Sample records for technical procedures management

  1. Becoming an expert carer: the process of family carers learning to manage technical health procedures at home.

    PubMed

    McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William

    2016-09-01

    To describe the learning process of family carers who manage technical health procedures (such as enteral tube feeding, intravenous therapy, dialysis or tracheostomy care) at home. Increasingly, complex procedures are being undertaken at home but little attention has been paid to the experiences of family carers who manage such procedures. Grounded theory, following Charmaz's constructivist approach. Interviews with 26 family carers who managed technical health procedures and 15 health professionals who taught carers such procedures. Data collection took place in New Zealand over 19 months during 2011-2013. Grounded theory procedures of iterative data collection, coding and analysis were followed, with the gradual development of theoretical ideas. The learning journey comprised three phases: (1) an initial, concentrated period of training; (2) novice carers taking responsibility for day-to-day care of procedures while continuing their learning; and (3) with time, experience and ongoing self-directed learning, the development of expertise. Teaching and support by health professionals (predominantly nurses) was focussed on the initial phase, but carers' learning continued throughout, developed through their own experience and using additional sources of information (notably the Internet and other carers). Further work is needed to determine the best educational process for carers, including where to locate training, who should teach them, optimal teaching methods and how structured or individualized teaching should be. Supporting carers well also benefits patient care. © 2016 John Wiley & Sons Ltd.

  2. The 'wayfinding' experience of family carers who learn to manage technical health procedures at home: a grounded theory study.

    PubMed

    McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William

    2017-12-01

    With more care taking place in the home, family carers play an important role in supporting patients. Some family carers undertake technical health procedures generally managed by health professionals in hospital settings (e.g. managing a tracheostomy or enteral feeding). To explore how family carers learn to manage technical health procedures in order to help health professionals better understand and support this process. A grounded theory study using data from interviews with 26 New Zealand family carers who managed technical health procedures including nasogastric or gastrostomy feeding, stoma care, urinary catheterisation, tracheostomy management, intravenous therapy, diabetes management and complex wound dressings. Most (20 participants) were caring for their child and the remaining six for their spouse, parent or grandparent. Following grounded theory methods, each interview was coded soon after completion. Additional data were compared with existing material, and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was developed. Interviewing continued until no new ideas emerged and concepts were well defined. The core concept of 'wayfinding' indicates that the learning process for family carers is active, individualised and multi-influenced, developing over time as a response to lived experience. Health professional support was concentrated on the initial phase of carers' training, reducing and becoming more reactive as carers took responsibility for day-to-day management. Wayfinding involves self-navigation by carers, in contrast to patient navigator models which provide continuing professional assistance to patients receiving cancer or chronic care services. Wayfinding by carers raises questions about how carers should be best supported in their initial and ongoing learning as the management of these procedures changes over time. © 2017 Nordic College of Caring Science.

  3. How family carers engage with technical health procedures in the home: a grounded theory study.

    PubMed

    McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William

    2015-07-06

    To explore the experiences of family carers who manage technical health procedures at home and describe their learning process. A qualitative study using grounded theory. New Zealand family carers (21 women, 5 men) who managed technical health procedures such as enteral feeding, peritoneal dialysis, tracheostomy care, a central venous line or urinary catheter. In addition, 15 health professionals involved in teaching carers were interviewed. Semistructured interviews were coded soon after completion and preliminary analysis influenced subsequent interviews. Additional data were compared with existing material and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was described. Interviewing continued until no new ideas emerged and concepts were well defined. The response of carers to the role of managing technical health procedures in the home is presented in terms of five dispositions: (1) Embracing care, (2) Resisting, (3) Reluctant acceptance, (4) Relinquishing and (5) Being overwhelmed. These dispositions were not static and carers commonly changed between them. Embracing care included cognitive understanding of the purpose and benefits of a procedure; accepting a 'technical' solution; practical management; and an emotional response. Accepting embrace is primarily motivated by perceived benefits for the recipient. It may also be driven by a lack of alternatives. Resisting or reluctant acceptance results from a lack of understanding about the procedure or willingness to manage it. Carers need adequate support to avoid becoming overwhelmed, and there are times when it is appropriate to encourage them to relinquish care for the sake of their own needs. The concept of embracing care encourages health professionals to extend their attention beyond simply the practical aspects of technical procedures to assessing and addressing carers' emotional and behavioural responses to health technology during the training process

  4. How family carers engage with technical health procedures in the home: a grounded theory study

    PubMed Central

    McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William

    2015-01-01

    Objectives To explore the experiences of family carers who manage technical health procedures at home and describe their learning process. Design A qualitative study using grounded theory. Participants New Zealand family carers (21 women, 5 men) who managed technical health procedures such as enteral feeding, peritoneal dialysis, tracheostomy care, a central venous line or urinary catheter. In addition, 15 health professionals involved in teaching carers were interviewed. Methods Semistructured interviews were coded soon after completion and preliminary analysis influenced subsequent interviews. Additional data were compared with existing material and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was described. Interviewing continued until no new ideas emerged and concepts were well defined. Results The response of carers to the role of managing technical health procedures in the home is presented in terms of five dispositions: (1) Embracing care, (2) Resisting, (3) Reluctant acceptance, (4) Relinquishing and (5) Being overwhelmed. These dispositions were not static and carers commonly changed between them. Embracing care included cognitive understanding of the purpose and benefits of a procedure; accepting a ‘technical’ solution; practical management; and an emotional response. Accepting embrace is primarily motivated by perceived benefits for the recipient. It may also be driven by a lack of alternatives. Resisting or reluctant acceptance results from a lack of understanding about the procedure or willingness to manage it. Carers need adequate support to avoid becoming overwhelmed, and there are times when it is appropriate to encourage them to relinquish care for the sake of their own needs. Conclusions The concept of embracing care encourages health professionals to extend their attention beyond simply the practical aspects of technical procedures to assessing and addressing carers’ emotional and

  5. Space Geodesy Project Information and Configuration Management Procedure

    NASA Technical Reports Server (NTRS)

    Merkowitz, Stephen M.

    2016-01-01

    This plan defines the Space Geodesy Project (SGP) policies, procedures, and requirements for Information and Configuration Management (CM). This procedure describes a process that is intended to ensure that all proposed and approved technical and programmatic baselines and changes to the SGP hardware, software, support systems, and equipment are documented.

  6. A procedural skills OSCE: assessing technical and non-technical skills of internal medicine residents.

    PubMed

    Pugh, Debra; Hamstra, Stanley J; Wood, Timothy J; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

    2015-03-01

    Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal medicine (IM) residents to assess their technical and non-technical skills when performing procedures. Thirty-five first to third-year IM residents participated in a 5-station PS-OSCE, which combined partial task models, standardized patients, and allied health professionals. Formal blueprinting was performed and content experts were used to develop the cases and rating instruments. Examiners underwent a frame-of-reference training session to prepare them for their rater role. Scores were compared by levels of training, experience, and to evaluation data from a non-procedural OSCE (IM-OSCE). Reliability was calculated using Generalizability analyses. Reliabilities for the technical and non-technical scores were 0.68 and 0.76, respectively. Third-year residents scored significantly higher than first-year residents on the technical (73.5 vs. 62.2%) and non-technical (83.2 vs. 75.1%) components of the PS-OSCE (p < 0.05). Residents who had performed the procedures more frequently scored higher on three of the five stations (p < 0.05). There was a moderate disattenuated correlation (r = 0.77) between the IM-OSCE and the technical component of the PS-OSCE scores. The PS-OSCE is a feasible method for assessing multiple competencies related to performing procedures and this study provides validity evidence to support its use as an in-training examination.

  7. Pollutant Assessments Group procedures manual: Volume 2, Technical procedures

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

    Not Available

    1992-03-01

    This is volume 2 of the manuals that describes the technical procedures currently in use by the Pollution Assessments Group. This manual incorporates new developments in hazardous waste assessment technology and administrative policy. Descriptions of the equipment, procedures and operations of such things as radiation detection, soil sampling, radionuclide monitoring, and equipment decontamination are included in this manual. (MB)

  8. Groundwater technical procedures of the U.S. Geological Survey

    USGS Publications Warehouse

    Cunningham, William L.; Schalk, Charles W.

    2011-01-01

    A series of groundwater technical procedures documents (GWPDs) has been released by the U.S. Geological Survey, Water-Resources Discipline, for general use by the public. These technical procedures were written in response to the need for standardized technical procedures of many aspects of groundwater science, including site and measuring-point establishment, measurement of water levels, and measurement of well discharge. The techniques are described in the GWPDs in concise language and are accompanied by necessary figures and tables derived from cited manuals, reports, and other documents. Because a goal of this series of procedures is to remain current with the state of the science, and because procedures change over time, this report is released in an online format only. As new procedures are developed and released, they will be linked to this document.

  9. A Procedural Skills OSCE: Assessing Technical and Non-Technical Skills of Internal Medicine Residents

    ERIC Educational Resources Information Center

    Pugh, Debra; Hamstra, Stanley J.; Wood, Timothy J.; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

    2015-01-01

    Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal…

  10. Multimodal Analgesia in Breast Surgical Procedures: Technical and Pharmacological Considerations for Liposomal Bupivacaine Use

    PubMed Central

    Newman, Martin I.; Seeley, Neil; Hutchins, Jacob; Smith, Kevin L.; Mena, Gabriel; Selber, Jesse C.; Saint-Cyr, Michel H.; Gadsden, Jeffrey C.

    2017-01-01

    Enhanced recovery after surgery is a multidisciplinary perioperative clinical pathway that uses evidence-based interventions to improve the patient experience as well as increase satisfaction, reduce costs, mitigate the surgical stress response, accelerate functional recovery, and decrease perioperative complications. One of the most important elements of enhanced recovery pathways is multimodal pain management. Herein, aspects relating to multimodal analgesia following breast surgical procedures are discussed with the understanding that treatment decisions should be individualized and guided by sound clinical judgment. A review of liposomal bupivacaine, a prolonged-release formulation of bupivacaine, in the management of postoperative pain following breast surgical procedures is presented, and technical guidance regarding optimal administration of liposomal bupivacaine is provided. PMID:29062649

  11. Simulation fails to replicate stress in trainees performing a technical procedure in the clinical environment.

    PubMed

    Baker, B G; Bhalla, A; Doleman, B; Yarnold, E; Simons, S; Lund, J N; Williams, J P

    2017-01-01

    Simulation-based training (SBT) has become an increasingly important method by which doctors learn. Stress has an impact upon learning, performance, technical, and non-technical skills. However, there are currently no studies that compare stress in the clinical and simulated environment. We aimed to compare objective (heart rate variability, HRV) and subjective (state trait anxiety inventory, STAI) measures of stress theatre with a simulated environment. HRV recordings were obtained from eight anesthetic trainees performing an uncomplicated rapid sequence induction at pre-determined procedural steps using a wireless Polar RS800CX monitor © in an emergency theatre setting. This was repeated in the simulated environment. Participants completed an STAI before and after the procedure. Eight trainees completed the study. The theatre environment caused an increase in objective stress vs baseline (p = .004). There was no significant difference between average objective stress levels across all time points (p = .20) between environments. However, there was a significant interaction between the variables of objective stress and environment (p = .045). There was no significant difference in subjective stress (p = .27) between environments. Simulation was unable to accurately replicate the stress of the technical procedure. This is the first study that compares the stress during SBT with the theatre environment and has implications for the assessment of simulated environments for use in examinations, rating of technical and non-technical skills, and stress management training.

  12. Should Project Managers Buy Technical Data

    DTIC Science & Technology

    2017-04-06

    Should Project Managers Buy Technical Data? Jerry Harper April 6, 2017 PUBLISHED BY The Defense...intellectual property (IP) management and technical data rights (TDR) strategies. According to DoD Instruction 5000.02 (DoD, 2017), project managers (PMs...Defense Authorization Act NDI ................nondevelopmental item PM ................. project manager R&D ...............research and development

  13. Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part II: Catheter Care and Management of Common Systemic Post-procedural Complications.

    PubMed

    Taslakian, Bedros; Sridhar, Divya

    2017-09-01

    Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety. The aim of this second part, in conjunction with part 1, is to complete the comprehensive review of post-procedural care in patients undergoing interventional radiology procedures. We discuss common problems encountered after insertion of drainage and vascular catheters and describe effective methods of troubleshooting these problems. Commonly encountered systemic complications in IR are described, and ways for immediate identification and management of these complications are provided.

  14. Management of technical date in Nihon Doro kodan

    NASA Astrophysics Data System (ADS)

    Hanada, Jun'ichi

    Nihon Doro Kodan Laboratory has collected and contributed technical data (microfiches, aerial photographs, books and literature) on plans, designs, constructions and maintenance of the national expressways and the ordinary toll roads since 1968. This work is systematized on computer to retrieve and contribute data faster. Now Laboratory operates Technical Data Management System which manages all of technical data and Technical Document Management System which manages technical documents. These systems stand on users' on-line retrieval and data accumuration by microfiches and optical disks.

  15. Writing a technical note.

    PubMed

    Ng, K H; Peh, W C G

    2010-02-01

    A technical note is a short article giving a brief description of a specific development, technique or procedure, or it may describe a modification of an existing technique, procedure or device applicable to medicine. The technique, procedure or device described should have practical value and should contribute to clinical diagnosis or management. It could also present a software tool, or an experimental or computational method. Technical notes are variously referred to as technical innovations or technical developments. The main criteria for publication will be the novelty of concepts involved, the validity of the technique and its potential for clinical applications.

  16. Information Exchange Procedures. Outcomes Study Procedures. Technical Report No. 66.

    ERIC Educational Resources Information Center

    Byers, Maureen

    The Information Exchange Procedures (IEP) developed by the National Center for Higher Education Management Systems (NCHEMS) are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional characteristics. A fundamental purpose…

  17. Technical Training for Managers.

    ERIC Educational Resources Information Center

    Haverland, Edgar M.

    The question has arisen as to what kind of information a manager without extensive technical training needs to learn to supervise effectively. For example, the Nike Hercules fire control platoon leader, usually an officer in his first active duty assignment, seldom has had extensive technical training. Yet he is responsibile for the…

  18. TWRS technical baseline database manager definition document

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

    Acree, C.D.

    1997-08-13

    This document serves as a guide for using the TWRS Technical Baseline Database Management Systems Engineering (SE) support tool in performing SE activities for the Tank Waste Remediation System (TWRS). This document will provide a consistent interpretation of the relationships between the TWRS Technical Baseline Database Management software and the present TWRS SE practices. The Database Manager currently utilized is the RDD-1000 System manufactured by the Ascent Logic Corporation. In other documents, the term RDD-1000 may be used interchangeably with TWRS Technical Baseline Database Manager.

  19. 25 CFR 286.11 - Management and technical assistance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Management and technical assistance. 286.11 Section 286... DEVELOPMENT PROGRAM § 286.11 Management and technical assistance. (a) Prior to and concurrent with the making... insure that competent management and technical assistance is available to the grantee in the preparation...

  20. 25 CFR 286.11 - Management and technical assistance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Management and technical assistance. 286.11 Section 286... DEVELOPMENT PROGRAM § 286.11 Management and technical assistance. (a) Prior to and concurrent with the making... insure that competent management and technical assistance is available to the grantee in the preparation...

  1. 25 CFR 286.11 - Management and technical assistance.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Management and technical assistance. 286.11 Section 286.11... DEVELOPMENT PROGRAM § 286.11 Management and technical assistance. (a) Prior to and concurrent with the making... insure that competent management and technical assistance is available to the grantee in the preparation...

  2. 25 CFR 286.11 - Management and technical assistance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Management and technical assistance. 286.11 Section 286... DEVELOPMENT PROGRAM § 286.11 Management and technical assistance. (a) Prior to and concurrent with the making... insure that competent management and technical assistance is available to the grantee in the preparation...

  3. The Skills that Technical Communicators Need: An Investigation of Technical Communication Graduates, Managers, and Curricula

    ERIC Educational Resources Information Center

    Whiteside, Aimee L.

    2003-01-01

    This study examines the skills that recent technical communication graduates and managers believe technical communication students need before entering business and industry as new technical communicators. Through questionnaires and interviews with recent graduates and managers of technical communication departments as well as an analysis of the…

  4. Technical Communication, Knowledge Management, and XML.

    ERIC Educational Resources Information Center

    Applen, J. D.

    2002-01-01

    Describes how technical communicators can become involved in knowledge management. Examines how technical communicators can teach organizations to design, access, and contribute to databases; alert them to new information; and facilitate trust and sharing. Concludes that successful technical communicators would do well to establish a culture that…

  5. 75 FR 16345 - Administrative Practices and Procedures; Good Guidance Practices; Technical Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    .... FDA-1999-N-3539] (formerly Docket No. 1999N-4783) Administrative Practices and Procedures; Good Guidance Practices; Technical Amendment AGENCY: Food and Drug Administration, HHS. ACTION: Final rule... Subjects in 21 CFR Part 10 Administrative practice and procedure, News media. 0 Therefore, under the...

  6. Value Engineering. Technical Manual. School Facilities Development Procedures Manual.

    ERIC Educational Resources Information Center

    Washington Office of the State Superintendent of Public Instruction, Olympia.

    Value Engineering (VE) is a cost-optimizing technique used to analyze design quality and cost-effectiveness. The application of VE procedures to the design and construction of school facilities has been adopted by the state of Washington. This technical manual provides guidance in developing the scope and applicability of VE to school projects; in…

  7. Nuclear emergency management procedures in Europe

    NASA Astrophysics Data System (ADS)

    Carter, Emma

    The Chernobyl accident brought to the fore the need for decision-making in nuclear emergency management to be transparent and consistent across Europe. A range of systems to support decision-making in future emergencies have since been developed, but, by and large, with little consultation with potential decision makers and limited understanding of the emergency management procedures across Europe and how they differ. In nuclear emergency management, coordination, communication and information sharing are of paramount importance. There are many key players with their own technical expertise, and several key activities occur in parallel, across different locations. Business process modelling can facilitate understanding through the representation of processes, aid transparency and structure the analysis, comparison and improvement of processes. This work has been conducted as part of a European Fifth Framework Programme project EVATECH, whose aim was to improve decision support methods, models and processes taking into account stakeholder expectations and concerns. It has involved the application of process modelling to document and compare the emergency management processes in four European countries. It has also involved a multidisciplinary approach taking a socio-technical perspective. The use of process modelling did indeed facilitate understanding and provided a common platform, which was not previously available, to consider emergency management processes. This thesis illustrates the structured analysis approach that process modelling enables. Firstly, through an individual analysis for the United Kingdom (UK) model that illustrated the potential benefits for a country. These are for training purposes, to build reflexive shared mental models, to aid coordination and for process improvement. Secondly, through a comparison of the processes in Belgium, Germany, Slovak Republic and the UK. In this comparison of the four processes we observed that the four process

  8. The Management of Technical Services--1980.

    ERIC Educational Resources Information Center

    Rohdy, Margaret A.

    1981-01-01

    Examines the literature of administration of library technical services from both a library and a management approach, and describes some of the activities of management sections of various library organizations. There are 27 references. (RAA)

  9. 25 CFR 286.11 - Management and technical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Management and technical assistance. 286.11 Section 286.11 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ECONOMIC ENTERPRISES INDIAN BUSINESS DEVELOPMENT PROGRAM § 286.11 Management and technical assistance. (a) Prior to and concurrent with the making...

  10. Network-Based Management Procedures.

    ERIC Educational Resources Information Center

    Buckner, Allen L.

    Network-based management procedures serve as valuable aids in organizational management, achievement of objectives, problem solving, and decisionmaking. Network techniques especially applicable to educational management systems are the program evaluation and review technique (PERT) and the critical path method (CPM). Other network charting…

  11. Technical Operating Procedures for Resource Documentation Under the Oil Pollution Act of 1990

    DOT National Transportation Integrated Search

    1996-06-01

    Technical Operating Procedures (TOPs) for Resource Documentation under the Oil Pollution Act of 1990 (P.L.101-380) have been developed to provide guidance to users operating as, or in support of, the Federal On-Scene Coordinator(FOSC). The procedures...

  12. Technical Communications in Aeronautics: Results of an Exploratory Study. An Analysis of Profit Managers' and Nonprofit Managers' Responses. NASA Technical Memorandum 101626.

    ERIC Educational Resources Information Center

    Pinelli, Thomas E.; And Others

    Data collected from an exploratory study concerned with the technical communications practices of aerospace engineers and scientists were analyzed to test the primary assumption that profit and nonprofit managers in the aerospace community have different technical communications practices. Profit and nonprofit managers were compared in five…

  13. Avoidable Technical and Clinical Denial Write-Off Management in Hospitals, Physician Offices, and Clinics.

    PubMed

    Terra, Sandra Marlene; Byrne, Amanda

    2016-01-01

    This article reviews the various types of technical and clinical denials that are usually "written off" and proposes strategies to prevent this loss. For purposes of this writing, avoidable technical and clinical denial write-offs are defined as revenue lost from "first-pass" denials rejections. For example, a procedure that requires an authorization is performed without having had an authorization obtained. After appeals and attempts to recoup the revenue, often unsuccessful, the organization ultimately "writes off" the revenue as not collectable. The question to ask is: Are these claims really not collectable or can actionable steps be taken to conserve these dollars and improve the bottom line? Acute care hospitals, physician offices, and clinics. In today's environment, the need to manage costs is ubiquitous. Cost management is on the priority list of all savvy health care executives, even if margins are healthy, revenue is under pressure, and the magnitude of cost reduction needed is greater than what past efforts have achieved. As hospitals and physician clinics prioritize areas for improvement, reduction in lost revenue-especially avoidable lost revenue-should be at the top of the list. Attentively managing claim denial write-offs will significantly reduce lost revenue. There is significant interface between case management and the revenue cycle. Developing core competencies for reducing clinical and technical denials should be a critical imperative in overall cost management strategy. Case managers are well placed to prevent these unnecessary losses through accurate status determination and clinical documentation review. These clinical professionals can also provide insight into work flow and other processes inherent in the preauthorization process.

  14. 77 FR 48112 - Pipeline Safety: Administrative Procedures; Updates and Technical Corrections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    ...This Notice of Proposed Rulemaking updates the administrative civil penalty maximums for violation of the pipeline safety regulations to conform to current law, updates the informal hearing and adjudication process for pipeline enforcement matters to conform to current law, amends other administrative procedures used by PHMSA personnel, and makes other technical corrections and updates to certain administrative procedures. The proposed amendments do not impose any new operating, maintenance, or other substantive requirements on pipeline owners or operators.

  15. Colorectal endoscopic submucosal dissection: Recent technical advances for safe and successful procedures

    PubMed Central

    Yamamoto, Katsumi; Michida, Tomoki; Nishida, Tsutomu; Hayashi, Shiro; Naito, Masafumi; Ito, Toshifumi

    2015-01-01

    Endoscopic submucosal dissection (ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability is poor because of colonic flexure and extensibility. A high risk of perforation has been reported in colorectal ESD. To prevent complications such as perforation and unexpected bleeding, it is crucial to ensure good visualization of the submucosal layer by creating a mucosal flap, which is an exfoliated mucosa for inserting the tip of the endoscope under it. The creation of a mucosal flap is often technically difficult; however, various types of equipment, appropriate strategy, and novel procedures including our clip-flap method, appear to facilitate mucosal flap creation, improving the safety and success rate of ESD. Favorable treatment outcomes with colorectal ESD have already been reported in many advanced institutions, and appropriate understanding of techniques and development of training systems are required for world-wide standardization of colorectal ESD. Here, we describe recent technical advances for safe and successful colorectal ESD. PMID:26468335

  16. Developing technical expertise in emergency medicine--the role of simulation in procedural skill acquisition.

    PubMed

    Wang, Ernest E; Quinones, Joshua; Fitch, Michael T; Dooley-Hash, Suzanne; Griswold-Theodorson, Sharon; Medzon, Ron; Korley, Frederick; Laack, Torrey; Robinett, Adam; Clay, Lamont

    2008-11-01

    Developing technical expertise in medical procedures is an integral component of emergency medicine (EM) practice and training. This article is the work of an expert panel composed of members from the Society for Academic Emergency Medicine (SAEM) Interest Group, the SAEM Technology in Medical Education Committee, and opinions derived from the May 2008 Academic Emergency Medicine Consensus Conference, "The Science of Simulation in Healthcare." The writing group reviewed the simulation literature on procedures germane to EM training, virtual reality training, and instructional learning theory as it pertains to skill acquisition and procedural skills decay. The authors discuss the role of simulation in teaching technical expertise, identify training conditions that lead to effective learning, and provide recommendations for future foci of research.

  17. A National Needs Assessment to Identify Technical Procedures in Vascular Surgery for Simulation Based Training.

    PubMed

    Nayahangan, L J; Konge, L; Schroeder, T V; Paltved, C; Lindorff-Larsen, K G; Nielsen, B U; Eiberg, J P

    2017-04-01

    Practical skills training in vascular surgery is facing challenges because of an increased number of endovascular procedures and fewer open procedures, as well as a move away from the traditional principle of "learning by doing." This change has established simulation as a cornerstone in providing trainees with the necessary skills and competences. However, the development of simulation based programs often evolves based on available resources and equipment, reflecting convenience rather than a systematic educational plan. The objective of the present study was to perform a national needs assessment to identify the technical procedures that should be integrated in a simulation based curriculum. A national needs assessment using a Delphi process was initiated by engaging 33 predefined key persons in vascular surgery. Round 1 was a brainstorming phase to identify technical procedures that vascular surgeons should learn. Round 2 was a survey that used a needs assessment formula to explore the frequency of procedures, the number of surgeons performing each procedure, risk and/or discomfort, and feasibility for simulation based training. Round 3 involved elimination and ranking of procedures. The response rate for round 1 was 70%, with 36 procedures identified. Round 2 had a 76% response rate and resulted in a preliminary prioritised list after exploring the need for simulation based training. Round 3 had an 85% response rate; 17 procedures were eliminated, resulting in a final prioritised list of 19 technical procedures. A national needs assessment using a standardised Delphi method identified a list of procedures that are highly suitable and may provide the basis for future simulation based training programs for vascular surgeons in training. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Restoring tactile and erogenous penile sensation in low-spinal-lesion patients: procedural and technical aspects following 43 TOMAX nerve transfer procedures.

