launch Pad 39B.

The Visiting Specialist Model of Rural Health Care Delivery: A Survey in Massachusetts

ERIC Educational Resources Information Center

Drew, Jacob; Cashman, Suzanne B.; Savageau, Judith A.; Stenger, Joseph

2006-01-01

Context: Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. Purpose: To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of…

[Demand and supply of otolaryngology specialists based on evidence: What is the required number of specialists who should be trained?].

PubMed

Sánchez Gómez, Serafín; Suárez Nieto, Carlos; Cobeta Marco, Ignacio

2009-01-01

Several concurrent circumstances have created an impression through the media of a presumed lack of specialists in Spain, which has one of the highest densities of doctors per population in the world: simultaneous creation of jobs in many newly built hospitals; accepting garbage contracts (for months, half/thirds of days, shifts) in relevant hospitals rather than moving to unattractive positions; full dedication to the field of public or private healthcare rather than matching them; bad public healthcare working conditions (low wages, excessive healthcare pressure, lack of respect from the public and from healthcare managers, shifts, scarce professional promotion, difficult family reunification); decreased mobility due to insulation of the markets as a result of decentralization of healthcare by regions. There is no shortage of specialists in otolaryngology, but instead there are sporadic inequalities in their geographical distribution. The current number of positions as training doctors offered annually is higher at the moment than the demand of the Spanish society, for specialists who have adapted smoothly to the requirements of the new medical practice: clinical management, care quality, technology-based efficiency, evidence-based medicine. The modification of working conditions through higher flexibility in the working models and an increase of salaries based on activity and quality will show that the otolaryngology workforce which is generated with the current offer can assume the present and future demand. A high quality of specialized otolaryngology training is the substrate to be improved, so that future otolaryngology specialists will be able to face health challenges without unduly increasing their number.

The relationship between target joints and direct resource use in severe haemophilia.

PubMed

O'Hara, Jamie; Walsh, Shaun; Camp, Charlotte; Mazza, Giuseppe; Carroll, Liz; Hoxer, Christina; Wilkinson, Lars

2018-01-16

Target joints are a common complication of severe haemophilia. While factor replacement therapy constitutes the majority of costs in haemophilia, the relationship between target joints and non drug-related direct costs (NDDCs) has not been studied. Data on haemophilia patients without inhibitors was drawn from the 'Cost of Haemophilia across Europe - a Socioeconomic Survey' (CHESS) study, a cost assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the United Kingdom) in which 139 haemophilia specialists provided demographic and clinical information for 1285 adult patients. NDDCs were calculated using publicly available cost data, including 12-month ambulatory and secondary care activity: haematologist and other specialist consultant consultations, medical tests and examinations, bleed-related hospital admissions, and payments to professional care providers. A generalized linear model was developed to investigate the relationship between NDDCs and target joints (areas of chronic synovitis), adjusted for patient covariates. Five hundred and thirteen patients (42% of the sample) had no diagnosed target joints; a total of 1376 target joints (range 1-10) were recorded in the remaining 714 patients. Mean adjusted NDDCs for persons with no target joints were EUR 3134 (standard error (SE) EUR 158); for persons with one or more target joints, mean adjusted NDDCs were EUR 3913 (SE EUR 157; average mean effect EUR 779; p < 0.001). Our analysis suggests that the presence of one or more target joints has a significant impact on NDDCs for patients with severe haemophilia, ceteris paribus. Prevention and management of target joints should be an important consideration of managing haemophilia patients.

The requirements of a specialist Breast Centre.

PubMed

Wilson, A R M; Marotti, L; Bianchi, S; Biganzoli, L; Claassen, S; Decker, T; Frigerio, A; Goldhirsch, A; Gustafsson, E G; Mansel, R E; Orecchia, R; Ponti, A; Poortmans, P; Regitnig, P; Rosselli Del Turco, M; Rutgers, E J Th; van Asperen, C; Wells, C A; Wengström, Y; Cataliotti, L

2013-11-01

In recognition of the advances and evidence based changes in clinical practice that have occurred in recent years and taking into account the knowledge and experience accumulated through the voluntary breast unit certification programme, Eusoma has produced this up-dated and revised guidelines on the requirements of a Specialist Breast Centre (BC). The content of these guidelines is based on evidence from the recent relevant peer reviewed literature and the consensus of a multidisciplinary team of European experts. The guidelines define the requirements for each breast service and for the specialists who work in specialist Breast Centres. The guidelines identify the minimum requirements needed to set up a BC, these being an integrated Breast Centre, dealing with a sufficient number of cases to allow effective working and continuing expertise, dedicated specialists working with a multidisciplinary approach, providing all services throughout the patients pathway and data collection and audit. It is essential that the BC also guarantees the continuity of care for patients with advanced (metastatic) disease offering treatments according to multidisciplinary competencies and a high quality palliative care service. The BC must ensure that comprehensive support and expertise may be needed, not only through the core BC team, but also ensure that all other medical and paramedical expertise that may be necessary depending on the individual case are freely available, referring the patient to the specific care provider depending on the problem. Applying minimum requirements and quality indicators is essential to improve organisation, performance and outcome in breast care. Efficacy and compliance have to be constantly monitored to evaluate the quality of patient care and to allow appropriate corrective actions leading to improvements in patient care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Polish Code of Ethics of a Medical Laboratory Specialist

PubMed Central

2014-01-01

Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists’ identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world. PMID:27683468

LLNL Scientist is Passionate About Targets

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

Butlin, Becky

With a lifelong passion for problem-solving and a love of production, Becky Butlin has helped lead the National Ignition Facility Target Fabrication Team through obstacles and challenges for the past six years.

Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.

PubMed

Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn

2016-02-01

This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Understanding the internet-based distance learning preferences of European respiratory specialists.

PubMed

Roberts, C M; Milon, S; Kurosinski, P

2006-08-01

We studied the learning preferences of 160 respiratory specialists from four European countries who participated in ten internet-based learning modules and answered linked survey questions. Specialists were enthusiastic for internet learning amongst all national groups and particularly wanted to access material for teaching others. The value of social interactive learning was acknowledged but British and German subjects appeared more reluctant to participate. Internet delivered distance learning is well perceived amongst respiratory specialists. There is potential for both individual and group learning that could be realized by developing Europe-wide continuing professional development communities.

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed

Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges

2012-12-31

Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed Central

2012-01-01

Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important influencing factors in

Integrating HCI Specialists into Open Source Software Development Projects

NASA Astrophysics Data System (ADS)

Hedberg, Henrik; Iivari, Netta

Typical open source software (OSS) development projects are organized around technically talented developers, whose communication is based on technical aspects and source code. Decision-making power is gained through proven competence and activity in the project, and non-technical end-user opinions are too many times neglected. In addition, also human-computer interaction (HCI) specialists have encountered difficulties in trying to participate in OSS projects, because there seems to be no clear authority and responsibility for them. In this paper, based on HCI and OSS literature, we introduce an extended OSS development project organization model that adds a new level of communication and roles for attending human aspects of software. The proposed model makes the existence of HCI specialists visible in the projects, and promotes interaction between developers and the HCI specialists in the course of a project.

The potential Public Health Impact of Mycobacterium avium ssp. paratuberculosis: Global Opinion Survey of Topic Specialists.

PubMed

Waddell, L A; Rajić, A; Stärk, K D C; McEwen, S A

2016-05-01

Global research knowledge has accumulated over the past few decades, and there is reasonable evidence for a positive association between Mycobacterium avium spp. paratuberculosis and Crohn's disease in humans, although its role as a human pathogen has not been entirely accepted. For this reason, management of public health risk due to M. paratuberculosis remains an important policy issue in agri-food public health arenas in many countries. Responsible authorities must decide whether existing mitigation strategies are sufficient to prevent or reduce human exposure to M. paratuberculosis. A Web-based questionnaire was administered to topic specialists to elicit empirical knowledge and opinion on the overall public health impact of M. paratuberculosis, the importance of various routes of human exposure to the pathogen, existing mitigation strategies and the need for future strategies. The questionnaire had four sections and consisted of 20 closed and five open questions. Topic specialists believed that M. paratuberculosis is likely a risk to human health (44.8%) and, given the paucity of available evidence, most frequently ranked it as a moderate public health issue (40.1%). A significant correlation was detected between topic specialists' commitment to M. paratuberculosis in terms of the number of years or proportion of work dedicated to this topic, and the likelihood of an extreme answer (high or low) to the above questions. Topic specialists identified contact with ruminants and dairy products as the most likely routes of exposure for humans. There was consensus on exposure routes for ruminants and what commodities to target in mitigation efforts. Described mandatory programmes mainly focused on culling diseased animals and voluntary on-farm prevention programmes. Despite ongoing difficulties in the identification of subclinical infections in animals, the topic specialists largely agreed that further enhancement of on-farm programmes in affected commodities by

Longitudinal gas-density profilometry for plasma-wakefield acceleration targets

NASA Astrophysics Data System (ADS)

Schaper, Lucas; Goldberg, Lars; Kleinwächter, Tobias; Schwinkendorf, Jan-Patrick; Osterhoff, Jens

2014-03-01

Precise tailoring of plasma-density profiles has been identified as one of the critical points in achieving stable and reproducible conditions in plasma wakefield accelerators. Here, the strict requirements of next generation plasma-wakefield concepts, such as hybrid-accelerators, with densities around 1017 cm-3 pose challenges to target fabrication as well as to their reliable diagnosis. To mitigate these issues we combine target simulation with fabrication and characterization. The resulting density profiles in capillaries with gas jet and multiple in- and outlets are simulated with the fluid code OpenFOAM. Satisfactory simulation results then are followed by fabrication of the desired target shapes with structures down to the 10 μm level. The detection of Raman scattered photons using lenses with large collection solid angle allows to measure the corresponding longitudinal density profiles at different number densities and allows a detection sensitivity down to the low 1017 cm-3 density range at high spatial resolution. This offers the possibility to gain insight into steep density gradients as for example in gas jets and at the plasma-to-vacuum transition.

ISD Designed Medical Specialist Training.

ERIC Educational Resources Information Center

Rock, Samuel K., Jr.; Chagalis, George P.

The Basic Medical Specialist course has one of the largest enrollments of the U.S. Army's Academy of Health Sciences; 11,000 soldiers were trained in this course in 1977 and 1978. Training encompasses both emergency first aid (for field medics) and basic nursing skills. A task force working to improve Army training developed this course, in…

STS-101 Mission Specialist Williams arrives at KSC for 4th launch attempt

NASA Technical Reports Server (NTRS)

2000-01-01

STS-101 Mission Specialist Jeffrey N. Williams stands ready to begin preparations for the launch on May 18 after arriving at KSC's Shuttle Landing Facility aboard a T-38 jet aircraft. The mission will take the crew of seven to the International Space Station, delivering logistics and supplies, plus preparing the Station for the arrival of the Zvezda Service Module, expected to be launched by Russia in July 2000. Also, the crew will conduct one space walk to perform maintenance on the Space Station. This will be the third assembly flight for the Space Station. STS-101 is targeted for liftoff at 6:38 a.m. EDT from Launch Pad 39A.

The changing role of specialist care in NHS dentistry.

PubMed

Seward, M

1998-07-11

Specialisation and Specialist Training in Dentistry in the UK have been central issues for debate in the last few years. The profession has emerged stronger in understanding the respective roles of the generalist who should remain free to practise across the whole spectrum of dentistry and the specialist who can work in primary and secondary care. The overriding principle is that the patient remains the true beneficiary of a specialised service within the NHS.

Marketing and the medical specialist in the managed care environment.

PubMed

Treister, N W

1997-01-01

Marketing means more than just communicating or advertising to potential patients; marketing means identifying your customers and working to meet or exceed their expectations. There are five key areas of a marketing plan: (1) Establish the foundation, beginning with your mission statement; (2) Assess your marketing environment by internal and external research; (3) Target your efforts, looking at image and perception; (4) Develop your particular mix of product, price, place of distribution, and promotion; and (5) implement and evaluate your marketing process. This article discusses the importance of a marketing plan for the medical specialist and highlights the features unique to a practice working in a system of capitated reimbursement. Applying these principles will help to demonstrate added value, protect the fundamental role of the patient-physician relationship, ensure that our efforts are aligned with professional missions and goals, and ultimately increase profitability and professional success.

Copper deposition on fabrics by rf plasma sputtering for medical applications

NASA Astrophysics Data System (ADS)

Segura, G.; Guzmán, P.; Zuñiga, P.; Chaves, S.; Barrantes, Y.; Navarro, G.; Asenjo, J.; Guadamuz Vargas, S., VI; Chaves, J.

2015-03-01

The present work is about preparation and characterization of RF sputtered Cu films on cotton by the usage of a Magnetron Sputter Source and 99.995% purity Cu target at room temperature. Cotton fabric samples of 1, 2 and 4 min of sputtering time at discharge pressure of 1×10-2 Torr and distance between target and sample of 8 cm were used. The main goal was to qualitatively test the antimicrobial action of copper on fabrics. For that purpose, a reference strain of Escherichia Coli ATCC 35218 that were grown in TSA plates was implemented. Results indicated a decrease in the growth of bacteria by contact with Cu; for fabric samples with longer sputtering presented lower development of E. coli colonies. The scope of this research focused on using these new textiles in health field, for example socks can be made with this textile for the treatment of athlete's foot and the use in pajamas, sheets, pillow covers and robes in hospital setting for reducing the spread of microorganisms.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

PubMed

Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

2011-10-31

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

Specialist public health capacity in England: working in the new primary care organizations.

PubMed

Chapman, J; Shaw, S; Congdon, P; Carter, Y H; Abbott, S; Petchey, R

2005-01-01

To determine the capacity and development needs, in relation to key areas of competency and skills, of the specialist public health workforce based in primary care organizations following the 2001 restructuring of the UK National Health Service. Questionnaire survey to all consultants and specialists in public health (including directors of public health) based in primary care trusts (PCTs) and strategic health authorities (SHAs) in England. Participants reported a high degree of competency. However, skill gaps were evident in some areas of public health practice, most notably "developing quality and risk management" and in relation to media communication, computing, management and leadership. In general, medically qualified individuals were weaker on community development than non-medically qualified specialists, and non-medically qualified specialists were less able to perform tasks that require epidemiological or clinical expertise than medically qualified specialists. Less than 50% of specialists felt that their links to external organizations, including public health networks, were strong. Twenty-nine percent of respondents felt professionally isolated and 22% reported inadequate team working within their PCT or SHA. Approximately 21% of respondents expressed concerns that they did not have access to enough expertise to fulfil their tasks and that their skills were not being adequately utilized. Some important skill gaps are evident among the specialist public health workforce although, in general, a high degree of competency was reported. This suggests that the capacity deficit is a problem of numbers of specialists rather than an overall lack of appropriate skills. Professional isolation must be addressed by encouraging greater partnership working across teams.

Environmental Compliance Specialists, Inc. (ECSI) Information Sheet

EPA Pesticide Factsheets

Environmental Compliance Specialists, Inc. (ECSI) (the Company) is located in Kingston, New Hampshire. The Complaint involves renovation activities conducted at property constructed prior to 1978, located in Manchester, New Hampshire.

[Management of allocation of positions for specialist medical training].

PubMed

Alonso, M I

2003-01-01

Currently there is a large imbalance between supply and demand for medical specialists in the Spanish Health System. The aim of this study was to demonstrate the possible effects of current policies of allocating vacancies for interns and residents as well as to describe several measures and alternative policies. Using the methodology of System Dynamics, we designed a simulation model of the allocation process. Based on the validated model, possible changes in the system through time in response to diverse allocation policies were simulated. Specifically, changes in the accumulated number of graduates who over the years have remained without specialty, the number of unemployed specialists, and the imbalance between supply and demand in the period under consideration were observed. The results obtained from the simulation indicate that allocation policies such as the current one tends to reduce the accumulated number of graduates without specialty, due to the philosophy characterizing this policy, but that it considerably increases the number of unemployed specialists and aggravates the supply-demand imbalance. In the simulation, this tendency remained over time even though more restrictive measures in numerus clausus and retirement age were adopted. Equally, a policy based on social needs and aware of delays in training would substantially contribute to eliminating unemployment among specialists and supply-demand imbalance over time. If such a policy were combined with the above-mentioned measures the results would be even better, more rapidly eliminating graduates without specialty, unemployed specialists, and supply-demand imbalances. If the Health Administration continues with the current system of allocation of places, the present imbalance in supply and demand will become even worse. Therefore, new and far-sighted measures and policies are required, as well as greater coordination between undergraduate and postgraduate training.

STS-107 Mission Specialist David Brown arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- STS-107 Mission Specialist David Brown arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists Kalpana Chawla and Laurel Clark and Payload Specialist Ilan Ramon (the first Israeli astronaut). STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-107 Mission Specialist Laurel Clark arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- STS-107 Mission Specialist Laurel Clark arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists Kalpana Chawla and David Brown, and Payload Specialist Ilan Ramon, the first Israeli astronaut. STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-107 Mission Specialist Kalpana Chawla arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. - STS-107 Mission Specialist Kalpana Chawla arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists David Brown and Laurel Clark and Payload Specialist Ilan Ramon (the first Israeli astronaut). STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-87 Mission Specialist Doi addresses the media at the SLF

NASA Technical Reports Server (NTRS)

1997-01-01

As STS-87 Commander Kevin Kregel looks on, Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan addresses members of the press and media at Kennedy Space Center's Shuttle Landing Facility after arriving for the final prelaunch activities leading up to the scheduled Nov. 19 liftoff. Other STS-87 crew members not pictured are Pilot Steven Lindsey; Mission Specialists Kalpana Chawla, Ph.D., and Winston Scott; and Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine. STS-87 will be the fourth flight of the United States Microgravity Payload and the Spartan-201 deployable satellite.

Internal medicine specialists' attitudes towards working part-time: a comparison between 1996 and 2004

PubMed Central

Lugtenberg, Marjolein; Heiligers, Phil JM; de Jong, Judith D; Hingstman, Lammert

2006-01-01

Background Although medical specialists traditionally hold negative views towards working part-time, the practice of medicine has evolved. Given the trend towards more part-time work and that there is no evidence that it compromises the quality of care, attitudes towards part-time work may have changed as well in recent years. The aim of this paper was to examine the possible changes in attitudes towards part-time work among specialists in internal medicine between 1996 and 2004. Moreover, we wanted to determine whether these attitudes were associated with individual characteristics (age, gender, investments in work) and whether attitudes of specialists within a partnership showed more resemblance than specialists' attitudes from different partnerships. Methods Two samples were used in this study: data of a survey conducted in 1996 and in 2004. After selecting internal medicine specialists working in general hospitals in The Netherlands, the sample consisted of 219 specialists in 1996 and 363 specialists in 2004. They were sent a questionnaire, including topics on the attitudes towards part-time work. Results Internal medicine specialists' attitudes towards working part-time became slightly more positive between 1996 and 2004. Full-time working specialists in 2004 still expressed concerns regarding the investments of part-timers in overhead tasks, the flexibility of task division, efficiency, communication and continuity of care. In 1996 gender was the only predictor of the attitude, in 2004 being a full- or a part-timer, age and the time invested in work were associated with this attitude. Furthermore, specialists' attitudes were not found to cluster much within partnerships. Conclusion In spite of the increasing number of specialists working or preferring to work part-time, part-time practice among internal medicine specialists seems not to be fully accepted. The results indicate that the attitudes are no longer gender based, but are associated with age and work

Apprentice Still Photographic Specialist (AFSC 23132).

ERIC Educational Resources Information Center

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice still photographic specialists. Covered in the individual volumes are general subjects (career ladder progression, security, photographic safety, and photographic laboratory administration); still photographic…

Impact of specialist palliative care on coping with Parkinson's disease: patients and carers.