    PubMed

    Overgoor, Max L E; de Jong, Tom P V M; Kon, Moshe

    2014-08-01

    The "TOMAX" (TO MAX-imize sensation, sexuality, and quality of life) procedure restores genital sensation in men with low spinal lesions, improving sexual health, as shown previously. It connects the dorsal nerve of the penis to the intact ipsilateral ilioinguinal nerve, unilaterally or bilaterally. This study reports on the technical aspects based on 43 TOMAX nerve transfers. In 40 patients with no penile but intact groin sensation, 43 nerve transfers were performed. Data on patient selection, surgical history, anatomy of the ilioinguinal nerve and dorsal nerve of the penis, unilateral or bilateral surgery, surgical technique, complications, and patient information were collected prospectively. Regardless of origin, all patients with no penile but good groin sensation are eligible for the procedure, provided the ilioinguinal nerve is not damaged because of former inguinal surgery or absent because of anatomical variations. Selection of a unilateral or bilateral procedure depends on the presence or absence of reflex erections and bulbocavernosus reflex. Preliminary experience with the first three bilateral cases shows that it is technically feasible, with encouraging results. The surgical technique has evolved (described in detail, including video) to enhance outcome and reduce complications. Patients are better informed, resulting in realistic expectations. This article synthesizes the procedural and technical experience of 43 TOMAX nerve transfers. Anyone skilled in peripheral nerve surgery and microsurgery can adopt this concept and further develop it. The TOMAX procedure can then be used to restore erogenous penile sensation and improve the quality of sexual health in patients with absent penile but good groin sensation.

  19. The Office of Environmental Management technical reports: a bibliography

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

    NONE

    1997-07-01

    The Office of Environmental Management`s (EM) technical reports bibliography is an annual publication that contains information on scientific and technical reports sponsored by the Office of Environmental Management added to the Energy Science and Technology Database from July 1, 1995 through Sept. 30, 1996. This information is divided into the following categories: Focus Areas and Crosscutting Programs. Support Programs, Technology Integration and International Technology Exchange are now included in the General category. EM`s Office of Science and Technology sponsors this bibliography.

  20. Core Technical Capability Laboratory Management System

    NASA Technical Reports Server (NTRS)

    Shaykhian, Linda; Dugger, Curtis; Griffin, Laurie

    2008-01-01

    The Core Technical Capability Lab - oratory Management System (CTCLMS) consists of dynamically generated Web pages used to access a database containing detailed CTC lab data with the software hosted on a server that allows users to have remote access.

  1. Procedures for Determining Historical Full Costs. Technical Report 65. Second Edition.

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers, Washington, DC.

    The procedures form the costing component of the National Center for Higher Education Management Systems'"Information Exchange Procedures" (IEP). The IEP are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional…

  2. Cytological preparations for molecular analysis: A review of technical procedures, advantages and limitations for referring samples for testing.

    PubMed

    da Cunha Santos, G; Saieg, M A; Troncone, G; Zeppa, P

    2018-04-01

    Minimally invasive procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) must yield not only good quality and quantity of material for morphological assessment, but also an adequate sample for analysis of molecular markers to guide patients to appropriate targeted therapies. In this context, cytopathologists worldwide should be familiar with minimum requirements for refereeing cytological samples for testing. The present manuscript is a review with comprehensive description of the content of the workshop entitled Cytological preparations for molecular analysis: pre-analytical issues for EBUS TBNA, presented at the 40th European Congress of Cytopathology in Liverpool, UK. The present review emphasises the advantages and limitations of different types of cytology substrates used for molecular analysis such as archival smears, liquid-based preparations, archival cytospin preparations and FTA (Flinders Technology Associates) cards, as well as their technical requirements/features. These various types of cytological specimens can be successfully used for an extensive array of molecular studies, but the quality and quantity of extracted nucleic acids rely directly on adequate pre-analytical assessment of those samples. In this setting, cytopathologists must not only be familiar with the different types of specimens and associated technical procedures, but also correctly handle the material provided by minimally invasive procedures, ensuring that there is sufficient amount of material for a precise diagnosis and correct management of the patient through personalised care. © 2018 John Wiley & Sons Ltd.

  3. Policies and Procedures Governing the Operation of Vocational-Technical Education in Nevada.

    ERIC Educational Resources Information Center

    Nevada State Dept. of Education, Carson City. Div. of Vocational-Technical and Adult Education.

    This manual was prepared to assist local public schools in organizing and conducting a broadened program of vocational education of significant scope. Operating policies and procedures are provided in areas of: (1) Administration of Vocational-Technical Education, (2) Agricultural Education, (3) Vocational Business and Office Occupations, (4)…

  4. Technical Operating Procedures for State Access Under the Oil Pollution Act of 1990

    DOT National Transportation Integrated Search

    1992-11-01

    Technical Operating Procedures (TOPs) to be used by the National Pollution Funds : Center (NPFC) to provide guidance to Federal On-Scene Coordinators (FOSCs) and : Coast Guard Districts concerning a State Governor's request for access to the : Oil Sp...

  5. Insight into the da Vinci® Xi - technical notes for single-docking left-sided colorectal procedures.

    PubMed

    Ngu, James Chi-Yong; Sim, Sarah; Yusof, Sulaiman; Ng, Chee-Yung; Wong, Andrew Siang-Yih

    2017-12-01

    The adoption of robot-assisted laparoscopic colorectal surgery has been hampered by issues with docking, operative duration, technical difficulties in multi-quadrant access, and cost. The da Vinci® Xi has been designed to overcome some of these limitations. We describe our experience with the system and offer technical insights to its application in left-sided colorectal procedures. Our initial series of left-sided robotic colorectal procedures was evaluated. Patient demographics and operative outcomes were recorded prospectively using a predefined database. Between March 2015 and April 2016, 54 cases of robot-assisted laparoscopic left-sided colorectal procedures were successfully completed with no cases of conversion. The majority were low anterior resections for colorectal malignancies. Using the da Vinci® Xi Surgical System, multi-quadrant surgery involving dissection from the splenic flexure to the pelvis was possible without redocking. The da Vinci® Xi simplifies the docking procedure and makes single-docking feasible for multi-quadrant left-sided colorectal procedures. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Do technical skills correlate with non-technical skills in crisis resource management: a simulation study.

    PubMed

    Riem, N; Boet, S; Bould, M D; Tavares, W; Naik, V N

    2012-11-01

    Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score. TS and NTS were significantly correlated to each other (r=0.45, P<0.05). During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.

  7. Cost Finding Principles and Procedures. Preliminary Field Review Edition. Technical Report 26.

    ERIC Educational Resources Information Center

    Ziemer, Gordon; And Others

    This report is part of the Larger Cost Finding Principles Project designed to develop a uniform set of standards, definitions, and alternative procedures that will use accounting and statistical data to find the full cost of resources utilized in the process of producing institutional outputs. This technical report describes preliminary procedures…

  8. Management Studies Educational Knowledge: Technical, Elite or Political?

    ERIC Educational Resources Information Center

    Hordern, Jim

    2014-01-01

    This paper draws on the technical, elite and political interpretations of the purpose of management, to identify demands for particular forms of educational knowledge in the management studies curriculum. The varied character of this knowledge is discussed using Bernsteinian concepts of verticality, grammaticality, classification and framing, and…

  9. Report-reading patterns of technical managers and nonmanagers

    NASA Technical Reports Server (NTRS)

    Pinelli, T. E.; Cordle, V. M.; Glassman, M.; Vondran, R. F., Jr.

    1984-01-01

    A survey to determine the review and reading processes used by technical managers and nonmanagers indicates that the summary, abstract, conclusion, title page, and introduction are the components used most frequently by both groups to decide whether to read a NASA technical report. In the review process, significantly more managers than nonmanagers use the summary and conclusion, whereas significantly more nonmanagers use the abstract and title page. The most common sequence of review consists of the title page, abstract, and summary, in that order, for both groups. In the reading process, the conclusion, results and discussion, and summary are the components read by the highest percentage of both groups.

  10. Technical and management information system: The tool for professional productivity on the space station program

    NASA Technical Reports Server (NTRS)

    Montoya, G.; Boldon, P.

    1985-01-01

    The Space Station Program is highly complex not only in its technological goals and requirements but also in its organizational structure. Eight Contractor teams supporting four NASA centers plus Headquarters must depend on effective exchange of information--the lifeblood of the program. The Technical and Management Information System (TMIS) is the means by which this exchange can take place. Value of the TMIS in increasing productivity comes primarily from its ability to make the right information available to whomever needs it when it is needed. Productivity of the aerospace professional and how it can be enhanced by the use of specifically recommended techniques and procedures for information management using the TMIS are discussed.

  11. DOE scientific and technical information management

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

    Beasly, M.

    The objective of this paper was a discussion of the mission objectives and program activities of the DOE Office of Scientific and Technical Information. Topics of discussion were: (1) program direction and structure; (2) representation in gov`t and international organizations; (3) management of information; and (4) consultation and assistance.

  12. 48 CFR 242.7401 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Procedures. 242.7401 Section 242.7401 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Technical Representation at...

  13. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Interest-rate-risk-management procedures. 563... ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures... association's management of that risk. (b) The board of directors shall formerly adopt a policy for the...

  14. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Interest-rate-risk-management procedures. 563... ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures... association's management of that risk. (b) The board of directors shall formerly adopt a policy for the...

  15. Technical and Management Information System (TMIS)

    NASA Technical Reports Server (NTRS)

    Rau, Timothy R.

    1987-01-01

    The TMIS goals developed to support the Space Station Program (SSP) mission requirements are outlined. The TMIS will provide common capabilities to all SSP centers and facilitate the flow of technical and management information throughout the program as well as SSP decision-making processes. A summary is presented of the various TMIS phases.

  16. Meta-analysis of the technical performance of an imaging procedure: guidelines and statistical methodology.

    PubMed

    Huang, Erich P; Wang, Xiao-Feng; Choudhury, Kingshuk Roy; McShane, Lisa M; Gönen, Mithat; Ye, Jingjing; Buckler, Andrew J; Kinahan, Paul E; Reeves, Anthony P; Jackson, Edward F; Guimaraes, Alexander R; Zahlmann, Gudrun

    2015-02-01

    Medical imaging serves many roles in patient care and the drug approval process, including assessing treatment response and guiding treatment decisions. These roles often involve a quantitative imaging biomarker, an objectively measured characteristic of the underlying anatomic structure or biochemical process derived from medical images. Before a quantitative imaging biomarker is accepted for use in such roles, the imaging procedure to acquire it must undergo evaluation of its technical performance, which entails assessment of performance metrics such as repeatability and reproducibility of the quantitative imaging biomarker. Ideally, this evaluation will involve quantitative summaries of results from multiple studies to overcome limitations due to the typically small sample sizes of technical performance studies and/or to include a broader range of clinical settings and patient populations. This paper is a review of meta-analysis procedures for such an evaluation, including identification of suitable studies, statistical methodology to evaluate and summarize the performance metrics, and complete and transparent reporting of the results. This review addresses challenges typical of meta-analyses of technical performance, particularly small study sizes, which often causes violations of assumptions underlying standard meta-analysis techniques. Alternative approaches to address these difficulties are also presented; simulation studies indicate that they outperform standard techniques when some studies are small. The meta-analysis procedures presented are also applied to actual [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) test-retest repeatability data for illustrative purposes. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Meta-analysis of the technical performance of an imaging procedure: Guidelines and statistical methodology

    PubMed Central

    Huang, Erich P; Wang, Xiao-Feng; Choudhury, Kingshuk Roy; McShane, Lisa M; Gönen, Mithat; Ye, Jingjing; Buckler, Andrew J; Kinahan, Paul E; Reeves, Anthony P; Jackson, Edward F; Guimaraes, Alexander R; Zahlmann, Gudrun

    2017-01-01

    Medical imaging serves many roles in patient care and the drug approval process, including assessing treatment response and guiding treatment decisions. These roles often involve a quantitative imaging biomarker, an objectively measured characteristic of the underlying anatomic structure or biochemical process derived from medical images. Before a quantitative imaging biomarker is accepted for use in such roles, the imaging procedure to acquire it must undergo evaluation of its technical performance, which entails assessment of performance metrics such as repeatability and reproducibility of the quantitative imaging biomarker. Ideally, this evaluation will involve quantitative summaries of results from multiple studies to overcome limitations due to the typically small sample sizes of technical performance studies and/or to include a broader range of clinical settings and patient populations. This paper is a review of meta-analysis procedures for such an evaluation, including identification of suitable studies, statistical methodology to evaluate and summarize the performance metrics, and complete and transparent reporting of the results. This review addresses challenges typical of meta-analyses of technical performance, particularly small study sizes, which often causes violations of assumptions underlying standard meta-analysis techniques. Alternative approaches to address these difficulties are also presented; simulation studies indicate that they outperform standard techniques when some studies are small. The meta-analysis procedures presented are also applied to actual [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) test–retest repeatability data for illustrative purposes. PMID:24872353

  18. Leveraging Independent Management and Chief Engineer Hierarchy: Vertically and Horizontally-Derived Technical Authority Value

    NASA Technical Reports Server (NTRS)

    Barley, Bryan; Newhouse, Marilyn

    2012-01-01

    In the development of complex spacecraft missions, project management authority is usually extended hierarchically from NASA's highest agency levels down to the implementing institution's project team level, through both the center and the program. In parallel with management authority, NASA utilizes a complementary, but independent, hierarchy of technical authority (TA) that extends from the agency level to the project, again, through both the center and the program. The chief engineers (CEs) who serve in this technical authority capacity oversee and report on the technical status and ensure sound engineering practices, controls, and management of the projects and programs. At the lowest level, implementing institutions assign project CEs to technically engage projects, lead development teams, and ensure sound technical principles, processes, and issue resolution. At the middle level, programs and centers independently use CEs to ensure the technical success of their projects and programs. At the agency level, NASA's mission directorate CEs maintain technical cognizance over every program and project in their directorate and advise directorate management on the technical, cost, schedule, and programmatic health of each. As part of this vertically-extended CE team, a program level CE manages a continually varying balance between penetration depth and breadth across his or her assigned missions. Teamwork issues and information integration become critical for management at all levels to ensure value-added use of both the synergy available between CEs at the various agency levels, and the independence of the technical authority at each organization.

  19. INDEPENDENT TECHNICAL ASSESSMENT OF MANAGEMENT OF STORMWATER AND WASTEWATER AT THE SEPARATIONS PROCESS RESEARCH UNIT (SPRU) DISPOSITION PROJECT, NEW YORK

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

    Abitz, R.; Jackson, D.; Eddy-Dilek, C.

    2011-06-27

    The U.S. Department of Energy (DOE) is currently evaluating the water management procedures at the Separations Process Research Unit (SPRU). The facility has three issues related to water management that require technical assistance: (1) due to a excessive rainfall event in October, 2010, contaminated water collected in basements of G2 and H2 buildings. As a result of this event, the contractor has had to collect and dispose of water offsite; (2) The failure of a sump pump at a KAPL outfall resulted in a Notice of Violation issued by the New York State Department of Environment and Conservation (NYSDEC) andmore » subsequent Consent Order. On-site water now requires treatment and off-site disposition; and (3) stormwater infiltration has resulted in Strontium-90 levels discharged to the storm drains that exceed NR standards. The contractor has indicated that water management at SPRU requires major staff resources (at least 50 persons). The purpose of this review is to determine if the contractor's technical approach warrants the large number of staff resources and to ensure that the technical approach is compliant and in accordance with federal, state and NR requirements.« less

  20. Using Civilian Supply Chain Management Best Practices to Improve Army Supply Chain Management Procedures

    DTIC Science & Technology

    2017-06-09

    USING CIVILIAN SUPPLY CHAIN MANAGEMENT BEST PRACTICES TO IMPROVE ARMY SUPPLY CHAIN MANAGEMENT PROCEDURES A thesis presented to......Army Supply Chain Management Procedures 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Chief Warrant

  1. AgRISTARS: Foreign Commodity production forecasting. Project procedures designation and description document, volume 1

    NASA Technical Reports Server (NTRS)

    Waggoner, J. T.; Phinney, D. E. (Principal Investigator)

    1981-01-01

    The crop estimation analysis procedures documentation of the AgRISTARS - Foreign Commodity Production Forecasting Project (FCPF) is presented. Specifically it includes the technical/management documentation of the remote sensing data analysis procedures prepared in accordance with the guidelines provided in the FCPF communication/documentation standards manual. Standard documentation sets are given arranged by procedural type and level then by crop types or other technically differentiating categories.

  2. [The LESS (Laparo-endoscopic Single-Site) procedure in urology. Technical and clinical aspects].

    PubMed

    Neri, F; Cindolo, L; Gidaro, S; Schips, L

    2010-01-01

    Minimally invasive urology is rapidly advancing, and single-site laparoscopic surgery is being explored clinically. Such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing. In the last years several surgeons all over the world have explored the feasibility and safety of LESS using several and different ports, approaches and devices. Hundreds of procedures have been described with overall favorable intraoperative and postoperative outcomes. Our experience consists of more than 30 procedures successfully completed for adrenal, kidney disease and varicocele. To date, LESS could be considered feasible and effective using currently available devices, however it is to be considered as an initial status technique requiring further confirmatory studies and advanced laparoscopic skills.

  3. Unique strategies for technical information management at Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Krishen, Vijay

    1994-01-01

    In addition to the current NASA manned programs, the maturation of Space Station and the introduction of the Space Exploration programs are anticipated to add substantially to the number and variety of data and documentation at NASA Johnson Space Center (JSC). This growth in the next decade has been estimated at five to ten fold compared to the current numbers. There will be an increased requirement for the tracking and currency of space program data and documents with National pressures to realize economic benefits from the research and technological developments of space programs. From a global perspective the demand for NASA's technical data and documentation is anticipated to increase at local, national, and international levels. The primary users will be government, industry, and academia. In our present national strategy, NASA's research and technology will assume a great role in the revitalization of the economy and gaining international competitiveness. Thus, greater demand will be placed on NASA's data and documentation resources. In this paper the strategies and procedures developed by DDMS, Inc., to accommodate the present and future information utilization needs are presented. The DDMS, Inc., strategies and procedures rely on understanding user requirements, library management issues, and technological applications for acquiring, searching, storing, and retrieving specific information accurately and quickly. The proposed approach responds to changing customer requirements and product deliveries. The unique features of the proposed strategy include: (1) To establish customer driven data and documentation management through an innovative and unique methods to identify needs and requirements. (2) To implement a structured process which responds to user needs, aimed at minimizing costs and maximizing services, resulting in increased productivity. (3) To provide a process of standardization of services and procedures. This standardization is the central

  4. Interventional Radiology-Operated Cholecystoscopy for the Management of Symptomatic Cholelithiasis: Approach, Technical Success, Safety, and Clinical Outcomes.

    PubMed

    Patel, Nishant; Chick, Jeffrey Forris Beecham; Gemmete, Joseph J; Castle, Jordan C; Dasika, Narasimham; Saad, Wael E; Srinivasa, Ravi N

    2018-05-01

    The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula. Cholecystostomy access, time between cholecystostomy and cholecystoscopy, endoscopic and fragmentation devices used, technical success, procedure time, fluoroscopy time, complications, length of hospital stay, time between cholecystoscopy and cholecystostomy removal, follow-up, and acute cholecystitis recurrence were recorded. Eleven (85%) patients underwent transhepatic cholecystostomy, and two (15%) patients underwent transperitoneal cholecystostomy. The mean time from cholecystostomy to cholecystoscopy was 151 days. Flexible endoscopy was used in eight (62%) patients, rigid endoscopy in three (23%), and both flexible and rigid in two (15%). Electrohydraulic lithotripsy was used in eight procedures, nitinol baskets in seven, ultrasonic lithotripsy in two, and percutaneous thrombectomy devices in one. Primary technical success was achieved in 11 (85%) patients, and secondary technical success was achieved in 13 (100%) patients. The mean procedure time was 164 minutes, and the mean number of procedures required to clear all gallstones was 1. One (8%) patient developed acute pancreatitis, and one (8%) patient died of gastrointestinal hemorrhage. The median hospital length of stay after cholecystoscopy was 1 day for postoperative monitoring. The mean time between cholecystoscopy and cholecystostomy removal was 39 days. One (8%) patient developed recurrent

  5. The use of a checklist improves anaesthesiologists' technical and non-technical performance for simulated malignant hyperthermia management.

    PubMed

    Hardy, Jean-Baptiste; Gouin, Antoine; Damm, Cédric; Compère, Vincent; Veber, Benoît; Dureuil, Bertrand

    2018-02-01

    Anaesthesiologists may occasionally manage life-threatening operating room (OR) emergencies. Managing OR emergencies implies real-time analysis of often complicated situations, prompt medical knowledge retrieval, coordinated teamwork and effective decision making in stressful settings. Checklists are recommended to improve performance and reduce the risk of medical errors. This study aimed to assess the usefulness of the French Society of Anaesthesia and Intensive Care's (SFAR) "Malignant Hyperthermia" (MH) checklist on a simulated episode of MH crisis and management thereof by registered anesthesiologists. Twenty-four anaesthesiologists were allocated to 2 groups (checklist and control). Their technical performance in adherence with the SFAR guidelines was assessed by a 30-point score and their non-technical performance was assessed by the Anaesthetists' Non-Technical Skills (ANTS) score. Every task completion was assessed independently. Data are shown as median (first-third quartiles). Anaesthesiologists in the checklist group had higher technical performance scores (24/30 (21.5-25) vs 18/30 (15.5-19.5), P=0.002) and ANTS scores (56.5/60 (47.5-58) vs 48.5/60 (41-50.5), P=0.024). They administered the complete initial dose of dantrolene (2mg/kg) more quickly (15.7 minutes [13.9-18.3] vs 22.4 minutes [18.6-25]) than the control group (P=0.017). However, anaesthesiologists deemed the usability of the checklist to be perfectible. Registered anaesthesiologists' use of the MH checklist during a simulation session widely improved their adherence to guidelines and non-technical skills. This study strongly suggests the benefit of checklist tools for emergency management. Notwithstanding, better awareness and training for anaesthesiologists could further improve the use of this tool. Copyright © 2017 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  6. Framework conditions and requirements to ensure the technical functional safety of reprocessed medical devices.

    PubMed

    Kraft, Marc

    2008-09-03

    Testing and restoring technical-functional safety is an essential part of medical device reprocessing. Technical functional tests have to be carried out on the medical device in the course of the validation of reprocessing procedures. These ensure (in addition to the hygiene tests) that the reprocessing procedure is suitable for the medical device. Functional tests are, however, also a part of reprocessing procedures. As a stage in the reprocessing, they ensure for the individual medical device that no damage or other changes limit the performance. When determining which technical-functional tests are to be carried out, the current technological standard has to be taken into account in the form of product-specific and process-oriented norms. Product-specific norms primarily define safety-relevant requirements. The risk management method described in DIN EN ISO 14971 is the basis for recognising hazards; the likelihood of such hazards arising can be minimised through additional technical-functional tests, which may not yet have been standardised. Risk management is part of a quality management system, which must be bindingly certified for manufacturers and processors of critical medical devices with particularly high processing demands by a body accredited by the competent authority.

  7. Framework conditions and requirements to ensure the technical functional safety of reprocessed medical devices

    PubMed Central

    Kraft, Marc

    2008-01-01

    Testing and restoring technical-functional safety is an essential part of medical device reprocessing. Technical functional tests have to be carried out on the medical device in the course of the validation of reprocessing procedures. These ensure (in addition to the hygiene tests) that the reprocessing procedure is suitable for the medical device. Functional tests are, however, also a part of reprocessing procedures. As a stage in the reprocessing, they ensure for the individual medical device that no damage or other changes limit the performance. When determining which technical-functional tests are to be carried out, the current technological standard has to be taken into account in the form of product-specific and process-oriented norms. Product-specific norms primarily define safety-relevant requirements. The risk management method described in DIN EN ISO 14971 is the basis for recognising hazards; the likelihood of such hazards arising can be minimised through additional technical-functional tests, which may not yet have been standardised. Risk management is part of a quality management system, which must be bindingly certified for manufacturers and processors of critical medical devices with particularly high processing demands by a body accredited by the competent authority. PMID:20204095

  8. Intra-operative disruptions, surgeon's mental workload, and technical performance in a full-scale simulated procedure.

    PubMed

    Weigl, Matthias; Stefan, Philipp; Abhari, Kamyar; Wucherer, Patrick; Fallavollita, Pascal; Lazarovici, Marc; Weidert, Simon; Euler, Ekkehard; Catchpole, Ken

    2016-02-01

    Surgical flow disruptions occur frequently and jeopardize perioperative care and surgical performance. So far, insights into subjective and cognitive implications of intra-operative disruptions for surgeons and inherent consequences for performance are inconsistent. This study aimed to investigate the effect of surgical flow disruption on surgeon's intra-operative workload and technical performance. In a full-scale OR simulation, 19 surgeons were randomly allocated to either of the two disruption scenarios (telephone call vs. patient discomfort). Using a mixed virtual reality simulator with a computerized, high-fidelity mannequin, all surgeons were trained in performing a vertebroplasty procedure and subsequently performed such a procedure under experimental conditions. Standardized measures on subjective workload and technical performance (trocar positioning deviation from expert-defined standard, number, and duration of X-ray acquisitions) were collected. Intra-operative workload during simulated disruption scenarios was significantly higher compared to training sessions (p < .01). Surgeons in the telephone call scenario experienced significantly more distraction compared to their colleagues in the patient discomfort scenario (p < .05). However, workload tended to be increased in surgeons who coped with distractions due to patient discomfort. Technical performance was not significantly different between both disruption scenarios. We found a significant association between surgeons' intra-operative workload and technical performance such that surgeons with increased mental workload tended to perform worse (β = .55, p = .04). Surgical flow disruptions affect surgeons' intra-operative workload. Increased mental workload was associated with inferior technical performance. Our simulation-based findings emphasize the need to establish smooth surgical flow which is characterized by a low level of process deviations and disruptions.

  9. 77 FR 31615 - Improving Mail Management Policies, Procedures, and Activities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... Mail Management Policies, Procedures, and Activities AGENCY: Office of Governmentwide Policy, General... Administration (GSA) has issued Federal Management Regulation (FMR) Bulletin G-03 which provides guidance to Executive Branch agencies for improving mail management policies, procedures, and activities. FMR Bulletin G...

  10. An SNMP-based solution to enable remote ISO/IEEE 11073 technical management.

    PubMed

    Lasierra, Nelia; Alesanco, Alvaro; García, José

    2012-07-01

    This paper presents the design and implementation of an architecture based on the integration of simple network management protocol version 3 (SNMPv3) and the standard ISO/IEEE 11073 (X73) to manage technical information in home-based telemonitoring scenarios. This architecture includes the development of an SNMPv3-proxyX73 agent which comprises a management information base (MIB) module adapted to X73. In the proposed scenario, medical devices (MDs) send information to a concentrator device [designated as compute engine (CE)] using the X73 standard. This information together with extra information collected in the CE is stored in the developed MIB. Finally, the information collected is available for remote access via SNMP connection. Moreover, alarms and events can be configured by an external manager in order to provide warnings of irregularities in the MDs' technical performance evaluation. This proposed SNMPv3 agent provides a solution to integrate and unify technical device management in home-based telemonitoring scenarios fully adapted to X73.