PubMed

Badger, Nathan J; Frizelle, Dorothy; Adams, Debi; Johnson, Miriam J

2018-06-01

UK guidelines recommend palliative care access for people with Parkinson's disease; however, this remains sporadic, and it is unknown whether specialist palliative care helps patients and carers cope with this distressing condition. This study aimed to explore whether, and how, access to specialist palliative care services affected patients' and carers' coping with Parkinson's disease. Semistructured interviews were conducted, audio-recorded and verbatim transcribed. Data were analysed using interpretative phenomenological analysis. Participants were patients with advanced idiopathic Parkinson's disease (n=3), and carers of people with Parkinson's disease (n=5, however, one diagnosis was reviewed) receiving care from an integrated specialist palliative care and Parkinson's disease service in North East England. Access to specialist palliative care helped participants cope with some aspects of advanced Parkinson's disease. Three superordinate themes were developed:' managing uncertainty', 'impacts on the self' and 'specialist palliative care maintaining a positive outlook'. Specialist palliative care helped patients and carers cope with advanced Parkinson's disease. Specialist palliative care is a complex intervention that acknowledges the complex and holistic nature of Parkinson's disease, enabling health in some domains despite continued presence of pathology. These exploratory findings support the utility of this approach for people living with Parkinson's disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The specialist physician's approach to rheumatoid arthritis in South Africa.

PubMed

Bester, Frederik C J; Bosch, Fredricka J; van Rensburg, Barend J Jansen

2016-03-01

Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles.

STS-101 Mission Specialist Helms suits up for second launch attempt.

NASA Technical Reports Server (NTRS)

2000-01-01

In the Operations and Checkout Building, STS-101 Mission Specialist Susan J. Helms (left) and a suit technician grin with anticipation for a successful second attempt at launch of Space Shuttle Atlantis on mission STS-101. The previous day's launch attempt was scrubbed due to high cross winds at the Shuttle Landing Facility. The mission will take the crew to the International Space Station to deliver logistics and supplies and to prepare the Station for the arrival of the Zvezda Service Module, expected to be launched by Russia in July 2000. Also, the crew will conduct one space walk. This will be the third assembly flight to the Space Station. Liftoff is targeted for 3:52 p.m. EDT. The mission is expected to last about 10 days, with Atlantis landing at KSC Saturday, May 6, about 11:53 a.m. EDT.

Production of Engineered Fabrics Using Artificial Neural Network-Genetic Algorithm Hybrid Model

NASA Astrophysics Data System (ADS)

Mitra, Ashis; Majumdar, Prabal Kumar; Banerjee, Debamalya

2015-10-01

The process of fabric engineering which is generally practised in most of the textile mills is very complicated, repetitive, tedious and time consuming. To eliminate this trial and error approach, a new approach of fabric engineering has been attempted in this work. Data sets of construction parameters [comprising of ends per inch, picks per inch, warp count and weft count] and three fabric properties (namely drape coefficient, air permeability and thermal resistance) of 25 handloom cotton fabrics have been used. The weights and biases of three artificial neural network (ANN) models developed for the prediction of drape coefficient, air permeability and thermal resistance were used to formulate the fitness or objective function and constraints of the optimization problem. The optimization problem was solved using genetic algorithm (GA). In both the fabrics which were attempted for engineering, the target and simulated fabric properties were very close. The GA was able to search the optimum set of fabric construction parameters with reasonably good accuracy except in case of EPI. However, the overall result is encouraging and can be improved further by using larger data sets of handloom fabrics by hybrid ANN-GA model.

Characterization studies of prototype ISOL targets for the RIA

NASA Astrophysics Data System (ADS)

Greene, John P.; Burtseva, Tatiana; Neubauer, Janelle; Nolen, Jerry A.; Villari, Antonio C. C.; Gomes, Itacil C.

2005-12-01

Targets employing refractory compounds are being developed for the rare isotope accelerator (RIA) facility to produce ion species far from stability. With the 100 kW beams proposed for the production targets, dissipation of heat becomes a challenging issue. In our two-step target design, neutrons are generated in a refractory primary target, inducing fission in the surrounding uranium carbide. The interplay of density, grain size, thermal conductivity and diffusion properties of the UC2 needs to be well understood before fabrication. Thin samples of uranium carbide were prepared for thermal conductivity measurements using an electron beam to heat the sample and an optical pyrometer to observe the thermal radiation. Release efficiencies and independent thermal analysis on these samples are being undertaken at Oak Ridge National Laboratory (ORNL). An alternate target concept for RIA, the tilted slab approach promises to be simple with fast ion release and capable of withstanding high beam intensities while providing considerable yields via spallation. A proposed small business innovative research (SBIR) project will design a prototype tilted target, exploring the materials needed for fabrication and testing at an irradiation facility to address issues of heat transfer and stresses within the target.

[What is parents' and medical health care specialists knowledge about vaccinations?].

PubMed

Tarczoń, Izabela; Domaradzka, Ewa; Czajka, Hanna

2009-01-01

The aim of the study was to become familiar with parents' and Medical Health Care specialists knowledge and attitude towards vaccinations. The influence of information, provided to patients from various sources, on general opinion about immunization and its coverage within the last year were evaluated. Analysis of questionnaires about vaccinations performed among 151 parents and 180 Medical Health Care specialists. Medical Health Care specialists knowledge was considerably higher in comparison to questioned parents. Surprisingly enough, only approximately 90% of Medical Health Care workers knew about prophylaxis of Hib infections. A doctor is the main and the most reliable source of information for parents. Significant impact on parents' attitude to vaccinations is made not only by campaigns promoting vaccinations, but also by widespread opinions about their harmfulness. The doctor is the major source of reliable information about vaccinations for parents. Therefore, there is the need of continuous improvement of Medical Health Care specialists knowledge, but also the ability of successfully communicating it to parents.

The role of rehabilitation specialists in Canadian NICUs: a national survey.

PubMed

Limperopoulos, Catherine; Majnemer, Annette

2002-01-01

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.

STS-88 Pilot Sturckow and Mission Specialist Currie arrive for launch

NASA Technical Reports Server (NTRS)

1998-01-01

Pilot Frederick W. 'Rick' Sturckow and Mission Specialist Nancy J. Currie walk across the landing strip at the Shuttle Landing Facility after exiting the T-38 jet aircraft behind them that brought them to KSC. They join other crew members Mission Commander Robert D. Cabana, Mission Specialist Jerry L. Ross, Mission Specialist James H. Newman and Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut, for pre-launch preparations for mission STS-88 aboard Space Shuttle Endeavour. The scheduled time of launch is 3:56 a.m. EST on Dec. 3 from Launch Pad 39A. The mission is the first U.S. launch for the International Space Station. Endeavour carries the Unity connecting module which the crew will be mating with the Russian- built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. Endeavour is expected to land at KSC at 10:17 p.m. on Monday, Dec. 14.

Male imprisoned firesetters have different characteristics than other imprisoned offenders and require specialist treatment.

PubMed

Gannon, Theresa A; Ciardha, Caoilte Ó; Barnoux, Magali F L; Tyler, Nichola; Mozova, Katarina; Alleyne, Emma K A

2013-01-01

This study investigated whether a group of firesetters (n = 68) could be distinguished, psychologically, from a matched group of non-firesetting offenders (n = 68). Participants completed measures examining psychological variables relating to fire, emotional/self-regulation, social competency, self-concept, boredom proneness, and impression management. Official prison records were also examined to record offending history and other offense-related variables. A series of MANOVAs were conducted with conceptually related measures identified as the dependent variables. Follow-up discriminant function and clinical cut-off score analyses were also conducted to examine the best discriminating variables for firesetters. Firesetters were clearly distinguishable, statistically, from non-firesetters on three groups of conceptually related measures relating to: fire, emotional/self-regulation, and self-concept. The most successful variables for the discrimination of firesetters determined via statistical and clinical significance testing were higher levels of anger-related cognition, interest in serious fires, and identification with fire and lower levels of perceived fire safety awareness, general self-esteem, and external locus of control. Firesetters appear to be a specialist group of offenders who hold unique psychological characteristics. Firesetters are likely to require specialist treatment to target these psychological needs as opposed to generic offending behavior programs.

A Survey of Headache Medicine Specialists on Career Satisfaction and Burnout.

PubMed

Evans, Randolph W; Ghosh, Kamalika

2015-01-01

Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists. The aim of the present survey was to learn more about how headache medicine physicians are affected by these issues. An email survey was sent to 749 physician members of the American Headache Society with questions or statements about demographics, professional quality of life and satisfaction, future practice plans, and professional burnout using the Maslach Burnout Inventory. In a sample of 127 headache medicine specialists, 66 (57.4%) physicians reported symptoms of professional burnout reflected by high Emotional Exhaustion and/or high Depersonalization. There is widespread dissatisfaction with work schedules, government regulations, implementation of the Affordable Care Act, insurance company policies, malpractice concerns, patient telephone calls, and compensation. Sixty-two percent of respondents concur that headache medicine is becoming more complicated without patient benefit, 14% concur that headache medicine specialists are fairly compensated, and 59% would go into headache medicine again if they were fourth year medical students. In the next 1 to 3 years, 21.3% plan to cut back on hours, 14.2% plan to cut back on patients seen, and 12.6% plan to switch to a cash practice. Medicine and healthcare are changing in such a way that 33.9% concur that they will accelerate their retirement plans. Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians' age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal

Payload specialist Ronald Parise using SAREX

NASA Technical Reports Server (NTRS)

1995-01-01

ASTRO-2 payload specialist Ronald A. Parise reminisces on his inspace amateur radio experience of five years ago in the ASTRO-1 mission. Using the Shuttle Amateur Radio Experiment (SAREX), Parise talks to students on Earth from the flight deck of the Earth orbiting Space Shuttle Endeavour.

School Library Media Specialists: Essentially Administrators.

ERIC Educational Resources Information Center

Alewine, Martha

2003-01-01

Considers how school library media specialist administrative responsibilities can carry over to a job as state consultant for school library media services. Discusses characteristics of effective administrators; collaboration; the appreciative inquiry process for systemic change; and duties and projects of the state program that strengthen media…

Administrative Perceptions on the Role of the School Library Media Specialist

ERIC Educational Resources Information Center

Page, Kayla

2013-01-01

Despite the efforts of local school library media specialists to promote their programming, many administrators do not understand the roles and responsibilities of the school library media specialist. Using a constructivist theoretical framework, this study was designed to examine the local school administrators' perceptions of the role of the…

Health Education Specialist Practice Analysis 2015 (HESPA 2015): Process and Outcomes

ERIC Educational Resources Information Center

McKenzie, James F.; Dennis, Dixie; Auld, M. Elaine; Lysoby, Linda; Doyle, Eva; Muenzen, Patricia M.; Caro, Carla M.; Kusorgbor-Narh, Cynthia S.

2016-01-01

The Health Education Specialist Practice Analysis 2015 (HESPA 2015) was conducted to update and validate the Areas of Responsibilities, Competencies, and Sub-competencies for Entry- and Advanced-Level Health Education Specialists. Two data collection instruments were developed--one was focused on Sub-competencies and the other on knowledge items…

STS-93 Mission Specialist Coleman drives an M-113 during training

NASA Technical Reports Server (NTRS)

1999-01-01

Under the watchful eyes of Capt. George Hoggard (left), trainer with the KSC Fire Department, STS-93 Mission Specialist Catherine G. Coleman (Ph.D.) drives the M-113 armored personnel carrier during emergency egress training at the launch pad. Behind her is Pilot Jeffrey S. Ashby and Commander Eileen M. Collins. In preparation for their mission, the STS-93 crew are participating in Terminal Countdown Demonstration Test activities that also include a launch-day dress rehearsal culminating with a simulated main engine cut-off. Others in the crew participating are Mission Specialists Steven A. Hawley (Ph.D.) and Michel Tognini of France, who represents the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as a mission commander. The primary mission of STS-93 is the release of the Chandra X-ray Observatory, which will allow scientists from around the world to obtain unprecedented X-ray images of exotic environments in space to help understand the structure and evolution of the universe. Chandra is expected to provide unique and crucial information on the nature of objects ranging from comets in our solar system to quasars at the edge of the observable universe. Since X-rays are absorbed by the Earth's atmosphere, space-based observatories are necessary to study these phenomena and allow scientists to analyze some of the greatest mysteries of the universe. The targeted launch date for STS-93 is no earlier than July 20 at 12:36 a.m. EDT from Launch Pad 39B.

STS-95 Payload Specialist Mukai poses with NASDA president

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Payload Specialist Chiaki Mukai, M.D. (center), with the National Space Development Agency of Japan (NASDA), poses for a photograph with NASDA President Isao Uchida (left). Behind her at the right is a representative of the European Space Agency (ESA). Mukai was one of a crew of seven aboard orbiter Discovery, which landed at KSC at 12:04 p.m. EST, after a successful mission spanning nine days and 3.6 million miles. The other crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialists Stephen K. Robinson; Scott E. Parazynski and Pedro Duque of Spain, with the European Space Agency; and Payload Specialist John H. Glenn Jr., senator from Ohio. The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Payload specialists Rodolfo Neri prepares to begin experiments for Mexico

NASA Image and Video Library

1985-11-26

61B-05-021 (26 Nov-3 Dec 1985) --- Payload Specialist Rodolfo Neri, representing Mexico on the STS-61B space mission aboard the Atlantis, prepares to begin one of the experiments for Mexico. Neri used a nearby 35mm camera to record plants and bacteria for various prescribed testing. Here the payload specialist has opened a stowage drawer to retrieve components of one of the tests.

STS-113 Mission Specialist John B. Herrington arrives at KSC for launch

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- STS-113 Mission Specialist John B. Herrington smiles for the camera upon his arrival at KSC's Shuttle Landing Facility to prepare for launch. STS-113 is the 16th American assembly flight to the International Space Station. The primary objective of the mission is bringing the Expedition 6 crew to the Station and returning the Expedition 5 crew to Earth. The major task of the mission is delivery of the Port 1 (P1) Integrated Truss Assembly, which will be attached to the port side of the S0 truss. Three spacewalks are planned to install and activate the truss and its associated equipment. Launch of Space Shuttle Endeavour on mission STS-113 is targeted for no earlier than Nov. 22 between 7 and 11 p.m. EST.

Transcriptional profile and differential fitness in a specialist milkweed insect across host plants varying in toxicity.

PubMed

Birnbaum, Stephanie S L; Rinker, David C; Gerardo, Nicole M; Abbot, Patrick

2017-12-01

Interactions between plants and herbivorous insects have been models for theories of specialization and co-evolution for over a century. Phytochemicals govern many aspects of these interactions and have fostered the evolution of adaptations by insects to tolerate or even specialize on plant defensive chemistry. While genomic approaches are providing new insights into the genes and mechanisms insect specialists employ to tolerate plant secondary metabolites, open questions remain about the evolution and conservation of insect counterdefences, how insects respond to the diversity defences mounted by their host plants, and the costs and benefits of resistance and tolerance to plant defences in natural ecological communities. Using a milkweed-specialist aphid (Aphis nerii) model, we test the effects of host plant species with increased toxicity, likely driven primarily by increased secondary metabolites, on aphid life history traits and whole-body gene expression. We show that more toxic plant species have a negative effect on aphid development and lifetime fecundity. When feeding on more toxic host plants with higher levels of secondary metabolites, aphids regulate a narrow, targeted set of genes, including those involved in canonical detoxification processes (e.g., cytochrome P450s, hydrolases, UDP-glucuronosyltransferases and ABC transporters). These results indicate that A. nerii marshal a variety of metabolic detoxification mechanisms to circumvent milkweed toxicity and facilitate host plant specialization, yet, despite these detoxification mechanisms, aphids experience reduced fitness when feeding on more toxic host plants. Disentangling how specialist insects respond to challenging host plants is a pivotal step in understanding the evolution of specialized diet breadths. © 2017 John Wiley & Sons Ltd.

Seed dispersal by specialist versus generalist foragers: the plant's perspective

USGS Publications Warehouse

Larson, D.L.

1996-01-01

I examined the seed dispersal ecology of the stem parasitic plant, desert mistletoe (Phoradendron californicum, Viscaceae), with the objectives of (1) determining the relative effectiveness of specialist and generalist foragers for seed dispersal, (2) determining the extent to which desert mistletoe fruiting characteristics correspond to those predicted for plants attracting specialist versus generalist foragers, and (3) examining the potential consequences of the observed dispersal strategy for mistletoe reproduction. Three species of birds, phainopepla, Gila woodpecker, and northern mockingbird, fed on desert mistletoe at my study site. The specialist, phainopepla, was the most abundant and the most likely to perch in host species, where defecated seeds had a greater probability of lodging in a site suitable for establishment. Gila woodpeckers, although abundant, spent little time in host plants, thus dooming most of the seeds they consumed. Mockingbirds may disperse a small number of seeds, but were abundant enough to consume only a small portion of the available fruits. As expected for plants attracting specialist frugivores, mistletoes produced fruits throughout the 6-month season in which phainopeplas reside in the Sonoran desert. Contrary to expectation, numbers of fruits produced far exceeded the amount that could be consumed by the frugivores at my study site. Fruit crop size was positively related to absolute fruit removal, but not to proportional removal at the scale of the entire study site. However, crop size was positively related to proportional removal within the neighborhood of mistletoes occupying an individual host tree. Frugivores were attracted to infected hosts, host attractiveness increased, although proportional removal of fruit declined, with number of female mistletoes. The observed dispersal ecology of desert mistletoe suggests the likelihood of increasingly clumped distributions of mistletoe plants, as more and more seeds are deposited

What Is a Pediatric Infectious Diseases Specialist?

MedlinePlus

... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... through the teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases ...

What Is a Pediatric Critical Care Specialist?

MedlinePlus

... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... offered in the PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care ...

14 CFR § 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialist relationship with sponsoring institutions. § 1214.306 Section § 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

Special Education Technology Specialist. Careers in Special Education and Related Services.

ERIC Educational Resources Information Center

National Clearinghouse for Professions in Special Education, Reston, VA.

Designed for high school students interested in careers in special education and related services, this guide outlines the role of the special education technology specialist. It addresses the nature of the work, the education required, personal qualities that technology specialists should have, job outlook and advancement, and how to prepare for…

STS-40 Payload Specialist Hughes-Fulford "flies" through SLS-1 module

NASA Image and Video Library

1991-06-14

STS040-212-006 (5-14 June 1991) --- Payload specialist Millie Hughes-Fulford floats through the Spacelab Life Sciences (SLS-1) module aboard the Earth-orbiting Columbia. Astronaut James P. Bagian, mission specialist, is at the blood draw station in the background. The scene was photographed with a 35mm camera.

The Curriculum Roles and Responsibilities of Library Media Specialists. ERIC Digest.

ERIC Educational Resources Information Center

Berkowitz, Robert E.; Eisenberg, Michael B.

This digest brings together the various views on curriculum-related roles for library media specialists. The first section considers reasons why a disparity between theory and practice exists in regard to the involvement of library media specialists as curriculum consultants. Several sources addressing this issue are reviewed in the second…

STS-120 Mission Specialist Doug Wheelock During EVA

NASA Technical Reports Server (NTRS)

2007-01-01

Astronaut Doug Wheelock, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, astronaut Scott Parazynski (out of frame), mission specialist, cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Wheelock assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

Research competency and specialist registration: Quo vadis ?

PubMed

Szabo, C P; Ramlall, S

2016-12-01

The requirement of 'research completion' as necessary for specialist registration with the Health Professions Council of South Africa (HPCSA) has recently been subject to legal action, with a court order potentially shifting requirements beyond those envisaged by the HPCSA. The research requirement is congruent with National Department of Health strategy in this regard, i.e. the strengthening of research as a stated priority. While the expectation of research competency is not in itself contentious, the capacity of institutions and the ability of registrars to facilitate and complete, respectively, have brought the issue into focus. Specifically, the apparent discrepancy between a court order and a regulation needs to be resolved to ensure that specialist registration is not unduly hampered, while ensuring that a potentially important contributor to a national priority is not prejudiced.