  11. Pleural procedures in the management of malignant effusions

    PubMed Central

    Ferreiro, Lucía; Suárez-Antelo, Juan; Valdés, Luis

    2017-01-01

    Malignant pleural effusion (MPE) is common in clinical practice, and despite the existence of studies to guide clinical decisions, it often poses diagnostic and therapeutic dilemmas. Once it is diagnosed, median survival does not usually exceed 6 months. The management of these patients focuses on symptom relief since no treatments have been shown to increase survival to date. Conversely, poor management can shorten survival. The approach must be multidisciplinary and allow for individualized care. Initial diagnostic procedures should be minimally invasive and, according to the results and other factors, procedures of increasing complexity will be selecting. Likewise, the treatment of MPEs should be individualized according to factors such as type of tumor, patient functional status, means available, benefits of each procedure, or life expectancy. Currently, treatment seems to tend toward less interventional approaches, in which patients can be managed on an outpatient basis, thus minimizing both the discomfort that more aggressive approaches involve and the costs of care associated with this disease. This article reviews the pleural procedures employed in the management of MPEs with special emphasis on the indication for each one, its usefulness, benefits, and complications. PMID:28197215

  12. Engineering, technical, and management support services

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This report summarizes by task the engineering, technical, and management support services provided by Vitro Corporation to NASA Headquarters Office of Safety, Reliability, Maintainability, and Quality Assurance (now called Office of Safety and Mission Assurance (OSMA)) (Code Q) under Contract Number NASW-4311 from the period February 10, 1994. Each task summary includes significant Vitro accomplishments, conclusions, and recommendations for future efforts in each of the divisions within OSMA.

  13. Epidemiology and management of painful procedures in children in Canadian hospitals

    PubMed Central

    Stevens, Bonnie J.; Abbott, Laura K.; Yamada, Janet; Harrison, Denise; Stinson, Jennifer; Taddio, Anna; Barwick, Melanie; Latimer, Margot; Scott, Shannon D.; Rashotte, Judith; Campbell, Fiona; Finley, G. Allen

    2011-01-01

    Background Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. Methods We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ2) analyses. Results Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. Interpretation For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of

  14. Retrospective analysis of technical success rate and procedure-related complications of 867 percutaneous CT-guided needle biopsies of lung lesions.

    PubMed

    Mills, M; Choi, J; El-Haddad, G; Sweeney, J; Biebel, B; Robinson, L; Antonia, S; Kumar, A; Kis, B

    2017-12-01

    To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (p<0.001), longer transparenchymal distance (p<0.001), and prone position (p=0.027). There was positive correlation between the need for chest tube placement and longer transparenchymal distance (p=0.007) and smaller lesion diameter (p=0.018). Lesions in the left lower lobe had the lowest rates of pneumothorax (p=0.008) and chest tube drainage (p=0.018). Patients whose pneumothoraces were diagnosed on the follow-up chest X-ray, but not on the immediate post-procedural CT scan had significantly higher requirement for chest tube drainage (p=0.039). CT-guided lung biopsy has a high rate of technical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. 48 CFR 342.7101-2 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Procedures. 342.7101-2 Section 342.7101-2 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACT MANAGEMENT... data received; (2) Request audit or cost advisory services, and technical support, as necessary, for...

  16. Dredging Operations Technical Support Program. Design and Management of Dredged Material Containment Areas to Improve Hydraulic Performance.

    DTIC Science & Technology

    1987-06-01

    in chlorine contact chambers were not sensit ive to experimentil procedure, and ’"When the dye test was repeated on the same hsin undcr ident i ; I I...neither YA t 1idth nor Ienzth ar’ 1n t -r,1ined i u , nd i t ion, costs are , iunti , t ion I .< and N . ( u yen % and Iltl ;I<,, r[i,. hte used tc com...DREDGING OPERATIONS TECHNICAL SUPPORT PROGRAM TEHIA REPORT D-87-2 DESIGN AND MANAGEMENT OF DREDGED MATERIAL CONTAINMENT AREAS TO% N IMPROVE

  17. Main clinical, therapeutic and technical factors related to patient's maximum skin dose in interventional cardiology procedures

    PubMed Central

    Journy, N; Sinno-Tellier, S; Maccia, C; Le Tertre, A; Pirard, P; Pagès, P; Eilstein, D; Donadieu, J; Bar, O

    2012-01-01

    Objective The study aimed to characterise the factors related to the X-ray dose delivered to the patient's skin during interventional cardiology procedures. Methods We studied 177 coronary angiographies (CAs) and/or percutaneous transluminal coronary angioplasties (PTCAs) carried out in a French clinic on the same radiography table. The clinical and therapeutic characteristics, and the technical parameters of the procedures, were collected. The dose area product (DAP) and the maximum skin dose (MSD) were measured by an ionisation chamber (Diamentor; Philips, Amsterdam, The Netherlands) and radiosensitive film (Gafchromic; International Specialty Products Advanced Materials Group, Wayne, NJ). Multivariate analyses were used to assess the effects of the factors of interest on dose. Results The mean MSD and DAP were respectively 389 mGy and 65 Gy cm−2 for CAs, and 916 mGy and 69 Gy cm−2 for PTCAs. For 8% of the procedures, the MSD exceeded 2 Gy. Although a linear relationship between the MSD and the DAP was observed for CAs (r=0.93), a simple extrapolation of such a model to PTCAs would lead to an inadequate assessment of the risk, especially for the highest dose values. For PTCAs, the body mass index, the therapeutic complexity, the fluoroscopy time and the number of cine frames were independent explanatory factors of the MSD, whoever the practitioner was. Moreover, the effect of technical factors such as collimation, cinematography settings and X-ray tube orientations on the DAP was shown. Conclusion Optimising the technical options for interventional procedures and training staff on radiation protection might notably reduce the dose and ultimately avoid patient skin lesions. PMID:22457404

  18. Coagulation management in patients undergoing neurosurgical procedures.

    PubMed

    Robba, Chiara; Bertuetti, Rita; Rasulo, Frank; Bertuccio, Alessando; Matta, Basil

    2017-10-01

    Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures. Antihemostatic and anticoagulant drugs have shown to be associated with perioperative bleeding. On the other hand, an increased risk of venous thromboembolism and hypercoagulative state after elective and emergency neurosurgery, in particular after brain tumor surgery, has been described in several patients. To balance the risk between thrombosis and bleeding, it is important to be familiar with the perioperative changes in coagulation and with the recent management guidelines for anticoagulated patients undergoing neurosurgical procedures, in particular for those taking new direct anticoagulants. We have considered the current clinical trials and literature regarding both safety and efficacy of deep venous thrombosis prophylaxis in the neurosurgical population. These were mainly trials concerning both elective surgical and intensive care patients with a poor grade intracranial bleed or multiple traumas with an associated severe traumatic brain injury (TBI). Coagulation management remains a major issue in patients undergoing neurosurgical procedures. However, in this field of research, literature quality is poor and further studies are necessary to identify the best strategies to minimize risks in this group of patients.

  19. Computerising the Salesforce: The Introduction of Technical Change in a Non-Union Workforce.

    ERIC Educational Resources Information Center

    Newell, Helen; Lloyd, Caroline

    1998-01-01

    Results of interviews with 13 pharmaceutical sales representatives, five sales managers, and six human-resource managers and 47 survey responses showed that introduction of information technology was seen as purely technical; human-resources departments played no role; and informal communication procedures enabled management to ignore individual…

  20. Security and emergency management technical assistance for the top 50 transit agencies

    DOT National Transportation Integrated Search

    2007-04-01

    Between May 2002 and July 2006, the Federal Transit Administration (FTA) provided technical assistance to the top 50 transit agencies through the Security and Emergency Management Technical Assistance Program (SEMTAP). The scope and purpose of the pr...

  1. Spruce-fir management and spruce budworm; SAF region VI technical conference

    Treesearch

    Daniel Schmitt; ed.

    1985-01-01

    Presents a technical update of the management of spruce-fir forests. Integrated management of eastern spruce budworm is not yet a reality. The ecological, social, and economic knowledge needed to develop an integrated management system is not available. The conference was designed to move individuals to a higher level of spruce budworm management in the eastern spruce-...

  2. Non-Procedural Languages for Information Resource Management.

    ERIC Educational Resources Information Center

    Bearley, William L.

    The future of information resources management requires new approaches to implementing systems which will include a type of data base management that frees users to solve data processing problems logically by telling the system what they want, together with powerful non-procedural languages that will permit communication in simple, concise…

  3. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...

  4. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...

  5. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...

  6. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Natural history resource management procedures. [Reserved] 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands...-CRIMINAL Recreation Programs § 9268.2 Natural history resource management procedures. [Reserved] ...

  7. 13 CFR 124.701 - What is the purpose of the 7(j) management and technical assistance program?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) management and technical assistance program? 124.701 Section 124.701 Business Credit and Assistance SMALL...) Business Development Management and Technical Assistance Program § 124.701 What is the purpose of the 7(j) management and technical assistance program? Section 7(j)(1) of the Small Business Act, 15 U.S.C. 636(j)(1...

  8. Technical Communications in Aeronautics: Results of an Exploratory Study. An Analysis of Managers' and Nonmanagers' Responses. NASA Technical Memorandum 101625.

    ERIC Educational Resources Information Center

    Pinelli, Thomas E.; And Others

    Data collected from an exploratory study concerned with the technical communications practices of aerospace engineers and scientists were analyzed to test the primary assumption that aerospace managers and nonmanagers have different technical communications practices. Five secondary assumptions were established for the analysis: (1) that the…

  9. 23 CFR 630.1106 - Policy and procedures for work zone safety management.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Policy and procedures for work zone safety management... Policy and procedures for work zone safety management. (a) Each agency's policy and processes, procedures... established in accordance with 23 CFR 630.1006, shall include the consideration and management of road user...

  10. 13 CFR 124.704 - What additional management and technical assistance is reserved exclusively for concerns eligible...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What additional management and.../SMALL DISADVANTAGED BUSINESS STATUS DETERMINATIONS 8(a) Business Development Management and Technical... management and technical assistance through its service providers exclusively to small business concerns...

  11. Report format preferences of technical managers and nonmanagers

    NASA Technical Reports Server (NTRS)

    Pinelli, T. E.; Cordle, V. M.; Glassman, M.; Vondran, R. F., Jr.

    1984-01-01

    A survey of engineers and scientists concerning the format of NASA technical reports indicates that a summary as well as an abstract should be included, that the definitions of symbols and glossary of terms should be located in the front of the report, and that the illustrative material should be integrated with the text rather than grouped at the end of the report. Citation of references by number, one-column, ragged-right-margin layout, and third-person writing style are also preferred by a majority of the respondents. The preferences of managers and nonmanagers are very similar for all aspects of technical report format covered by the survey.

  12. Improving technical information use: what can be learnt from a manager's perspective?

    PubMed

    Jacobson, C; Lisle, A; Carter, R W; Hockings, M T

    2013-07-01

    Conservation practice reportedly suffers from low use of technical information. Understanding of factors that affect the influence of technical information on management decision-making is limited. We sought to identify leverage points for improved technical information dissemination in the New South Wales Parks and Wildlife Service, Australia, given the significant recent investments in monitoring and evaluation that had been made. We did so by exploring the inter-relationships between factors affecting the influence of different information types on management decisions. Results indicate that managers have a high inclination toward adaptive behavior, given they operate in an information poor environment. The most influential types of information were those that enabled interaction between information provider and recipient (e.g., staff experience and expertise). An analysis of the concordance in individuals' responses for different information types showed that neither accessibility nor organizational expectation of use was aligned with influence on decision-making. Alignment of responses also varied by work area. Raising expectations of information use or increasing access to particular types of information is therefore unlikely to result in an increase in influence on management decision-making. Rather than focussing on matching accessibility and expected use of particular information types, our results indicate that technical information uptake is best supported through existing peer networks tailored to specific work areas.

  13. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    NASA Technical Reports Server (NTRS)

    Raiman, Laura B.

    1992-01-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  14. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    NASA Astrophysics Data System (ADS)

    Raiman, Laura B.

    1992-12-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  15. Intradural Procedural Time to Assess Technical Difficulty of Superciliary Keyhole and Pterional Approaches for Unruptured Middle Cerebral Artery Aneurysms

    PubMed Central

    Choi, Yeon-Ju; Son, Wonsoo; Park, Ki-Su

    2016-01-01

    Objective This study used the intradural procedural time to assess the overall technical difficulty involved in surgically clipping an unruptured middle cerebral artery (MCA) aneurysm via a pterional or superciliary approach. The clinical and radiological variables affecting the intradural procedural time were investigated, and the intradural procedural time compared between a superciliary keyhole approach and a pterional approach. Methods During a 5.5-year period, patients with a single MCA aneurysm were enrolled in this retrospective study. The selection criteria for a superciliary keyhole approach included : 1) maximum diameter of the unruptured MCA aneurysm <15 mm, 2) neck diameter of the MCA aneurysm <10 mm, and 3) aneurysm location involving the sphenoidal or horizontal segment of MCA (M1) segment and MCA bifurcation, excluding aneurysms distal to the MCA genu. Meanwhile, the control comparison group included patients with the same selection criteria as for a superciliary approach, yet who preferred a pterional approach to avoid a postoperative facial wound or due to preoperative skin trouble in the supraorbital area. To determine the variables affecting the intradural procedural time, a multiple regression analysis was performed using such data as the patient age and gender, maximum aneurysm diameter, aneurysm neck diameter, and length of the pre-aneurysm M1 segment. In addition, the intradural procedural times were compared between the superciliary and pterional patient groups, along with the other variables. Results A total of 160 patients underwent a superciliary (n=124) or pterional (n=36) approach for an unruptured MCA aneurysm. In the multiple regression analysis, an increase in the diameter of the aneurysm neck (p<0.001) was identified as a statistically significant factor increasing the intradural procedural time. A Pearson correlation analysis also showed a positive correlation (r=0.340) between the neck diameter and the intradural procedural time

  16. Ohio Medical Office Management. Technical Competency Profile (TCP).

    ERIC Educational Resources Information Center

    Ray, Gayl M.; Wilson, Nick; Mangini, Rick

    This document provides a framework for a broad-based secondary and postsecondary curriculum to prepare students for employment in medical office management. The first part of the technical competency profile (TCP) contains the following items: an explanation of the purpose and scope of Ohio's TCPs; college tech prep program standards; an overview…

  17. The Role of Formal Education, Technical and Management Training on Information Systems (IS) Managers' Managerial Effectiveness as Perceived by Their Subordinates

    ERIC Educational Resources Information Center

    Ligon, Jerry; Abdullah, ABM; Talukder, Majharul

    2007-01-01

    This study examined the relationship between Information Systems (IS) managers' formal education, level of technical and managerial training and their managerial effectiveness as perceived by their subordinates. The study finds that there is a strong positive relationship between the amount of technical training IS managers have received and their…

  18. 45 CFR 1304.51 - Management systems and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... control program quality, maintain program accountability, and advise governing bodies, policy groups, and... DELEGATE AGENCIES Program Design and Management § 1304.51 Management systems and procedures. (a) Program... program planning that includes consultation with the program's governing body, policy groups, and program...

  19. An audit questionnaire that examines specifically the management of technical activities clauses in ISO 15189.

    PubMed

    Hartley, T F

    2010-01-01

    The aim of this study was to design an audit questionnaire that focuses on the management of the technical activities in a Diagnostic Pathology Laboratory. The ISO 15189 Standard is written in such a way that it continually moves back and forth from topics where the auditor needs to question bench level staff, to topics where the auditor needs to question Technical Management Staff. This makes for a disjointed audit process - both Bench Staff and Technical Managers are repeatedly interrupted. The solution was to do a clause by clause analysis of the Standard and assign the major responsibility for the compliance to each clause to either Technical Managers or Bench Staff. The Clauses were then grouped under four topic headings regardless of whether they were a Section 4 or Section 5 Clause. Two questionnaires have emerged - the one described in this work and one directed primarily towards the activities of bench staff. There are 95 questions and it takes approximately two hours to complete.

  20. Intraarticular Sacroiliac Joint Injection Under Computed Tomography Fluoroscopic Guidance: A Technical Note to Reduce Procedural Time and Radiation Dose

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

    Paik, Nam Chull, E-mail: pncspine@gmail.com

    2016-07-15

    PurposeA technique for computed tomography fluoroscopy (CTF)-guided intraarticular (IA) sacroiliac joint (SIJ) injection was devised to limit procedural time and radiation dose.MethodsOur Institutional Review Board approved this retrospective analysis and waived the requirement for informed consent. Overall, 36 consecutive diagnostic or therapeutic IA SIJ injections (unilateral, 20; bilateral, 16) performed in 34 patients (female, 18; male, 16) with a mean age of 45.5 years (range 20–76 years) under CTF guidance were analyzed, assessing technical success (i.e., IA contrast spread), procedural time, and radiation dose.ResultsAll injections were successful from a technical perspective and were free of serious complications. Respective median proceduralmore » times and effective doses of SIJ injection were as follows: unilateral, 5.28 min (range 3.58–8.00 min) and 0.11 millisievert (mSv; range 0.07–0.24 mSv); and bilateral, 6.72 min (range 4.17–21.17 min) and 0.11 mSv (range 0.09–0.51 mSv).ConclusionsGiven the high rate of technical success achieved in limited time duration and with little radiation exposure, CTF-guided IA SIJ injection is a practical and low-risk procedure.« less

  1. Procedures to Help Program Offices with Earned Value Management

    EPA Pesticide Factsheets

    EPA’s Earned Value Management (EVM) Procedures describe the Agency methods for collecting and reporting performance information on major IT investments. The EVM Procedures explain how EPA Program Offices are to receive, organize, analyze, and report cost.

  2. The French Space Operation Act: Technical Regulations

    NASA Astrophysics Data System (ADS)

    Trinchero, J. P.; Lazare, B.

    2010-09-01

    The French Space Operation Act(FSOA) stipulates that a prime objective of the National technical regulations is to protect people, property, public health and the environment. Compliance with these technical regulations is mandatory as of 10 December 2010 for space operations by French space operators and for space operations from French territory. The space safety requirements and regulations governing procedures are based on national and international best practices and experience. A critical design review of the space system and procedures shall be carried out by the applicant, in order to verify compliance with the Technical Regulations. An independent technical assessment of the operation is delegated to CNES. The principles applied when drafting technical regulations are as follows: requirements must as far as possible establish the rules according to the objective to be obtained, rather than how it is to be achieved; requirements must give preference to international standards recognised as being the state of the art; requirements must take previous experience into account. Technical regulations are divided into three sections covering common requirements for the launch, control and return of a space object. A dedicated section will cover specific rules to be applied at the Guiana Space Centre. The main topics addressed by the technical regulations are: operator safety management system; study of risks to people, property, public health and the Earth’s environment; impact study on the outer space environment: space debris generated by the operation; planetary protection.

  3. Meningomyelocele Simulation Model: Pre-surgical Management-Technical Report.

    PubMed

    Rosen, Orna; Angert, Robert M

    2018-02-26

    This technical report describes the creation of a myelomeningocele model of a newborn baby. This is a simple, low-cost, and easy-to-assemble model that allows the medical team to practice the delivery room management of a newborn with myelomeningocele. The report includes scenarios and a suggested checklist with which the model can be employed.

  4. Integrated Measurement of Crew Resource Management and Technical Flying Skills

    DOT National Transportation Integrated Search

    1993-08-01

    This report presents the findings of a study designed with two objectives: to produce a prototype performance : measurement instrument (PMI) that integrates the assessment of Crew Resource Management (CRM) and technical flying : skills and to investi...

  5. Ohio Marketing Management and Research. Technical Competency Profile (TCP).

    ERIC Educational Resources Information Center

    Ray, Gayl M.; Wilson, Nick; Mangini, Rick

    This document provides a framework for a broad-based secondary and postsecondary curriculum to prepare students for employment in marketing management and research (MMR). The first part of the technical competency profile (TCP) contains the following items: an explanation of the purpose and scope of Ohio's TCPs; college tech prep program…

  6. Automated dredging and disposal alternatives management system (ADDAMS). Environmental effects of dredging. Technical note

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

    NONE

    This technical note describes the current capabilities and availability of the Automated Dredging and Disposal Alternatives Management System (ADDAMS). The technical note replaces the earlier Technical Note EEDP-06-12, which should be discarded. Planning, design, and management of dredging and dredged material disposal projects often require complex or tedious calculations or involve complex decision-making criteria. In addition, the evaluations often must be done for several disposal alternatives or disposal sites. ADDAMS is a personal computer (PC)-based system developed to assist in making such evaluations in a timely manner. ADDAMS contains a collection of computer programs (applications) designed to assist in managingmore » dredging projects. This technical note describes the system, currently available applications, mechanisms for acquiring and running the system, and provisions for revision and expansion.« less

  7. Laparoscopic partial nephrectomy: Technical considerations and an update

    PubMed Central

    Dominguez-Escrig, Jose L; Vasdev, Nikhil; O’Riordon, Anna; Soomro, Naeem

    2011-01-01

    The widespread use of radiological imaging (ultrasound, computed tomography and magnetic resonance imaging) has resulted in a steady increase in the incidental diagnosis of small renal masses. While open partial nephrectomy (OPN) remains the reference standard for the management of small renal masses, laparoscopic partial nephrectomy (LPN) continues to evolve. LPN is currently advocated to be at par with OPN oncologically. The steep learning curve and technical demand of LPN make it challenging to establish this as a new procedure. We present a detailed up-to-date review on the previous, current and planned technical considerations for the use of LPN, highlighting important surgical techniques, including single-port and robotic surgery, techniques on improving intra-operative haemostasis and the management of complications specific to LPN. PMID:22022109

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

    NASA Technical Reports Server (NTRS)

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

    1972-01-01

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

  9. The 'Whip-Stow' procedure: an innovative modification to the whipple procedure in the management of premalignant and malignant pancreatic head disease.

    PubMed

    Jeyarajah, D Rohan; Khithani, Amit; Curtis, David; Galanopoulos, Christos A

    2010-01-01

    Pancreaticoduodenectomy (PD) is the standard of care in the treatment of premalignant and malignant diseases of the head of the pancreas. Variability exists in anastomosis with the pancreatic remnant. This work describes a safe and easy modification for the pancreatic anastomosis after PD. Ten patients underwent the "Whip-Stow" procedure for the management of the pancreatic remnant. PD combined with a Puestow (lateral pancreaticojejunostomy [LPJ]) was completed using a running single-layer, 4-0 Prolene obeying a duct-to-mucosa technique. LPJ and pancreaticogastrostomy (PG) historical leak rates are reported to be 13.9 and 15.8 per cent, respectively. Mortality, leak, and postoperative bleeding rates were 0 per cent in all patients. The Whip-Stow was completed without loops or microscope with a 4-0 single-layer suture decreasing the time and complexity of the anastomosis. Average time was 12 minutes as compared with the 50 minutes of a 5 or 6-0 interrupted, multilayered duct-mucosa anastomosis. Benefits included a long-segment LPJ. In this study, the Whip-Stow procedure has proven to be a safe and simple approach to pancreatic anastomosis in selected patients. This new technique provides the benefit of technical ease while obeying the age old principles of obtaining a wide duct to mucosa anastomosis.

  10. The procedure execution manager and its application to Advanced Photon Source operation

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

    Borland, M.

    1997-06-01

    The Procedure Execution Manager (PEM) combines a complete scripting environment for coding accelerator operation procedures with a manager application for executing and monitoring the procedures. PEM is based on Tcl/Tk, a supporting widget library, and the dp-tcl extension for distributed processing. The scripting environment provides support for distributed, parallel execution of procedures along with join and abort operations. Nesting of procedures is supported, permitting the same code to run as a top-level procedure under operator control or as a subroutine under control of another procedure. The manager application allows an operator to execute one or more procedures in automatic, semi-automatic,more » or manual modes. It also provides a standard way for operators to interact with procedures. A number of successful applications of PEM to accelerator operations have been made to date. These include start-up, shutdown, and other control of the positron accumulator ring (PAR), low-energy transport (LET) lines, and the booster rf systems. The PAR/LET procedures make nested use of PEM`s ability to run parallel procedures. There are also a number of procedures to guide and assist tune-up operations, to make accelerator physics measurements, and to diagnose equipment. Because of the success of the existing procedures, expanded use of PEM is planned.« less

  11. Biologic considerations regarding the one and two step procedures in the management of patients with invasive carcinoma of the breast.

    PubMed

    Fisher, E R; Sass, R; Fisher, B

    1985-09-01

    Investigation of the biologic significance of delay between biopsy and mastectomy was performed upon women with invasive carcinoma of the breast in protocol four of the NSABP. Since the period of delay was two weeks or less in approximately 75 per cent, no comment concerning the possible effects of longer periods can be made. Life table analyses failed to reveal any difference in ten year survival rates between patients undergoing radical mastectomy management by the one and two step procedures. Similarly, no difference in adjusted ten year survival rate was observed between women managed by the two step procedure who did or did not have residual tumor identified in the mastectomy specimen after the first step or biopsy. Importantly, the clinical or pathologic stages, sizes of tumor or histologic grades were similar in women managed by the one and two step procedures minimizing selection bias. The material used also allowed for study of the possible causative role of biopsy of the breast on the development of sinus histiocytosis in regional axillary lymph nodes. No difference in degree or types of this nodal reaction could be discerned in the lymph nodes of the mastectomy specimens obtained from patients who had undergone the one and two step procedures. This finding indicates that nodal sinus histiocytosis is indeed related to the neoplastic process, albeit in an undefined manner, rather than the trauma of biopsy per se as has been suggested. These results do not invalidate the use of the one step procedure in the management of patients with carcinoma of the breast. Indeed, it is highly likely that it will be commonly used now that breast-conserving operations appear to represent a viable alternative modality for the primary surgical treatment of carcinoma of the breast. Yet, it is apparent that the one step procedure will be performed for technical and practical rather than biologic reasons.

  12. Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) Quality Assurance Management Plan

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

    Fix, N. J.