Part-time and full-time medical specialists, are there differences in allocation of time?

PubMed

de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

2006-03-03

An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part-time work is not only a female

Part-time and full-time medical specialists, are there differences in allocation of time?

PubMed Central

de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

2006-01-01

Background An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. Methods A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Results Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. Conclusion In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part

STS-47 Payload Specialist Mohri and Japanese backups pose in SLJ module at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-47 payload specialists representing Japan's National Space Development Agency (NASDA) examine the interior of the Spacelab Japan (SLJ) laboratory module recently installed in Endeavour's, Orbiter Vehicle (OV) 105's, payload bay (PLB). Left to right are Payload Specialist Mamoru Mohri, backup Payload Specialist Chiaki Naito-Mukai, and backup Payload Specialist Takao Doi. The crewmembers visited OV-105, currently undergoing preflight processing in a high bay area of Kennedy Space Center's (KSC's) Orbiter Processing Facility (OPF). View provided by KSC with alternate KSC number KSC-92PC-1649.

What influences the job satisfaction of staff and associate specialist hospital doctors?

PubMed

French, Fiona; Ikenwilo, Divine; Scott, Anthony

2007-08-01

Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.

Foreign Area Studies in the USSR. Training and Employment of Specialists.

ERIC Educational Resources Information Center

Gottemoeller, Rose E.; Langer, Paul F.

A study was undertaken to arrive at a broad overview of the Soviet training utilization of foreign area specialists. To gather data for the study, researchers examined European, United States, and Soviet publications and interviewed Soviet emigres and U.S. specialists on the Soviet Union. According to these data sources, specialized training for…

A guide to breast implants for the non-breast specialist.

PubMed

Harvey, Kate L; Clark, Sarah E

2016-11-01

Breast augmentation is an increasingly popular cosmetic surgery procedure, and breast implants can also be used in reconstructive surgery following mastectomy. Problematic breast implants can present to any discipline of medicine, most frequently to primary care or acute service such as emergency medicine. This guide aims to inform the non-breast specialist in how to assess and treat common problems and when referral to specialist services is necessary.

A guide to breast implants for the non-breast specialist

PubMed Central

Harvey, Kate L.; Clark, Sarah E.

2016-01-01

Breast augmentation is an increasingly popular cosmetic surgery procedure, and breast implants can also be used in reconstructive surgery following mastectomy. Problematic breast implants can present to any discipline of medicine, most frequently to primary care or acute service such as emergency medicine. This guide aims to inform the non-breast specialist in how to assess and treat common problems and when referral to specialist services is necessary. PMID:29334026

STS-89 Mission Specialist Dunbar participates in the CEIT

NASA Technical Reports Server (NTRS)

1997-01-01

STS-89 Mission Specialist Bonnie Dunbar, Ph.D., participates in the Crew Equipment Interface Test (CEIT) in front of the Real- time Radiation Monitoring Device (RRMD) at the SPACEHAB Payload Processing Facility at Port Canaveral in preparation for the mission, slated to be the first Shuttle launch of 1998. The CEIT gives astronauts an opportunity to get a hands-on look at the payloads with which they will be working on-orbit. STS-89 will be the eighth of nine scheduled Mir dockings and will include a double module of SPACEHAB, used mainly as a large pressurized cargo container for science, logistical equipment and supplies to be exchanged between the orbiter Endeavour and the Russian Space Station Mir. The nine- day flight of STS-89 also is scheduled to include the transfer of the seventh American to live and work aboard the Russian orbiting outpost. Liftoff of Endeavour and its seven- member crew is targeted for Jan. 15, 1998, at 1:03 a.m. EDT from Launch Pad 39A.

Field precision machining technology of target chamber in ICF lasers

NASA Astrophysics Data System (ADS)

Xu, Yuanli; Wu, Wenkai; Shi, Sucun; Duan, Lin; Chen, Gang; Wang, Baoxu; Song, Yugang; Liu, Huilin; Zhu, Mingzhi

2016-10-01

In ICF lasers, many independent laser beams are required to be positioned on target with a very high degree of accuracy during a shot. The target chamber provides a precision platform and datum reference for final optics assembly and target collimation and location system. The target chamber consists of shell with welded flanges, reinforced concrete pedestal, and lateral support structure. The field precision machining technology of target chamber in ICF lasers have been developed based on ShenGuangIII (SGIII). The same center of the target chamber is adopted in the process of design, fabrication, and alignment. The technologies of beam collimation and datum reference transformation are developed for the fabrication, positioning and adjustment of target chamber. A supporting and rotating mechanism and a special drilling machine are developed to bore the holes of ports. An adjustment mechanism is designed to accurately position the target chamber. In order to ensure the collimation requirements of the beam leading and focusing and the target positioning, custom-machined spacers are used to accurately correct the alignment error of the ports. Finally, this paper describes the chamber center, orientation, and centering alignment error measurements of SGIII. The measurements show the field precision machining of SGIII target chamber meet its design requirement. These information can be used on similar systems.

Avionics Instrument Systems Specialist (AFSC 32551).

ERIC Educational Resources Information Center

Miller, Lawrence B.; Crowcroft, Robert A.

This six-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for avionics instrument systems specialists. Covered in the individual volumes are career field familiarization (career field progression and training, security, occupational safety and health, and career field reference material);…

Metrication: What Can HRD Specialists Do?

ERIC Educational Resources Information Center

Short, Larry G.

1978-01-01

First discusses some features of the Metric Conversion Act which established federal support of metric system usage in the United States. Then covers the following: what HRD (Human Resources Development) specialists can do to assist their company managers during the conversion process; metric training strategies; and how to prepare for metric…

Community-Based Prevention Specialist. Trainer Manual.

ERIC Educational Resources Information Center

University Research Corp., Bethesda, MD.

This trainer manual is designed to assist facilitators in the design of entry-level courses and programs for substance abuse prevention specialists. The manual initially concentrates on a basic, generic approach to community work, and introduces the knowledge and skills needed to implement substance abuse prevention programs by using the community…

Specialist Teams Needed to Support Youth.

ERIC Educational Resources Information Center

Mellin, Laurel M.

1991-01-01

Presents seven reasons why it is important for health specialist teams to take action supporting the prevention and treatment of childhood obesity. The article offers guidelines to help parents assist their children in maintaining positive eating, exercise, and self-esteem patterns, noting sensitive intervention is preferable to imposed diets. (SM)

Air traffic control specialist performance measurement database.

DOT National Transportation Integrated Search

1999-06-01

The Air Traffic Control Specialist (ATCS) Performance Measurement Database is a compilation of performance measures and : measurement techniques that researchers have used. It may be applicable to other human factor research related to air traffic co...

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

PubMed

Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

2016-01-01

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

PubMed

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

[Beginners' operations and medical specialist standards : Avoidance of criminal liability and civil liability].

PubMed

Schneider, H

2018-05-16

In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter. This article portrays the requirements of civil liability and criminal responsibility concerning beginners' operations on the basis of cases and judgments of the Federal Court and the Higher Regional Courts in Germany. Additionally, the reception of the jurisprudence by the relevant legal literature will be discussed. Jurisprudence and legal literature categorize breaches of duty of care. Assistant physicians can be subject to contributory negligence liabilities, while specialists can bear liabilities for negligent selection, organization or supervision. Responsible specialist and assistant physicians can protect themselves (and the patient) and avoid legal risks by only performing operations adequate to their educational level or by delegating operations to beginners and ensuring intervention by a specialist by supervision of the operation which is suitable to the assistant physician's level of education.

STS-67 Payload Specialists Durrance and Parise suit up

NASA Technical Reports Server (NTRS)

1995-01-01

In the Operations and Checkout Building, STS-67 Payload Specialists Samuel T. Durrance (left) and Ronald A. Parise have finished donning their launch/entry suits and chat with astronaut Joe Tanner while waiting for the rest of the crew. The two payload specialists -- who are both making their second trip into space -- and five fellow crew members will soon depart for Launch Pad 39A, where the Space Shuttle Endeavour is being readied for liftoff during a launch window opening at 1:37 a.m. EST, March 2.

View of Mission Specialist Judith Resnik on the middeck

NASA Image and Video Library

1984-09-08

41D-13-025 (30 Aug 1984) --- Astronaut Judith A. Resnik, one of three mission specialists, positions herself on the floor of the Space Shuttle Discovery's mid-deck to note some items on a clipboard pad. Nearby, Charles D. Walker, payload specialist (partially out of frame at left), anchors himself with a foot restraint while working at a stowage locker. Between the two is a sign fashioned by Dr. Resnik and held up to a nearby TV camera during early STS-41D downlinked television. This is a 35mm frame.

Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists.

PubMed

Morais, Fábio Barreto; Arantes, Tiago Eugênio Faria E; Muccioli, Cristina

2018-01-01

To describe treatment practices for ocular toxoplasmosis among members of the Brazilian Uveitis Society. An online questionnaire sent to specialists, between October 2014 and March 2015. Most respondents (67.9%) treat all active cases. Most specialists consider visual acuity <20/200 (88.2%), severe vitreous inflammation (94.1%), and ocular disease during acquired infection (88.2%) as absolute indications for treatment. Systemic steroids are associated with anti-toxoplasmic therapy in most cases by 50.9% of the respondents. For immunocompetent individuals, 57.4% of the respondents chose trimethoprim/sulfamethoxazole. Classical therapy (sulfadiazine/pyrimethamine) is preferred most for patients with central lesions (70.4%), immunosuppression (68.4%), acquired infection (70.4%), and atypical forms (74.1%). For patients with frequent relapses, 84.9% of the respondents preferred antibiotic prophylaxis. Treatment patterns of ocular toxoplasmosis are not uniform among Brazilian specialists. Most specialists treat all cases of active retinochoroiditis. Typical cases are more frequently treated with trimethoprim/sulfamethoxazole. However, classical therapy is the regimen of choice when lesions are considered more severe.

Role expectations in dementia care among family physicians and specialists.

PubMed

Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

2014-09-01

The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Physicians' clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the "bad cop" to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Future research could further explore physicians' and other multi-disciplinary members' perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario.

Role Expectations in Dementia Care Among Family Physicians and Specialists

PubMed Central

Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

2014-01-01

Background The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Methods Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Results Physicians’ clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the “bad cop” to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Conclusions Future research could further explore physicians’ and other multi-disciplinary members’ perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario. PMID:25232368

Effects of a Malpractice Crisis on Specialist Supply and Patient Access to Care

PubMed Central

Mello, Michelle M.; Studdert, David M.; DesRoches, Catherine M.; Peugh, Jordon; Zapert, Kinga; Brennan, Troyen A.; Sage, William M.

2005-01-01

Objective: To investigate specialist physicians' practice decisions in response to liability concerns and their perceptions of the impact of the malpractice environment on patient access to care. Summary Background Data: A perennial concern during “malpractice crises” is that liability costs will drive physicians in high-risk specialties out of practice, creating specialist shortages and access-to-care problems. Methods: Mail survey of 824 Pennsylvania physicians in general surgery, neurosurgery, orthopedic surgery, obstetrics/gynecology, emergency medicine, and radiology eliciting information on practice decisions made in response to rising liability costs. Results: Strong majorities of specialists reported increases over the last 3 years in patients' driving distances (58%) and waiting times (83%) for specialist care or surgery, waiting times for emergency department care (82%), and the number of patients forced to switch physicians (89%). Professional liability costs and managed care were both considered important contributing factors. Small proportions of specialists reported that they would definitely retire (7%) or relocate their practice out of state (4%) within the next 2 years; another third (32% and 29%, respectively) said they would likely do so. Forty-two percent of specialists have reduced or eliminated high-risk aspects of their practice, and 50% are likely to do so over the next 2 years. Conclusions: Our data suggest that claims of a “physician exodus” from Pennsylvania due to rising liability costs are overstated, but the malpractice situation is having demonstrable effects on the supply of specialist physicians in affected areas and their scope of practice, which likely impinges upon patients' access to care. PMID:16244532

3D printing of graphene-doped target for "matrix-free" laser desorption/ionization mass spectrometry.

PubMed

Wang, Dingyi; Huang, Xiu; Li, Jie; He, Bin; Liu, Qian; Hu, Ligang; Jiang, Guibin

2018-03-13

We report a graphene-doped resin target fabricated via a 3D printing technique for laser desorption/ionization mass spectrometry analysis. The graphene doped in the target acts as an inherent laser absorber and ionization promoter, thus permitting the direct analysis of samples without adding matrix. This work reveals a new strategy for easy designing and fabrication of functional mass spectrometry devices.

Tools for in silico target fishing.

PubMed

Cereto-Massagué, Adrià; Ojeda, María José; Valls, Cristina; Mulero, Miquel; Pujadas, Gerard; Garcia-Vallve, Santiago

2015-01-01

Computational target fishing methods are designed to identify the most probable target of a query molecule. This process may allow the prediction of the bioactivity of a compound, the identification of the mode of action of known drugs, the detection of drug polypharmacology, drug repositioning or the prediction of the adverse effects of a compound. The large amount of information regarding the bioactivity of thousands of small molecules now allows the development of these types of methods. In recent years, we have witnessed the emergence of many methods for in silico target fishing. Most of these methods are based on the similarity principle, i.e., that similar molecules might bind to the same targets and have similar bioactivities. However, the difficult validation of target fishing methods hinders comparisons of the performance of each method. In this review, we describe the different methods developed for target prediction, the bioactivity databases most frequently used by these methods, and the publicly available programs and servers that enable non-specialist users to obtain these types of predictions. It is expected that target prediction will have a large impact on drug development and on the functional food industry. Copyright © 2014 Elsevier Inc. All rights reserved.

Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors.

PubMed

Ashton, Toni; Brown, Paul; Sopina, Elizaveta; Cameron, Linda; Tenbensel, Timothy; Windsor, John

2013-09-27

As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated. Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Sources of job satisfaction and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system.

Commissioning of specialist palliative care services in England.

PubMed

Lancaster, Harriet; Finlay, Ilora; Downman, Maxwell; Dumas, James

2018-03-01

Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services. 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services. The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Apprentice Food Service Specialist (AFSC 62230).

ERIC Educational Resources Information Center

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This two-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice food service specialists. Covered in the first volume are fundamentals of food preparation and service (careers in food service, food service sanitation, principles of food preparation and service, and baking…

Landing response of Aedes (Stegomyia) polynesiensis mosquitoes to coloured targets.

PubMed

Chambers, E W; Bossin, H C; Ritchie, S A; Russell, R C; Dobson, S L

2013-09-01

Aedes polynesiensis Marks (Diptera: Culicidae) is the primary vector of lymphatic filariasis (LF) in the island countries and territories of the South Pacific. In the development of a novel control tool, the response of Ae. polynesiensis to six different colours (three solid fabrics, two patterned fabrics and a plastic tarp) was measured using a digital photographic system. Adult mosquitoes were placed into an environmental chamber and allowed to choose between a white target and one of six experimental targets. Mosquito landing frequency and landing duration were calculated. Adult female Ae. polynesiensis preferred all of the experimental targets to the white control target. Mosquito landing frequency was highest for the solid targets (black, navy blue and red) followed in turn by the two colour pattern targets and the polyethylene target. Mosquito landing duration was greater for experimental targets when compared with white control targets. Mosquito landing frequencies did not change over time during the course of the assay. The response of male Ae. polynesiensis was also measured when exposed to a 100% cotton black target. Male mosquitoes preferred the black target to the white control target, although at levels lower than that observed in female mosquitoes. The results suggest that future investigations evaluating the visual responses of Ae. polynesiensis mosquitoes are warranted, with a special emphasis on semi-field and field-based experiments. © 2013 The Royal Entomological Society.

Safe use of chemicals by professional users and health care specialists

PubMed Central

Apatsidou, Margarita; Konstantopoulou, Ioanna; Foufa, Eleni; Tsarouhas, Konstantinos; Papalexis, Petros; Rezaee, Ramin; Spandidos, Demetrios A.; Kouretas, Demetrios; Tsitsimpikou, Christina

2018-01-01

The awareness of Greek professional users and health care specialists regarding the safe use of chemicals was investigated, to be the best of our knowledge, for the first time after the introduction of Regulations (EC) 1907/2006 (REACH) and 1272/2008 (CLP) on chemicals. A total of 200 professional users and 150 health care specialists from various regions of Greece contributed to the use of a closed-ended, anonymous and validated questionnaire. The findings showed that over 85% of the responders were not aware of classification, labelling and packaging (CLP) and 67.8% of the responders were unaware of any changes made in the labeling of the products they were using. The majority (>75%) of individuals were cognizant that they were using hazardous products; however, the perception of hazard varied significantly between the two groups (P=0.012) and statistically were dependent on the educational (P=0.022) and the profession (P=0.014) level. One third of the professional users read the label as the main source of information for the product, while for health care specialists the number increased to 65% and a strong correlation was detected with the educational level (P=0.017). In both groups, 7% of professional users and health care specialists declared that hazard communication through product labeling is not well understood. The use of personal protective equipment (PPE) is almost universal for health care specialists with women being more sensitive (P=0.041), while 25% of the professional users do not use any PPE. Almost 60% of the health care specialists are required to provide instructions regarding the safe use of chemicals or the action to be undertaken in case of accident. In the latter situation, the National Poisoning Centre is the reference point for information. Limited use of the safety data sheets has been observed both for professional users (18%) and health care specialists (23%). In conclusion, rising awareness campaigns are needed, in collaboration

Bioinstrumentation for evaluation of workload in payload specialists - Results of ASSESS II

NASA Technical Reports Server (NTRS)

Wegmann, H. M.; Herrmann, R.; Winget, C. M.

1979-01-01

Results of the medical experiment on payload specialist workloads conducted as part of the ASSESS II airborne simulation of Spacelab conditions are reported. Subjects were fitted with temperature probes and ECG, EEG and EOG electrodes, and hormone and electrolyte excretion was monitored in order to evaluate the changes in circadian rhythms, sleep patterns and stress responses brought about by mission schedules over the ten days of the experiment. Internal dissociations of circadian rhythms, sleep disturbances and increased stress levels were observed, especially during the first three days of the experiment, indicating a considerable workload to be imposed upon the payload specialists. An intensive premission simulation is suggested as a means of estimating overall workloads and allowing payload specialist adaptation to mission conditions. The bioinstrumentation which was developed and applied to the airborne laboratory is concluded to be a practical and reliable tool in the assessment of payload specialist workloads.

Analysis of pharmacologic and nonpharmacologic prescription patterns of general practitioners and specialists in the AMICA study.

PubMed

Scarpa, Raffaele; Sarzi-Puttini, Piercarlo; Cimmino, Marco A; Caporali, Roberto; Parazzini, Fabio; Zaninelli, Augusto; Canesi, Bianca

2005-08-01

To evaluate the prescription modalities of general practitioners (GPs) and specialists in symptomatic osteoarthritis (OA) patients enrolled in the AMICA study. This study started in 2001 as a cohort investigation of OA patients seen by 2764 GPs and 316 specialists. Enrolled were 28,981 patients with symptomatic OA of the hand, hip, or knee. GPs and physical medicine specialists treated OA less frequently with pharmacological therapy than rheumatologists (OR 0.35; CI 0.26 to 0.47) or orthopedic surgeons (OR 0.65; CI 0.54 to 0.77). Pharmacological therapies (alone or in association with nonpharmacological modalities) were selected by 97% of the GPs, 96% of the rheumatologists, 94% of the orthopedic surgeons, and 85% of the physical medicine specialists. In comparison with GPs, all of the specialists more frequently used disease-modifying OA drugs (DMOADs) (rheumatologists: OR 6.86, CI 6.03 to 7.80; orthopedic surgeons: OR 2.20, CI 1.94 to 2.49; physical medicine specialists: OR 2.11, CI 1.69 to 2.63). Nonpharmacological therapies were selected by 44% of the GPs, 54% of the rheumatologists, 71% of the orthopedic surgeons, and 90% of the physical medicine specialists. They were used alone uncommonly (by 3% of the GPs, 3% of the rheumatologists, 6% of the orthopedic surgeons, and 15% of the physical medicine specialists). GPs use nonpharmacological treatment less than specialists: OR 0.53; CI 0.47 to 0.60 versus rheumatologists; OR 0.20; CI 0.18 to 0.21 versus orthopedic surgeons; and OR 0.07; CI 0.05 to 0.09 versus physical medicine specialists. Ultrasound (US) (11%) and transcutaneous electrical nerve stimulation (TENS) (7%) were the nonpharmacological therapies most frequently prescribed by GPs. Among the specialists, physical medicine specialists most frequently prescribed US (35%) and TENS (21%); US was also preferred by rheumatologists, whereas the orthopedic surgeon's choice was magnetotherapy (21%). Exercises and other passive or active rehabilitation strategies

Polymorphous computing fabric

DOEpatents

Wolinski, Christophe Czeslaw [Los Alamos, NM; Gokhale, Maya B [Los Alamos, NM; McCabe, Kevin Peter [Los Alamos, NM

2011-01-18

Fabric-based computing systems and methods are disclosed. A fabric-based computing system can include a polymorphous computing fabric that can be customized on a per application basis and a host processor in communication with said polymorphous computing fabric. The polymorphous computing fabric includes a cellular architecture that can be highly parameterized to enable a customized synthesis of fabric instances for a variety of enhanced application performances thereof. A global memory concept can also be included that provides the host processor random access to all variables and instructions associated with the polymorphous computing fabric.

STS-87 Payload Specialist Kadenyuk in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine is assisted with final preparations before launch in the white room at Launch Pad 39B by Danny Wyatt, NASA quality assurance specialist, at left; Dave Law, USA mechanical technician, facing Kadenyuk; and Travis Thompson, USA orbiter vehicle closeout chief, at right. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. The 16- day mission will include the Collaborative Ukrainian Experiment (CUE), a collection of 10 plant space biology experiments that will fly in Columbias middeck and will feature an educational component that involves evaluating the effects of microgravity on Brassica rapa seedlings.

Design and Fabrication of Multifunctional Sericin Nanoparticles for Tumor Targeting and pH-Responsive Subcellular Delivery of Cancer Chemotherapy Drugs.

PubMed

Huang, Lei; Tao, Kaixiong; Liu, Jia; Qi, Chao; Xu, Luming; Chang, Panpan; Gao, Jinbo; Shuai, Xiaoming; Wang, Guobin; Wang, Zheng; Wang, Lin

2016-03-01

The severe cytotoxicity of cancer chemotherapy drugs limits their clinical applications. Various protein-based nanoparticles with good biocompatibility have been developed for chemotherapy drug delivery in hope of reducing drugs' side effects. Sericin, a natural protein from silk, has no immunogenicity and possesses diverse bioactivities that have prompted sericin's application studies. However, the potential of sericin as a multifunctional nanoscale vehicle for cancer therapy have not been fully explored. Here we report the successful fabrication and characterization of folate-conjugated sericin nanoparticles with cancer-targeting capability for pH-responsive release of doxorubicin (these nanoparticles are termed "FA-SND"). DOX is covalently linked to sericin through pH-sensitive hydrazone bonds that render a pH-triggered release property. The hydrophobicity of DOX and the hydrophilicity of sericin promote the self-assembly of sericin-DOX (SND) nanoconjugates. Folate (FA) is then covalently grafted to SND nanoconjugates as a binding unit for actively targeting cancer cells that overexpress folate receptors. Our characterization study shows that FA-SND nanoparticles exhibit negative surface charges that would reduce nonspecific clearance by circulation. These nanoparticles possess good cytotoxicity and hemocompatibiliy. Acidic environment (pH 5.0) triggers effective DOX release from FA-SND, 5-fold higher than does a neutral condition (pH 7.4). Further, FA-SND nanoparticles specifically target folate-receptor-rich KB cells, and endocytosed into lysosomes, an acidic organelle. The acidic microenvironment of lysosomes promotes a rapid release of DOX to nuclei, producing cancer specific chemo-cytotoxicity. Thus, FA-mediated cancer targeting and lysosomal-acidity promoting DOX release, two sequentially-occurring cellular events triggered by the designed components of FA-SND, form the basis for FA-SND to achieve its localized and intracellular chemo

Personalizing protocol-driven care: the case of specialist heart failure nurses.

PubMed

Sanders, Tom; Harrison, Stephen; Checkland, Katherine

2010-09-01

This paper is a report of a study conducted to explore how specialist heart failure nurses negotiate treatment advice with patients, in the context of an increasing expectation that clinical staff in the National Health Services will follow guidelines in their daily work. The development of specialist nurse roles has given rise to questions about their compatibility with patient-centred care. However, research has revealed little about how specialist nurses balance clinical guidelines with traditional caring tasks. Semi-structured interviews (n = 10) were conducted with specialist heart failure nurses in northern England recruited from a heart failure specialist nursing contact list. In addition, non-participant observations were carried out on nurse-patient consultations (n = 16) in one regional nurse-led heart failure clinic. Data were collected between 2003 and 2005, and analysed using a variation of grounded theory. Heart failure nurses sought to combine traditional caring work with the wider goal of improving patient outcomes by 'personalizing' their advice to patients and presenting their heart failure as 'typical'. They accommodated protocol-driven care into their daily routines, and perceived no disjuncture between evidence-based practice and patient-centredness. However, their approach allowed little space for the exploration of each patient's own priorities about their illness. There is a need both to re-examine the appropriateness of traditional caring concepts, and to reflect on the need to incorporate patients' own values into the consultation process.

The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services

PubMed Central

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-01-01

Objectives International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. Design A cross-sectional survey of hospital and community-based DNS in Ireland. Methods Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. Results The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Conclusions Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. PMID:28801394

One Team: Classroom Teachers and Specialists

ERIC Educational Resources Information Center

Gale, Sheila Levine

2016-01-01

This View from the Chalkboard article reflects my view of how today's classroom teacher and specialist have joined together to create "One Team" that benefits the student. This was not always the case but the trend, in my view, is clear and the benefits compelling. I highlight the "reading workshop model" as an approach with…

Business Systems Specialist. Technical Committee Report.

ERIC Educational Resources Information Center

Idaho State Dept. of Education, Boise. Div. of Vocational Education.

This Technical Committee Report prepared by industry representatives in Idaho lists the skills currently necessary for an employee in that state to obtain a job as a business systems specialist, retain a job once hired, and advance in that occupational field. (Task lists are grouped according to duty areas generally used in industry settings, and…

The role of specialist nurses in multiple sclerosis: a rapid and systematic review.

PubMed

De Broe, S; Christopher, F; Waugh, N

2001-01-01

Multiple sclerosis (MS) is a disease of the central nervous system. The cause is unknown. There are about 80-160 people with MS per 100,000 population, with twice as many women affected as men. The management of individuals with MS includes treatment of acute relapses and chronic symptoms. The care of MS patients is provided by various healthcare professionals, such as general practitioners (GPs), neurologists, physiotherapists, occupational therapists and nurses. Some MS patients have access to an MS specialist nurse, although this provision varies geographically. The aim of this report is to assess the effectiveness and relative cost-effectiveness of MS specialist nurses in improving care and outcomes for patients with MS. A systematic review of the literature, involving a range of databases, was performed. Full details are described in the main report. Only one study was identified that tried to evaluate the benefit of MS specialist nurses. The study concluded that MS patients and their carers found the MS specialist nurse to be helpful, particularly in improving their knowledge of MS, ability to cope, mood and confidence about the future. GPs also reported finding the nurse to be helpful with their MS patients, and 40% of the GPs stated they would purchase the services of an MS specialist nurse if their practices became fundholding. However, there were considerable methodological weaknesses inherent in the study design, and it was unclear whether the results of the study could be extrapolated to other settings or to other MS patient groups. RESULTS - ONGOING RESEARCH: There are two ongoing research studies regarding MS specialist nurses. One of these studies involves the provision of MS nurses to several areas, but also has two control populations to allow evaluation of the health benefits of the nurses to MS patients and their carers. This study will help to fill the evidence gap. RESULTS - COSTS: The costs of providing MS specialist nurses consist of their

Are specialists at risk under environmental change? Neoecological, paleoecological and phylogenetic approaches

PubMed Central

Colles, Audrey; Liow, Lee Hsiang; Prinzing, Andreas

2009-01-01

The question ‘what renders a species extinction prone’ is crucial to biologists. Ecological specialization has been suggested as a major constraint impeding the response of species to environmental changes. Most neoecological studies indicate that specialists suffer declines under recent environmental changes. This was confirmed by many paleoecological studies investigating longer-term survival. However, phylogeneticists, studying the entire histories of lineages, showed that specialists are not trapped in evolutionary dead ends and could even give rise to generalists. Conclusions from these approaches diverge possibly because (i) of approach-specific biases, such as lack of standardization for sampling efforts (neoecology), lack of direct observations of specialization (paleoecology), or binary coding and prevalence of specialists (phylogenetics); (ii) neoecologists focus on habitat specialization; (iii) neoecologists focus on extinction of populations, phylogeneticists on persistence of entire clades through periods of varying extinction and speciation rates; (iv) many phylogeneticists study species in which specialization may result from a lack of constraints. We recommend integrating the three approaches by studying common datasets, and accounting for range-size variation among species, and we suggest novel hypotheses on why certain specialists may not be particularly at risk and consequently why certain generalists deserve no less attention from conservationists than specialists. PMID:19580588

Bleeding Hearts, Profiteers, or Both: Specialist Physician Fees in an Unregulated Market.

PubMed

Johar, Meliyanni; Mu, Chunzhou; Van Gool, Kees; Wong, Chun Yee

2017-04-01

This study shows that, in an unregulated fee-setting environment, specialist physicians practise price discrimination on the basis of their patients' income status. Our results are consistent with profit maximisation behaviour by specialists. These findings are based on a large population survey that is linked to administrative medical claims records. We find that, for an initial consultation, specialist physicians charge their high-income patients AU$26 more than their low-income patients. While this gap equates to a 19% lower fees for the poorest patients (bottom 25% of the household income distribution), it is unlikely to remove the substantial financial barriers they face in accessing specialist care. There are large variations across specialties, with neurologists exhibiting the largest fee gap between the high-income and low-income patients. Several possible channels for deducing the patient's income are examined. We find that patient characteristics such as age, health concession card status and private health insurance status are all used by specialists as proxies for income status. These characteristics are particularly important to further practise price discrimination among the low-income patients but are less relevant for the high-income patients. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Payload specialists Patrick Baudry conducts equilibrium experiments

NASA Technical Reports Server (NTRS)

1985-01-01

Payload specialists Patrick Baudry participates in an experiment involving equilibrium and vertigo. He is anchored to the orbiter floor by foot restraints and is wearing a device over his eyes to measure angular head movement and up and down eye movement.

Stars For Citizens With Urban Star Parks and Lighting Specialists

NASA Astrophysics Data System (ADS)

Grigore, Valentin

2015-08-01

General contextOne hundred years ago, almost nobody imagine a life without stars every night even in the urban areas. Now, to see a starry sky is a special event for urban citizens.It is possible to see the stars even inside cities? Yes, but for that we need star parks and lighting specialists as partners.Educational aspectThe citizens must be able to identify the planets, constellations and other celestial objects in their urban residence. This is part of a basic education. The number of the people living in the urban area who never see the main constellations or important stars increase every year. We must do something for our urban community.What is an urban star park?An urban public park where we can see the main constellations can be considered an urban star park. There can be organized a lot of activities as practical lessons of astronomy, star parties, etc.Classification of the urban star parksA proposal for classification of the urban star parks taking in consideration the quality of the sky and the number of the city inhabitants:Two categories:- city star parks for cities with < 100.000 inhabitants- metropolis star parks for cities with > 100.000 inhabitantsFive levels of quality:- 1* level = can see stars of at least 1 magnitude with the naked eyes- 2* level = at least 2 mag- 3* level = at least 3 mag- 4* level= at least 4 mag- 5* level = at least 5 magThe urban star urban park structure and lighting systemA possible structure of a urban star park and sky-friend lighting including non-electric illumination are descripted.The International Commission on IlluminationA description of this structure which has as members national commissions from all over the world.Dark-sky activists - lighting specialistsNational Commissions on Illumination organize courses of lighting specialist. Dark-sky activists can become lighting specialists. The author shows his experience in this aspect as a recent lighting specialist and his cooperation with the Romanian National

Relative costs of specialist services in a family practice population

PubMed Central

Norton, Peter G.; Nelson, Wendy; Rudner, Howard L.; Dunn, Earl V.

1985-01-01

The frequency and cost of referrals to specialists in March 1984 for 8980 rostered patients attending a family practice clinic located in a teaching hospital were analysed. The patients made 1891 visits to specialists. In all age groups and for all specialties female patients were more likely to be seen. The total direct provider costs were higher for female patients than for male patients. However, costs per patient seen were higher for male patients, except for psychiatry and medicine. Visits to surgeons had the highest total cost, while visits to psychiatrists had the highest cost per patient seen. Of the direct provider costs 61% was for specialist services. The family physician, in the “gatekeeper” role, has an opportunity to control some of the costs of the health care system by ensuring that the best and most efficient use is made of the referral network. PMID:4042059

STS-108 Mission Specialist Linda A. Godwin arrives at KSC

NASA Technical Reports Server (NTRS)

2001-01-01

STS-108 Mission Specialist Linda A. Godwin arrives at KSC KSC-01PD-1710 KENNEDY SPACE CENTER, Fla. -- STS-108 Mission Specialist Linda A. Godwin pauses after her arrival at KSC. She and the rest of the crew will be preparing for launch Nov. 29 on Space Shuttle Endeavour. Liftoff is scheduled for 7:41 p.m. EST. Top priorities for the STS-108 (UF-1) mission of Endeavour are rotation of the International Space Station Expedition Three and Expedition Four crews, bringing water, equipment and supplies to the station in the Multi-Purpose Logistics Module Raffaello, and completion of spacewalk and robotics tasks. Mission Specialists Daniel M. Tani and Godwin will take part in the spacewalk to install thermal blankets over two pieces of equipment at the bases of the Space Station's solar wings. Other crew members are Commander Dominic L. Gorie and Pilot Mark E. Kelly.

STS-108 Mission Specialist Daniel M. Tani arrives at KSC

NASA Technical Reports Server (NTRS)

2001-01-01

STS-108 Mission Specialist Daniel M. Tani arrives at KSC KSC-01PD-1707 KENNEDY SPACE CENTER, Fla. -- STS-108 Mission Specialist Daniel M. Tani arrives at KSC in a T-38 jet trainer. He and the rest of the crew will be preparing for launch Nov. 29 on Space Shuttle Endeavour. Liftoff is scheduled for 7:41 p.m. EST. Top priorities for the STS-108 (UF-1) mission of Endeavour are rotation of the International Space Station Expedition Three and Expedition Four crews, bringing water, equipment and supplies to the station in the Multi-Purpose Logistics Module Raffaello, and completion of spacewalk and robotics tasks. Mission Specialists Linda A. Godwin and Tani will take part in the spacewalk to install thermal blankets over two pieces of equipment at the bases of the Space Station's solar wings. Other crew members are Commander Dominic L. Gorie and Pilot Mark E. Kelly.

The impact of specialist trauma service on major trauma mortality.

PubMed

Wong, Ting Hway; Lumsdaine, William; Hardy, Benjamin M; Lee, Keegan; Balogh, Zsolt J

2013-03-01

Trauma services throughout the world have had positive effects on trauma-related mortality. Australian trauma services are generally more consultative in nature rather than the North American model of full trauma admission service. We hypothesized that the introduction of a consultative specialist trauma service in a Level I Australian trauma center would reduce mortality of the severely injured. A 10-year retrospective study (January 1, 2002-December 31, 2011) was performed on all trauma patients admitted with an Injury Severity Score (ISS) > 15. Patients were identified from the trauma registry, and data for age, sex, mechanism of injury, ISS, survival to discharge, and length of stay were collected. Mortality was examined for patients with severe injury (ISS > 15) and patients with critical injury (ISS > 24) and compared for the three periods: 2002-2004 (without trauma specialist), 2005-2007 (with trauma specialist), and 2008-2011 (with specialist trauma service). A total of 3,869 severely injured (ISS > 15) trauma patients were identified during the 10-year period. Of these, 2,826 (73%) were male, 1,513 (39%) were critically injured (ISS > 24), and more than 97% (3,754) were the victim of blunt trauma. Overall mortality decreased from 12.4% to 9.3% (relative risk, 0.75) from period one to period three and from 25.4% to 20.3% (relative risk, 0.80) for patients with critical injury. A 0.46% per year decrease (p = 0.018) in mortality was detected (odds ratio, 0.63; p < 0.001). For critically injured (ISS > 24), the trend was (0.61% per year; odds ratio, 0.68; p = 0.039). The introduction of a specialist trauma service decreased the mortality of patients with severe injury, the model of care should be considered to implement state- and nationwide in Australia. Epidemiologic study, level III.

The Association for Educational Communications and Technology: Division of School Media Specialists.

ERIC Educational Resources Information Center

Miller, Mary Mock

1993-01-01

Reports on the Division of School Media Specialists of the Association for Educational Communications and Technology (AECT). Highlights include the mission statement; publications; board members and committee chairs; activities at the AECT conferences; and future concerns, including public relations and marketing plans for media specialists and…

Entomology Specialist 1-1. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

Jones, Jimmie L.

This individualized, self-paced course for training an entomology specialist was adapted from military curriculum materials for use in vocational and technical education. Completion of the course should provide students with basic information needed to accomplish the following duties of an entomology specialist: perform entomological work, apply…

Asthma management in a specialist setting: Results of an Italian Respiratory Society survey.

PubMed

Braido, Fulvio; Baiardini, Ilaria; Alleri, Pietro; Bacci, Elena; Barbetta, Carlo; Bellocchia, Michela; Benfante, Alida; Blasi, Francesco; Bucca, Caterina; Busceti, Maria Teresa; Centanni, Stefano; Colanardi, Maria Cristina; Contoli, Marco; Corsico, Angelo; D'Amato, Maria; Di Marco, Fabiano; Marco, Dottorini; Ferrari, Marta; Florio, Giovanni; Fois, Alessandro Giuseppe; Foschino Barbaro, Maria Pia; Silvia, Garuti; Girbino, Giuseppe; Grosso, Amelia; Latorre, Manuela; Maniscalco, Sara; Mazza, Francesco; Mereu, Carlo; Molinengo, Giorgia; Ora, Josuel; Paggiaro, Pierluigi; Patella, Vincenzo; Pelaia, Girolamo; Pirina, Pietro; Proietto, Alfio; Rogliani, Paola; Santus, Pierachille; Scichilone, Nicola; Simioli, Francesca; Solidoro, Paolo; Terraneo, Silvia; Zuccon, Umberto; Canonica, Giorgio Walter

2017-06-01

Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used

Charismatic authority in modern healthcare: the case of the 'diabetes specialist podiatrist'.

PubMed

Bacon, Dawn; Borthwick, Alan M

2013-09-01

Professional specialisation is broadly considered to result from increased complexity in professional knowledge and to be linked to specialist education, formalised credentials and registration. However, the degree of formal organisation may vary across professions. In healthcare, although medical specialisation is linked to rigorous selection criteria, formal training programmes and specialist registration, some forms of specialisation in the allied health professions are much less formal. Drawing on Weber's concept of charismatic authority, the establishment of a specialist role in podiatry, the 'diabetes specialist podiatrist', in the absence of codified or credentialed authority, is explored. 'Charismatic' leaders in podiatry, having attracted a following of practitioners, were able to constitute a speciality area of practice in the absence of established career pathways and acquire a degree of legitimacy in the medical field of diabetology. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/JohnWiley & Sons Ltd. Published by John Wiley & Sons Ltd.