    The scope of the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) is to provide technical and integration support to Fluor Hanford, Inc., including operable unit investigations at 300-FF-5 and other groundwater operable units, strategic integration, technical integration and assessments, remediation decision support, and science and technology. This Quality Assurance Management Plan provides the quality assurance requirements and processes that will be followed by the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project).

  13. Academic Unit Planning and Management. Technical Report No. 75.

    ERIC Educational Resources Information Center

    Miyataki, Glenn K.; Byers, Maureen L.

    Intended to provide a systematic aid for planning and managing academic units (schools, colleges, departments, or divisions) within an institution, the Academic Unit Planning and Management (AUPM) manual consists of a multifaceted set of techniques and procedures that can be used by academic unit administrators. Data regarding academic unit…

  14. Technical Communications in OSS Content Management Systems: An Academic Institutional Case Study

    ERIC Educational Resources Information Center

    Cripps, Michael J.

    2011-01-01

    Single sourcing through a content management system (CMS) is altering technical communication practices in many organizations, including institutions of higher education. Open source software (OSS) solutions are currently among the most popular content management platforms adopted by colleges and universities in the United States and abroad. The…

  15. USAF/SCEEE Graduate Student Summer Support Program (1982). Management and Technical Report.

    DTIC Science & Technology

    1982-10-01

    AD-A130 767 USAF/SCEEE GRADUATE STUDENT SUMMER SUPPORT PROGRAM (1982) MANAGEMENT AND..(U) SOUTHEASTERN CENTER FORELECTRICAL ENGINEERING EDUCATION INC...SUMMER SUPPORT PROGRAM Conducted by Southeastern Center for Electrical Engineering Education under USAF Contract Number F49620-82-C-0035 MANAGEMENT ...UNITED STATES AIR FORCE GRADUATE STUDENT SL24MER SUPPORT PROGRAM 1982 PROGRAM MANAGEMENT AND TECHNICAL REPORT SOUTHEASTERN CENTER FOR ELECTRICAL

  16. Acceptability of Flight Deck-Based Interval Management Crew Procedures

    NASA Technical Reports Server (NTRS)

    Murdock, Jennifer L.; Wilson, Sara R.; Hubbs, Clay E.; Smail, James W.

    2013-01-01

    The Interval Management for Near-term Operations Validation of Acceptability (IM-NOVA) experiment was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC) in support of the NASA Next Generation Air Transportation System (NextGen) Airspace Systems Program's Air Traffic Management Technology Demonstration - 1 (ATD-1). ATD-1 is intended to showcase an integrated set of technologies that provide an efficient arrival solution for managing aircraft using NextGen surveillance, navigation, procedures, and automation for both airborne and ground-based systems. The goal of the IM-NOVA experiment was to assess if procedures outlined by the ATD-1 Concept of Operations, when used with a minimum set of Flight deck-based Interval Management (FIM) equipment and a prototype crew interface, were acceptable to and feasible for use by flight crews in a voice communications environment. To investigate an integrated arrival solution using ground-based air traffic control tools and aircraft automatic dependent surveillance broadcast (ADS-B) tools, the LaRC FIM system and the Traffic Management Advisor with Terminal Metering and Controller Managed Spacing tools developed at the NASA Ames Research Center (ARC) were integrated in LaRC's Air Traffic Operations Laboratory. Data were collected from 10 crews of current, qualified 757/767 pilots asked to fly a high-fidelity, fixed based simulator during scenarios conducted within an airspace environment modeled on the Dallas-Fort Worth (DFW) Terminal Radar Approach Control area. The aircraft simulator was equipped with the Airborne Spacing for Terminal Area Routes algorithm and a FIM crew interface consisting of electronic flight bags and ADS-B guidance displays. Researchers used "pseudo-pilot" stations to control 24 simulated aircraft that provided multiple air traffic flows into DFW, and recently retired DFW air traffic controllers served as confederate Center, Feeder, Final, and Tower

  17. Applied Space Systems Engineering. Chapter 17; Manage Technical Data

    NASA Technical Reports Server (NTRS)

    Kent, Peter

    2008-01-01

    Effective space systems engineering (SSE) is conducted in a fully electronic manner. Competitive hardware, software, and system designs are created in a totally digital environment that enables rapid product design and manufacturing cycles, as well as a multitude of techniques such as modeling, simulation, and lean manufacturing that significantly reduce the lifecycle cost of systems. Because the SSE lifecycle depends on the digital environment, managing the enormous volumes of technical data needed to describe, build, deploy, and operate systems is a critical factor in the success of a project. This chapter presents the key aspects of Technical Data Management (TDM) within the SSE process. It is written from the perspective of the System Engineer tasked with establishing the TDM process and infrastructure for a major project. Additional perspectives are reflected from the point of view of the engineers on the project who work within the digital engineering environment established by the TDM toolset and infrastructure, and from the point of view of the contactors who interface via the TDM infrastructure. Table 17.1 lists the TDM process as it relates to SSE.

  18. STP 4-06 Model-Based Technical Data in Procurement, 3D PDF Technology Data Demonstration Project. Phase 1 Summary

    DTIC Science & Technology

    2015-07-01

    O R G STP 4-06 MODEL-BASED TECHNICAL DATA IN PROCUREMENT 3D PDF TECHNOLOGY DATA DEMONSTRATION PROJECT PHASE 1 SUMMARY REPORT DL309T2...LMI’s ISO- certified quality management procedures. J U L Y 2 0 1 5 STP 4-06 MODEL-BASED TECHNICAL DATA IN PROCUREMENT 3D PDF TECHNICAL DATA...Based Technical Data ..................................................................................... 5 3D PDF Demonstration Team

  19. A Human Factors Analysis of Technical and Team Skills Among Surgical Trainees During Procedural Simulations in a Simulated Operating Theatre

    PubMed Central

    Moorthy, Krishna; Munz, Yaron; Adams, Sally; Pandey, Vikas; Darzi, Ara

    2005-01-01

    Background: High-risk organizations such as aviation rely on simulations for the training and assessment of technical and team performance. The aim of this study was to develop a simulated environment for surgical trainees using similar principles. Methods: A total of 27 surgical trainees carried out a simulated procedure in a Simulated Operating Theatre with a standardized OR team. Observation of OR events was carried out by an unobtrusive data collection system: clinical data recorder. Assessment of performance consisted of blinded rating of technical skills, a checklist of technical events, an assessment of communication, and a global rating of team skills by a human factors expert and trained surgical research fellows. The participants underwent a debriefing session, and the face validity of the simulated environment was evaluated. Results: While technical skills rating discriminated between surgeons according to experience (P = 0.002), there were no differences in terms of the checklist and team skills (P = 0.70). While all trainees were observed to gown/glove and handle sharps correctly, low scores were observed for some key features of communication with other team members. Low scores were obtained by the entire cohort for vigilance. Interobserver reliability was 0.90 and 0.89 for technical and team skills ratings. Conclusions: The simulated operating theatre could serve as an environment for the development of surgical competence among surgical trainees. Objective, structured, and multimodal assessment of performance during simulated procedures could serve as a basis for focused feedback during training of technical and team skills. PMID:16244534

  20. [NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 3:] Technical communications in aeronautics: Results of an exploratory study. An analysis of profit managers' and nonprofit managers' responses

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Glassman, Myron; Barclay, Rebecca O.; Oliu, Walter E.

    1989-01-01

    Data collected from an exploratory study concerned with the technical communications practices of aerospace engineers and scientists were analyzed to test the primary assumption that profit and nonprofit managers in the aerospace community have different technical communications practices. Five assumptions were established for the analysis. Profit and nonprofit managers in the aerospace community were found to have different technical communications practices for one of the five assumptions tested. It was, therefore, concluded that profit and nonprofit managers in the aerospace community do not have different technical communications practices.

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

    PubMed

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

    2015-08-01

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

  2. 32 CFR 250.5 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.5 Procedures. All determinations to disseminate or withhold technical data subject to this part shall be consistent both with the policies set forth in § 250.4 of this part, and with the following procedures: (a) Requests for technical data shall be...

  3. Gastroschisis Simulation Model: Pre-surgical Management Technical Report.

    PubMed

    Rosen, Orna; Angert, Robert M

    2017-03-22

    This technical report describes the creation of a gastroschisis model for a newborn. This is a simple, low-cost task trainer that provides the opportunity for Neonatology providers, including fellows, residents, nurse practitioners, physician assistants, and nurses, to practice the management of a baby with gastroschisis after birth and prior to surgery. Included is a suggested checklist with which the model can be employed. The details can be modified to suit different learning objectives.

  4. Transition to Office-based Obstetric and Gynecologic Procedures: Safety, Technical, and Financial Considerations.

    PubMed

    Peacock, Lisa M; Thomassee, May E; Williams, Valerie L; Young, Amy E

    2015-06-01

    Office-based surgery is increasingly desired by patients and providers due to ease of access, overall efficiency, reimbursement, and satisfaction. The adoption of office-based surgery requires careful consideration of safety, efficacy, cost, and feasibility within a providers practice. This article reviews the currently available data regarding patient and provider satisfaction as well as practical considerations of staffing, equipment, and supplies. To aid the practitioner, issues of office-based anesthesia and safety with references to currently available national guidelines and protocols are provided. Included is a brief review of billing, coding, and reimbursement. Technical procedural aspects with information and recommendations are summarized.

  5. Self-Management Procedures for Coping with Stress

    ERIC Educational Resources Information Center

    Vattano, Anthony J.

    1978-01-01

    Relaxation training, systematic desensitization, and meditation are effective self-management procedures for coping with stress and anxiety. This article describes research on stress and anxiety that led to development of these techniques, as well as current applications, and implications for social work education and practice. (Author)

  6. Evaluation and treatment of failed shoulder instability procedures.

    PubMed

    Ho, Anthony G; Gowda, Ashok L; Michael Wiater, J

    2016-09-01

    Management of the unstable shoulder after a failed stabilization procedure can be difficult and challenging. Detailed understanding of the native shoulder anatomy, including its static and dynamic restraints, is necessary for determining the patient's primary pathology. In addition, evaluation of the patient's history, physical exam, and imaging is important for identifying the cause for failure after the initial procedure. Common mistakes include under-appreciation of bony defects, failure to recognize capsular laxity, technical errors, and missed associated pathology. Many potential treatment options exist for revision surgery, including open or arthroscopic Bankart repair, bony augmentation procedures, and management of Hill Sachs defects. The aim of this narrative review is to discuss in-depth the common risk factors for post-surgical failure, components for appropriate evaluation, and the different surgical options available for revision stabilization. Level of evidence Level V.

  7. An analysis of the technical status of high level radioactive waste and spent fuel management systems

    NASA Technical Reports Server (NTRS)

    English, T.; Miller, C.; Bullard, E.; Campbell, R.; Chockie, A.; Divita, E.; Douthitt, C.; Edelson, E.; Lees, L.

    1977-01-01

    The technical status of the old U.S. mailine program for high level radioactive nuclear waste management, and the newly-developing program for disposal of unreprocessed spent fuel was assessed. The method of long term containment for both of these waste forms is considered to be deep geologic isolation in bedded salt. Each major component of both waste management systems is analyzed in terms of its scientific feasibility, technical achievability and engineering achievability. The resulting matrix leads to a systematic identification of major unresolved technical or scientific questions and/or gaps in these programs.

  8. 20 CFR 670.960 - What are the procedures for management of student records?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Administrative and Management Provisions § 670.960 What are the procedures for management of student records? The Secretary issues... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the procedures for management of...

  9. Habitat Evaluation Procedures (HEP) Report; Precious Lands Wildlife Management Area, Technical Report 2000-2003.

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

    Kozusko, Shana

    The Nez Perce Tribe (NPT) currently manages a 15,325 acre parcel of land known as the Precious Lands Wildlife Management Area that was purchased as mitigation for losses incurred by construction of the four lower Snake River dams. The Management Area is located in northern Wallowa County, Oregon and southern Asotin County, Washington (Figure 1). It is divided into three management parcels--the Buford parcel is located on Buford Creek and straddles the WA-OR state line, and the Tamarack and Basin parcels are contiguous to each other and located between the Joseph Creek and Cottonwood Creek drainages in Wallowa County, OR.more » The project was developed under the Pacific Northwest Electric Power Planning and Conservation Act of 1980 (P.L. 96-501), with funding from the Bonneville Power Administration (BPA). The acreage protected under this contract will be credited to BPA as habitat permanently dedicated to wildlife and wildlife mitigation. A modeling strategy known as Habitat Evaluation Procedure (HEP) was developed by the U.S. Fish and Wildlife Service and adopted by BPA as a habitat equivalency accounting system. Nine wildlife species models were used to evaluate distinct cover type features and provide a measure of habitat quality. Models measure a wide range of life requisite variables for each species and monitor overall trends in vegetation community health and diversity. One product of HEP is an evaluation of habitat quality expressed in Habitat Units (HUs). This HU accounting system is used to determine the amount of credit BPA receives for mitigation lands. After construction of the four lower Snake River dams, a HEP loss assessment was conducted to determine how many Habitat Units were inundated behind the dams. Twelve target species were used in that evaluation: Canada goose, mallard, river otter, downy woodpecker, song sparrow, yellow warbler, marsh wren, western meadowlark, chukar, ring-necked pheasant, California quail, and mule deer. The U.S. Army

  10. Gastroschisis Simulation Model: Pre-surgical Management Technical Report

    PubMed Central

    Angert, Robert M

    2017-01-01

    This technical report describes the creation of a gastroschisis model for a newborn. This is a simple, low-cost task trainer that provides the opportunity for Neonatology providers, including fellows, residents, nurse practitioners, physician assistants, and nurses, to practice the management of a baby with gastroschisis after birth and prior to surgery. Included is a suggested checklist with which the model can be employed. The details can be modified to suit different learning objectives. PMID:28439484

  11. Peri-procedural risk stratification and management of patients with Williams syndrome.

    PubMed

    Collins Ii, R Thomas; Collins, Margaret G; Schmitz, Michael L; Hamrick, Justin T

    2017-03-01

    Williams syndrome (WS) is a congenital, multisystem disorder affecting the cardiovascular, connective tissue, and central nervous systems in 1 in 10 000 live births. Cardiovascular involvement is the most common cause of morbidity and mortality in patients with WS, and noninvasive and invasive procedures are common. Sudden cardiovascular collapse in patients with WS is a well-known phenomenon, especially in the peri-procedural period. Detailed guidelines for peri-procedural management of patients with WS are limited. The goal of this review is to provide thoughtful, safe and effective management strategies for the peri-procedural care of patients with WS with careful consideration of hemodynamic impacts of anesthetic strategies. In addition, an expanded risk stratification system for anesthetic administration is provided. © 2017 Wiley Periodicals, Inc.

  12. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

  13. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

  14. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

  15. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2). (d...

  16. 20 CFR 668.860 - What cash management procedures apply to INA grant funds?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What cash management procedures apply to INA... Administrative Requirements § 668.860 What cash management procedures apply to INA grant funds? INA grantees must... implement the Cash Management Improvement Act, found at 31 CFR part 205, apply by law to most recipients of...

  17. 20 CFR 668.860 - What cash management procedures apply to INA grant funds?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What cash management procedures apply to INA... Administrative Requirements § 668.860 What cash management procedures apply to INA grant funds? INA grantees must... implement the Cash Management Improvement Act, found at 31 CFR part 205, apply by law to most recipients of...

  18. Procedure for Electronic Management of Rulemaking and Other Docketed Records in the Federal Docket Management System

    EPA Pesticide Factsheets

    This procedure identifies the specific requirements, processes and supporting documents EPA uses to electronically manage rulemaking and other docketed records in the Federal Docket Management System (FDMS).

  19. Technical-economic modelling of integrated water management: wastewater reuse in a French island.

    PubMed

    Xu, P; Valette, F; Brissaud, F; Fazio, A; Lazarova, V

    2001-01-01

    An integrated technical-economic model is used to address water management issues in the French island of Noirmoutier. The model simulates potable water production and supply, potable and non potable water demand and consumption, wastewater collection, treatment and disposal, water storage, transportation and reuse. A variety of water management scenarios is assessed through technical, economic and environmental evaluation. The scenarios include wastewater reclamation and reuse for agricultural and landscape irrigation as well as domestic non potable application, desalination of seawater and brackish groundwater for potable water supply. The study shows that, in Noirmoutier, wastewater reclamation and reuse for crop irrigation is the most cost-effective solution to the lack of water resources and the protection of sensitive environment. Some water management projects which are regarded as having less economic benefit in the short-term may become competitive in the future, as a result of tightened environmental policy, changed public attitudes and advanced water treatment technologies. The model provides an appropriate tool for water resources planning and management.

  20. MSFC Skylab Apollo Telescope Mount. [a technical history and management critique

    NASA Technical Reports Server (NTRS)

    Morse, A. R.

    1974-01-01

    A technical history and management critique of the Skylab Apollo Telescope Mount (ATM) from initial conception through the design, manufacturing, testing and prelaunch phases is presented. A mission performance summary provides a general overview of the ATM's achievements in relationship to its design goals. Recommendations and conclusions applicable to hardware design, test program philosophy and performance, and program management techniques for the ATM with potential application to future programs are also discussed.

  1. Aircraft/Air Traffic Management Functional Analysis Model: Technical Description. 2.0

    NASA Technical Reports Server (NTRS)

    Etheridge, Melvin; Plugge, Joana; Retina, Nusrat

    1998-01-01

    The Aircraft/Air Traffic Management Functional Analysis Model, Version 2.0 (FAM 2.0), is a discrete event simulation model designed to support analysis of alternative concepts in air traffic management and control. FAM 2.0 was developed by the Logistics Management Institute (LMI) under a National Aeronautics and Space Administration (NASA) contract. This document provides a technical description of FAM 2.0 and its computer files to enable the modeler and programmer to make enhancements or modifications to the model. Those interested in a guide for using the model in analysis should consult the companion document, Aircraft/Air Traffic Management Functional Analysis Model, Version 2.0 Users Manual.

  2. Technical knowledge and water resources management: A comparative study of river basin councils, Brazil

    NASA Astrophysics Data System (ADS)

    Lemos, Maria Carmen; Bell, Andrew R.; Engle, Nathan L.; Formiga-Johnsson, Rosa Maria; Nelson, Donald R.

    2010-06-01

    Better understanding of the factors that shape the use of technical knowledge in water management is important both to increase its relevance to decision-making and sustainable governance and to inform knowledge producers where needs lie. This is particularly critical in the context of the many stressors threatening water resources around the world. Recent scholarship focusing on innovative water management institutions emphasizes knowledge use as critical to water systems' adaptive capacity to respond to these stressors. For the past 15 years, water resources management in Brazil has undergone an encompassing reform that has created a set of participatory councils at the river basin level. Using data from a survey of 626 members of these councils across 18 river basins, this article examines the use of technical knowledge (e.g., climate and weather forecasts, reservoir streamflow models, environmental impact assessments, among others) within these councils. It finds that use of knowledge positively aligns with access, a more diverse and broader discussion agenda, and a higher sense of effectiveness. Yet, use of technical knowledge is also associated with skewed levels of power within the councils.

  3. Realizing what's essential: a case study on integrating electronic journal management into a print-centric technical services department.

    PubMed

    Dollar, Daniel M; Gallagher, John; Glover, Janis; Marone, Regina Kenny; Crooker, Cynthia

    2007-04-01

    To support migration from print to electronic resources, the Cushing/Whitney Medical Library at Yale University reorganized its Technical Services Department to focus on managing electronic resources. The library hired consultants to help plan the changes and to present recommendations for integrating electronic resource management into every position. The library task force decided to focus initial efforts on the periodical collection. To free staff time to devote to electronic journals, most of the print subscriptions were switched to online only and new workflows were developed for e-journals. Staff learned new responsibilities such as activating e-journals, maintaining accurate holdings information in the online public access catalog and e-journals database ("electronic shelf reading"), updating the link resolver knowledgebase, and troubleshooting. All of the serials team members now spend significant amounts of time managing e-journals. The serials staff now spends its time managing the materials most important to the library's clientele (e-journals and databases). The team's proactive approach to maintenance work and rapid response to reported problems should improve patrons' experiences using e-journals. The library is taking advantage of new technologies such as an electronic resource management system, and library workflows and procedures will continue to evolve as technology changes.

  4. Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

    PubMed

    Rüter, Anders; Vikstrom, Tore

    2009-01-01

    Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

  5. Cognitive Dissonance and Pediatric Procedural Pain Management: A Concept Clarification.

    PubMed

    Bice, April A

    2018-06-01

    Pediatric nurses have often reported that pain management is a vital part of patient care. Evidence, however, suggests pediatric procedural pain treatments are often underused. Cognitive dissonance, the mental conflict leading to unpleasant thoughts and or feelings, may be related to this evidence-based gap found between what pediatric nurses claim about procedural pain management (that it is important) and what they actually do (underutilize pain treatments). The purpose of this manuscript is to clarify and further develop the concept of cognitive dissonance in terms of its relationship to nurses' mental struggles with underutilization of pediatric procedural pain treatments. A more relevant and extended definition of cognitive dissonance is presented. The concept of cognitive dissonance was examined using Rodgers' evolutionary concept analysis approach/framework. Analysis Methods: Through a six-step process of concept identification, setting and sample identification, data collection, data analysis, and future implication discussion, a more accurate and representative definition of cognitive dissonance is described. Databases used included CINAHL, Google Scholar, PsycINFO, ERIC, and PubMed. Seminal, recent, and relevant works were included in the review to adequately develop and clarify the concept. Procedural pain management breech among pediatric nurses is proposed to occur before the mental conflict produced. The unpleasant mental conflict created after the breech is followed by the nurse's determination to reduce mental conflict through attitude change followed by cognition change, which more closely reflects his or her behavior. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. Technical complications of implant-causes and management: A comprehensive review

    PubMed Central

    Gupta, Swati; Gupta, Hemant; Tandan, Amrit

    2015-01-01

    Given the increasing popularity of dental implants, the number of failures due to late implant fracture is also expected to increase. Hence, the scope for prevention and management needs to be emphasized. The objective of this review article is to analyze the various causes of failure of dental implants due to implant fixture/abutment screw fractures and also to enumerate the management and the preventive options for these failures, thereby aiming to help the clinicians to properly plan the implant-supported prosthesis treatment by considering the important biomechanical aspects of this type of rehabilitation. The present review emphasizes the causes and management of technical complications and not the incidence of such complications. PMID:26668445

  7. Evaluation of Flight Deck-Based Interval Management Crew Procedure Feasibility

    NASA Technical Reports Server (NTRS)

    Wilson, Sara R.; Murdoch, Jennifer L.; Hubbs, Clay E.; Swieringa, Kurt A.

    2013-01-01

    Air traffic demand is predicted to increase over the next 20 years, creating a need for new technologies and procedures to support this growth in a safe and efficient manner. The National Aeronautics and Space Administration's (NASA) Air Traffic Management Technology Demonstration - 1 (ATD-1) will operationally demonstrate the feasibility of efficient arrival operations combining ground-based and airborne NASA technologies. The integration of these technologies will increase throughput, reduce delay, conserve fuel, and minimize environmental impacts. The ground-based tools include Traffic Management Advisor with Terminal Metering for precise time-based scheduling and Controller Managed Spacing decision support tools for better managing aircraft delay with speed control. The core airborne technology in ATD-1 is Flight deck-based Interval Management (FIM). FIM tools provide pilots with speed commands calculated using information from Automatic Dependent Surveillance - Broadcast. The precise merging and spacing enabled by FIM avionics and flight crew procedures will reduce excess spacing buffers and result in higher terminal throughput. This paper describes a human-in-the-loop experiment designed to assess the acceptability and feasibility of the ATD-1 procedures used in a voice communications environment. This experiment utilized the ATD-1 integrated system of ground-based and airborne technologies. Pilot participants flew a high-fidelity fixed base simulator equipped with an airborne spacing algorithm and a FIM crew interface. Experiment scenarios involved multiple air traffic flows into the Dallas-Fort Worth Terminal Radar Control airspace. Results indicate that the proposed procedures were feasible for use by flight crews in a voice communications environment. The delivery accuracy at the achieve-by point was within +/- five seconds and the delivery precision was less than five seconds. Furthermore, FIM speed commands occurred at a rate of less than one per minute

  8. Examining the Impact of Non-Technical Security Management Factors on Information Security Management in Health Informatics

    ERIC Educational Resources Information Center

    Imam, Abbas H.

    2013-01-01

    Complexity of information security has become a major issue for organizations due to incessant threats to information assets. Healthcare organizations are particularly concerned with security owing to the inherent vulnerability of sensitive information assets in health informatics. While the non-technical security management elements have been at…

  9. The Vocational-Technical Resource Consortia Serving Business and Industry in Ohio. Digest of Study: Operational Procedures for Successful Vocational-Technical Resource Consortia in Serving Business and Industry in Ohio.

    ERIC Educational Resources Information Center

    Frasier, James E.; Stanton, William

    This publication reports the development of the vocational-technical resource consortia in Ohio and identifies the operational procedures associated with successful programs. Five exemplary consortia were studied in some depth; however, data were obtained from all of the 23 consortia in the state. The research indicates that the consortium is an…

  10. 28 CFR 34.110 - Management of peer reviews.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Management of peer reviews. 34.110 Section 34.110 Judicial Administration DEPARTMENT OF JUSTICE OJJDP COMPETITION AND PEER REVIEW PROCEDURES Peer Review § 34.110 Management of peer reviews. A technical support contractor may assist in managing...

  11. Student Flow Model SFM-IA: System Documentation. Technical Report 41B. Preliminary Edition.

    ERIC Educational Resources Information Center

    Busby, John C.; Johnson, Richard S.

    Technical specifications, operating procedures, and reference information for the National Center for Higher Education Management Systems' (NCHEMS) Student Flow Model (SFM) computer programs are presented. Included are narrative descriptions of the system and its modules, specific program documentation for each of the modules, system flowcharts,…

  12. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Bridge resource management policy... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1... in charge of the navigational watch concerning the need for continuously reassessing how bridge-watch...