STS-93 Mission Specialist Tognini drives an M-113 during training

NASA Technical Reports Server (NTRS)

1999-01-01

Under the watchful eyes of KSC Fire Department trainer Capt. George Hoggard (seated on the front), STS-93 Mission Specialist Michel Tognini of France (right) drives the M-113 armored personnel carrier during emergency egress training at the launch pad. Tognini represents the Centre National d'Etudes Spatiales (CNES). At the far left is Roland Nedelkovich, with the Vehicle Integration Test Team, JSC. In preparation for their mission, the STS-93 crew are participating in Terminal Countdown Demonstration Test activities that also include a launch-day dress rehearsal culminating with a simulated main engine cut-off. Others in the crew participating are Commander Eileen M. Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Steven A. Hawley (Ph.D.) and Catherine G. Coleman (Ph.D.) Collins is the first woman to serve as a Shuttle commander. The primary mission of STS-93 is the release of the Chandra X-ray Observatory, which will allow scientists from around the world to obtain unprecedented X-ray images of exotic environments in space to help understand the structure and evolution of the universe. Chandra is expected to provide unique and crucial information on the nature of objects ranging from comets in our solar system to quasars at the edge of the observable universe. Since X-rays are absorbed by the Earth's atmosphere, space-based observatories are necessary to study these phenomena and allow scientists to analyze some of the greatest mysteries of the universe. The targeted launch date for STS-93 is no earlier than July 20 at 12:36 a.m. EDT from Launch Pad 39B.

The content of the work of clinical nurse specialists described by use of daily activity diaries.

PubMed

Oddsdóttir, Elín Jakobína; Sveinsdóttir, Herdís

2011-05-01

Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Prospective exploratory study. The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. The development of advanced nursing practice

STS-55 German payload specialists and backups pose in front of SL-D2 at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists and backup (alternate) payload specialists pose in front of the Spacelab Deutsche 2 (SL-D2) science module at a Kennedy Space Center (KSC) processing facility. These four Germans have been assigned to support the STS-55/SL-D2 mission. Left to right are Payload Specialist 2 Hans Schlegel, backup Payload Specialist Dr. P. Gerhard Thiele (kneeling), Payload Specialist 1 Ulrich Walter, and backup Payload Specialist Renate Brummer. Walter and Schlegel are scheduled to fly aboard OV-102 for the mission while Brummer and Thiele will serve as alternates and fill supportive roles on the ground. Clearly visible on the SL-D2 module are the European Space Agency (ESA) insignia, the feedthrough plate, and the D2 insignia.

Impact of specialist care on clinical outcomes for medical emergencies.

PubMed

Moore, Stuart; Gemmell, Islay; Almond, Solomon; Buchan, Iain; Osman, Isameldin; Glover, Andrew; Williams, Peter; Carroll, Nadine; Rhodes, Jonathan

2006-01-01

General hospitals have commonly involved a wide range of medical specialists in the care of unselected medical emergency admissions. In 1999, the Royal Liverpool University Hospital, a 915-bed hospital with a busy emergency service, changed its system of care for medical emergencies to allow early placement of admitted patients under the care of the most appropriate specialist team, with interim care provided by specialist acute physicians on an acute medicine unit - a system we have termed 'specialty triage'. Here we describe a retrospective study in which all 133,509 emergency medical admissions from February 1995 to January 2003 were analysed by time-series analysis with correction for the underlying downward trend from 1995 to 2003. This showed that the implementation of specialty triage in May 1999 was associated with a subsequent additional reduction in the mortality of the under-65 age group by 0.64% (95% CI 0.11 to 1.17%; P=0.021) from the 2.4% mortality rate prior to specialty triage, equivalent to approximately 51 fewer deaths per year. No significant effect was seen for those over 65 or all age groups together when corrected for the underlying trend. Length of stay and readmission rates showed a consistent downward trend that was not significantly affected by specialty triage. The data suggest that appropriate specialist management improves outcomes for medical emergencies, particularly amongst younger patients.

Exploring the situational motivation of medical specialists: a qualitative study

PubMed Central

Kusurkar, Rashmi A.; Croiset, Gerda; Peerdeman, Saskia M.

2018-01-01

Objectives The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. Methods A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Results Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists’ motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one’s planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists’ motivation. Regarding the design of the study, we found that situational motivation is indeed observable. Conclusions The basic psychological needs autonomy, competence, and relatedness are important for specialists’ motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research. PMID:29485972

Evaluation of specialist referrals at a rural health care clinic.

PubMed

Biggerstaff, Mary Ellen; Short, Nancy

2017-07-01

Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%. The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals. The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements. ©2017 American Association of Nurse Practitioners.

Trying To Reduce Your Technostress?: Helpful Activities for Teachers and Library Media Specialists.

ERIC Educational Resources Information Center

McKenzie, Barbara K.; And Others

1997-01-01

As pressure increases to integrate technology into instruction, many teachers and library media specialists are having difficulty coping with "technostress." Presents suggestions and activities for teachers and library media specialists designed to reduce "technostress." (PEN)

The Generalist versus the Specialist: The New Oxford Dictionary Reveals a Gap.

ERIC Educational Resources Information Center

Levine, Martin Lyon

1981-01-01

There is a gap, it is suggested, separating the generally cultured person, not just from the scientist, but from specialists in many fields. Dictionary definitions are seen as one means of seeing the extent to which specialists and those in the general culture speak the same language. (MLW)

Embracing technology: patients', family members' and nurse specialists' experience of communicating using e-mail.

PubMed

Cornwall, Amanda; Moore, Sally; Plant, Hilary

2008-07-01

This paper reports on a study exploring the usefulness of e-mail as a means of communication between nurse specialists and patients with lung cancer and their families. The study involved two lung cancer nurse specialists and 16 patients and family members who used e-mail with them during the 6-month study period. Data were collected from three sources: (1) e-mail contact between the nurse specialists and patients/family members, (2) patient/family member questionnaire and (3) a focus group/reflective session with the nurse specialists. Quantitative data collected from the e-mails and the questionnaires were analysed descriptively and are presented as summary statistics. Text data from the questionnaires and e-mails were analysed using content analysis. Findings suggest that e-mail can be an effective and convenient means of communication between nurse specialists, and patients and family members. Patients and family members reported high levels of satisfaction with this method of communication. It was found to be quick and easy, and patients and family members were satisfied with both the response and the speed of response from the nurse specialists. Nurse specialists were also positive about e-mail use and found that the benefits of using e-mail with patients/family members outweighed any disadvantages. Further investigation is recommended involving other health care professionals and different patient groups to ensure the safe and appropriate use of e-mail within health care.

Facilitating the quality of care in a specialist Pacific ophthalmic nursing workforce.

PubMed

du Toit, R; Hughes, F; Mason, I; Tousignant, B

2011-03-01

Sufficient, appropriately trained health personnel need to be retained in the workforce, and their performance maintained, to achieve quality care. Mid-level ophthalmic personnel in Western Pacific Island Countries and Territories (WPICT) are no exception. The study aims to assess influences on the quality of care provided by specialist mid-level ophthalmic personnel in WPICT and devise strategies to train, retain and maintain performance of these personnel. A situational assessment employed a checklist and semi-structured interviews with specialist mid-level ophthalmic personnel, nursing bodies and Ministry of Health representatives from seven WPICT. A selective literature review guided strategies to address the issues identified. Appropriate training allows nurses to fulfill a mid-level role in WPICT as specialist ophthalmic nurses. Resources generally do not restrict practice. Nursing structures have generally failed to support professionalism: scope and conditions of service, clinical supervision, career structures, professional recognition and opportunities for continuing professional development are rudimentary. Ophthalmic nurses were dissatisfied with the lack of specialty recognition, career progression and salary increase. Regional and local strategies tailored to each country have been devised to establish sustainable processes for support. Salary was a major cause of dissatisfaction. It should be addressed along with professional recognition and related processes. Without professional support, specialist and advanced cadres within nursing may cease to exist, nurses' performance may be affected or they may leave. Specialist ophthalmic nursing, recognized, situated within and properly supported by nursing structures can provide a model for specialist clinical care for other specialties and in other countries. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

Monitoring stream temperatures—A guide for non-specialists

USGS Publications Warehouse

Heck, Michael P.; Schultz, Luke D.; Hockman-Wert, David; Dinger, Eric C.; Dunham, Jason B.

2018-04-19

Executive SummaryWater temperature influences most physical and biological processes in streams, and along with streamflows is a major driver of ecosystem processes. Collecting data to measure water temperature is therefore imperative, and relatively straightforward. Several protocols exist for collecting stream temperature data, but these are frequently directed towards specialists. This document was developed to address the need for a protocol intended for non-specialists (non-aquatic) staff. It provides specific step-by-step procedures on (1) how to launch data loggers, (2) check the factory calibration of data loggers prior to field use, (3) how to install data loggers in streams for year-round monitoring, (4) how to download and retrieve data loggers from the field, and (5) how to input project data into organizational databases.

View of Zero-G training for astronauts and payload specialists

NASA Image and Video Library

1984-08-27

S84-40538 (24 Aug 1984) --- Two 41-G payload specialists and a backup for one of them appear to be at home in zero gravity in this scene photographed aboard a KC-135 "Zero gravity" aircraft flying one of its weightlessness opportunity parabolas. Paul D. Scully-Power, a civilian oceanographer with the U.S. Navey, is flanked by Marc Garneau (left) and Robert Thirsk, both representing the National Research Council of Canada. Thirsk is back up payload specialist for Garneau.

STS-47 Japanese Payload Specialist Mohri during Homestead water training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Japanese Payload Specialist Mamoru Mohri, wearing inflated life jacket, participates in water survival training at Homestead Air Force Base, Florida. Dockside, Mohri washes the salt water from his personalized helmet (#3) after a water exercise. The three-day course was attended by the STS-47 prime and alternate payload specialists shortly after they were announced for the scheduled summer of 1992 Spacelab Japan (SLJ) mission. Mohri represents the National Space Development Agency of Japan (NASDA).

NEON non-specialist use case; science data reuse in a classroom

NASA Astrophysics Data System (ADS)

Fox, P. A.; Wee, B.; West, P.; Wilson, J.; Wang, H.; Zednik, S.

2012-12-01

We present our experience in bringing science data into the undergraduate classroom. In particular we have worked with scientists associated with the NSF-funded NEON (neoninc.org) project. We have developed a non-specialist use case aimed at undergraduate education. This exercise was developed to give the teacher/professor/facilitator the means to create a lesson plan that will allow students the opportunity to work with large, spatially diverse data sets on water quality and other ecological parameters of streams in the United States. The stream parameters investigated here are total nitrogen, total phosphorus and a macro invertebrate index for the 10 EPA regions in the contiguous US. Instructors would use this lesson as an opportunity to discuss the concept of "ecosystem health," a controversial topic in science but with intuitive resonance among the general public. However, current research data is highly specialized, lacking understandable, or all together lacking, metadata. This metadata is highly specialized, understandable by only the science specialist, or domain expert. Also, the data and metadata is difficult to locate by a non-specialist. The scientist knows where to find the data, how to collect the data, and can understand the structure of the data and what the data means. The meaning, the knowledge, the understanding is in the minds of the scientist. Thus, specific accommodation of the semantics for non-specialists is required. We include a current description of the activity and its outcomes and discuss the effectiveness of our semantic web development methodology in developing this non-specialist use case.

STS-55 MS3 Harris & Payload Specialist Schlegel conduct Anthrorack experiment

NASA Image and Video Library

1993-05-06

STS055-45-017 (26 April-6 May 1993) --- Hans Schlegel (foreground) participates in the ongoing investigation of human physiology under microgravity conditions as he works out on the ergometer at the Anthrorack. Monitoring the "run" is astronaut Bernard A. Harris, Jr., STS-55 mission specialist. Schlegel is one of two payload specialists representing the German Aerospace Research Establishment (DLR) on the Spacelab D-2 mission.

Ensemble modeling to predict habitat suitability for a large-scale disturbance specialist

Treesearch

Quresh S. Latif; Victoria A. Saab; Jonathan G. Dudley; Jeff P. Hollenbeck

2013-01-01

To conserve habitat for disturbance specialist species, ecologists must identify where individuals will likely settle in newly disturbed areas. Habitat suitability models can predict which sites at new disturbances will most likely attract specialists. Without validation data from newly disturbed areas, however, the best approach for maximizing predictive accuracy can...

Professional Insiders/Outsiders? Teacher Professionalism and the Primary School Physical Education Specialist

ERIC Educational Resources Information Center

Brooks, Caroline; DinanThompson, Maree

2013-01-01

This paper provides a context for exploring the positioning of Physical Education specialist teachers (PE specialist teachers) in primary schools in Queensland in the discourses of teacher professionalism. A critical analysis of literature on the history and status of the subject and its practitioners aims to contextualize discourses in and about…

Variation of fee-for-service specialist direct care work effort with patient overall illness burden.

PubMed

Goodman, Robert

2011-08-01

To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant (P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional

Introducing the National Library for Health Skin Conditions Specialist Library.

PubMed

Grindlay, Douglas; Boulos, Maged N Kamel; Williams, Hywel C

2005-04-26

This paper introduces the new National Library for Health Skin Conditions Specialist Library http://www.library.nhs.uk/skin. The aims, scope and audience of the new NLH Skin Conditions Specialist Library, and the composition and functions of its core Project Team, Editorial Team and Stakeholders Group are described. The Library's collection building strategy, resource and information types, editorial policies, quality checklist, taxonomy for content indexing, organisation and navigation, and user interface are all presented in detail. The paper also explores the expected impact and utility of the new Library, as well as some possible future directions for further development. The Skin Conditions Specialist Library is not just another new Web site that dermatologists might want to add to their Internet favourites then forget about it. It is intended to be a practical, "one-stop shop" dermatology information service for everyday practical use, offering high quality, up-to-date resources, and adopting robust evidence-based and knowledge management approaches.

Introducing the National Library for Health Skin Conditions Specialist Library

PubMed Central

Grindlay, Douglas; Boulos, Maged N Kamel; Williams, Hywel C

2005-01-01

Background This paper introduces the new National Library for Health Skin Conditions Specialist Library . Description The aims, scope and audience of the new NLH Skin Conditions Specialist Library, and the composition and functions of its core Project Team, Editorial Team and Stakeholders Group are described. The Library's collection building strategy, resource and information types, editorial policies, quality checklist, taxonomy for content indexing, organisation and navigation, and user interface are all presented in detail. The paper also explores the expected impact and utility of the new Library, as well as some possible future directions for further development. Conclusion The Skin Conditions Specialist Library is not just another new Web site that dermatologists might want to add to their Internet favourites then forget about it. It is intended to be a practical, "one-stop shop" dermatology information service for everyday practical use, offering high quality, up-to-date resources, and adopting robust evidence-based and knowledge management approaches. PMID:15854224

Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.

PubMed

Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey

Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

Use of buprenorphine for addiction treatment: perspectives of addiction specialists and general psychiatrists.

PubMed

Thomas, Cindy Parks; Reif, Sharon; Haq, Sayeda; Wallack, Stanley S; Hoyt, Alexander; Ritter, Grant A

2008-08-01

In 2002 buprenorphine (Suboxone or Subutex) was approved by the U.S. Food and Drug Administration for office-based treatment of opioid addiction. The goal of office-based pharmacotherapy is to bring more opiate-dependent people into treatment and to have more physicians address this problem. This study examined prescribing practices for buprenorphine, including facilitators and barriers, and the organizational settings that facilitate its being incorporated into treatment. Addiction specialists and other psychiatrists in four market areas were surveyed by mail and Internet in fall 2005 to examine prescribing practices for buprenorphine. Respondents included 271 addiction specialists (72% response rate) and 224 psychiatrists who were not listed as addiction specialists but who had patients with addictions in their practice (57% response rate). Three years after approval of buprenorphine for office-based addiction treatment, nearly 90% of addiction specialists had been approved to prescribe it and two-thirds treated patients with buprenorphine. However, fewer than 10% of non-addiction specialist psychiatrists prescribed it. Regression-adjusted factors predicting prescribing of buprenorphine included support of training and use of buprenorphine by the physician's main affiliated organization, less time in general psychiatry compared with addictions treatment, more time in group practice rather than solo, ten or more opiate-dependent patients, belief that drugs play a large role in addiction treatment, and patient demand. Office-based pharmacotherapy offers a promising path to improved access to addictions treatment, but prescribing has expanded little beyond the addiction specialist community.

Gel Fabrication of Molybdenum “Beads”

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

Lowden, Richard Andrew; Armstrong, Beth L.; Cooley, Kevin M.

2016-11-01

Spherical molybdenum particles or “beads” of various diameters are of interest as feedstock materials for the additive manufacture of targets and assemblies used in the production of 99Mo medical isotopes using accelerator technology. Small metallic beads or ball bearings are typically fabricated from wire; however, small molybdenum spheres cannot readily be produced in this manner. Sol-gel processes are often employed to produce small dense microspheres of metal oxides across a broad diameter range that in the case of molybdenum could be reduced and sintered to produce metallic spheres. These Sol-gel type processes were examined for forming molybdenum oxide beads; however,more » the molybdenum trioxide was chemically incompatible with commonly used gelation materials. As an alternative, an aqueous alginate process being assessed for the fabrication of oxide spheres for catalyst applications was employed to form molybdenum trioxide beads that were successfully reduced and sintered to produce small molybdenum spheres.« less

The specialist physician’s approach to rheumatoid arthritis in South Africa

PubMed Central

Bester, Frederik C. J.; Bosch, Fredricka J.; van Rensburg, Barend J. Jansen

2016-01-01

Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles. PMID:26932399

10.3%-efficient submicron-thick Cu(In,Ga)Se2 solar cells with absorber fabricated by sputtering In2Se3, CuGaSe2 and Cu2Se targets

NASA Astrophysics Data System (ADS)

Peng, Xiao; Zhao, Ming; Zhuang, Daming; Sun, Rujun; Zhang, Leng; Wei, Yaowei; Lv, Xunyan; Wu, Yixuan; Ren, Guoan

2018-06-01

We reported a new method to fabricate submicron-thick CIGS with smooth surface by sputtering In2Se3, CuGaSe2 and Cu2Se targets with post-selenization. The influence of gallium content on the properties of CIGS thin film was evaluated by the crystallinity and the cells performance. The most suitable value of Ga content in our submicron-thick CIGS is 0.32 and cells based on it demonstrated the highest efficiency of 10.3%.

How medical specialists appraise three controversial health innovations: scientific, clinical and social arguments.

PubMed

Lehoux, Pascale; Denis, Jean-Louis; Rock, Melanie; Hivon, Myriam; Tailliez, Stephanie

2010-01-01

Medical specialists play a pivotal role in health innovation evaluation and policy making. Their influence derives not only from their expertise, but also from their social status and the power of their professional organisations. Little is known, however, about how medical specialists determine what makes a health innovation desirable and why. Our qualitative study investigated the views of 28 medical specialists and experts from Quebec and Ontario (Canada) on three controversial innovations: electroconvulsive therapy, prostate-specific antigen screening and prenatal screening for Down's syndrome. Our findings indicate that the scientific, clinical and social arguments of medical specialists combine to create a relatively consistent narrative for each innovation. Our comparative analysis suggests that these narratives bring about a 'soft' resolution to controversies, which relies on a more or less tacit understanding of the social desirability of innovations and which sets the stage for their routinisation. Such an unpacking of medical specialists' arguments both for and against new technologies is needed because such arguments may easily be considered authoritative and because there are few forums for debating the social desirability of innovations not generally deemed to be highly controversial.

Tests and measures used by specialist physical therapists when examining patients with stroke.

PubMed

Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C

2008-09-01

Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.

Protecting an endangered species: the contribution and constraints of nurses working in a specialist role.

PubMed

McCorkell, Gillian; Brown, Geraldine; Michaelides, Bernie; Coates, Vivien

2015-03-01

The project aims to assess current specialist practice in relation to the new and ever-changing healthcare climate and explore some of the issues that specialist nurses encounter. The current financial recession is driving a range of economic policy changes and consequently service provision, in particular the work and impact of nurses working in a specialist role, being examined. This has resulted in many specialist nurses feeling very vulnerable. A cross sectional survey was completed by nurses working in specialist roles (n = 96) in a large health and social care setting in the United Kingdom. A response rate of 62% was achieved: 44% provide nurse led clinics and 42% are nurse prescribers. The mean length of time qualified as a registered nurse was 27 years. Less than a third felt that the current computer system for activity recording reflected their current workload and 65% needed administrative support. This study demonstrates the insufficient resources available to specialist nurses resulting in inappropriate but necessary, use of time and restricted opportunities for learning and development. © 2013 John Wiley & Sons Ltd.

Developing Fabrication Technologies to Provide On Demand Manufacturing for Exploration of the Moon and Mars

NASA Technical Reports Server (NTRS)

Hammond, Monica S.; Good, James E.; Gilley, Scott D.; Howard, Richard W.

2006-01-01

NASA's human exploration initiative poses great opportunity and risk for manned and robotic missions to the Moon, Mars, and beyond. Engineers and scientists at the Marshall Space Flight Center (MSFC) are developing technologies for in situ fabrication capabilities during lunar and Martian surface operations utilizing provisioned and locally refined materials. Current fabrication technologies must be advanced to support the special demands and applications of the space exploration initiative such as power, weight and volume constraints. In Situ Fabrication and Repair (ISFR) will advance state-of-the-art technologies in support of habitat structure development, tools, and mechanical part fabrication. The repair and replacement of space mission components, such as life support items or crew exercise equipment, fall within the ISFR scope. This paper will address current fabrication technologies relative to meeting ISFR targeted capabilities, near-term advancement goals, and systematic evaluation of various fabrication methods.

Dancing in a Minefield: An Analysis of Turnaround Specialists in Arizona Schools

ERIC Educational Resources Information Center

McMillie, Kyann L.

2010-01-01

In 2008, educational leaders from the Arizona Department of Education (ADE) assigned a group of turnaround specialists to work in four failing public schools in a large, urban school district in Phoenix, Arizona in hopes of improving those schools. The utilization of turnaround specialists in failing schools was Arizona's method of enacting…

Overview on the target fabrication facilities at ELI-NP and ongoing strategies

NASA Astrophysics Data System (ADS)

Gheorghiu, C. C.; Leca, V.; Popa, D.; Cernaianu, M. O.; Stutman, D.

2016-10-01

Along with the development of petawatt class laser systems, the interaction between high power lasers and matter flourished an extensive research, with high-interest applications like: laser nuclear physics, proton radiography or cancer therapy. The new ELI-NP (Extreme Light Infrastructure - Nuclear Physics) petawatt laser facility, with 10PW and ~ 1023W/cm2 beam intensity, is one of the innovative projects that will provide novel research of fundamental processes during light-matter interaction. As part of the ELI-NP facility, Targets Laboratory will provide the means for in-house manufacturing and characterization of the required targets (mainly solid ones) for the experiments, in addition to the research activity carried out in order to develop novel target designs with improved performances. A description of the Targets Laboratory with the main pieces of equipment and their specifications are presented. Moreover, in view of the latest progress in the target design, one of the proposed strategies for the forthcoming experiments at ELI-NP is also described, namely: ultra-thin patterned foil of diamond-like carbon (DLC) coated with a carbon-based ultra-low density layer. The carbon foam which behaves as a near-critical density plasma, will allow the controlled-shaping of the laser pulse before the main interaction with the solid foil. Particular emphasis will be directed towards the target's design optimization, by simulation tests and tuning the key-properties (thickness/length, spacing, density foam, depth, periodicity etc.) which are expected to have a crucial effect on the laser-matter interaction process.

STS-26 Mission Specialist (MS) Hilmers prepares meal on OV-103's middeck

NASA Image and Video Library

1988-10-03

STS026-06-033 (5 Oct 1988) --- Astronaut David C. Hilmers, STS-26 mission specialist, reads teleprinted message which has been clipped to stowage locker doors on the middeck. Food, a galley and various experiments surround the mission specialist.

Three-dimensional plotter technology for fabricating polymeric scaffolds with micro-grooved surfaces.

PubMed

Son, JoonGon; Kim, GeunHyung

2009-01-01

Various mechanical techniques have been used to fabricate biomedical scaffolds, including rapid prototyping (RP) devices that operate from CAD files of the target feature information. The three-dimensional (3-D) bio-plotter is one RP system that can produce design-based scaffolds with good mechanical properties for mimicking cartilage and bones. However, the scaffolds fabricated by RP have very smooth surfaces, which tend to discourage initial cell attachment. Initial cell attachment, migration, differentiation and proliferation are strongly dependent on the chemical and physical characteristics of the scaffold surface. In this study, we propose a new 3-D plotting method supplemented with a piezoelectric system for fabricating surface-modified scaffolds. The effects of the physically-modified surface on the mechanical and hydrophilic properties were investigated, and the results of cell culturing of chondrocytes indicate that this technique is a feasible new method for fabricating high-quality 3-D polymeric scaffolds.

Fabrication and characterization of UV-emitting nanoparticles as novel radiation sensitizers targeting hypoxic tumor cells

NASA Astrophysics Data System (ADS)

Squillante, Michael R.; Jüstel, Thomas; Anderson, R. Rox; Brecher, Charles; Chartier, Daniel; Christian, James F.; Cicchetti, Nicholas; Espinoza, Sara; McAdams, Daniel R.; Müller, Matthias; Tornifoglio, Brooke; Wang, Yimin; Purschke, Martin

2018-06-01

Radiation therapy is one of the primary therapeutic techniques for treating cancer, administered to nearly two-thirds of all cancer patients. Although largely effective in killing cancer cells, radiation therapy, like other forms of cancer treatment, has difficulty dealing with hypoxic regions within solid tumors. The incomplete killing of cancer cells can lead to recurrence and relapse. The research presented here is investigating the enhancement of the efficacy of radiation therapy by using scintillating nanoparticles that emit UV photons. UV photons, with wavelengths between 230 nm and 280 nm, are able to inactivate cells due to their direct interaction with DNA, causing a variety of forms of damage. UV-emitting nanoparticles will enhance the treatment in two ways: first by generating UV photons in the immediate vicinity of cancer cells, leading to direct and oxygen-independent DNA damage, and second by down-converting the applied higher energy X-rays into softer X-rays and particles that are more efficiently absorbed in the targeted tumor region. The end result will be nanoparticles with a higher efficacy in the treatment of hypoxic cells in the tumor, filling an important, unmet clinical need. Our preliminary experiments show an increase in cell death using scintillating LuPO4:Pr nanoparticles over that achieved by the primary radiation alone. This work describes the fabrication of the nanoparticles, their physical characterization, and the spectroscopic characterization of the UV emission. The work also presents in vitro results that demonstrate an enhanced efficacy of cell killing with x-rays and a low unspecific toxicity of the nanoparticles.

Clinical nurse specialist education: actualizing the systems leadership competency.

PubMed

Thompson, Cathy J; Nelson-Marten, Paula

2011-01-01

The purpose of this article was to show how sequenced educational strategies aid in the acquisition of systems leadership and change agent skills, as well as other essential skills for professional clinical nurse specialist (CNS) practice. Clinical nurse specialist education offers the graduate student both didactic and clinical experiences to help the student transition into the CNS role. Clinical nurse specialist faculty have a responsibility to prepare students for the realities of advanced practice. Systems leadership is an integral competency of CNS practice. The contemporary CNS is to be a leader in the translation of evidence into practice. To assist students to acquire this competency, all CNS students are expected to use research and other sources of evidence to identify, design, implement, and evaluate a specific practice change. Anecdotal comments from students completing the projects are offered. Student projects have been focused in acute and critical care, palliative care, and adult/gerontologic health clinical settings; community outreach has been the focus of a few change projects. Examples of student projects related to the systems leadership competency and correlated to the spheres of influence impacted are presented.

Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Joyce, Catherine M; Stoelwinder, Johannes

2016-06-01

Objective This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations. Methods The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusive models of rural outreach were studied. Results Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). In comparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21-0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95% CI 2.32-7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately. Conclusions Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services. What is known about this topic? There are numerous case studies describing outreach by specialist doctors. However, there is no systematic evidence describing the distribution of rural outreach services and models of outreach by specialists living in different locations and the broad-level factors that affect this. What does this paper add? The present study provides the first description of outreach service distribution and models of rural outreach by specialist doctors living in rural versus metropolitan areas. It shows

Entrustable professional activity (EPA) reshapes the practice of specialist training.

PubMed

Niemi-Murola, Leila

In addition to medical expertise, competence-based medical training comprises communication and collaboration skills, professionalism, and leadership skills. Continuous feedback is essential for learning and development, and feedback only from the medical specialist examination taken in the end of training does not ensure thorough specialist training. Entrustable professional activity (EPA) is a unit of professional practice, defined as tasks or responsibilities typical of the specialty. EPA translates competence-based training into manageable and meaningful entities and provides tools for the evaluation of medical competence.

STS-47 Payload Specialist Mohri during Homestead water survival training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Spacelab Japan (SLJ) Payload Specialist Mamoru Mohri participates in water survival training exercises at Homestead Air Force Base, Florida. Mohri ignites a flare used to find assistance during an emergency as training personnel look on. The flare familiarization was part of an overall course on water survival, attended by STS-47 prime and alternate payload specialists shortly after they were announced for the scheduled summer of 1992 SLJ mission. Mohri represents the National Space Development Agency of Japan (NASDA).

Source Dependence and Story Production: A Comparison of Religion News Coverage by Specialists and Non-specialists at Three Newspapers.

ERIC Educational Resources Information Center

Buddenbaum, Judith M.

A study was conducted to compare the news reporting of religion specialists and nonspecialists at three major metropolitan newspapers. Representing different news policies and structural constraints, 1,164 religion news items from the "New York Times," Minneapolis "Star," and the Richmond (Virginia) "Times-Dispatch"…

Loss to specialist follow-up in congenital heart disease; out of sight, out of mind

PubMed Central

Wray, Jo; Frigiola, Alessandra; Bull, Catherine

2013-01-01

Objective To evaluate the scale and clinical importance of loss to follow-up of past patients with serious congenital heart disease, using a common malformation as an example. To better understand the antecedents of loss to specialist follow-up and patients’ attitudes to returning. Design Cohort study using NHS number functionality. Content and thematic analysis of telephone interviews of subset contacted after loss to follow-up. Patients, intervention and setting Longitudinal follow-up of complete consecutive list of all 1085 UK patients with repair of tetralogy of Fallot from single institution 1964–2009. Main outcome measures Survival, freedom from late pulmonary valve replacement, loss to specialist follow-up, shortfall in late surgical revisions related to loss to follow-up. Patients’ narrative about loss to follow-up. Results 216 (24%) of patients known to be currently alive appear not to be registered with specialist clinics; some are seen in general cardiology clinics. Their median age is 32 years and median duration of loss to follow-up is 22 years; most had been lost before Adult Congenital services had been consolidated in their present form. 48% of the late deaths to date have occurred in patients not under specialist follow-up. None of those lost to specialist follow-up has had secondary pulmonary valve replacement while 188 patients under specialist care have. Patients lost to specialist follow-up who were contacted by telephone had no knowledge of its availability. Conclusions Loss to specialist follow-up, typically originating many years ago, impacts patient management. PMID:23257171

An Analysis of the Alteration Specialist Occupation.

ERIC Educational Resources Information Center

Buerkel, Elaine; Rehling, Joseph H.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the textile service occupation. The industry needs properly trained alteration specialists, bushelmen and dressmakers, in the repairing, remodeling, altering or renovating of garments. Their personal…

Readying the Health Education Specialist for Emergencies

ERIC Educational Resources Information Center

Geiger, Brian F.; Firsing, Stephen L., III; Beric, Bojana; Rodgers, Joel B.

2013-01-01

This article provides a resourceful guide for the health education specialist to improve emergency management knowledge and skills specific to their setting, including training and preparing for emergencies and providing adequate support to students, clients, and colleagues. Five steps guide competent health education practice before, during, and…

Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review.

PubMed

Cook, Olivia; McIntyre, Meredith; Recoche, Katrina; Lee, Susan

2017-08-01

The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. A three-step search strategy

38 CFR 17.142 - Authority to approve sharing agreements, contracts for scarce medical specialist services and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... sharing agreements, contracts for scarce medical specialist services and contracts for other medical... medical specialist services and contracts for other medical services. The Under Secretary for Health is... specialist services at Department of Veterans Affairs health care facilities (including, but not limited to...

Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists.

PubMed

Broaddus, Michelle R; Owczarzak, Jill; Schumann, Casey; Koester, Kimberly A

2017-10-01

To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.

Fabrication of superhydrophobic cotton fabrics using crosslinking polymerization method

NASA Astrophysics Data System (ADS)

Jiang, Bin; Chen, Zhenxing; Sun, Yongli; Yang, Huawei; Zhang, Hongjie; Dou, Haozhen; Zhang, Luhong

2018-05-01

With the aim of removing and recycling oil and organic solvent from water, a facile and low-cost crosslinking polymerization method was first applied on surface modification of cotton fabrics for water/oil separation. Micro-nano hierarchical rough structure was constructed by triethylenetetramine (TETA) and trimesoyl chloride (TMC) that formed a polymeric layer on the surface of the fabric and anchored Al2O3 nanoparticles firmly between the fabric surface and the polymer layer. Superhydrophobic property was further obtained through self-assembly grafting of hydrophobic groups on the rough surface. The as-prepared cotton fabric exhibited superoleophilicity in atmosphere and superhydrophobicity both in atmosphere and under oil with the water contact angle of 153° and 152° respectively. Water/oil separation test showed that the as-prepared cotton fabric can handle with various oil-water mixtures with a high separation efficiency over 99%. More importantly, the separation efficiency remained above 98% over 20 cycles of reusing without losing its superhydrophobicity which demonstrated excellent reusability in oil/water separation process. Moreover, the as-prepared cotton fabric possessed good contamination resistance ability and self-cleaning property. Simulation washing process test showed the superhydrophobic cotton fabric maintained high value of water contact angle above 150° after 100 times washing, indicating great stability and durability. In summary, this work provides a brand-new way to surface modification of cotton fabric and makes it a promising candidate material for oil/water separation.

Fabrication of highly textured lithium cobalt oxide films by rapid thermal annealing

DOEpatents

Bates, John B.

2003-04-29

Systems and methods are described for fabrication of highly textured lithium cobalt oxide films by rapid thermal annealing. A method of forming a lithium cobalt oxide film includes depositing a film of lithium cobalt oxide on a substrate; rapidly heating the film of lithium cobalt oxide to a target temperature; and maintaining the film of lithium cobalt oxide at the target temperature for a target annealing time of at most, approximately 60 minutes. The systems and methods provide advantages because they require less time to implement and are, therefore less costly than previous techniques.

Fabrication of highly textured lithium cobalt oxide films by rapid thermal annealing

DOEpatents

Bates, John B.

2002-01-01

Systems and methods are described for fabrication of highly textured lithium cobalt oxide films by rapid thermal annealing. A method of forming a lithium cobalt oxide film includes depositing a film of lithium cobalt oxide on a substrate; rapidly heating the film of lithium cobalt oxide to a target temperature; and maintaining the film of lithium cobalt oxide at the target temperature for a target annealing time of at most, approximately 60 minutes. The systems and methods provide advantages because they require less time to implement and are, therefore less costly than previous techniques.

Fabrication of highly textured lithium cobalt oxide films by rapid thermal annealing

DOEpatents

Bates, John B.

2003-05-13

Systems and methods are described for fabrication of highly textured lithium cobalt oxide films by rapid thermal annealing. A method of forming a lithium cobalt oxide film includes depositing a film of lithium cobalt oxide on a substrate; rapidly heating the film of lithium cobalt oxide to a target temperature; and maintaining the film of lithium cobalt oxide at the target temperature for a target annealing time of at most, approximately 60 minutes. The systems and methods provide advantages because they require less time to implement and are, therefore less costly than previous techniques.

Pain chronification: what should a non-pain medicine specialist know?

PubMed

Morlion, Bart; Coluzzi, Flaminia; Aldington, Dominic; Kocot-Kepska, Magdalena; Pergolizzi, Joseph; Mangas, Ana Cristina; Ahlbeck, Karsten; Kalso, Eija

2018-04-12

Pain is one of the most common reasons for an individual to consult their primary care physician, with most chronic pain being treated in the primary care setting. However, many primary care physicians/non-pain medicine specialists lack enough awareness, education and skills to manage pain patients appropriately, and there is currently no clear, common consensus/formal definition of "pain chronification". This article, based on an international Change Pain Chronic Advisory Board meeting which was held in Wiesbaden, Germany, in October 2016, provides primary care physicians/non-pain medicine specialists with a narrative overview of pain chronification, including underlying physiological and psychosocial processes, predictive factors for pain chronification, a brief summary of preventive strategies, and the role of primary care physicians and non-pain medicine specialists in the holistic management of pain chronification. Based on currently available evidence, we propose the following consensus-based definition of pain chronification which provides a common framework to raise awareness among non-pain medicine specialists: "Pain chronification describes the process of transient pain progressing into persistent pain; pain processing changes as a result of an imbalance between pain amplification and pain inhibition; genetic, environmental and biopsychosocial factors determine the risk, the degree, and time-course of chronification." Early intervention plays an important role in preventing pain chronification and, as key influencers in the management of patients with acute pain, it is critical that primary care physicians are equipped with the necessary awareness, education and skills to manage pain patients appropriately.

Post-Baccalaureate Laboratory Specialist Certifications and Master’s Degrees in Laboratory Medicine

PubMed Central

Johnson, Susan T.

2013-01-01

Opportunities to advance one’s knowledge and position are available within the clinical laboratory arena. By obtaining a specialist credential in chemistry, hematology or microbiology, a laboratorian has demonstrated advance knowledge and ability in their respective discipline. These specialist certifications open doors within and outside the laboratory profession and may lead to promotion. The specialist in blood banking credential is unique in that accredited training programs are available, some of which are affiliated with universities and graduate credit is granted for program completion. Other avenues available include pathologist assistants programs, diplomats in laboratory management and Master of Science degrees in clinical laboratory science. There are a number of choices available to achieve your professional goal. PMID:27683434

Modelling invasion for a habitat generalist and a specialist plant species

USGS Publications Warehouse

Evangelista, P.H.; Kumar, S.; Stohlgren, T.J.; Jarnevich, C.S.; Crall, A.W.; Norman, J. B.; Barnett, D.T.

2008-01-01

Predicting suitable habitat and the potential distribution of invasive species is a high priority for resource managers and systems ecologists. Most models are designed to identify habitat characteristics that define the ecological niche of a species with little consideration to individual species' traits. We tested five commonly used modelling methods on two invasive plant species, the habitat generalist Bromus tectorum and habitat specialist Tamarix chinensis, to compare model performances, evaluate predictability, and relate results to distribution traits associated with each species. Most of the tested models performed similarly for each species; however, the generalist species proved to be more difficult to predict than the specialist species. The highest area under the receiver-operating characteristic curve values with independent validation data sets of B. tectorum and T. chinensis was 0.503 and 0.885, respectively. Similarly, a confusion matrix for B. tectorum had the highest overall accuracy of 55%, while the overall accuracy for T. chinensis was 85%. Models for the generalist species had varying performances, poor evaluations, and inconsistent results. This may be a result of a generalist's capability to persist in a wide range of environmental conditions that are not easily defined by the data, independent variables or model design. Models for the specialist species had consistently strong performances, high evaluations, and similar results among different model applications. This is likely a consequence of the specialist's requirement for explicit environmental resources and ecological barriers that are easily defined by predictive models. Although defining new invaders as generalist or specialist species can be challenging, model performances and evaluations may provide valuable information on a species' potential invasiveness.