  13. Pain Management for Gynecologic Procedures in the Office.

    PubMed

    Ireland, Luu Doan; Allen, Rebecca H

    2016-02-01

    Satisfactory pain control for women undergoing office gynecologic procedures is critical for both patient comfort and procedure success. Therefore, it is important for clinicians to be aware of the safety and efficacy of different pain control regimens. This article aimed to review the literature regarding pain control regimens for procedures such as endometrial biopsy, intrauterine device insertion, colposcopy and loop electrosurgical excisional procedure, uterine aspiration, and hysteroscopy. A search of published literature using PubMed was conducted using the following keywords: "pain" or "anesthesia." These terms were paired with the following keywords: "intrauterine device" or "IUD," "endometrial biopsy," "uterine aspiration" or "abortion," "colposcopy" or "loop electrosurgical excisional procedure" or "LEEP," "hysteroscopy" or "hysteroscopic sterilization." The search was conducted through July 2015. Articles were hand reviewed and selected by the authors for study quality. Meta-analyses and randomized controlled trials were prioritized. Although local anesthesia is commonly used for gynecologic procedures, a multimodal approach may be more effective including oral medication, a dedicated emotional support person, and visual or auditory distraction. Women who are nulliparous, are postmenopausal, have a history of dysmenorrhea, or suffer from anxiety are more likely to experience greater pain with gynecologic procedures. Evidence for some interventions exists; however, the interpretation of intervention comparisons is limited by the use of different regimens, pain measurement scales, patient populations, and procedure techniques. There are many options for pain management for office gynecologic procedures, and depending on the procedure, different modalities may work best. The importance of patient counseling and selection cannot be overstated.

  14. ITS/CVO technical project management for non-technical managers : participant guide

    DOT National Transportation Integrated Search

    1998-09-01

    In 1996, the FHWA Office of Motor Carriers (OMC) identified the need to develop a Technical Training Program to support the deployment of Intelligent Transportation System (ITS) technologies for Commercial Vehicle Operations (CVO). The workforce -...

  15. Consumer managed care appeals: are the available procedural protections fundamentally fair?

    PubMed

    Nevers, A H

    2000-01-01

    Managed care incentives to reduce costs have also resulted in incentives to deny care. Anecdotes concerning managed care denials of care have led to a consumer outcry for protection either through the use of procedural due process or by the establishment of patient rights that would include appeal and grievance protections. This Article reviews the procedural protections of constitutional due process, the Consumer Due Process Protocol, and the Patient Bill of Rights. The Article then extensively discusses the availability of these procedural protections in various public and private forums. The discussion of public forums includes proposals contained in recent national legislative initiatives. The author then reviews relevant federal and state law, as well as Uniform Law proposals. Next, the Article analyzes the protections provided by accreditation agencies, dispute resolution organizations, professional organizations, and health insurers. Finally, the author recommends criteria to be used to determine whether a procedure is fundamentally fair.

  16. 75 FR 50713 - Procedural Changes to the Fire Management Assistance Declaration Process

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-17

    ... FEMA-2010-0036] RIN-1660-AA72 Procedural Changes to the Fire Management Assistance Declaration Process... Federal Emergency Management Agency (FEMA) is updating its Fire Management Assistance Grant Program regulations to reflect a change in the internal delegation of authority for fire management assistance...

  17. Technical Performance as a Predictor of Clinical Outcomes in Laparoscopic Gastric Cancer Surgery.

    PubMed

    Fecso, Andras B; Bhatti, Junaid A; Stotland, Peter K; Quereshy, Fayez A; Grantcharov, Teodor P

    2018-03-23

    The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery. Laparoscopic gastrectomy for cancer is an advanced procedure with high rate of postoperative morbidity and mortality. Many variables including patient, disease, and perioperative management factors have been shown to impact postoperative outcomes; however, the role of surgical performance is insufficiently investigated. A retrospective review was performed for all patients who had undergone laparoscopic gastrectomy for cancer at 3 teaching institutions between 2009 and 2015. Patients with available, unedited video-recording of their procedure were included in the study. Video files were rated for technical performance, using Objective Structured Assessments of Technical Skills (OSATS) and Generic Error Rating Tool instruments. The main outcome variable was major short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy. Sixty-one patients with available video recordings were included in the study. The overall complication rate was 29.5%. The mean Charlson comorbidity index, type of procedure, and the global OSATS score were included in the final predictive model. Lower performance score (OSATS ≤29) remained an independent predictor for major short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure. Intraoperative technical performance predicts major short-term outcomes in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills using modern, evidence-based strategies might improve short-term patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery.

  18. Procedural Influence on Internal and External Assessment Scores of Undergraduate Vocational and Technical Education Research Projects in Nigerian Universities

    ERIC Educational Resources Information Center

    A. C., John; Manabete, S. S.

    2015-01-01

    This study sought to determine the procedural influence on internal and external assessment scores of undergraduate research projects in vocational and technical education programmes in the university under study. A survey research design was used for the conduct of this study. The population consisted of 130 lecturers and 1,847 students in the…

  19. Bibliography--Unclassified Technical Reports, Special Reports, and Technical Notes: FY 1982.

    DTIC Science & Technology

    1982-11-01

    in each category are listed in chronological order under seven areas: manpower management, personnel administration , organization management, education...7633). Technical reports listed that have unlimited distribution can also be obtained from the National Technical Information Service , 5285 Port Royal...simulations of manpower systems. This research exploits the technology of computer-managed large-scale data bases. PERSONNEL ADMINISTRATION The personnel

  20. Gadolinium Use in Spine Pain Management Procedures for Patients with Contrast Allergies: Results in 527 Procedures

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

    Safriel, Yair; Ang, Roberto; Ali, Muhammed

    2008-03-15

    Introduction. To review the safety and efficacy of gadolinium in spine pain management procedures in patients at high risk for a contrast reaction and who are not suitable candidates for the use of standard non-ionic contrast. Methods. We reviewed records over a 61-month period of all image-guided spinal pain management procedures where patients had allergies making them unsuitable candidates for standard non-ionic contrast and where gadolinium was used to confirm needle tip placement prior to injection of medication. Results. Three hundred and four outpatients underwent 527 procedures. A spinal needle was used in all but 41 procedures. Gadolinium was visualizedmore » using portable C-arm fluoroscopy in vivo allowing for confirmation of needle tip location. The gadolinium dose ranged from 0.2 to 10 ml per level. The highest dose received by one patient was 15.83 ml intradiscally during a three-level discogram. Three hundred and one patients were discharged without complication or known delayed complications. One patient had documented intrathecal injection but without sequelae and 2 patients who underwent cervical procedures experienced seizures requiring admission to the intensive care unit. Both the latter patients were discharged without any further complications. Conclusion. Based on our experience we recommend using gadolinium judiciously for needle tip confirmation. We feel more confident using gadolinium in the lumbar spine and in cervical nerve blocks. Gadolinium should probably not be used as an injectate volume expander. The indications for gadolinium use in cervical needle-guided spine procedures are less clear and use of a blunt-tipped needle should be considered.« less

  1. Development of a requirements management system for technical decision - making processes in the geological disposal project

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

    Hiroyoshi Ueda; Katsuhiko Ishiguro; Kazumi Kitayama

    2007-07-01

    NUMO (Nuclear Waste Management Organization of Japan) has a responsibility for implementing geological disposal of vitrified HLW (High-Level radioactive Waste) in the Japanese nuclear waste management programme. Its staged siting procedure was initiated in 2002 by an open call for volunteer sites. Careful management strategy and methodology for the technical decision-making at every milestone are required to prepare for the volunteer site application and the site investigation stages after that. The formal Requirement Management System (RMS) is planned to support the computerized implementation of the specific management methodology, termed the NUMO Structured Approach (NSA). This planned RMS will help formore » comprehensive management of the decision-making processes in the geological disposal project, change management towards the anticipated project deviations, efficient project driving such as well programmed R and D etc. and structured record-keeping regarding the past decisions, which leads to soundness of the project in terms of the long-term continuity. The system should have handling/management functions for the database including the decisions/requirements in the project in consideration, their associated information and the structures composed of them in every decision-making process. The information relating to the premises, boundary conditions and time plan of the project should also be prepared in the system. Effective user interface and efficient operation on the in-house network are necessary. As a living system for the long-term formal use, flexibility to updating is indispensable. In advance of the formal system development, two-year activity to develop the preliminary RMS was already started. The purpose of this preliminary system is to template the decision/requirement structure, prototype the decision making management and thus show the feasibility of the innovative RMS. The paper describes the current status of the development, focusing on

  2. Management of bisphosphonate-related osteonecrosis of the jaw with a platelet-rich fibrin membrane: technical report.

    PubMed

    Soydan, Sıdıka Sinem; Uckan, Sina

    2014-02-01

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a challenging complication resulting from the long-term application of bisphosphonates. In most cases, BRONJ occurs after a surgical procedure involving the jawbone. Currently, the management of BRONJ remains controversial, and there is no definitive treatment other than palliative methods. Platelet-rich fibrin (PRF) represents a relatively new biotechnology for the stimulation and acceleration of tissue healing and bone regeneration. This technical note describes the total closure of moderate bone exposure in persistent BRONJ in 2 weeks with a double-layer PRF membrane. PRF may stimulate gingival healing and act as a barrier membrane between the alveolar bone and the oral cavity. PRF may offer a fast, easy, and effective alternative method for the closure of bone exposure in BRONJ. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Management of Patients with Orthopaedic Implants Undergoing Dental Procedures.

    PubMed

    Quinn, Robert H; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S

    2017-07-01

    The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics. The 64 patient scenarios and 1 treatment were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).

  4. Succession Planning for Management Staff at a Canadian Post Secondary Technical Institute.

    ERIC Educational Resources Information Center

    da Costa, Jose; Cembrowski, Barbara

    2001-01-01

    Analyzed interviews to explore how nine administrators, at three different career stages, perceived career-development and succession planning at a Canadian postsecondary technical institute. Managers attribute career success to possession of varied personal attributes, diverse work experiences, serendipity, and a fulfilling work environment. Job…

  5. Frey procedure for surgical management of chronic pancreatitis in children.

    PubMed

    Rollins, Michael D; Meyers, Rebecka L

    2004-06-01

    The authors adopted the Frey procedure for the surgical management of chronic pancreatitis after one of their patients had recurrent disease in the head of the gland after a longitudinal pancreaticojejunostomy (LPJ or modified Puestow procedure). This is the first description of its use in children. A retrospective chart review was performed of all children undergoing a drainage or resection procedure for chronic pancreatitis from 1995 to 2002. Eleven children (6 boys, 5 girls, ages 8 to 18 years) underwent either the LPJ (3) or Frey (8) procedure. Etiologies included: idiopathic (5), familial (2), congenital anomaly of the major papilla (1), pancreatic head mass (1), short bowel syndrome (1), and pancreatic divisum (1). Before surgical therapy, patients had been symptomatic 2.3 years (range, 1 month to 6 years) and had been hospitalized for pancreatitis 4 times (range, 1 to 10). Four patients did not respond to endoscopic stenting, and 5 had a pancreatic pseudocyst. Patients were followed up in clinic an average of 2.5 years, with total time elapsed since surgery averaging 4.6 years. Eight of 11 patients experienced excellent or good results subsequent to surgical intervention. The Frey procedure is effective for children who have not responded to conservative management of chronic pancreatitis and may prevent recurrent disease in the head of the gland.

  6. Relationship between intraoperative non-technical performance and technical events in bariatric surgery.

    PubMed

    Fecso, A B; Kuzulugil, S S; Babaoglu, C; Bener, A B; Grantcharov, T P

    2018-03-30

    The operating theatre is a unique environment with complex team interactions, where technical and non-technical performance affect patient outcomes. The correlation between technical and non-technical performance, however, remains underinvestigated. The purpose of this study was to explore these interactions in the operating theatre. A prospective single-centre observational study was conducted at a tertiary academic medical centre. One surgeon and three fellows participated as main operators. All patients who underwent a laparoscopic Roux-en-Y gastric bypass and had the procedures captured using the Operating Room Black Box ® platform were included. Technical assessment was performed using the Objective Structured Assessment of Technical Skills and Generic Error Rating Tool instruments. For non-technical assessment, the Non-Technical Skills for Surgeons (NOTSS) and Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) tools were used. Spearman rank-order correlation and N-gram statistics were conducted. Fifty-six patients were included in the study and 90 procedural steps (gastrojejunostomy and jejunojejunostomy) were analysed. There was a moderate to strong correlation between technical adverse events (r s  = 0·417-0·687), rectifications (r s  = 0·380-0·768) and non-technical performance of the surgical and nursing teams (NOTSS and SPLINTS). N-gram statistics showed that after technical errors, events and prior rectifications, the staff surgeon and the scrub nurse exhibited the most positive non-technical behaviours, irrespective of operator (staff surgeon or fellow). This study demonstrated that technical and non-technical performances are related, on both an individual and a team level. Valuable data can be obtained around intraoperative errors, events and rectifications. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  7. ENVIRONMENTAL METHODS TESTING SITE PROJECT: DATA MANAGEMENT PROCEDURES PLAN

    EPA Science Inventory

    The Environmental Methods Testing Site (EMTS) Data Management Procedures Plan identifies the computer hardware and software resources used in the EMTS project. It identifies the major software packages that are available for use by principal investigators for the analysis of data...

  8. Development of CMS monitoring procedures : technical summary.

    DOT National Transportation Integrated Search

    1998-04-01

    This research study is concerned with the development of a set of procedures for monitoring congestion using GPS and GIS. These procedures are meant to be used more as a planning tool than for everyday traffic monitoring. Under this assumption, a ser...

  9. The CHPRC Groundwater and Technical Integration Support (Master Project) Quality Assurance Management Plan

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

    Fix, N. J.

    The scope of the CH2M Hill Plateau Remediation Company, LLC (CHPRC) Groundwater and Technical Integration Support (Master Project) is for Pacific Northwest National Laboratory staff to provide technical and integration support to CHPRC. This work includes conducting investigations at the 300-FF-5 Operable Unit and other groundwater operable units, and providing strategic integration, technical integration and assessments, remediation decision support, and science and technology. The projects under this Master Project will be defined and included within the Master Project throughout the fiscal year, and will be incorporated into the Master Project Plan. This Quality Assurance Management Plan provides the quality assurancemore » requirements and processes that will be followed by the CHPRC Groundwater and Technical Integration Support (Master Project) and all releases associated with the CHPRC Soil and Groundwater Remediation Project. The plan is designed to be used exclusively by project staff.« less

  10. A Study of Program Management Procedures in the Campus-Based and Basic Grant Programs. Technical Report No. 1: Sample Design, Student Survey Yield and Bias.

    ERIC Educational Resources Information Center

    Puma, Michael J.; Ellis, Richard

    Part of a study of program management procedures in the campus-based and Basic Educational Opportunity Grant programs reports on the design of the site visit component of the study and the results of the student survey, both in terms of the yield obtained and the quality of the data. Chapter 2 describes the design of sampling methodology employed…

  11. Succession Planning for Management Staff at a Western Canadian Postsecondary Technical Institute.

    ERIC Educational Resources Information Center

    Cembrowski, Barbara Joan; da Costa, Jose L.

    This study used naturalistic inquiry to gain an understanding of how managerial personnel perceived career development and succession planning at a postsecondary technical institute in Canada. A total of nine individuals in three different career development stages completed semistructured interviews. It was found that managers perceived the…

  12. Air Traffic Management Technology Demostration: 1 Research and Procedural Testing of Routes

    NASA Technical Reports Server (NTRS)

    Wilson, Sara R.; Kibler, Jennifer L.; Hubbs, Clay E.; Smail, James W.

    2015-01-01

    NASA's Air Traffic Management Technology Demonstration-1 (ATD-1) will operationally demonstrate the feasibility of efficient arrival operations combining ground-based and airborne NASA technologies. The ATD-1 integrated system consists of the Traffic Management Advisor with Terminal Metering which generates precise time-based schedules to the runway and merge points; Controller Managed Spacing decision support tools which provide controllers with speed advisories and other information needed to meet the schedule; and Flight deck-based Interval Management avionics and procedures which allow flight crews to adjust their speed to achieve precise relative spacing. Initial studies identified air-ground challenges related to the integration of these three scheduling and spacing technologies, and NASA's airborne spacing algorithm was modified to address some of these challenges. The Research and Procedural Testing of Routes human-in-the-loop experiment was then conducted to assess the performance of the new spacing algorithm. The results of this experiment indicate that the algorithm performed as designed, and the pilot participants found the airborne spacing concept, air-ground procedures, and crew interface to be acceptable. However, the researchers concluded that the data revealed issues with the frequency of speed changes and speed reversals.

  13. Self-Management Procedures: A Comparison across the Autism Spectrum

    ERIC Educational Resources Information Center

    Southall, Candice M.; Gast, David L.

    2011-01-01

    Individuals with autism spectrum disorders (ASD) have difficulty generalizing learned behavior to varied environments with independence. This review of 24 empirical studies compares self-management as a systematic procedure for modifying one's own behavior, to increase target behaviors in students with either autistic disorder (AD) or…

  14. Evaluating the role of clinical pharmacists in pre-procedural anticoagulation management.

    PubMed

    Kataruka, Akash; Renner, Elizabeth; Barnes, Geoffrey D

    2018-02-01

    While physicians are typically responsible for managing perioperative warfarin, clinic pharmacists may improve pre-procedural decision-making. We assessed the impact of pharmacist-driven care for chronic warfarin-treated patients undergoing outpatient right heart catheterization (RHC). 200 warfarin patients who underwent RHC between January 2012 and September 2015 were analyzed. Pharmacist-care (n = 79) was compared to the usual care model (n = 121). The primary outcome was a composite of (1) documentation of anticoagulation plan, (2) holding warfarin at least 5 days prior to procedure, (3) guideline-congruent low molecular weight heparin (LMWH) bridging, and (4) correct LMWH dosing if bridging deemed necessary. Chi-squared test performed to assess the role of pharmacist. A multivariable logistic regression analysis was performed to the composite endpoint, adjusted for the month of procedure. Compared to the usual care model, pharmacist-driven care (OR 4.69, 95% CI 1.73-12.71, p = 0.002) and date of the procedure (OR 1.06/month, 95% CI 1.01-1.10, p = 0.011) were independently associated with the primary composite outcome. Of the individual outcome components, pharmacist-driven care was only associated with documentation (96.2% vs. 67.8%, OR 9.19, 95% CI 2.19-38.62, p = 0.002). Remaining components including hold warfarin for at least 5 days, appropriate bridging and correct LMWH dosing were not significantly associated with pharmacist-care. Pharmacist-care is associated with better guideline-based anticoagulation management, but this was primarily driven by improved documentation. The impact of pharmacist managed peri-procedural anticoagulation on clinical outcomes remains unknown.

  15. Development, Implementation, and Evaluation of Leadership/Management Training within Army Battalions. Volume 2. Technical Appendices

    DTIC Science & Technology

    1975-06-01

    8217- r AD-A012 774 DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF LEADERSHIP / MANAGEMENT TRAINING WITHIN ARMY BATTALIONS. VOLUME 2. TECHNICAL...and Identify by block numbera) This report describes the development and eva.L.uuLion of an experiential-based, leadership / management trai iing...organizational intervention and change similar to that presented in Figure H-1. According to this approach, training in more effective leadership / management skills

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

    PubMed

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

    2005-04-01

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

  17. Scaffolding Collaborative Technical Writing with Procedural Facilitation and Synchronous Discussion

    ERIC Educational Resources Information Center

    Yeh, Shiou-Wen; Lo, Jia-Jiunn; Huang, Jeng-Jia

    2011-01-01

    With the advent of computer technology, researchers and instructors are attempting to devise computer support for effective collaborative technical writing. In this study, a computer-supported environment for collaborative technical writing was developed. This system (Process-Writing Wizard) provides process-oriented scaffolds and a synchronous…

  18. Role of medical, technical, and administrative leadership in the human resource management life cycle: a team approach to laboratory management.

    PubMed

    Wilkinson, D S; Dilts, T J

    1999-01-01

    We believe the team approach to laboratory management achieves the best outcomes. Laboratory management requires the integration of medical, technical, and administrative expertise to achieve optimal service, quality, and cost performance. Usually, a management team of two or more individuals must be assembled to achieve all of these critical leadership functions. The individual members of the management team must possess the requisite expertise in clinical medicine, laboratory science, technology management, and administration. They also must work together in a unified and collaborative manner, regardless of where individual team members appear on the organizational chart. The management team members share in executing the entire human resource management life cycle, creating the proper environment to maximize human performance. Above all, the management team provides visionary and credible leadership.

  19. Technical performance score is associated with outcomes after the Norwood procedure.

    PubMed

    Nathan, Meena; Sleeper, Lynn A; Ohye, Richard G; Frommelt, Peter C; Caldarone, Christopher A; Tweddell, James S; Lu, Minmin; Pearson, Gail D; Gaynor, J William; Pizarro, Christian; Williams, Ismee A; Colan, Steven D; Dunbar-Masterson, Carolyn; Gruber, Peter J; Hill, Kevin; Hirsch-Romano, Jennifer; Jacobs, Jeffrey P; Kaltman, Jonathan R; Kumar, S Ram; Morales, David; Bradley, Scott M; Kanter, Kirk; Newburger, Jane W

    2014-11-01

    The technical performance score (TPS) has been reported in a single center study to predict the outcomes after congenital cardiac surgery. We sought to determine the association of the TPS with outcomes in patients undergoing the Norwood procedure in the Single Ventricle Reconstruction trial. We calculated the TPS (class 1, optimal; class 2, adequate; class 3, inadequate) according to the predischarge echocardiograms analyzed in a core laboratory and unplanned reinterventions that occurred before discharge from the Norwood hospitalization. Multivariable regression examined the association of the TPS with interval to first extubation, Norwood length of stay, death or transplantation, unplanned postdischarge reinterventions, and neurodevelopment at 14 months old. Of 549 patients undergoing a Norwood procedure, 356 (65%) had an echocardiogram adequate to assess atrial septal restriction or arch obstruction or an unplanned reintervention, enabling calculation of the TPS. On multivariable regression, adjusting for preoperative variables, a better TPS was an independent predictor of a shorter interval to first extubation (P=.019), better transplant-free survival before Norwood discharge (P<.001; odds ratio, 9.1 for inadequate vs optimal), shorter hospital length of stay (P<.001), fewer unplanned reinterventions between Norwood discharge and stage II (P=.004), and a higher Bayley II psychomotor development index at 14 months (P=.031). The TPS was not associated with transplant-free survival after Norwood discharge, unplanned reinterventions after stage II, or the Bayley II mental development index at 14 months. TPS is an independent predictor of important outcomes after Norwood and could serve as a tool for quality improvement. Copyright © 2014 The American Association for Thoracic Surgery. All rights reserved.

  20. 77 FR 57196 - Proposed Collection; Comment Request for Revenue Procedure 2011-4, Revenue Procedure 2011-5...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-17

    ...) of the Internal Revenue Service to give advice on filing letter ruling, determination letter, and... Procedure 2011-4 (Letter Rulings), Revenue Procedure 2011-5 (Technical Advice), Revenue Procedure 2011-6... Advice), Revenue Procedure 2011-6 (Determination Letters), and Revenue Procedure 2011-8 (User Fees). OMB...

  1. [NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 2:] Technical communications in aeronautics: Results of an exploratory study. An analysis of managers' and nonmanagers' responses

    NASA Technical Reports Server (NTRS)

    Pinelli, Thomas E.; Glassman, Myron; Barclay, Rebecca O.; Oliu, Walter E.

    1989-01-01

    Data collected from an exploratory study concerned with the technical communications practices of aerospace engineers and scientists were analyzed to test the primary assumption that aerospace managers and nonmanagers have different technical communications practices. Five assumptions were established for the analysis. Aerospace managers and nonmanagers were found to have different technical communications practices for three of the five assumptions tested. Although aerospace managers and nonmanagers were found to have different technical communications practices, the evidence was neither conclusive nor compelling that the presumption of difference in practices could be attributed to the duties performed by aerospace managers and nonmanagers.

  2. Equipment management user's handbook for property custodians

    NASA Technical Reports Server (NTRS)

    1993-01-01

    The NASA Equipment Management User's Handbook for Property Custodians is issued as an instructional guide for personnel designated as property custodians and technical personnel involved in the acquisition, management, and use of NASA-owned equipment. This handbook provides general information and basic operational procedures for processing equipment transactions through the agency-wide NASA Equipment Management System (NEMS). Each NASA installation must prepare supplementary instructions for local requirements beyond the scope of NASA-wide policies and procedures contained herein, or as specified for local implementation in NHB 4200.1, 'NASA Equipment Management Manual.' NHB 4200.1 sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for the acquisition, management, and use of NASA-owned equipment. This handbook is a controlled document, issued in loose-leaf form and revised by page changes. Additional copies for internal use may be obtained through normal distribution.

  3. Integrated corridor management initiative : demonstration phase evaluation – Dallas technical capability analysis test plan.

    DOT National Transportation Integrated Search

    2012-08-01

    This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration. The ICM ...

  4. Differences in the Vocational Interests of Research and Development Managers versus Technical Specialists.

    ERIC Educational Resources Information Center

    Hill, Raymond E.; Roselle, Pamela F.

    1985-01-01

    Compared the occupational interests of research and development managers (N=110) and technical specialists (N=55). Analysis on the general occupational themes and basic interest scales of the Strong-Campbell Interest Inventory indicated the social, enterprising, and conventional areas predicted managerial group membership, whereas the artistic…

  5. Final priority; Technical Assistance on State Data Collection--IDEA Data Management Center. Final priority.

    PubMed

    2014-08-05

    The Assistant Secretary for the Office of Special Education and Rehabilitative Services (OSERS) announces a priority under the Technical Assistance on State Data Collection program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to fund a cooperative agreement to establish and operate an IDEA Data Management Center (Center) that will provide technical assistance (TA) to improve the capacity of States to meet the data collection requirements of the Individuals with Disabilities Education Act (IDEA).

  6. Technical Facilities Management, Loan Pool, and Calibration

    NASA Technical Reports Server (NTRS)

    Smith, Jacob

    2011-01-01

    My work at JPL for the SURF program began on June 11, 2012 with the Technical Facilities Management group (TFM). As well as TFM, I worked with Loan Pool and Metrology to help them out with various tasks. Unlike a lot of other interns, I did not have a specific project rather many different tasks to be completed over the course of the 10 weeks.The first task to be completed was to sort through old certification reports in 6 different boxes to locate reports that needed to be archived into a digital database. There were no reports within these boxes that needed to be archived but rather were to be shredded. The reports went back to the early 1980's and up to the early 2000's. I was looking for reports dated from 2002 to 2012

  7. Policy and Procedures for Managing Dual Use Research of Concern

    EPA Pesticide Factsheets

    The DURC and iDURC Policies require all federal departments and agencies that conduct life sciences research to implement their provisions. EPA Order 1000.19, Policy and Procedures for Managing Dual Use Research of Concern, implements both policies at EPA.

  8. 78 FR 70586 - Technical Support Document: Technical Update of the Social Cost of Carbon for Regulatory Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... OFFICE OF MANAGEMENT AND BUDGET Technical Support Document: Technical Update of the Social Cost of... Budget, Executive Office of the President. ACTION: Notice of availability and request for comments. SUMMARY: The Office of Management and Budget (OMB) requests comments on the Technical Support Document...