Didactical determinants use of information and communication technology in process of training of future specialists.

PubMed

Palamar, Borys I; Vaskivska, Halyna O; Palamar, Svitlana P

In the article the author touches upon the subject of significance of computer equipment for organization of cooperation of professor and future specialists. Such subject-subject interaction may be directed to forming of professional skills of future specialists. By using information and communication technologies in education system range of didactic tasks can be solved. Improving of process of teaching of subjects in high school, self-learning future specialists, motivating to learning and self-learning, the development of reflection in the learning process. The authors considers computer equipment as instrument for development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems on the creative basis. Based on results of researches the author comes to certain conclusions about the effectiveness of usage of computer technologies in process of teaching future specialists and their self-learning. Improper supplying of high schools with computer equipment, lack of appropriate educational programs, professors' teachers' poor knowledge and usage of computers have negative impact on organization of process of teaching disciplines in high schools. Computer equipment and ICT in general are the instruments of development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems. So, the formation of psychosocial environment of development of future specialist is multifaceted, complex and didactically important issue.

Challenging the 'view from nowhere': citizen reflections on specialist expertise in a deliberative process.

PubMed

Davies, Gail; Burgess, Jacquelin

2004-12-01

This paper presents analysis of citizen encounters with specialists in a deliberative process, called Deliberative Mapping, which explored options for addressing the shortage of organs for transplantation in the UK. There is a rich theoretical literature about the extent to which citizens are competent to question the knowledge claims of specialists in complex decision-making processes, suggesting the trustworthiness of scientific expertise will depend on the qualities of social interaction in face-to-face dialogue, but little empirical analysis of specific encounters. This paper presents evidence of how citizens located specialist expertise in making judgements about the legitimacy and credibility of specialist knowledge claims, in ways that reflect differences in epistemic procedures valued by the panels of men and women in this process.

Insideness and Outsideness: An Autoethnography of a Primary Physical Education Specialist Teacher

ERIC Educational Resources Information Center

Brooks, Caroline; Thompson, Maree Dinan

2015-01-01

The purpose of this study is to provide an authentic and legitimate voice to the physical education (PE) specialist teacher in the primary school and to give an insight into professional knowledge. An autoethnographic approach has been used to invite readers to enter my world of the primary PE specialist teacher and observe and respond to its…

Learning Mathematics for Teaching Mathematics: Non-Specialist Teachers' Mathematics Teacher Identity

ERIC Educational Resources Information Center

Crisan, Cosette; Rodd, Melissa

2017-01-01

A non-specialist teacher of mathematics is a school teacher who qualified to teach in a subject other than mathematics yet teaches mathematics to students in secondary school. There is an emerging interest internationally in this population, a brief report of which is given in the paper. Because of concerns about the quality of non-specialists'…

The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services.

PubMed

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-08-11

International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. A cross-sectional survey of hospital and community-based DNS in Ireland. Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

Specialist Physicians' Attitudes and Practice Patterns Regarding Disclosure of Pre-referral Medical Errors.

PubMed

Dossett, Lesly A; Kauffmann, Rondi M; Lee, Jay S; Singh, Harkamal; Lee, M Catherine; Morris, Arden M; Jagsi, Reshma; Quinn, Gwendolyn P; Dimick, Justin B

2018-06-01

Our objective was to determine specialist physicians' attitudes and practices regarding disclosure of pre-referral errors. Physicians are encouraged to disclose their own errors to patients. However, no clear professional norms exist regarding disclosure when physicians discover errors in diagnosis or treatment that occurred at other institutions before referral. We conducted semistructured interviews of cancer specialists from 2 National Cancer Institute-designated Cancer Centers. We purposively sampled specialists by discipline, sex, and experience-level who self-described a >50% reliance on external referrals (n = 30). Thematic analysis of verbatim interview transcripts was performed to determine physician attitudes regarding disclosure of pre-referral medical errors; whether and how physicians disclose these errors; and barriers to providing full disclosure. Participants described their experiences identifying different types of pre-referral errors including errors of diagnosis, staging and treatment resulting in adverse events ranging from decreased quality of life to premature death. The majority of specialists expressed the belief that disclosure provided no benefit to patients, and might unnecessarily add to their anxiety about their diagnoses or prognoses. Specialists had varying practices of disclosure including none, non-verbal, partial, event-dependent, and full disclosure. They identified a number of barriers to disclosure, including medicolegal implications and damage to referral relationships, the profession's reputation, and to patient-physician relationships. Specialist physicians identify pre-referral errors but struggle with whether and how to provide disclosure, even when clinical circumstances force disclosure. Education- or communication-based interventions that overcome barriers to disclosing pre-referral errors warrant development.

STS-95 Payload Specialist Glenn participates in a media briefing before returning to JSC

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, participates in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Also participating in the briefing were the other STS-95 crew members: Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

PubMed

Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

2016-05-01

This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. © 2016 Pharmacotherapy Publications, Inc.

An inexpensive and fast method for infiltration coating of complex geometry matrices for ISOL production target applications

NASA Astrophysics Data System (ADS)

Kawai, Y.; Alton, G. D.; Bilheux, J.-C.

2005-12-01

An inexpensive, fast, and close to universal infiltration coating technique has been developed for fabricating fast diffusion-release ISOL targets. Targets are fabricated by deposition of finely divided (∼1 μm) compound materials in a paint-slurry onto highly permeable, complex structure reticulated-vitreous-carbon-foam (RVCF) matrices, followed by thermal heat treatment. In this article, we describe the coating method and present information on the physical integrity, uniformity of deposition, and matrix adherence of SiC, HfC and UC2 targets, destined for on-line use as targets at the Holifield Radioactive Ion Beam Facility (HRIBF).

22 CFR 501.8 - Reappointment of Foreign Service Officers and Career Overseas Specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Career Overseas Specialists. 501.8 Section 501.8 Foreign Relations BROADCASTING BOARD OF GOVERNORS APPOINTMENT OF FOREIGN SERVICE OFFICERS § 501.8 Reappointment of Foreign Service Officers and Career Overseas... Governors) may reappoint to the Service a former career Overseas Specialist. (a) Requirements for...

STS-87 Mission Specialist Doi and his wife pose at LC 39B

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan poses with his wife, Hitomi Doi, in front of Kennedy Space Center's Launch Pad 39B during final prelaunch activities leading up to the scheduled Nov. 19 liftoff. The other STS-87 crew members are Commander Kevin Kregel; Pilot Steven Lindsey; Mission Specialists Kalpana Chawla, Ph.D., and Winston Scott; and Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine. STS-87 will be the fourth flight of the United States Microgravity Payload and the Spartan- 201 deployable satellite.

Can plant resistance to specialist herbivores be explained by plant chemistry or resource use strategy?

PubMed

Kirk, Heather; Vrieling, Klaas; Pelser, Pieter B; Schaffner, Urs

2012-04-01

At both a macro- and micro-evolutionary level, selection of and performance on host plants by specialist herbivores are thought to be governed partially by host plant chemistry. Thus far, there is little evidence to suggest that specialists can detect small structural differences in secondary metabolites of their hosts, or that such differences affect host choice or performance of specialists. We tested whether phytochemical differences between closely related plant species are correlated with specialist host choice. We conducted no-choice feeding trials using 17 plant species of three genera of tribe Senecioneae (Jacobaea, Packera, and Senecio; Asteraceae) and a more distantly related species (Cynoglossum officinale; Boraginaceae) containing pyrrolizidine alkaloids (PAs), and four PA-sequestering specialist herbivores of the genus Longitarsus (Chrysomelidae). We also assessed whether variation in feeding by specialist herbivores is attributable to different resource use strategies of the tested plant species. Plant resource use strategy was quantified by measuring leaf dry matter content, which is related to both plant nutritive value and to plant investment in quantitative defences. We found no evidence that intra-generic differences in PA profiles affect feeding by specialist herbivores. Instead, our results indicate that decisions to begin feeding are related to plant resource use strategy, while decisions to continue feeding are not based on any plant characteristics measured in this study. These findings imply that PA composition does not significantly affect host choice by these specialist herbivores. Leaf dry matter content is somewhat phylogenetically conserved, indicating that plants may have difficulty altering resource use strategy in response to selection pressure by herbivores and other environmental factors on an evolutionary time scale.

Provision and practice of specialist preterm labour clinics: a UK survey of practice.

PubMed

Sharp, A N; Alfirevic, Z

2014-03-01

To identify the current status of specialist preterm labour (PTL) clinic provision and management within the UK. Postal survey of clinical practice. All consultant-led obstetric units within the UK. A questionnaire was sent by post to all 210 NHS consultant-led obstetric units within the UK. Units that had a specialist PTL clinic were asked to complete a further 20 questions defining their protocol for risk stratification and management. Current practice in specialist preterm labour clinics. We have identified 23 specialist clinics; the most common indications for attendance were previous PTL (100%), preterm prelabour rupture of membranes (95%), two large loop excisions of the transformation zone (95%) or cone biopsy (95%). There was significant heterogeneity in the indications for and method of primary treatment for short cervix, with cervical cerclage used in 45% of units, progesterone in 18% of units and Arabin cervical pessary in 5%. A further 23% used multiple treatment modalities in combination. A significant heterogeneity in all topics surveyed suggests an urgent need for networking, more evidence-based guidelines and prospective comparative audits to ascertain the real impact of specialist PTL clinics on the reduction in preterm birth and its sequelae. © 2013 Royal College of Obstetricians and Gynaecologists.

The Multi-Faceted Role of Ohio's Elementary Reading Specialists: Instruction, Assessment, Leadership and beyond

ERIC Educational Resources Information Center

Lipp, Jamie R.

2017-01-01

Over the past 65 years, the roles of the reading specialist have continually evolved. Historically, reading specialists have been hired by schools to work predominantly with struggling readers (Bean, Cassidy, Grumet, Shelton & Wallis, 2002; Bean, Swan & Knaub, 2003). Reading specialists today serve in a variety of roles within their…

Control of the interaction strength of photonic molecules by nanometer precise 3D fabrication.

PubMed

Rawlings, Colin D; Zientek, Michal; Spieser, Martin; Urbonas, Darius; Stöferle, Thilo; Mahrt, Rainer F; Lisunova, Yuliya; Brugger, Juergen; Duerig, Urs; Knoll, Armin W

2017-11-28

Applications for high resolution 3D profiles, so-called grayscale lithography, exist in diverse fields such as optics, nanofluidics and tribology. All of them require the fabrication of patterns with reliable absolute patterning depth independent of the substrate location and target materials. Here we present a complete patterning and pattern-transfer solution based on thermal scanning probe lithography (t-SPL) and dry etching. We demonstrate the fabrication of 3D profiles in silicon and silicon oxide with nanometer scale accuracy of absolute depth levels. An accuracy of less than 1nm standard deviation in t-SPL is achieved by providing an accurate physical model of the writing process to a model-based implementation of a closed-loop lithography process. For transfering the pattern to a target substrate we optimized the etch process and demonstrate linear amplification of grayscale patterns into silicon and silicon oxide with amplification ratios of ∼6 and ∼1, respectively. The performance of the entire process is demonstrated by manufacturing photonic molecules of desired interaction strength. Excellent agreement of fabricated and simulated structures has been achieved.

Clinical nurse specialist prescriber characteristics and challenges in Oregon.

PubMed

Klein, Tracy

2015-01-01

The purpose of this study was to assess role characteristics of clinical nurse specialists (CNSs) with prescriptive authority in Oregon 10 years after passage of Senate Bill 460. Factors examined included role preparation and mentorship, use and maintenance of authority, prescribing benefits and barriers, and types of drugs/nondrugs prescribed. This study was a descriptive survey using both quantitative and qualitative analysis. The sample was obtained from a list provided on June 13, 2014, by the Oregon State Board of Nursing of all CNSs in Oregon who had ever been granted prescriptive authority (n = 40). Twenty-nine with active authority, 7 with expired authority, and 4 with inactive status were sampled. E-mail distribution with Qualtrics software was released on June 27, 2014. Reminder e-mails were sent at 1 and 2 weeks. Of the 38 e-mails successfully delivered, 23 responses were received for a total response rate of 60%. Clinical nurse specialists successfully maintained their authority in Oregon and felt well prepared for their role. Their prescribing mentorship included nurse and nonnurse prescribers. They were most likely to have ever prescribed psychiatric, noncontrolled analgesics and durable medical equipment. They most frequently prescribed nutrition/electrolytes/fluids, durable medical equipment, and controlled analgesics. Lapse in authority was attributed to constraints regarding certification or credentialing in the role. Clinical nurse specialists uniformly expressed benefits from prescriptive authority. There were no differences in perceptions of preparation based on type of mentorship or educational modality for completion of prescribing requirements. There were systems barriers including lack of employer and colleague support to use of authority. Durable medical equipment authority is important to the CNS role. Clinical nurse specialists valued and maintained their prescriptive authority despite barriers. Further research is recommended to support

Blur and the School Library Media Specialist.

ERIC Educational Resources Information Center

Barron, Daniel D.

1999-01-01

Discusses the concept of "Blur" (described in "Blur: The Speed of Change in the Connected Economy") and what the technology-based, expanded connectivity means for K-12 educators and information specialists. Reviews online and print resources that deal with the rapid development of technology and its effects on society. (AEF)

Environmental Support Specialist. J3ABR56631

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

This document package contains an Air Force course used to train environmental support specialists. The course is organized in four blocks of instruction covering 320 hours (or eight weeks), and is designed for group instruction. The four blocks cover the following topics: environmental fundamentals and support equipment, water and wastewater…

Professional Training of Marketing Specialists: Foreign Experience

ERIC Educational Resources Information Center

Zakharchenko, Yuliia

2017-01-01

Due to content-based analysis of marketing specialists' professional training and approaches to development of their educational trajectory, it has been revealed that curricula and their content are given much attention by employers whose demands are focused on meeting current labour market conditions. It has been justified that despite the…

US Influence on the Education System in Turkey: An Analysis of Reports by American Education Specialists

ERIC Educational Resources Information Center

Keskin, Yusuf

2014-01-01

This study aimed to analyse reports prepared by American education specialists visiting Turkey from the Proclamation of the Republic till the end of the 1950's to inspect Turkey's education system. In accordance with this purpose, first, the foreign specialists' reports are briefly introduced chronologically and then American specialist reports…

Initiation of a voluntary certification program for health education specialists.

PubMed Central

Wolle, J M; Cleary, H P; Stone, E J

1989-01-01

As health education has become a major strategy for addressing current health problems, the need for expertise in health education has increased. Today health education specialists work not only in health agencies and educational institutions but also in hospitals and other health and medical facilities, in businesses and industries, and in consulting firms. To promote quality assurance in the delivery of health education services to the public, the profession has launched a voluntary credentialing system for health education specialists. Seven areas of responsibilities and the competencies that they require have been delineated as generic to the practice of entry level health education specialists, regardless of the setting (for example, school, health agency, work site) where they work. The purposes and rationale for new National Commission for Health Education Credentialing, Inc., are described as well as the benefits of certification for the profession. The events and accomplishments of the past decade that have provided the foundation for the newly established credentialing program for the health education profession are chronicled. PMID:2502814

Are cost differences between specialist and general hospitals compensated by the prospective payment system?

PubMed

Longo, Francesco; Siciliani, Luigi; Street, Andrew

2017-10-23

Prospective payment systems fund hospitals based on a fixed-price regime that does not directly distinguish between specialist and general hospitals. We investigate whether current prospective payments in England compensate for differences in costs between specialist orthopaedic hospitals and trauma and orthopaedics departments in general hospitals. We employ reference cost data for a sample of hospitals providing services in the trauma and orthopaedics specialty. Our regression results suggest that specialist orthopaedic hospitals have on average 13% lower profit margins. Under the assumption of break-even for the average trauma and orthopaedics department, two of the three specialist orthopaedic hospitals appear to make a loss on their activity. The same holds true for 33% of departments in our sample. Patient age and severity are the main drivers of such differences.

Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists.

PubMed

Chiarchiaro, Jared; White, Douglas B; Ernecoff, Natalie C; Buddadhumaruk, Praewpannarai; Schuster, Rachel A; Arnold, Robert M

2016-05-01

Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audiorecorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship building. We used negative binomial modeling to determine whether there were differences between palliative care specialists' and intensivists' use of task-focused communication and relationship building. Single academic medical center ICU. Palliative care specialists and intensivists. None. We enrolled 11 palliative care specialists and 25 intensivists. The palliative care specialists were all attending physicians. The intensivist group consisted of 11 attending physicians, 9 pulmonary and critical care fellows, and 5 internal medicine residents rotating in the ICU. We excluded five residents from the primary analysis in order to reduce confounding due to training level. Physicians' mean age was 37 years with a mean of 8 years in practice. Palliative care specialists used 55% fewer task-focused communication statements (incidence rate ratio, 0.55; 95% CI, 0.36-0.83; p = 0.005) and 48% more relationship-building statements (incidence rate ratio, 1.48; 95% CI, 0.89-2.46; p = 0.13) compared with intensivists. We found that palliative care

HMO growth and the geographical redistribution of generalist and specialist physicians, 1987-1997.

PubMed Central

Escarce, J J; Polsky, D; Wozniak, G D; Kletke, P R

2000-01-01

OBJECTIVE: To assess the impact of the growth in HMO penetration in different metropolitan areas on the change in the number of generalists, specialists, and total physicians, and on the change in the proportion of physicians who are generalists. DATA SOURCES/STUDY SETTING: The American Medical Association Physician Masterfile, to obtain the number of patient care generalists and specialists in 1987 and in 1997 who were practicing in each of 316 metropolitan areas in the United States. Additional data for each metropolitan area were obtained from a variety of sources, and included HMO penetration in 1986 and 1996. STUDY DESIGN: We estimated multivariate regression models in which the change in the number of physicians between 1987 and 1997 was a function of HMO penetration in 1986, the change in HMO penetration between 1986 and 1996, population characteristics and physician fees in 1986, and the change in population characteristics and fees between 1986 and 1996. Each model was estimated using ordinary least squares (OLS) and two-stage least squares (TSLS). PRINCIPAL FINDINGS: HMO penetration did not affect the number of generalist physicians or hospital-based specialists, but faster HMO growth led to smaller increases in the numbers of medical/surgical specialists and total physicians. Faster HMO growth also led to larger increases in the proportion of physicians who were generalists. Our best estimate is that an increase in HMO penetration of .10 between 1986 and 1996 reduced the rate of increase in medical/surgical specialists by 10.3 percent and reduced the rate of increase in total physicians by 7.2 percent. CONCLUSIONS: The findings of this study support the notion that HMOs reduce the demand for physician services, particularly for specialists' services. The findings also imply that, during the past decade, there has been a redistribution of physicians-especially medical/surgical specialists-from metropolitan areas with high HMO penetration to low

Factors supporting good partnership working between generalist and specialist palliative care services: a systematic review.