  9. 48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

  10. 48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

  11. 48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

  12. 48 CFR 801.602-80 - Legal and technical review-Office of Construction and Facilities Management and National Cemetery...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...

  13. Complications of Minimally Invasive Cosmetic Procedures: Prevention and Management

    PubMed Central

    Levy, Lauren L; Emer, Jason J

    2012-01-01

    Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care. PMID:23060707

  14. Selecting Statistical Procedures for Quality Control Planning Based on Risk Management.

    PubMed

    Yago, Martín; Alcover, Silvia

    2016-07-01

    According to the traditional approach to statistical QC planning, the performance of QC procedures is assessed in terms of its probability of rejecting an analytical run that contains critical size errors (PEDC). Recently, the maximum expected increase in the number of unacceptable patient results reported during the presence of an undetected out-of-control error condition [Max E(NUF)], has been proposed as an alternative QC performance measure because it is more related to the current introduction of risk management concepts for QC planning in the clinical laboratory. We used a statistical model to investigate the relationship between PEDC and Max E(NUF) for simple QC procedures widely used in clinical laboratories and to construct charts relating Max E(NUF) with the capability of the analytical process that allow for QC planning based on the risk of harm to a patient due to the report of erroneous results. A QC procedure shows nearly the same Max E(NUF) value when used for controlling analytical processes with the same capability, and there is a close relationship between PEDC and Max E(NUF) for simple QC procedures; therefore, the value of PEDC can be estimated from the value of Max E(NUF) and vice versa. QC procedures selected by their high PEDC value are also characterized by a low value for Max E(NUF). The PEDC value can be used for estimating the probability of patient harm, allowing for the selection of appropriate QC procedures in QC planning based on risk management. © 2016 American Association for Clinical Chemistry.

  15. Advances in pleural disease management including updated procedural coding.

    PubMed

    Haas, Andrew R; Sterman, Daniel H

    2014-08-01

    Over 1.5 million pleural effusions occur in the United States every year as a consequence of a variety of inflammatory, infectious, and malignant conditions. Although rarely fatal in isolation, pleural effusions are often a marker of a serious underlying medical condition and contribute to significant patient morbidity, quality-of-life reduction, and mortality. Pleural effusion management centers on pleural fluid drainage to relieve symptoms and to investigate pleural fluid accumulation etiology. Many recent studies have demonstrated important advances in pleural disease management approaches for a variety of pleural fluid etiologies, including malignant pleural effusion, complicated parapneumonic effusion and empyema, and chest tube size. The last decade has seen greater implementation of real-time imaging assistance for pleural effusion management and increasing use of smaller bore percutaneous chest tubes. This article will briefly review recent pleural effusion management literature and update the latest changes in common procedural terminology billing codes as reflected in the changing landscape of imaging use and percutaneous approaches to pleural disease management.

  16. [Multilevel analysis of the technical efficiency of hospitals in the Spanish National Health System by property and type of management].

    PubMed

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    2018-05-11

    To analyze technical efficiency by type of property and management of general hospitals in the Spanish National Health System (2010-2012) and identify hospital and regional explanatory variables. 230 hospitals were analyzed combining data envelopment analysis and fixed effects multilevel linear models. Data envelopment analysis measured overall, technical and scale efficiency, and the analysis of explanatory factors was performed using multilevel models. The average rate of overall technical efficiency of hospitals without legal personality is lower than hospitals with legal personality (0.691 and 0.876 in 2012). There is a significant variability in efficiency under variable returns (TE) by direct, indirect and mixed forms of management. The 29% of the variability in TE es attributable to the Region. Legal personality increased the TE of the hospitals by 11.14 points. On the other hand, most of the forms of management (different to those of the traditional hospitals) increased TE in varying percentages. At regional level, according to the model considered, insularity and average annual income per household are explanatory variables of TE. Having legal personality favours technical efficiency. The regulatory and management framework of hospitals, more than public or private ownership, seem to explain technical efficiency. Regional characteristics explain the variability in TE. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Data management procedures for Tiepoint Registration, pre and post processing, and ICD116

    NASA Technical Reports Server (NTRS)

    Nowakowski, B. S.

    1983-01-01

    The data management procedures for tiepoint registration, pre and post processing, and "ICD116' are described. With each procedure description, the pertinent execs are listed and purposes defined. An example run of each of the 32 execs is included with user inputs identified.

  18. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  19. Multi-procedure management in an eyeglasses-related open globe injury

    PubMed Central

    Skopiński, Piotr; Langwińska-Wośko, Ewa; Korwin, Magdalena; Kołodziejczyk, Wojciech; Ambroziak, Anna Maria

    2014-01-01

    We present a case of successful multi-procedure management of a patient with an open globe injury. A 47-year-old man sustained an injury to his left eye caused by glass fragments of his own spectacles shattered while he was protecting an unknown woman from physical assault at a bus stop. Over a span of 65 months the patient underwent multiple procedures including primary wound repair, penetrating keratoplasty combined with extracapsular cataract extraction, neodymium: YAG laser capsulotomy, and laser-assisted subepithelial keratectomy (LASEK), and had a successfully treated episode of corneal graft rejection. This sequence of treatment substantially improved his left eye vision from hand movements at the time of admission to 0.9–0.5 × 90 at the last follow-up nearly 10 years after the trauma. Proper initial surgical management of an open globe injury can create the possibility for virtually complete vision restoration. PMID:24729818

  20. Validity evidence of non-technical skills assessment instruments in simulated anaesthesia crisis management.

    PubMed

    Jirativanont, T; Raksamani, K; Aroonpruksakul, N; Apidechakul, P; Suraseranivongse, S

    2017-07-01

    We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisis management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents. The study included 70 participants, composed of 24 PGY-1, 24 PGY-2 and 22 PGY-3 residents. Both instruments differentiated the non-technical skills of PGY-1 from PGY-3 residents ( P <0.05). Inter-rater agreement was measured using the intraclass correlation coefficient (ICC). For the ANTS instrument, the intraclass correlation coefficients for task management, team-working, situation awareness and decision-making were 0.79, 0.34, 0.81 and 0.70, respectively. For the Ottawa GRS, the intraclass correlation coefficients for overall performance, leadership, problem-solving, situation awareness, resource utilisation and communication skills were 0.86, 0.83, 0.84, 0.87, 0.80 and 0.86, respectively. The Cronbach's alpha for internal consistency of the ANTS instrument was 0.93, and was 0.96 for the Ottawa GRS. There was a high correlation between the ANTS and Ottawa GRS. The raters reported the ease of use of the Ottawa GRS compared to the ANTS. We found sufficient evidence of validity in the ANTS instrument and the Ottawa GRS for the evaluation of non-technical skills in a simulated anaesthesia setting, but the Ottawa GRS was more practical and had higher reliability.

  1. A Comprehensive Surgical Procedure in Conservative Management of Placenta Accreta

    PubMed Central

    Kelekci, Sefa; Ekmekci, Emre; Aydogmus, Serpil; Gencdal, Servet

    2015-01-01

    Abstract We aimed to present a combined surgical procedure in conservative treatment of placenta accreta based on surgical outcomes in our cohort of patients. The study was designed as a prospective cohort series study. The setting involved two education and research hospitals in Turkey. This study included 12 patients with placenta accreta who were prenatally diagnosed and managed. We offered the patients the choice of conservative or nonconservative treatment. We then offered 2 choices for patients who had preferred conservative treatment, leaving the placenta in situ as is the classical procedure, or our surgical procedure. One patient preferred nonconservative treatment, the others opted for our procedure. We evaluated demographic and obstetric characteristics of patients, sonographic and operative parameters of patients, and surgical outcomes. We operated on 11 patients using this surgical procedure that we have developed for placenta accreta cases. We found that there was no need for hysterectomy in any patient, and we preserved the uterus for all of these patients. No patient presented any septic complication or secondary vaginal bleeding. Our surgical procedure seems to be effective and useful in the conservative treatment of placenta accreta. PMID:25700315

  2. 78 FR 65689 - Technical Mapping Advisory Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2013-0039] Technical Mapping Advisory Council AGENCY: Federal Emergency Management Agency, DHS. ACTION: Committee Management; Request for Applicants for Appointment to the Federal Emergency Management Agency's Technical...

  3. Technical Support for Contaminated Sites

    EPA Science Inventory

    In 1987, the U.S. Environmental Protection Agency’s (EPA) Office of Research and Development (ORD), Office of Land and Emergency Management, and EPA Regional waste management offices established the Technical Support Project. The creation of the Technical Support Project enabled...

  4. Procedures For Microbial-Ecology Laboratory

    NASA Technical Reports Server (NTRS)

    Huff, Timothy L.

    1993-01-01

    Microbial Ecology Laboratory Procedures Manual provides concise and well-defined instructions on routine technical procedures to be followed in microbiological laboratory to ensure safety, analytical control, and validity of results.

  5. 15 CFR 911.8 - Technical requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...

  6. 15 CFR 911.8 - Technical requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...

  7. 15 CFR 911.8 - Technical requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...

  8. 15 CFR 911.8 - Technical requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...

  9. 15 CFR 911.8 - Technical requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...

  10. A Study of the Relationship between Personality Types and the Acceptance of Technical Knowledge Management Systems (TKMS)

    ERIC Educational Resources Information Center

    Sullivan, Maureen S.

    2012-01-01

    Technical knowledge management systems (TKMSs) are not achieving the usage (acceptance) and the benefits that have been forecasted and are therefore, not enhancing competitive advantage and profits in organizations (Comb, 2004, "Assessing customer relationship management strategies for creating competitive advantage in electronic…

  11. US EPA Base Study Standard Operating Procedure for Data Processing and Data Management

    EPA Pesticide Factsheets

    The purpose of the Standard Operating Procedures (SOP) for data management and data processing is to facilitate consistent documentation and completion of data processing duties and management responsibilities in order to maintain a high standard of data quality.

  12. Faculty Performance Management System: The Faculty Development/Evaluation System at Beaufort Technical College, 1986-1987. Revised.

    ERIC Educational Resources Information Center

    Tobias, Earole; And Others

    Designed for faculty members at Beaufort Technical College (BTC) in South Carolina, this handbook describes the college's faculty evaluation process and procedures. The first sections of the handbook explain the rationale and method for the faculty evaluation process, state the purposes and objectives of the system, and offer a model which breaks…

  13. Principles and Procedures in Technical Assistance: An Approach to Educational Change

    ERIC Educational Resources Information Center

    Lillie, David L.; Black, Talbot

    1976-01-01

    The Technical Assistance Development System (TADS) has developed through the years a system for technical assistance and has identified some important principles that should be followed in the operation of organizational support systems. (Author/ER)

  14. Habitat Evaluation Procedures (HEP) Report : Grand Coulee Dam Mitigation, 1996-1999 Technical Report.

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

    Kieffer, B.; Singer, Kelly; Abrahamson, Twa-le

    1999-07-01

    The purpose of this Habitat Evaluation Procedures (HEP) study was to determine baseline habitat units and to estimate future habitat units for Bonneville Power Administration (BPA) mitigation projects on the Spokane Indian Reservation. The mitigation between BPA and the Spokane Tribe of Indians (STOI) is for wildlife habitat losses on account of the construction of Grand Coulee Dam. Analysis of the HEP survey data will assist in mitigation crediting and appropriate management of the mitigation lands.

  15. Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

    PubMed

    Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

    2017-12-19

    To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p < 0.01, GOALS score 18.0 vs 13.3, p < 0.01) and nontechnical performance (NOTSS score 13.8 vs 10.1, p = 0.03). Technical performance scores correlated with NOTSS scores (p < 0.01) and pass/fail rating correlated with technical performance (p < 0.01 for both checklist and GOALS), NOTSS score (p = 0.02), and blood loss (p < 0.01). Only the conscientiousness dimension of the big five inventory correlated with technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. Habitat Evaluation Procedures (HEP) Report; Tacoma/Trimble Area Management Plan, Technical Report 2001-2003.

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

    Entz, Ray; Lockwood, Jr., Neil; Holmes, Darren

    2003-10-01

    In 2000 and 2001, the Kalispel Natural Resource Department (KNRD) continued to mitigate the wildlife habitat losses as part of the Albeni Falls Wildlife Mitigation Project. Utilizing Bonneville Power Administration (BPA) funds, the Kalispel Tribe of Indians (Tribe) purchased three projects totaling nearly 1,200 acres. The Tacoma/Trimble Wildlife Management Area is a conglomeration of properties now estimated at 1,700 acres. It is the Tribe's intent to manage these properties in cooperation and collaboration with the Pend Oreille County Public Utility District (PUD) No. 1 and the U.S. Fish and Wildlife Service (USFWS) to benefit wildlife habitats and associated species, populations,more » and guilds.« less

  17. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VESSELS CARRYING OIL IN BULK Interim Measures for Certain Tank Vessels Without Double Hulls Carrying Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1..., processing, and interpreting all essential information and making it conveniently available to other members...

  18. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VESSELS CARRYING OIL IN BULK Interim Measures for Certain Tank Vessels Without Double Hulls Carrying Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1..., processing, and interpreting all essential information and making it conveniently available to other members...

  19. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VESSELS CARRYING OIL IN BULK Interim Measures for Certain Tank Vessels Without Double Hulls Carrying Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1..., processing, and interpreting all essential information and making it conveniently available to other members...

  20. SUPERFUND TECHNICAL SUPPORT

    EPA Science Inventory

    Under this task, technical support is provided to Regional Remedial Project Managers (RPMs)/On-Scene Coordinators (OSCs) at Superfund, RCRA, and Brownfields sites contaminated with hazardous materials by the Technical Support Center (TSC) for Monitoring and Site Characterization....

  1. Student Opinions about the Seven-Step Procedure in Problem-Based Hospitality Management Education

    ERIC Educational Resources Information Center

    Zwaal, Wichard; Otting, Hans

    2014-01-01

    This study investigates how hospitality management students appreciate the role and application of the seven-step procedure in problem-based learning. A survey was developed containing sections about personal characteristics, recall of the seven steps, overall report marks, and 30 statements about the seven-step procedure. The survey was…

  2. Complex socio-technical systems: Characterization and management guidelines.

    PubMed

    Righi, Angela Weber; Saurin, Tarcisio Abreu

    2015-09-01

    Although ergonomics has paid increasing attention to the perspective of complexity, methods for its operationalization are scarce. This study introduces a framework for the operationalization of the "attribute view" of complexity, which involves: (i) the delimitation of the socio-technical system (STS); (ii) the description of four complexity attributes, namely a large number of elements in dynamic interactions, a wide diversity of elements, unexpected variability, and resilience; (iii) the assessment of six management guidelines, namely design slack, give visibility to processes and outcomes, anticipate and monitor the impacts of small changes, monitor the gap between prescription and practice, encourage diversity of perspectives when making decisions, and create an environment that supports resilience; and (iv) the identification of leverage points for improving the STS design, based on both the analysis of relationships among the attributes and their classification as irreducible/manageable complexity, and liability/asset. The use of the framework is illustrated by the study of an emergency department of a University hospital. Data collection involved analysis of documents, observations of work at the front-line, interviews with employees, and the application of questionnaires. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. New Mexico Standards Based Assessment (NMSBA) Technical Report: 2006 Spring Administration

    ERIC Educational Resources Information Center

    Griph, Gerald W.

    2006-01-01

    The purpose of the NMSBA technical report is to provide users and other interested parties with a general overview of and technical characteristics of the 2006 NMSBA. The 2006 technical report contains the following information: (1) Test development; (2) Scoring procedures; (3) Calibration, scaling, and equating procedures; (4) Standard setting;…

  4. Assignment Procedures in the Air Force Procurement Management Information System.

    ERIC Educational Resources Information Center

    Ward, Joe H., Jr.; And Others

    An overview is presented of the procedure for offering jobs in the Air Force Procurement Management Information System (PROMIS), an assignment system which makes possible the use of human resources research findings to improve individual personnel assignments. A general framework for viewing personnel assignment systems is presented; then job…

  5. [Nursing management of a refractory cardiac death donor].

    PubMed

    Kaufmann, Marion

    2016-09-01

    The nursing management of a refractory circulatory death donor is a new procedure which forms an integral part of patient care. It comprises technical and organisational aspects, and requires a conceptual, ethical and deontological effort. Copyright © 2016. Published by Elsevier Masson SAS.

  6. The 1996 NAEP Technical Report.

    ERIC Educational Resources Information Center

    Allen, Nancy L.; Carlson, James E.; Zelenak, Christine A.

    This report documents the design, administration, and data analysis procedure of the National Assessment of Education Progress (NAEP) for 1996. It indicates the technical decisions that were made and the rationale behind them. Detailed substantive findings are not presented in this report. These chapters provide technical information about the…

  7. Computerized Information Management in Long-Term Care: A Case Study. Technical Report No. 303.

    ERIC Educational Resources Information Center

    Zawadski, Rick T.; Gee, Stephen

    This technical report describes the computerized information management system used at the Community Care Organization for Dependent Adults (CCODA) of the On Lok Senior Health Services in San Francisco's Chinatown (California). A background perspective on information systems in business, government, hospitals, and local community service agencies…

  8. Management and Accountability Procedures: DEEP - The New Mexico State Facilitator.

    ERIC Educational Resources Information Center

    New Mexico Univ., Albuquerque. Coll. of Education.

    Presented is a description of how DEEP (Developmental Economic Education Program) monitors activity and achievements to ensure that objectives are met effectively and efficiently, and that evidence of achievement is available for reports. The purposes of DEEP management and accountability procedures are: (1) to maintain both long term and short…

  9. Unresolved Technical Issues in Fair Interest Measurement.

    ERIC Educational Resources Information Center

    Cole, Nancy S.

    The problem of sex differences in interest measurement involves many technical issues and procedures. The purpose of this paper is to provide a description of the technical problems involved in construction, scoring, and interpretation of interest measures as related to sex differences and to suggest guidelines within these technical issues which…

  10. Software to Manage the Unmanageable

    NASA Technical Reports Server (NTRS)

    2005-01-01

    In 1995, NASA s Jet Propulsion Laboratory (JPL) contracted Redmond, Washington-based Lucidoc Corporation, to design a technology infrastructure to automate the intersection between policy management and operations management with advanced software that automates document workflow, document status, and uniformity of document layout. JPL had very specific parameters for the software. It expected to store and catalog over 8,000 technical and procedural documents integrated with hundreds of processes. The project ended in 2000, but NASA still uses the resulting highly secure document management system, and Lucidoc has managed to help other organizations, large and small, with integrating document flow and operations management to ensure a compliance-ready culture.

  11. Management of the athlete with a failed shoulder instability procedure.

    PubMed

    Gwathmey, F Winston; Warner, Jon J P

    2013-10-01

    The athlete with a failed instability procedure requires a thoughtful and systematic approach to achieve a good outcome. Goals of treatment should be defined and realistic expectations should be set. Revision stabilization has a high rate of recurrent instability, low rates of return to play, and low clinical outcome scores. Fundamental to successful revision surgery is choosing the correct procedure. The decision is straightforward in athletes with clear factors that predict recurrence (significant glenoid bone loss, engaging Hill-Sachs lesions) because only a bony procedure can restore the articular arc of the glenoid. Arthroscopic revision Bankart repair may be appropriate in those athletes who have an obvious Bankart tear and no bone loss after a traumatic reinjury. The challenge for the shoulder surgeon is identifying the best surgery for the athlete who does not have such clear-cut indications. Each factor that has the potential to lead to a poor outcome needs to be collected and calculated. Patient factors (age, laxity, type and level of sport), injury factors (mechanism of injury, capsulolabral injury, glenoid bone loss, Hill-Sachs lesion), and technical factors (previous surgery performed, integrity of repair, scarring) must be integrated into the treatment algorithm. Based on this collection of factors, the shoulder surgeon should be prepared to provide the athlete with the surgery that provides the best chance to return to playing sports and the lowest risk of recurrent instability. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Airway Management During Upper GI Endoscopic Procedures: State of the Art Review.

    PubMed

    Goudra, Basavana; Singh, Preet Mohinder

    2017-01-01

    With the growing popularity of propofol mediated deep sedation for upper gastrointestinal (GI) endoscopic procedures, challenges are being felt and appreciated. Research suggests that management of the airway is anything but routine in this setting. Although many studies and meta-analyses have demonstrated the safety of propofol sedation administered by registered nurses under the supervision of gastroenterologists (likely related to the lighter degrees of sedation than those provided by anesthesia providers and is under medicolegal controversy in the United States), there is no agreement on the optimum airway management for procedures such as endoscopic retrograde cholangiopancreatography. Failure to rescue an airway at an appropriate time has led to disastrous consequences. Inability to evaluate and appreciate the risk factors for aspiration can ruin the day for both the patient and the health care providers. This review apprises the reader of various aspects of airway management relevant to the practice of sedation during upper GI endoscopy. New devices and modification of existing devices are discussed in detail. Recognizing the fact that appropriate monitoring is important for timely recognition and management of potential airway disasters, these issues are explored thoroughly.

  13. 18 CFR 430.23 - Technical determinations and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... BASIN COMMISSION SPECIAL REGULATIONS GROUND WATER PROTECTION AREA: PENNSYLVANIA § 430.23 Technical... new or expanded ground water withdrawal, as required by §§ 430.11 and 430.13 of this part shall be as... considered (miles) 10,000 to 50,000 0.5 50,000 to 100,000 0.75 In excess of 100,000 1.0 (b) Ground water...

  14. 18 CFR 430.23 - Technical determinations and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... BASIN COMMISSION SPECIAL REGULATIONS GROUND WATER PROTECTION AREA: PENNSYLVANIA § 430.23 Technical... new or expanded ground water withdrawal, as required by §§ 430.11 and 430.13 of this part shall be as... considered (miles) 10,000 to 50,000 0.5 50,000 to 100,000 0.75 In excess of 100,000 1.0 (b) Ground water...

  15. Designing water demand management schemes using a socio-technical modelling approach.

    PubMed

    Baki, Sotiria; Rozos, Evangelos; Makropoulos, Christos

    2018-05-01

    Although it is now widely acknowledged that urban water systems (UWSs) are complex socio-technical systems and that a shift towards a socio-technical approach is critical in achieving sustainable urban water management, still, more often than not, UWSs are designed using a segmented modelling approach. As such, either the analysis focuses on the description of the purely technical sub-system, without explicitly taking into account the system's dynamic socio-economic processes, or a more interdisciplinary approach is followed, but delivered through relatively coarse models, which often fail to provide a thorough representation of the urban water cycle and hence cannot deliver accurate estimations of the hydrosystem's responses. In this work we propose an integrated modelling approach for the study of the complete socio-technical UWS that also takes into account socio-economic and climatic variability. We have developed an integrated model, which is used to investigate the diffusion of household water conservation technologies and its effects on the UWS, under different socio-economic and climatic scenarios. The integrated model is formed by coupling a System Dynamics model that simulates the water technology adoption process, and the Urban Water Optioneering Tool (UWOT) for the detailed simulation of the urban water cycle. The model and approach are tested and demonstrated in an urban redevelopment area in Athens, Greece under different socio-economic scenarios and policy interventions. It is suggested that the proposed approach can establish quantifiable links between socio-economic change and UWS responses and therefore assist decision makers in designing more effective and resilient long-term strategies for water conservation. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Develop a Comprehensive Technical Training and Data Collection Program for Structural Welders and Fitters: Technical Proposal

    DTIC Science & Technology

    2006-05-30

    implementation Final Report 4 TECHNICAL PLAN AND RESULTS Task 1: Initiate the Project Management System Two senior NGSS production management...1 Technical Plan and Results...Third the system is hosted on a handheld unit which provides the foremen with an efficient daily planning tool. The Pilot System which entails

  17. An approach to knowledge structuring for advanced phases of the Technical and Management Information System (TMIS)

    NASA Technical Reports Server (NTRS)

    Goranson, H. T.

    1986-01-01

    The Technical and Management Information System (TMIS) must employ on enlightened approach to its object structure, but basic issues in conceptual structuring remain to be resolved. Sirius outlines the necessary agenda and reports on progress toward solutions.

  18. New procedure to reduce the time and cost of broncho-pulmonary specimen management using the Previ Isola® automated inoculation system.

    PubMed

    Nebbad-Lechani, Biba; Emirian, Aurélie; Maillebuau, Fabienne; Mahjoub, Nadia; Fihman, Vincent; Legrand, Patrick; Decousser, Jean-Winoc

    2013-12-01

    The microbiological diagnosis of respiratory tract infections requires serial manual dilutions of the clinical specimen before agar plate inoculation, disrupting the workflow in bacteriology clinical laboratories. Automated plating instrument systems have been designed to increase the speed, reproducibility and safety of this inoculating step; nevertheless, data concerning respiratory specimens are lacking. We tested a specific procedure that uses the Previ Isola® (bioMérieux, Craponne, France) to inoculate with broncho-pulmonary specimens (BPS). A total of 350 BPS from a university-affiliated hospital were managed in parallel using the manual reference and the automated methods (expectoration: 75; broncho-alveolar lavage: 68; tracheal aspiration: 17; protected distal sample: 190). A specific enumeration reading grid, a pre-liquefaction step and a fluidity test, performed before the inoculation, were designed for the automated method. The qualitative (i.e., the number of specimens yielding a bacterial count greater than the clinical threshold) and quantitative (i.e., the discrepancy within a 0.5 log value) concordances were 100% and 98.2%, respectively. The slimmest subgroup of expectorations could not be managed by the automated method (8%, 6/75). The technical time and cost savings (i.e., number of consumed plates) reached 50%. Additional studies are required for specific populations, such as cystic fibrosis specimens and associated bacterial variants. An automated decapper should be implemented to increase the biosafety of the process. The PREVI Isola® adapted procedure is a time- and cost-saving method for broncho-pulmonary specimen processing. © 2013.

  19. Technical Management in an Age of Openness: The Political, Public, and Environmental Forest Ranger

    ERIC Educational Resources Information Center

    Anderson, Sarah E.; Hodges, Heather E.; Anderson, Terry L.

    2013-01-01

    Modern bureaucracy faces trade-offs between public and congressional input and agency expertise. The U.S. Forest Service offers an opportunity to quantitatively analyze whether an agency that is required to be more open to the public and congressional input will be forced to ignore its technical expertise in managing resources. This study uses…

  20. Percutaneous magnetic resonance imaging-guided bone tumor management and magnetic resonance imaging-guided bone therapy.