PubMed

Gardiner, Clare; Gott, Merryn; Ingleton, Christine

2012-05-01

The care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, district nurses and others who have not undertaken specialist training in palliative care. A key focus of recent UK policy is improving partnership working across the spectrum of palliative care provision. However there is little evidence to suggest factors which support collaborative working between specialist and generalist palliative care providers. To explore factors that support partnership working between specialist and generalist palliative care providers. Systematic review. A systematic review of studies relating to partnership working between specialist and generalist palliative care providers was undertaken. Six electronic databases were searched for papers published up until January 2011. Of the 159 articles initially identified, 22 papers met the criteria for inclusion. Factors supporting good partnership working included: good communication between providers; clear definition of roles and responsibilities; opportunities for shared learning and education; appropriate and timely access to specialist palliative care services; and coordinated care. Multiple examples exist of good partnership working between specialist and generalist providers; however, there is little consistency regarding how models of collaborative working are developed, and which models are most effective. Little is known about the direct impact of collaborative working on patient outcomes. Further research is required to gain the direct perspectives of health professionals and patients regarding collaborative working in palliative care, and to develop appropriate and cost-effective models for partnership working.

Improving specialist drug prescribing in primary care using task and error analysis: an observational study.

PubMed

Chana, Narinder; Porat, Talya; Whittlesea, Cate; Delaney, Brendan

2017-03-01

Electronic prescribing has benefited from computerised clinical decision support systems (CDSSs); however, no published studies have evaluated the potential for a CDSS to support GPs in prescribing specialist drugs. To identify potential weaknesses and errors in the existing process of prescribing specialist drugs that could be addressed in the development of a CDSS. Semi-structured interviews with key informants followed by an observational study involving GPs in the UK. Twelve key informants were interviewed to investigate the use of CDSSs in the UK. Nine GPs were observed while performing case scenarios depicting requests from hospitals or patients to prescribe a specialist drug. Activity diagrams, hierarchical task analysis, and systematic human error reduction and prediction approach analyses were performed. The current process of prescribing specialist drugs by GPs is prone to error. Errors of omission due to lack of information were the most common errors, which could potentially result in a GP prescribing a specialist drug that should only be prescribed in hospitals, or prescribing a specialist drug without reference to a shared care protocol. Half of all possible errors in the prescribing process had a high probability of occurrence. A CDSS supporting GPs during the process of prescribing specialist drugs is needed. This could, first, support the decision making of whether or not to undertake prescribing, and, second, provide drug-specific parameters linked to shared care protocols, which could reduce the errors identified and increase patient safety. © British Journal of General Practice 2017.

78 FR 14359 - Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

... Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Tampa, Florida; Amended Certification Regarding... Business Networks Services, Inc., Order Management Division, Philadelphia, Pennsylvania and Verizon...

Material engineering to fabricate rare earth erbium thin films for exploring nuclear energy sources

NASA Astrophysics Data System (ADS)

Banerjee, A.; Abhilash, S. R.; Umapathy, G. R.; Kabiraj, D.; Ojha, S.; Mandal, S.

2018-04-01

High vacuum evaporation and cold-rolling techniques to fabricate thin films of the rare earth lanthanide-erbium have been discussed in this communication. Cold rolling has been used for the first time to successfully fabricate films of enriched and highly expensive erbium metal with areal density in the range of 0.5-1.0 mg/cm2. The fabricated films were used as target materials in an advanced nuclear physics experiment. The experiment was designed to investigate isomeric states in the heavy nuclei mass region for exploring physics related to nuclear energy sources. The films fabricated using different techniques varied in thickness as well as purity. Methods to fabricate films with thickness of the order of 0.9 mg/cm2 were different than those of 0.4 mg/cm2 areal density. All the thin films were characterized using multiple advanced techniques to accurately ascertain levels of contamination as well as to determine their exact surface density. Detailed fabrication methods as well as characterization techniques have been discussed.

Equity in specialist waiting times by socioeconomic groups: evidence from Spain.

PubMed

Abásolo, Ignacio; Negrín-Hernández, Miguel A; Pinilla, Jaime

2014-04-01

In countries with publicly financed health care systems, waiting time--rather than price--is the rationing mechanism for access to health care services. The normative statement underlying such a rationing device is that patients should wait according to need and irrespective of socioeconomic status or other non-need characteristics. The aim of this paper is to test empirically that waiting times for publicly funded specialist care do not depend on patients' socioeconomic status. Waiting times for specialist care can vary according to the type of medical specialty, type of consultation (review or diagnosis) and the region where patients' reside. In order to take into account such variability, we use Bayesian random parameter models to explain waiting times for specialist care in terms of need and non-need variables. We find that individuals with lower education and income levels wait significantly more time than their counterparts.

Developing a Vision: Strategic Planning and the Library Media Specialist. Greenwood Professional Guides in School Librarianship.

ERIC Educational Resources Information Center

Crowley, John D.

Although the role of the school library media specialist is frequently undervalued, the media specialist can become a leader in restructuring a school through strategic planning methods. The book shows library media specialists how to help direct the planning team that is developing the vision of the school's future. The overall strategic planning…

Scholarly Productivity of School Psychology Faculty Members in Specialist-Level Programs: 2002-2011

ERIC Educational Resources Information Center

Laurent, Jeff; Runia, Elizabeth

2016-01-01

The scholarly productivity of school psychology faculty members in specialist-level only programs was examined. Information was gathered from the School Psychology Program Information portion of the website for the National Association of School Psychologists. A total of 137 specialist-level only school psychology programs were identified.…

Referral interventions from primary to specialist care: a systematic review of international evidence

PubMed Central

Blank, Lindsay; Baxter, Susan; Woods, Helen Buckley; Goyder, Elizabeth; Lee, Andrew; Payne, Nick; Rimmer, Melanie

2014-01-01

Background Demand management defines any method used to monitor, direct, or regulate patient referrals. Strategies have been developed to manage the referral of patients to secondary care, with interventions that target primary care, specialist services, or infrastructure. Aim To review the international evidence on interventions to manage referral from primary to specialist care. Design and setting Systematic review. Method Iterative, systematic searches of published and unpublished sources public health, health management, management, and grey literature databases from health care and other industries were undertaken to identify recent, relevant studies. A narrative synthesis of the data was completed to structure the evidence into groups of similar interventions. Results The searches generated 8327 unique results, of which 140 studies were included. Interventions were grouped into four intervention categories: GP education (n = 50); process change (n = 49); system change (n = 38); and patient-focused (n = 3). It is clear that there is no ‘magic bullet’ to managing demand for secondary care services: although some groups of interventions may have greater potential for development, given the existing evidence that they can be effective in specific contexts. Conclusions To tackle demand management of primary care services, the focus cannot be on primary care alone; a whole-systems approach is needed because the introduction of interventions in primary care is often just the starting point of the referral process. In addition, more research is needed to develop and evaluate interventions that acknowledge the role of the patient in the referral decision. PMID:25452541

Fabrication of Gold Nanoparticles for targeted therapy in pancreatic cancer**

PubMed Central

Patra, Chitta Ranjan; Bhattacharya, Resham; Mukhopadhyay, Debabrata; Mukherjee, Priyabrata

2009-01-01

The targeted delivery of a drug should result in enhanced therapeutic efficacy with low to minimal side effects. This is a widely accepted concept, but limited in application due to lack of available technologies and process of validation. Biomedical nanotechnology can play an important role in this respect. Biomedical nanotechnology is a burgeoning field with myriads of opportunities and possibilities for advancing medical science and disease treatment. Cancer nanotechnology (1–100 nm size range) is expected to change the very foundations of cancer treatment, diagnosis and detection. Nanomaterials, especially gold nanoparticles (AuNPs) have unique physicochemical properties, such as ultra small size, large surface area to mass ratio, and high surface reactivity, presence of surface plasmon resonance (SPR) bands, biocompatibility and ease of surface functionalization. In this review, we will discuss how the unique physico-chemical properties of gold nanoparticles may be utilized for targeted drug delivery in pancreatic cancer leading to increased efficacy of traditional chemotherapeutics. PMID:19914317

STS-95 Payload Specialist Glenn and his wife pose before their return flight to JSC

NASA Technical Reports Server (NTRS)

1998-01-01

At the Skid Strip at Cape Canaveral Air Station, STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, poses with his wife Annie before their return flight to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew also includes Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

Host plant invests in growth rather than chemical defense when attacked by a specialist herbivore.

PubMed

Arab, Alberto; Trigo, José Roberto

2011-05-01

Plant defensive compounds may be a cost rather than a benefit when plants are attacked by specialist insects that may overcome chemical barriers by strategies such as sequestering plant compounds. Plants may respond to specialist herbivores by compensatory growth rather than chemical defense. To explore the use of defensive chemistry vs. compensatory growth we studied Brugmansia suaveolens (Solanaceae) and the specialist larvae of the ithomiine butterfly Placidina euryanassa, which sequester defensive tropane alkaloids (TAs) from this host plant. We investigated whether the concentration of TAs in B. suaveolens was changed by P. euryanassa damage, and whether plants invest in growth, when damaged by the specialist. Larvae feeding during 24 hr significantly decreased TAs in damaged plants, but they returned to control levels after 15 days without damage. Damaged and undamaged plants did not differ significantly in leaf area after 15 days, indicating compensatory growth. Our results suggest that B. suaveolens responds to herbivory by the specialist P. euryanassa by investing in growth rather than chemical defense.

Comparison of the capture efficiency, prey processing, and nutrient extraction in a generalist and a specialist spider predator.

PubMed

García, Luis Fernando; Viera, Carmen; Pekár, Stano

2018-04-02

Predators are traditionally classified as generalists and specialists based on the presence of adaptations that increase efficiency of prey capture and consumption and selection of particular prey types. Nevertheless, empirical evidence comparing foraging efficiency between generalist and specialist carnivores is scarce. We compared the prey-capture and feeding efficiency in a generalist and a specialist (araneophagous) spider predator. By using two related species, the generalist Harpactea rubicunda (Dysderidae) and the specialist Nops cf. variabilis (Caponiidae), we evaluated their fundamental trophic niche by studying the acceptance of different prey. Then, we compared their predatory behavior, efficiency in capturing prey of varying sizes, feeding efficiency, and nutrient extraction. Nops accepted only spiders as prey, while Harpactea accepted all offered prey, confirming that Nops is stenophagous, while Harpactea is euryphagous. Further, Nops displayed more specialized (stereotyped) capture behavior than Harpactea, suggesting that Nops is a specialist, while Harpactea is a generalist. The specialist immobilized prey faster, overcame much larger prey, and gained more mass (due to feeding on larger prey) than the generalist. Both the specialist and the generalist spider extracted more proteins than lipids, but the extraction of macronutrients in the specialist was achieved mainly by consuming the prosoma of the focal prey. We show that the specialist has more efficient foraging strategy than the generalist.

Clinical Nurse Specialist Roles in Conducting Research: Changes Over 3 Years.

PubMed

Albert, Nancy M; Rice, Karen L; Waldo, Mary J; Bena, James F; Mayo, Ann M; Morrison, Shannon L; Westlake, Cheryl; Ellstrom, Kathleen; Powers, Jan; Foster, Jan

2016-01-01

The aim of this study is to describe clinical nurse specialists' characteristics, interest, confidence, motivators, and barriers in conducting research. This study was a descriptive, multicohort design. Clinical nurse specialists were recruited electronically through national and local organizations to complete anonymous surveys 3 times, over 3 years. Comparative analyses included χ and Kruskal-Wallis tests. Of 2052 responders (initial, n = 629; 18 months, n = 465; and 3 years, n = 958), mean (SD) participant age was 50.3 (9.3) years. Overall, 41.7% of participants were involved as principal or coinvestigators in research. Interest in conducting nursing research (on a 0-100 scale) was 61.1 (38.4) and was lowest among the 18-month time point participant group (score, 39.1 [32.2]) and highest at the 3-year time point (68.3, [30.7]; P < .001). Confidence in conducting research, discussion of statistics, and perceptions of motivators and barriers to conducting research did not differ across time period groups. Access to literature and mentors and research knowledge were the most prevalent barriers to conducting research. Less than 42% of clinical nurse specialists conducted research and the rate did not change between different time groups. Access and knowledge barriers to conducting research were prominent. Workplace leaders need to consider resources and support of academic educational opportunities to increase research conduct by clinical nurse specialists.

Facilities for investigating occupational asthma in UK non-specialist respiratory departments.

PubMed

Barber, Christopher M; Naylor, Steven; Bradshaw, Lisa; Francis, Mandy; Harris-Roberts, Joanne; Rawbone, Roger; Curran, Andrew; Fishwick, David

2008-01-01

The facilities which should be available to physicians offering specialist occupational asthma services have recently been agreed upon by a UK panel of experts. This study aimed to investigate whether these facilities are available in UK non-specialist secondary care respiratory departments and to document tertiary care referral patterns. A random sample of 100 UK respiratory units was selected, and the lead consultant invited to participate. Face-to-face interviews were conducted to document information on departmental facilities available for investigating cases of occupational asthma and utilization of tertiary referral centres. In total, 66% of consultants interviewed had seen a case of occupational asthma in the previous month, and 76% reported having ever referred a patient with suspected occupational asthma to a specialist centre for further investigation (referral distance range 1-111 miles). All the departments were able to perform the investigations previously deemed an absolute necessity in all patients. The availability of in-house facilities that were deemed as must be available varied between 3-100%. The results of this study demonstrate that while the majority of basic facilities are widely available, many respiratory departments do not have direct access to investigations routinely required to investigate occupational asthma. Access to specialist occupational respiratory centres varies within the UK, and in some parts of the country involves long travelling distances for patients.

Paediatric conscious sedation: views and experience of specialists in paediatric dentistry.

PubMed

Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L

2009-09-26

The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.

Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

PubMed

Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

2017-07-01

Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

Elementary School Math Instruction: Can Reading Specialists Assist?

ERIC Educational Resources Information Center

Heinrichs, Audrey S.

1987-01-01

Discusses the contradictions found in recommendations for direction instruction or informal math language development, and some suggestions for practical resolution of disagreements, to enable school reading specialists to provide both background and practical help to classroom instructors teaching math. (HTH)

Commentary: Sense and sensibility: the role of specialists in health care reform.

PubMed

Schwann, Nanette M; Nester, Brian A; McLoughlin, Thomas M

2012-03-01

How to redesign the incentives structure in the United States to reward effective coordinated care rather than production volume is a staggering public health policy challenge. In the mind of the public, there is a fine distinction between health care rationing and rational health care. Specialists have a vital but underappreciated role in reining in health care costs, but specific incentives to elicit behavior change with positive social outcomes remain ambiguous. It is imperative, therefore, that redesigning the incentives structure is thoughtfully considered, modeled, and tested prior to implementation, lest an inferior-quality model is inadvertently adopted and costs are only marginally contained. Quality metrics need to be universal and reflect real patient outcomes instead of the degree of investment by the institution in the reporting tools. Still, specialists should take immediate action to implement safe and efficient procedures and to assess their long-term impact on patients' quality of life. Scientific evaluations should guide both the assessment of the appropriateness and the safe delivery of care. Investment in high-quality data architecture and the science of health delivery implementation is an imperative if health care reform is to achieve its goals. Coordination and collaboration between specialists and primary care physicians is essential to this enterprise. Specialists can champion these efforts as they pertain to their areas of expertise by considering their care episodes in the context of the patient as a whole, working closely with generalists, and returning to the mindset of the specialist as a family doctor.

The Top Ten Reasons a Library Media Specialist Is a Teacher's Best Friend

ERIC Educational Resources Information Center

Hylen, Jan

2004-01-01

Many teachers think too little about the role of the library media specialist in their professional lives, and because of this oversight they underutilize this great resource. This article explains the top ten reasons why teachers should work with their library media specialists: (1) Improving test scores and enhancing student academic…

A decade in diabetes specialist services, 2000 to 2011, in England: the views of consultant diabetologists and diabetes specialist nurses amidst persistent healthcare delivery change.

PubMed

Gosden, C A; Barnard, K; Williams, D R R; Tinati, T; Turner, B; Holt, R I G

2015-12-01

To assess the impact of continual major National Health Service reorganization on commissioning, organizational and delivery arrangements for secondary care diabetes services. To explore how consultant diabetologists and diabetes specialist nurses perceive the issues facing diabetes specialist services in 2011 and how these have changed in the preceding decade. We used a longitudinal case study approach that combined quantitative and qualitative methods. Five locations in England were purposively selected to represent the wider diabetes specialist community, and seven semi-structured interviews were conducted. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Findings were compared with and contrasted to results from national quantitative surveys of diabetes specialist services undertaken in 2000 and 2006. Clinicians viewed positively the expertise and commitment of multidisciplinary teams and their ability to adapt to new situations. Negative perceptions persisted throughout the decade, relating to the continual change that threatens to dismantle relationships and services which had taken many years to establish. Lack of resources, inadequate manpower planning and poor access to psychological support for people with diabetes remained constant themes from 2000 to 2011. A willingness to innovate and work differently to improve services was identified; however, clinicians must be supported through organizational changes to ensure people with diabetes receive high-quality care. The disruptive nature of organizational change was a recurrent theme throughout the decade. Periods of stability must exist within commissioning to allow relationships, which are key to integration, to be maintained and permit service improvements to develop. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Preparation, Endorsement, and Employment of Mathematics Specialists

ERIC Educational Resources Information Center

Cicmanec, Karen B. Mauck

2008-01-01

For over 30 years, educators have recommended that mathematics specialists be placed in schools to provide teachers with the resources they need to assist their students. To assess whether these recommendations have been realized, a survey was used to gather data from large school districts, the 50 states, and District of Columbia. The outcome of…

STS-47 Payload Specialist Mohri parasails during Homestead AFB water training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Payload Specialist Mamoru Mohri parasails during a special survival training course hosted by Homestead Air Force Base (AFB) in Florida. Mohri simulates a paraglide into water. The exercise was part of an overall course on water survival, attended by the STS-47 prime and alternate (backup) payload specialists shortly after they were announced for the scheduled summer of 1992 Spacelab Japan (SLJ) mission. Mohri represents the National Space Development Agency of Japan (NASDA).

Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study.

PubMed

Aldridge, Cassie; Bion, Julian; Boyal, Amunpreet; Chen, Yen-Fu; Clancy, Mike; Evans, Tim; Girling, Alan; Lord, Joanne; Mannion, Russell; Rees, Peter; Roseveare, Chris; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Temple, Mark; Watson, Sam; Lilford, Richard

2016-07-09

Increased mortality rates associated with weekend hospital admission (the so-called weekend effect) have been attributed to suboptimum staffing levels of specialist consultants. However, evidence for a causal association is elusive, and the magnitude of the weekend specialist deficit remains unquantified. This uncertainty could hamper efforts by national health systems to introduce 7 day health services. We aimed to examine preliminary associations between specialist intensity and weekend admission mortality across the English National Health Service. Eligible hospital trusts were those in England receiving unselected emergency admissions. On Sunday June 15 and Wednesday June 18, 2014, we undertook a point prevalence survey of hospital specialists (consultants) to obtain data relating to the care of patients admitted as emergencies. We defined specialist intensity at each trust as the self-reported estimated number of specialist hours per ten emergency admissions between 0800 h and 2000 h on Sunday and Wednesday. With use of data for all adult emergency admissions for financial year 2013-14, we compared weekend to weekday admission risk of mortality with the Sunday to Wednesday specialist intensity ratio within each trust. We stratified trusts by size quintile. 127 of 141 eligible acute hospital trusts agreed to participate; 115 (91%) trusts contributed data to the point prevalence survey. Of 34,350 clinicians surveyed, 15,537 (45%) responded. Substantially fewer specialists were present providing care to emergency admissions on Sunday (1667 [11%]) than on Wednesday (6105 [42%]). Specialists present on Sunday spent 40% more time caring for emergency patients than did those present on Wednesday (mean 5·74 h [SD 3·39] vs 3·97 h [3·31]); however, the median specialist intensity on Sunday was only 48% (IQR 40-58) of that on Wednesday. The Sunday to Wednesday intensity ratio was less than 0·7 in 104 (90%) of the contributing trusts. Mortality risk among patients

Use of a screening tool and primary health care gerontology nurse specialist for high-needs older people.

PubMed

King, Anna; Boyd, Michal; Dagley, Lynelle

2017-02-01

To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.