    PubMed

    Sequeiros, Roberto Blanco; Fritz, Jan; Ojala, Risto; Carrino, John A

    2011-08-01

    Magnetic resonance imaging (MRI) is promising tool for image-guided therapy. In musculoskeletal setting, image-guided therapy is used to direct diagnostic and therapeutic procedures and to steer patient management. Studies have demonstrated that MRI-guided interventions involving bone, soft tissue, joints, and intervertebral disks are safe and in selected indications can be the preferred action to manage clinical situation. Often, these procedures are technically similar to those performed in other modalities (computed tomography, fluoroscopy) for bone and soft tissue lesions. However, the procedural perception to the operator can be very different to other modalities because of the vastly increased data.Magnetic resonance imaging guidance is particularly advantageous should the lesion not be visible by other modalities, for selective lesion targeting, intra-articular locations, cyst aspiration, and locations adjacent to surgical hardware. Palliative tumor-related pain management such as ablation therapy forms a subset of procedures that are frequently performed under MRI. Another suitable entity for MRI guidance are the therapeutic percutaneous osseous or joint-related benign or reactive conditions such as osteoid osteoma, epiphyseal bone bridging, osteochondritis dissecans, bone cysts, localized bone necrosis, and posttraumatic lesions. In this article, we will describe in detail the technical aspects of performing MRI-guided therapeutic musculoskeletal procedures as well as the clinical indications.

  1. Intraoperative cryoanalgesia for managing pain after the Nuss procedure.

    PubMed

    Graves, Claire; Idowu, Olajire; Lee, Sang; Padilla, Benjamin; Kim, Sunghoon

    2017-06-01

    Cryoanalgesia prevents pain by freezing the affected peripheral nerve. We report the use of intraoperative cryoanalgesia during the Nuss procedure for pectus excavatum and describe our initial experience, modifications of technique, and lessons learned. We retrospectively reviewed the medical records of patients who received cryoanalgesia during the Nuss procedure between June 1, 2015, and April 30, 2016, at our institutions and analyzed modifications in surgical technique during this early adoption period. Eight male and two female patients underwent the Nuss procedure with cryoanalgesia. The mean postoperative length of stay (LOS) was 2days (range 1-3). Average inpatient pain scores were 3.4, 3.2, and 4.6 on postoperative days 1-3, respectively (N=10, 7, and 2). At a 1-week postoperative visit, mean pain score was 1.1 (N=6). Compared to the preceding 15 Nuss patients at our institution, who were treated with a thoracic epidural, postoperative LOS was significantly shorter with cryoanalgesia (2.0±0.82 vs. 6.3±1.3days, P<0.001). We modified our technique for patient habitus and adopted single-lung ventilation for improved visualization. Cryoanalgesia may be the ideal pain management strategy for Nuss patients because it is effective and long lasting. Intraoperative application is easily integrated into the Nuss procedure. Treatment study: case series; Evidence level IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Human-Centered Technologies and Procedures for Future Air Traffic Management

    NASA Technical Reports Server (NTRS)

    Smith, Philip; Woods, David; McCoy, Elaine; Billings, Charles; Sarter, Nadine; Denning, Rebecca; Dekker, Sidney

    1997-01-01

    The use of various methodologies to predict the impact of future Air Traffic Management (ATM) concepts and technologies is explored. The emphasis has been on the importance of modeling coordination and cooperation among multiple agents within this system, and on understanding how the interactions among these agents will be influenced as new roles, responsibilities, procedures and technologies are introduced. To accomplish this, we have been collecting data on performance under the current air traffic management system, identifying critical problem areas and looking for examples suggestive of general approaches for solving such problems. Using the results of these field studies, we have developed a set of concrete scenarios centered around future designs, and have studied performance in these scenarios with a set of 40 controllers, dispatchers, pilots and traffic managers.

  3. Simulation of time-control procedures for terminal area flow management

    NASA Technical Reports Server (NTRS)

    Alcabin, M.; Erzberger, H.; Tobias, L.; Obrien, P. J.

    1985-01-01

    Simulations of a terminal area traffic-management system incorporating automated scheduling and time-control (four-dimensional) techniques conducted at NASA Ames Research Center jointly with the Federal Aviation Administration, have shown that efficient procedures can be developed for handling a mix of 4D-equipped and conventionally equipped aircraft. A crucial role in this system is played by an ATC host computer algorithm, referred to as a speed advisory, that allows controllers to maintain accurate time schedules of the conventionally equipped aircraft in the traffic mix. Results are of the most recent simulations in which two important special cases were investigated. First, the effects of a speed advisory on touchdown time scheduling are examined, when unequipped aircraft are constrained to follow fuel-optimized profiles in the near-terminal area, and rescheduling procedures are developed to handle missed approaches of 4D-equipped aircraft. Various performance measures, including controller opinion, are used to evaluate the effectiveness of the procedures.

  4. Technical Operating Procedures for Providing Funding to Natural Resource Trustees to Conduct an Initiation of Assessment of Natural Resource Damages Under the Oil Pollution Act of 1990

    DOT National Transportation Integrated Search

    1996-06-01

    Technical Operating Procedures (TOPS) for Providing Funding to Natural Resources : Trustees To Conduct An Initiation of Assessment of Natural Resource Damages : under the Oil Pollution Act of 1990 have been developed to provide guidance on : funding ...

  5. A comparative evaluation of two decompression procedures for technical diving using inflammatory responses: compartmental versus ratio deco.

    PubMed

    Spisni, Enzo; Marabotti, Claudio; De Fazio, Luigia; Valerii, Maria Chiara; Cavazza, Elena; Brambilla, Stefano; Hoxha, Klarida; L'Abbate, Antonio; Longobardi, Pasquale

    2017-03-01

    The aim of this study was to compare two decompression procedures commonly adopted by technical divers: the ZH-L16 algorithm modified by 30/85 gradient factors (compartmental decompression model, CDM) versus the 'ratio decompression strategy' (RDS). The comparison was based on an analysis of changes in diver circulating inflammatory profiles caused by decompression from a single dive. Fifty-one technical divers performed a single trimix dive to 50 metres' sea water (msw) for 25 minutes followed by enriched air (EAN50) and oxygen decompression. Twenty-three divers decompressed according to a CDM schedule and 28 divers decompressed according to a RDS schedule. Peripheral blood for detection of inflammatory markers was collected before and 90 min after diving. Venous gas emboli were measured 30 min after diving using 2D echocardiography. Matched groups of 23 recreational divers (dive to 30 msw; 25 min) and 25 swimmers were also enrolled as control groups to assess the effects of decompression from a standard air dive or of exercise alone on the inflammatory profile. Echocardiography at the single 30 min observation post dive showed no significant differences between the two decompression procedures. Divers adopting the RDS showed a worsening of post-dive inflammatory profile compared to the CDM group, with significant increases in circulating chemokines CCL2 (P = 0.001) and CCL5 (P = 0.006) levels. There was no increase in chemokines following the CDM decompression. The air scuba group also showed a statistically significant increase in CCL2 (P < 0.001) and CCL5 (P = 0.003) levels post dive. No cases of decompression sickness occurred. The ratio deco strategy did not confer any benefit in terms of bubbles but showed the disadvantage of increased decompression-associated secretion of inflammatory chemokines involved in the development of vascular damage.

  6. Review of telehealth stuttering management.

    PubMed

    Lowe, Robyn; O'Brian, Sue; Onslow, Mark

    2013-01-01

    Telehealth is the use of communication technology to provide health care services by means other than typical in-clinic attendance models. Telehealth is increasingly used for the management of speech, language and communication disorders. The aim of this article is to review telehealth applications to stuttering management. We conducted a search of peer-reviewed literature for the past 20 years using the Institute for Scientific Information Web of Science database, PubMed: The Bibliographic Database and a search for articles by hand. Outcomes for telehealth stuttering treatment were generally positive, but there may be a compromise of treatment efficiency with telehealth treatment of young children. Our search found no studies dealing with stuttering assessment procedures using telehealth models. No economic analyses of this delivery model have been reported. This review highlights the need for continued research about telehealth for stuttering management. Evidence from research is needed to inform the efficacy of assessment procedures using telehealth methods as well as guide the development of improved treatment procedures. Clinical and technical guidelines are urgently needed to ensure that the evolving and continued use of telehealth to manage stuttering does not compromise the standards of care afforded with standard in-clinic models.

  7. Designing Flightdeck Procedures: Literature Resources

    NASA Technical Reports Server (NTRS)

    Feldman, Jolene; Barshi, Immanuel; Degani, Asaf; Loukopoulou, Loukia; Mauro, Robert

    2017-01-01

    This technical publication contains the titles, abstracts, summaries, descriptions, and/or annotations of available literature sources on procedure design and development, requirements, and guidance. It is designed to provide users with an easy access to available resources on the topic of procedure design, and with a sense of the contents of these sources. This repository of information is organized into the following publication sources: Research (e.g., journal articles, conference proceedings), Manufacturers' (e.g., operation manuals, newsletters), and Regulatory and/or Government (e.g., advisory circulars, reports). An additional section contains synopses of Accident/Incident Reports involving procedures. This work directly supports a comprehensive memorandum by Barshi, Mauro, Degani, & Loukopoulou (2016) that summarizes the results of a multi-year project, partially funded by the FAA, to develop technical reference materials that support guidance on the process of developing cockpit procedures (see "Designing Flightdeck Procedures" https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20160013263.pdf). An extensive treatment of this topic is presented in a forthcoming book by the same authors.

  8. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  9. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  10. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  11. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  12. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  13. Peroral endoscopic myotomy: procedural complications and pain management for the perioperative clinician

    PubMed Central

    Misra, Lopa; Fukami, Norio; Nikolic, Katarina; Trentman, Terrence L

    2017-01-01

    Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus. The aim of our study is to document perioperative pain and associated pain management for our initial patients undergoing POEM and to review the literature for perioperative complications of this procedure. Therefore, anesthetic and pain management for our initial eleven patients undergoing POEM were reviewed. Patient demographics, pre-POEM pain medication history, perioperative pain medication requirements, and post-POEM pain scores were examined. We found post-POEM pain was usually in the mild–moderate range; a combination of medications was effective (opioids, nonsteroidal anti-inflammatory drugs, acetaminophen). Our literature search revealed a wide frequency range of complications such as pneumoperitoneum and subcutaneous emphysema, with rare serious events such as capnopericardium leading to cardiac arrest. In conclusion, our experience with POEM suggests pain and can be managed adequately with a combination of medications; the procedure appears to be safe and reasonable to perform in an outpatient endoscopy unit. PMID:28260955

  14. The intellectual information system for management of geological and technical arrangements during oil field exploitation

    NASA Astrophysics Data System (ADS)

    Markov, N. G.; E Vasilyeva, E.; Evsyutkin, I. V.

    2017-01-01

    The intellectual information system for management of geological and technical arrangements during oil fields exploitation is developed. Service-oriented architecture of its software is a distinctive feature of the system. The results of the cluster analysis of real field data received by means of this system are shown.

  15. 78 FR 70569 - Technical Mapping Advisory Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2013-0039] Technical Mapping Advisory Council AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice... Technical Mapping Advisory Council (TMAC). The notice incorrectly stated that contractors and potential...

  16. A procedure to evaluate environmental rehabilitation in limestone quarries.

    PubMed

    Neri, Ana Claudia; Sánchez, Luis Enrique

    2010-11-01

    A procedure to evaluate mine rehabilitation practices during the operational phase was developed and validated. It is based on a comparison of actually observed or documented practices with internationally recommended best practices (BP). A set of 150 BP statements was derived from international guides in order to establish the benchmark. The statements are arranged in six rehabilitation programs under three categories: (1) planning (2) operational and (3) management, corresponding to the adoption of the plan-do-check-act management systems model to mine rehabilitation. The procedure consists of (i) performing technical inspections guided by a series of field forms containing BP statements; (ii) classifying evidences in five categories; and (iii) calculating conformity indexes and levels. For testing and calibration purposes, the procedure was applied to nine limestone quarries and conformity indexes were calculated for the rehabilitation programs in each quarry. Most quarries featured poor planning practices, operational practices reached high conformity levels in 50% of the cases and management practices scored moderate conformity. Despite all quarries being ISO 14001 certified, their management systems pay low attention to issues pertaining to land rehabilitation and biodiversity. The best results were achieved by a quarry whose expansion was recently submitted to the environmental impact assessment process, suggesting that public scrutiny may play a positive role in enhancing rehabilitation practices. Conformity indexes and levels can be used to chart the evolution of rehabilitation practices at regular intervals, to establish corporate goals and for communication with stakeholders. Copyright 2010 Elsevier Ltd. All rights reserved.

  17. Development of Criteria and Procedures for Management of Classified Document Collections.

    ERIC Educational Resources Information Center

    Rea, Jack C.

    The report describes work done in development of criteria and procedures for management of collections of classified documents. Material is presented on philosophy of operation, concept of user service, accession and retention. Much of the discussion is based upon the concept of conversion to a microfiche-oriented library; however, hard copy…

  18. Technical Support for Contaminated Sites | Science Inventory ...

    EPA Pesticide Factsheets

    In 1987, the U.S. Environmental Protection Agency’s (EPA) Office of Research and Development (ORD), Office of Land and Emergency Management, and EPA Regional waste management offices established the Technical Support Project. The creation of the Technical Support Project enabled ORD to provide effective technical assistance by ensuring ORD scientists and engineers were accessible to the Agency’s Office and Regional decision makers, including Remedial Project Managers, On-Scene Coordinators, and corrective action staff. Five ORD Technical Support Centers (TSCs) were created to facilitate this technical assistance. Three of the five TSCs are supported by the Sustainable and Healthy Communities Research Program, and are summarized in the poster being presented:• Engineering Technical Support Center (ETSC) in Cincinnati, Ohio• Ground Water Technical Support Center (GWTSC) in Ada, Oklahoma• Site Characterization and Monitoring Technical Support Center (SCMTSC) in Atlanta, GeorgiaOver the past 29 years, the Technical Support Centers have provided numerous influential products to its internal Agency clients and to those at the State level (through the EPA Regions). These products include, but are not limited to the following: Annual TSC reports from the three Centers, a hard-rock mining conference every other year, PRO-UCL software development for site characterization statistics, groundwater modeling using state-of-the-art modeling software, numerical mo

  19. Treatment of Children with Protein – Losing Enteropathy After Fontan and Other Complex Congenital Heart Disease Procedures in Condition with Limited Human and Technical Resources

    PubMed Central

    Bejiqi, Ramush; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Vuqiterna, Armend; Maloku, Arlinda

    2014-01-01

    Background Protein-losing enteropathy (PLE) is a disorder characterized by abnormal and often profound enteric protein loss. It’s relatively uncommon complication of Fontan and other complex congenital heart disease (CCHD) procedures. Because of the complexity and rarity of this disease process, the pathogenesis and pathophysiology of protein-losing enteropathy remain poorly understood, and attempts at treatment seldom yield long-term success. Aim of presentation is to describe single centre experience in diagnosis, evaluation, management and treatment of children with protein-losing enteropathy after Fontan and other CCHD procedures in the current era and in centre with limited human and technical resources, follows with a comprehensive review of protein-losing enteropathy publications, and concludes with suggestions for prevention and treatment. Material and methodology Retrospectively we analyzed patients with CCHD and protein-losing enteropathy in our institution, starting from January 2000 to December 2012. The including criteria were age between two and 17 years, to have a complex congenital heart disease and available complete documentation of cardiac surgery under cardiopulmonary bypass. Results Of all patients we evaluated 18 cases with protein-losing enteropathy, aged 6 to 19 years (mean 14±9); there were three children who had undergone screening procedure for D-transposition, one Tetralogy of Fallot, and remaining 14 patients had undergone Fontan procedures; (anatomic diagnosis are: six with tricuspid atresia, seven with d-transposition, double outlet right ventricle and pulmonary atresia and two with hypoplastic left heart syndrome). The diagnosis of protein-losing enteropathy was made at median age of 5.6 years, ranging from 13 months to 15 years. Diagnosis was made using alpha 1-antitrypsin as a gold marker in stool. By physical examination in 14 patients edema was found, in three ascites, and six patients had pleural effusion. Laboratory findings

  20. Technical and Non-Technical Measures for air pollution emission reduction: The integrated assessment of the regional Air Quality Management Plans through the Italian national model

    NASA Astrophysics Data System (ADS)

    D'Elia, I.; Bencardino, M.; Ciancarella, L.; Contaldi, M.; Vialetto, G.

    2009-12-01

    The Italian Air Quality legislation underwent sweeping changes with the implementation of the 1996 European Air Quality Framework Directive when the Italian administrative Regions were entrusted with air quality management tasks. The most recent Regional Air Quality Management Plans (AQMPs) highlighted the importance of Non-Technical Measures (NTMs), in addition to Technical Measures (TMs), in meeting environmental targets. The aim of the present work is to compile a list of all the TMs and NTMs taken into account in the Italian Regional AQMPs and to give in the target year, 2010, an estimation of SO 2, NO x and PM 10 emission reductions, of PM 10 concentration and of the health impact of PM 2.5 concentrations in terms of Life Expectancy Reduction. In order to do that, RAINS-Italy, as part of the National Integrated Modeling system for International Negotiation on atmospheric pollution (MINNI), has been applied. The management of TMs and NTMs inside RAINS have often obliged both the introduction of exogenous driving force scenarios and the control strategy modification. This has inspired a revision of the many NTM definitions and a clear choice of the definition adopted. It was finally highlighted that only few TMs and NTMs implemented in the AQMPs represent effective measures in reaching the environmental targets.

  1. Design Study for Project on Standard Operating Procedures for Technical Library Services.

    ERIC Educational Resources Information Center

    Libbey, Miles A.; And Others

    The overall objective of the Technical Information Support Activities (TISA) Project is the production of a "Post Commander's Handbook." The handbook will be instrumental in achieving greater utilization of available technical information resources to assist army scientists and engineers engaged in the support of army combat and other…

  2. RTO Technical Publications: A Quarterly Listing

    NASA Technical Reports Server (NTRS)

    2005-01-01

    A quarterly listing of RTO technical publications is presented. The topics include: Handbook on the Analysis of Smaller-Scale Contingency Operations in Long Term Defence Planning; 2) Radar Polarimetry and Interferometry; 3) Combat Casualty Care in Ground-Based Tactical Situations: Trauma Technology and Emergency Medical Procedures; and 4) RTO Technical Publications: A Quarterly Listing

  3. 24 CFR 964.220 - Technical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Technical assistance. 964.220....220 Technical assistance. (a) Financial assistance. HUD will provide financial assistance, to the extent available, to resident councils or resident management corporations for technical assistance and...

  4. Increasing productivity through Total Reuse Management (TRM)

    NASA Technical Reports Server (NTRS)

    Schuler, M. P.

    1991-01-01

    Total Reuse Management (TRM) is a new concept currently being promoted by the NASA Langley Software Engineering and Ada Lab (SEAL). It uses concepts similar to those promoted in Total Quality Management (TQM). Both technical and management personnel are continually encouraged to think in terms of reuse. Reuse is not something that is aimed for after a product is completed, but rather it is built into the product from inception through development. Lowering software development costs, reducing risk, and increasing code reliability are the more prominent goals of TRM. Procedures and methods used to adopt and apply TRM are described. Reuse is frequently thought of as only being applicable to code. However, reuse can apply to all products and all phases of the software life cycle. These products include management and quality assurance plans, designs, and testing procedures. Specific examples of successfully reused products are given and future goals are discussed.

  5. [Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

    PubMed

    Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

    2009-06-01

    Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

  6. Ultrastructural characterization of the new NG97ht human-derived glioma cell line using two different electron microscopy technical procedures.

    PubMed

    Machado, Camila Maria Longo; Zorzeto, Tatiane Queiroz; Bianco, Juares E Romero; Rosa, Renata Giardini; Genari, Selma Candelaria; Joazeiro, Paulo Pinto; Verinaud, Liana

    2009-04-01

    On the basis of transmission electron microscopy observations in tumor cell lines, oncologists have made innumerous diagnostic and therapeutical progresses. Following this path, the UNICAMP immunopathologies laboratory established the NG97 cell line derived from a human astrocytoma grade III, which when injected to the athymic nude mouse flank developed a grade IV astrocytoma. In this study, we focused on ultrastructural characterization of the NG97 cells after being recovered from xenotransplant (NG97ht). These cells in culture were assayed by two different electron microscopy procedures to characterize ultrastructures related to grade IV astrocytomas and to observe their structures through cell subcultivation. Additionally, comparative morphological descriptions of different cell passages in these technical procedures could be a useful tool for improving electron microscopy cell lineage protocols. Results from many cell passage observations showed ultrastructural similarities, which suggest malignant and glioblastoma phenotypes. In the first procedure, NG97ht cells were harvested and then incorporated into agarose before subjecting them to electron microscopy protocols, whereas in the second one, monolayer cells grew first on cover slides. Comparison among protocols revealed that organelles, cytoplasmatic extensions, spatial conformation of filopodia, and cell attachment to substrate were more preserved in the second procedure. Furthermore, in this latter procedure, a unique ellipsoidal structure was observed, which was already described when dealing with gliosarcoma cell line elsewhere. Therefore, these analyses demonstrated a morphological characterization of a new NG97ht cell line using electron transmission microscopy. Moreover, it has been shown that the second procedure provides more detailed information compared with the first.

  7. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...) Allow no visitors except under controlled conditions to minimize the introduction of Salmonella and...

  8. 10 CFR 905.40 - Technical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Technical assistance. 905.40 Section 905.40 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Energy Services § 905.40 Technical assistance. Western shall establish a program that provides technical assistance to customers to conduct integrated...

  9. 24 CFR 901.235 - Technical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Technical assistance. 901.235... DEVELOPMENT PUBLIC HOUSING MANAGEMENT ASSESSMENT PROGRAM § 901.235 Technical assistance. (a) The Department may provide technical assistance to a PHA that is in substantial default. (b) The Department may...

  10. A tiered quality assurance review process for clinical data management standard operating procedures in an academic health center.

    PubMed

    Ittenbach, Richard F; Baker, Cynthia L; Corsmo, Jeremy J

    2014-05-01

    Standard operating procedures (SOPs) were once considered the province of the pharmaceutical industry but are now viewed as a key component of quality assurance programs. To address variability and increase the rigor of clinical data management (CDM) operations, the Cincinnati Children's Hospital Medical Center (CCHMC) decided to create CDM SOPs. In response to this challenge, and as part of a broader institutional initiative, the CCHMC leadership established an executive steering committee to oversee the development and implementation of CDM SOPs. This resulted in the creation of a quality assurance review process with three review panels: an SOP development team (16 clinical data managers and technical staff members), a faculty review panel (8 senior faculty and administrators), and an expert advisory panel (3 national CDM experts). This innovative, tiered review process helped ensure that the new SOPs would be created and implemented in accord with good CDM practices and standards. Twelve fully vetted, institutionally endorsed SOPs and one CDM template resulted from the intensive, iterative 10-month process (December 2011 to early October 2012). Phased implementation, which incoporated the CDM SOPs into the existing audit process for certain types of clinical research studies, was on schedule at the time of this writing. Once CCHMC researchers have had the opportunity to use the SOPs over time and across a broad range of research settings and conditions, the SOPs will be revisited and revalidated.

  11. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

  12. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

  13. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

  14. Technical report—Diagnosis and management of an initial UTI in febrile infants and young children.

    PubMed

    Finnell, S Maria E; Carroll, Aaron E; Downs, Stephen M

    2011-09-01

    The diagnosis and management of urinary tract infections (UTIs) in young children are clinically challenging. This report was developed to inform the revised, evidence-based, clinical guideline regarding the diagnosis and management of initial UTIs in febrile infants and young children, 2 to 24 months of age, from the American Academy of Pediatrics Subcommittee on Urinary Tract Infection. The conceptual model presented in the 1999 technical report was updated after a comprehensive review of published literature. Studies with potentially new information or with evidence that reinforced the 1999 technical report were retained. Meta-analyses on the effectiveness of antimicrobial prophylaxis to prevent recurrent UTI were performed. Review of recent literature revealed new evidence in the following areas. Certain clinical findings and new urinalysis methods can help clinicians identify febrile children at very low risk of UTI. Oral antimicrobial therapy is as effective as parenteral therapy in treating UTI. Data from published, randomized controlled trials do not support antimicrobial prophylaxis to prevent febrile UTI when vesicoureteral reflux is found through voiding cystourethrography. Ultrasonography of the urinary tract after the first UTI has poor sensitivity. Early antimicrobial treatment may decrease the risk of renal damage from UTI. Recent literature agrees with most of the evidence presented in the 1999 technical report, but meta-analyses of data from recent, randomized controlled trials do not support antimicrobial prophylaxis to prevent febrile UTI. This finding argues against voiding cystourethrography after the first UTI.

  15. Risk factors for technical failure of endoscopic double self-expandable metallic stent placement by partial stent-in-stent method.

    PubMed

    Kawakubo, Kazumichi; Kawakami, Hiroshi; Toyokawa, Yoshihide; Otani, Koichi; Kuwatani, Masaki; Abe, Yoko; Kawahata, Shuhei; Kubo, Kimitoshi; Kubota, Yoshimasa; Sakamoto, Naoya

    2015-01-01

    Endoscopic double self-expandable metallic stent (SEMS) placement by the partial stent-in-stent (PSIS) method has been reported to be useful for the management of unresectable hilar malignant biliary obstruction. However, it is technically challenging, and the optimal SEMS for the procedure remains unknown. The aim of this study was to identify the risk factors for technical failure of endoscopic double SEMS placement for unresectable malignant hilar biliary obstruction (MHBO). Between December 2009 and May 2013, 50 consecutive patients with MHBO underwent endoscopic double SEMS placement by the PSIS method. We retrospectively evaluated the rate of successful double SEMS placement and identified the risk factors for technical failure. The technical success rate for double SEMS placement was 82.0% (95% confidence interval [CI]: 69.2-90.2). On univariate analysis, the rate of technical failure was high in patients with metastatic disease and unilateral placement. Multivariate analysis revealed that metastatic disease was a significant risk factor for technical failure (odds ratio: 9.63, 95% CI: 1.11-105.5). The subgroup analysis after double guidewire insertion showed that the rate of technical success was higher in the laser-cut type SEMS with a large mesh and thick delivery system than in the braided type SEMS with a small mesh and thick delivery system. Metastatic disease was a significant risk factor for technical failure of double SEMS placement for unresectable MHBO. The laser-cut type SEMS with a large mesh and thin delivery system might be preferable for the PSIS procedure. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  16. 12 CFR 1805.303 - Technical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... proposes to become a CDFI. Such technical assistance may include training for management and other... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Technical assistance. 1805.303 Section 1805.303... COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS PROGRAM Use of Funds/Eligible Activities § 1805.303 Technical...

  17. 44 CFR 300.2 - Technical assistance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Technical assistance. 300.2... HOMELAND SECURITY PREPAREDNESS DISASTER PREPAREDNESS ASSISTANCE § 300.2 Technical assistance. Requests for technical assistance under section 201(b) of the Act shall be made by the Governor or his/her designated...

  18. Establishing a scientific and technical information program: Planning and resource management

    NASA Technical Reports Server (NTRS)

    Blados, Walter R.

    1992-01-01

    In the last 50 years, technological advances have accelerated at a rate unprecedented in history. We are experiencing a tremendous expansion of scientific and technological effort in many directions, and the result is a fantastic increase in the accumulation of scientific and technical information (STI) and knowledge. An integral part of the research and development (R&D) process is the STI associated with it. STI is both a raw material (input) and a product (output) of this process. The topics addressed include the following: the value of STI, management of an STI program, program policy and guidance, organizational structure, data sources, training/orientation, and the current information environment.

  19. 23 CFR 630.1106 - Policy and procedures for work zone safety management.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... established in accordance with 23 CFR 630.1006, shall include the consideration and management of road user...; Exposure Control Measures to avoid or minimize worker exposure to motorized traffic and road user exposure... road users. (b) Agency processes, procedures, and/or guidance should be based on consideration of...

  20. 48 CFR 227.7103-11 - Contractor procedures and records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Rights in Technical Data 227.7103-11 Contractor procedures and records. (a) The clause at 252.227-7013, Rights in Technical Data—Noncommercial Items, requires a contractor, and its subcontractors or suppliers that will deliver technical data with other than unlimited rights, to establish and follow written...

  1. Pediatric Drowning: A Standard Operating Procedure to Aid the Prehospital Management of Pediatric Cardiac Arrest Resulting From Submersion.

    PubMed

    Best, Rebecca R; Harris, Benjamin H L; Walsh, Jason L; Manfield, Timothy

    2017-05-08

    Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. A literature review on the management of pediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of pediatric drowning. A concise standard operating procedure was developed for resuscitation following pediatric submersion. Specific recommendations include the following: the Heimlich maneuver should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended. This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration.

  2. Development of QC Procedures for Ocean Data Obtained by National Research Projects of Korea

    NASA Astrophysics Data System (ADS)

    Kim, S. D.; Park, H. M.

    2017-12-01

    To establish data management system for ocean data obtained by national research projects of Ministry of Oceans and Fisheries of Korea, KIOST conducted standardization and development of QC procedures. After reviewing and analyzing the existing international and domestic ocean-data standards and QC procedures, the draft version of standards and QC procedures were prepared. The proposed standards and QC procedures were reviewed and revised by experts in the field of oceanography and academic societies several times. A technical report on the standards of 25 data items and 12 QC procedures for physical, chemical, biological and geological data items. The QC procedure for temperature and salinity data was set up by referring the manuals published by GTSPP, ARGO and IOOS QARTOD. It consists of 16 QC tests applicable for vertical profile data and time series data obtained in real-time mode and delay mode. Three regional range tests to inspect annual, seasonal and monthly variations were included in the procedure. Three programs were developed to calculate and provide upper limit and lower limit of temperature and salinity at depth from 0 to 1550m. TS data of World Ocean Database, ARGO, GTSPP and in-house data of KIOST were analysed statistically to calculate regional limit of Northwest Pacific area. Based on statistical analysis, the programs calculate regional ranges using mean and standard deviation at 3 kind of grid systems (3° grid, 1° grid and 0.5° grid) and provide recommendation. The QC procedures for 12 data items were set up during 1st phase of national program for data management (2012-2015) and are being applied to national research projects practically at 2nd phase (2016-2019). The QC procedures will be revised by reviewing the result of QC application when the 2nd phase of data management programs is completed.

  3. CAT-ASVAB Technical Bulletin Number 1

    DTIC Science & Technology

    2006-03-01

    CAT -ASVAB Technical Bulletin #1 Personnel Testing Division Defense Manpower Data Center March 2006 Report...2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE CAT -ASVAB Technical Bulletin #1 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...Hetter, R. D. "Psychometric Procedures for Administering CAT -ASVAB" (pp. 131-140) Chapter 4 Hetter, R. D., & Sympson J. B. "Item Exposure

  4. Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents.

    PubMed

    Siu, Joey; Maran, Nikki; Paterson-Brown, Simon

    2016-06-01

    The importance of non-technical skills in improving surgical safety and performance is now well recognised. Better understanding is needed of the impact that non-technical skills of the multi-disciplinary theatre team have on intra-operative incidents in the operating room (OR) using structured theatre-based assessment. The interaction of non-technical skills that influence surgical safety of the OR team will be explored and made more transparent. Between May-August 2013, a range of procedures in general and vascular surgery in the Royal Infirmary of Edinburgh were performed. Non-technical skills behavioural markers and associated intra-operative incidents were recorded using established behavioural marking systems (NOTSS, ANTS and SPLINTS). Adherence to the surgical safety checklist was also observed. A total of 51 procedures were observed, with 90 recorded incidents - 57 of which were considered avoidable. Poor situational awareness was a common area for surgeons and anaesthetists leading to most intra-operative incidents. Poor communication and teamwork across the whole OR team had a generally large impact on intra-operative incidents. Leadership was shown to be an essential set of skills for the surgeons as demonstrated by the high correlation of poor leadership with intra-operative incidents. Team-working and management skills appeared to be especially important for anaesthetists in the recovery from an intra-operative incident. A significant number of avoidable incidents occur during operative procedures. These can all be linked to failures in non-technical skills. Better training of both individual and team in non-technical skills is needed in order to improve patient safety in the operating room. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  5. Improved Management of the Technical Interfaces Between the Hanford Tank Farm Operator and the Hanford Waste Treatment Plant - 13383

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

    Duncan, Garth M.; Saunders, Scott A.

    2013-07-01

    The Department of Energy (DOE) is constructing the Waste Treatment and Immobilization Plant (WTP) at the Hanford site in Washington to treat and immobilize approximately 114 million gallons of high level radioactive waste (after all retrievals are accomplished). In order for the WTP to be designed and operated successfully, close coordination between the WTP engineering, procurement, and construction contractor, Bechtel National, Inc. and the tank farms operating contractor (TOC), Washington River Protection Solutions, LLC, is necessary. To develop optimal solutions for DOE and for the treatment of the waste, it is important to deal with the fact that two differentmore » prime contractors, with somewhat differing contracts, are tasked with retrieving and delivering the waste and for treating and immobilizing that waste. The WTP and the TOC have over the years cooperated to manage the technical interface. To manage what is becoming a much more complicated interface as the WTP design progresses and new technical issues have been identified, an organizational change was made by WTP and TOC in November of 2011. This organizational change created a co-located integrated project team (IPT) to deal with mutual and interface issues. The Technical Organization within the One System IPT includes employees from both TOC and WTP. This team has worked on a variety of technical issues of mutual interest and concern. Technical issues currently being addressed include: - The waste acceptance criteria; - Waste feed delivery and the associated data quality objectives (DQO); - Evaluation of the effects of performing a riser cut on a single shell tank on WTP operations; - The disposition of secondary waste from both TOC and WTP; - The close coordination of the TOC double shell tank mixing and sampling program and the Large Scale Integrated Test (LSIT) program for pulse jet mixers at WTP along with the associated responses to the Defense Nuclear Facilities Safety Board (DNFSB

  6. Determining procedures for simulation-based training in radiology: a nationwide needs assessment.

    PubMed

    Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars

    2018-06-01

    New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.

  7. Australian and New Zealand Perfusion Survey: Management and Procedure

    PubMed Central

    Tuble, Sigrid C.; Willcox, Timothy W.; Baker, Robert A.

    2009-01-01

    Abstract: In this report, we will discuss management and procedural aspects of perfusion practice. This report allows us to compare and contrast recent trends and changes in perfusion with historic practices. A survey comprised of 233 single-answer and 12 open-ended questions was sent by e-mail to senior perfusionists or individuals in charge of perfusion in 40 hospital groups. The survey encompasses a review of the perfusion practices for the calendar year of 2003, and respondents were required to answer the survey based on the predominant practice in their institutions. Standard management of routine adult cardiopulmonary bypass (CPB) in 2003 consisted of perfusion strategies that achieved a target temperature of 32.0°C (range, 28.0–35.0°C), a flow index of 2.4 L/min/m2 (range, 1.6–3.0 L/min/m2) during normothermia and 1.8 L/min/m2 (range, 1.2–3.0 L/min/m2) during hypothermia, and a pressure during CPB between 50 (range, 30–65 mmHg) and 70 mmHg (range, 60–95 mmHg). Myocardial protection with blood cardioplegia was used in 77% of the 20,688 CPB cases, whereas in 53% cases, cardiotomy blood was never processed. Pre-operatively, 76% of perfusion groups assessed their patients (21% directly with the patient), and 85% responded that perfusionists performed or participated in a formal pre-bypass checklist. The majority of the perfusion groups used a handwritten perfusion record (62%), 12% used an electronic perfusion record, and 26% used both, whereas more than one half of the groups were involved in quality assurance (79%), incident reporting (74%), audits (62%), research (53%), participating in interdisciplinary meetings (53%), and morbidity and mortality meetings (65%). Only 26% conducted formal perfusion team meetings. This report outlines the status of clinical management and procedural performance for perfusion practices in Australia and New Zealand in 2003. Awareness of these trends will allow perfusionists to assess both individual practices and

  8. Technical skills rotation for general surgery residents.

    PubMed

    Gonzalez, Ray I; Martinez, Jose M; Iglesias, Alberto R; Lo Menzo, Emanuele; Hutson, Duane; Sleeman, Danny; Livingstone, Alan S; Madan, Atul K

    2010-06-15

    Technical skills are an important part of any general surgery residency curriculum. With the demands of limited work weeks, it is imperative that educators create novel methods of teaching technical skills to their residents. Our program utilizes a dedicated month to help accomplish this. This study hypothesized that general surgery residents would report a positive effect of a dedicated technical skills rotation. Residents who had undergone a 1 mo rotation in technical skills during their first year were asked to fill out a survey concerning their experience. During the 1-mo rotation, the residents had almost no clinical responsibilities. Teaching of technical skills was performed with various activities, including video content (VC), virtual reality simulators (VR), open foam procedures (OF), laparoscopic box trainers (BT), surgical equipment in-service (SE), and animate sessions (AS). Responses were given on a Likert scale (1-10) with higher numbers being more positive responses. There were seven residents in this study. The residents gave a very positive response to the overall rotation (9.4) and exposure to laparoscopic procedures (9.6). The other responses were enthusiastic as well: exposure to open procedures (8.9) and preparation for operative room (9.4). After their rotation, the residents were comfortable performing a laparoscopic cholecystectomy (9.2), a hand-sewn anastomosis (8.7), and a stapled anastomosis (9.4). The residents found theses activities helpful in increasing order: VC (7.8), VR (8.0), BT (9.0), ES (9.7), OF (9.8), and AS (9.8). A 1-mo dedicated technical skills rotations was perceived to be extremely positive by the residents. The residents felt very comfortable performing a laparoscopic cholecystectomy, a hand-sewn anastomosis, and a stapled anastomosis. With the 80-h work week, alternatives to learning technical skills in the operating room are essential. Further studies need to be performed to determine if this rotation aids in

  9. Ground Water Technical Support Center (GWTSC) Annual ...

    EPA Pesticide Factsheets

    The Ground Water Technical Support Center (GWTSC) is part of the Ground Water and Ecosystems Restoration Division (GWERD), which is based in the Robert S. Kerr Environmental Research Center in Ada, Oklahoma. The GWERD is a research division of U.S. EPA’s National Risk Management Research Laboratory (NRMRL). The GWTSC is one of an interlinked group of specialized Technical Support Centersthat were established under the Technical Support Project (TSP). The GWTSC provides technical support on issues related to groundwater. Specifically, the GWTSC provides technical support to U.S. EPA and State regulators for issues and problems related to:1. subsurface contamination (contaminants in ground water, soils and sediments),2. cross-media transfer (movement of contaminants from the subsurface to other media such as surface water or air), and3. restoration of impacted ecosystems.The GWTSC works with Remedial Project Managers (RPMs) and other decision makers to solve specific problems at Superfund, RCRA (Resource Conservation and Recovery Act), Brownfields sites, and ecosystem restoration sites. The Ground Water Technical Support Center (GWTSC) is part of the Ground Water and Ecosystems Restoration Division (GWERD), which is based in the Robert S. Kerr Environmental Research Center in Ada, Oklahoma. The GWERD is a research division of U.S. EPA’s National Risk Management Research Laboratory (NRMRL). The GWTSC is one of an interlinked group of specialized Technical Suppo

  10. Adapting Project Management Practices to Research-Based Projects

    NASA Technical Reports Server (NTRS)

    Bahr, P.; Baker, T.; Corbin, B.; Keith, L.; Loerch, L.; Mullenax, C.; Myers, R.; Rhodes, B.; Skytland, N.

    2007-01-01

    From dealing with the inherent uncertainties in outcomes of scientific research to the lack of applicability of current NASA Procedural Requirements guidance documentation, research-based projects present challenges that require unique application of classical project management techniques. If additionally challenged by the creation of a new program transitioning from basic to applied research in a technical environment often unfamiliar with the cost and schedule constraints addressed by project management practices, such projects can find themselves struggling throughout their life cycles. Finally, supplying deliverables to a prime vehicle customer, also in the formative stage, adds further complexity to the development and management of research-based projects. The Biomedical Research and Countermeasures Projects Branch at NASA Johnson Space Center encompasses several diverse applied research-based or research-enabling projects within the newly-formed Human Research Program. This presentation will provide a brief overview of the organizational structure and environment in which these projects operate and how the projects coordinate to address and manage technical requirements. We will identify several of the challenges (cost, technical, schedule, and personnel) encountered by projects across the Branch, present case reports of actions taken and techniques implemented to deal with these challenges, and then close the session with an open forum discussion of remaining challenges and potential mitigations.

  11. Integrating Space Flight Resource Management Skills into Technical Lessons for International Space Station Flight Controller Training

    NASA Technical Reports Server (NTRS)

    Baldwin, Evelyn

    2008-01-01

    The Johnson Space Center s (JSC) International Space Station (ISS) Space Flight Resource Management (SFRM) training program is designed to teach the team skills required to be an effective flight controller. It was adapted from the SFRM training given to Shuttle flight controllers to fit the needs of a "24 hours a day/365 days a year" flight controller. More recently, the length reduction of technical training flows for ISS flight controllers impacted the number of opportunities for fully integrated team scenario based training, where most SFRM training occurred. Thus, the ISS SFRM training program is evolving yet again, using a new approach of teaching and evaluating SFRM alongside of technical materials. Because there are very few models in other industries that have successfully tied team and technical skills together, challenges are arising. Despite this, the Mission Operations Directorate of NASA s JSC is committed to implementing this integrated training approach because of the anticipated benefits.

  12. 75 FR 54063 - Demand Response Compensation in Organized Wholesale Energy Markets; Technical Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ... FURTHER INFORMATION CONTACT: David Hunger (Technical Information), Office of Energy Policy and Innovation....hunger@ferc.gov . Caroline Daly (Technical Information), Office of Energy Policy and [[Page 54064... information about the technical conference or comment procedures, please contact: David Hunger (Technical...

  13. Methylation analysis of polysaccharides: Technical advice.

    PubMed

    Sims, Ian M; Carnachan, Susan M; Bell, Tracey J; Hinkley, Simon F R

    2018-05-15

    Glycosyl linkage (methylation) analysis is used widely for the structural determination of oligo- and poly-saccharides. The procedure involves derivatisation of the individual component sugars of a polysaccharide to partially methylated alditol acetates which are analysed and quantified by gas chromatography-mass spectrometry. The linkage positions for each component sugar can be determined by correctly identifying the partially methylated alditol acetates. Although the methods are well established, there are many technical aspects to this procedure and both careful attention to detail and considerable experience are required to achieve a successful methylation analysis and to correctly interpret the data generated. The aim of this article is to provide the technical details and critical procedural steps necessary for a successful methylation analysis and to assist researchers (a) with interpreting data correctly and (b) in providing the comprehensive data required for reviewers to fully assess the work. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. 40 CFR 53.43 - Test procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Test procedures. 53.43 Section 53.43... PM10 § 53.43 Test procedures. (a) Sampling effectiveness—(1) Technical definition. The ratio (expressed... or filters to the mass concentration of particles of the same size approaching the sampler. (2) Test...

  15. 40 CFR 53.43 - Test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Test procedures. 53.43 Section 53.43... PM10 § 53.43 Test procedures. (a) Sampling effectiveness—(1) Technical definition. The ratio (expressed... or filters to the mass concentration of particles of the same size approaching the sampler. (2) Test...

  16. 42 CFR 493.1449 - Standard; Technical supervisor qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... service in which the laboratory performs high complexity tests or procedures. The director of a laboratory... may perform anatomic and clinical laboratory procedures and tests in all specialties and... tests in the subspecialty of bacteriology, the individual functioning as the technical supervisor must...

  17. 10 CFR 830.205 - Technical safety requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... must: (1) Develop technical safety requirements that are derived from the documented safety analysis... 10 Energy 4 2010-01-01 2010-01-01 false Technical safety requirements. 830.205 Section 830.205 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT Safety Basis Requirements § 830.205 Technical...

  18. 10 CFR 830.205 - Technical safety requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... must: (1) Develop technical safety requirements that are derived from the documented safety analysis... 10 Energy 4 2011-01-01 2011-01-01 false Technical safety requirements. 830.205 Section 830.205 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT Safety Basis Requirements § 830.205 Technical...

  19. 44 CFR 206.202 - Application procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Application procedures. 206.202 Section 206.202 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Administration § 206.202 Application procedures. (a) General. This section describes the policies and procedures...

  20. Management and governance processes in community health coalitions: a procedural justice perspective.

    PubMed

    Weiner, Bryan J; Alexander, Jeffrey A; Shortell, Stephen M

    2002-12-01

    Community-based coalitions are a popular strategy for promoting community health despite the fact that coalitions often fail to achieve measurable results. Using a procedural justice framework, this study seeks to advance knowledge about the relationship between coalition governance and management processes and indicators of coalition functioning. Member survey data from 25 coalitions participating in the Community Care Network Demonstration Program were analyzed using two-stage least squares regression. Results show that personal influence in decision making. decision process clarity, and collaborative conflict resolution were significantly associated with procedural fairness perceptions. Procedural fairness perceptions, in turn, were positively associated with member satisfaction with coalition decisions, but not personal engagement in the coalition or organizational integration of coalition goals and activities. Personal influence in decision making and collaborative conflict resolution also exhibited direct relationships with all three indicators of coalition functioning examined in the study.

  1. Assessing the compatibility of the management of standardized procedures with the complexity of a sociotechnical system: case study of a control room in an oil refinery.

    PubMed

    Saurin, Tarcisio Abreu; Gonzalez, Santiago Sosa

    2013-09-01

    Although the need for the management of complex socio-technical systems (STS) to be compatible with the nature of those systems is widely recognized, there are few guidelines on how to determine the actual extent of this compatibility. The purpose of this study is to assess how compatible the management of standardized procedures (SPs) is with the nature of a complex STS. To this end, a case study was made of a control room in an oil refinery, involving the following stages: (a) delimitation of the investigated STS; (b) description of the STS according to a set of characteristics of complex STS; (c) application of two types of questionnaires to thirty workers - one of them to assess their perceptions about the applicability of seven principles of SPs management in complex STS and the other to determine their perceptions about the actual use of these principles; and (d) a feedback meeting with workers to discuss the results of the assessment. The assessment is discussed in terms of its limitations, usefulness and ease of use of the data collection and analysis tools. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  2. Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?

    PubMed Central

    Krage, Ralf; Zwaan, Laura; Tjon Soei Len, Lian; Kolenbrander, Mark W; van Groeningen, Dick; Loer, Stephan A; Wagner, Cordula; Schober, Patrick

    2017-01-01

    Background Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stressful conditions when individuals are distracted from their tasks, and investigated the relationship between non-technical and technical skills under control conditions and when external stressors are present. Methods In this simulator-based randomised cross-over study, 30 anaesthesiologists and anaesthesia residents from the VU University Medical Center, Amsterdam, the Netherlands, participated in two different CPR scenarios in random order. In one scenario, external stressors (radio noise and a distractive scripted family member) were added, while the other scenario without stressors served as control condition. Non-technical performance of the team leader and technical performance of the team were measured using the ‘Anaesthetists’ Non-technical Skill’ score and a recently developed technical skills score. Analysis of variance and Pearson correlation coefficients were used for statistical analyses. Results Non-technical performance declined when external stressors were present (adjusted mean difference 3.9 points, 95% CI 2.4 to 5.5 points). A significant correlation between non-technical and technical performance scores was observed when external stressors were present (r=0.67, 95% CI 0.40 to 0.83, p<0.001), while no evidence for such a relationship was observed under control conditions (r=0.15, 95% CI −0.22 to 0.49, p=0.42). This was equally true for all individual domains of the non-technical performance score (task management, team

  3. Technical Leadership Development Program

    DTIC Science & Technology

    2010-12-13

    the traditional tenets of leadership and management , systems thinking, understanding SOS issues, and thinking and acting holistically. Our research...international element 2.0 Enterprise Leadership and Management UNCLASSIFIED Contract Number: H98230-08-D-0171 DO 002. TO002, RT 004 Report No...mechanisms for leadership of the overall technical effort, for systems engineering, for requirements, management , and for systems integration. o Develop

  4. Exploring the Mismatch between Skills and Jobs for Women in Saudi Arabia in Technical and Vocational Areas: The Views of Saudi Arabian Private Sector Business Managers.

    ERIC Educational Resources Information Center

    Calvert, John R.; Al-Shetaiwi, A. S.

    2002-01-01

    Gives an overview of women in both general and technical-vocational education and employment in Saudi Arabia. Reports on a survey of 220 private business managers: 83% indicated that Saudi women had limited participation in technical jobs; 63% suggested that vocational-technical education did not promote women's participation. (Contains 51…

  5. Activities identification for activity-based cost/management applications of the diagnostics outpatient procedures.

    PubMed

    Alrashdan, Abdalla; Momani, Amer; Ababneh, Tamador

    2012-01-01

    One of the most challenging problems facing healthcare providers is to determine the actual cost for their procedures, which is important for internal accounting and price justification to insurers. The objective of this paper is to find suitable categories to identify the diagnostic outpatient medical procedures and translate them from functional orientation to process orientation. A hierarchal task tree is developed based on a classification schema of procedural activities. Each procedure is seen as a process consisting of a number of activities. This makes a powerful foundation for activity-based cost/management implementation and provides enough information to discover the value-added and non-value-added activities that assist in process improvement and eventually may lead to cost reduction. Work measurement techniques are used to identify the standard time of each activity at the lowest level of the task tree. A real case study at a private hospital is presented to demonstrate the proposed methodology. © 2011 National Association for Healthcare Quality.

  6. [Interpersonal competence in orthopedics and traumatology : Why technical and procedural skills alone are not sufficient].

    PubMed

    Seemann, R; Münzberg, M; Stange, R; Rüsseler, M; Egerth, M; Bouillon, B; Hoffmann, R; Mutschler, M

    2016-10-01

    Patient safety has increasingly gained significance as criterion which clinics and doctors will be measured against in terms of ethics and finances. The "human factor" moved into focus regarding the question of how to reduce treatment errors in clinical daily routine. Nevertheless, systematic mediation of interpersonal competences only plays a minor role in the catalogue of requirements for medical specialization and professional training. This is the case not only in orthopedics and traumatology, but in other medical fields as well. At the insistence of DGOU and in cooperation with Lufthansa Flight Training, a training model was initiated, comparable to training models used in aviation. In aviation, apart from the training of procedural and technical abilities, regular soft skills training has become standard in the training of all Lufthansa staff. Several studies confirm that by improving communication, interaction, and teamwork skills not only a reduction of intolerable incidents is observed, but also a positive economic effect. Interpersonal competences should be firmly anchored in orthopedics and traumatology and thus be implemented as third post in specialist training.

  7. 47 CFR 68.7 - Technical criteria for terminal equipment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK General § 68.7 Technical criteria for... switched telephone network. (b) Technical criteria published by the Administrative Council for Terminal... network from harms caused by the connection of terminal equipment, subject to the appeal procedures in...

  8. 47 CFR 68.7 - Technical criteria for terminal equipment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK General § 68.7 Technical criteria for... switched telephone network. (b) Technical criteria published by the Administrative Council for Terminal... network from harms caused by the connection of terminal equipment, subject to the appeal procedures in...

  9. A VIRTUAL TECHNICAL SYSTEMS AUDIT OF RESEARCH QUALITY ASSURANCE AND RECORD MANAGEMENT SYSTEMS IN ORD, U.S EPA

    EPA Science Inventory

    NHEERL conducts technical systems audits (TSAs) on its research projects. The findings are reported by the QA Manager (QAM) to the Director of QA (DQA) as Exemplary Findings (things the QA Team liked); Corrective Actions (things that must be corrected immediately); and Areas for...

  10. NASA Technical Standards Program

    NASA Technical Reports Server (NTRS)

    Gill, Paul S.; Vaughan, William W.; Parker, Nelson C. (Technical Monitor)

    2002-01-01

    The NASA Technical Standards Program was officially established in 1997 as result of a directive issued by the Administrator. It is responsible for Agency wide technical standards development, adoption (endorsement), and conversion of Center-unique standards for Agency wide use. One major element of the Program is the review of NSA technical standards products and replacement with non-Government Voluntary Consensus Standards in accordance with directions issued by the Office of Management and Budget. As part of the Program's function, it developed a NASA Integrated Technical Standards Initiative that consists of and Agency wide full-text system, standards update notification system, and lessons learned-standards integration system. The Program maintains a 'one stop-shop' Website for technical standards ad related information on aerospace materials, etc. This paper provides information on the development, current status, and plans for the NAS Technical Standards Program along with metrics on the utility of the products provided to both users within the nasa.gov Domain and the Public Domain.

  11. NASA Technical Standards Program

    NASA Technical Reports Server (NTRS)

    Gill, Paul S.; Vaughan, WIlliam W.

    2003-01-01

    The NASA Technical Standards Program was officially established in 1997 as result of a directive issued by the Administrator. It is responsible for Agency wide technical standards development, adoption (endorsement), and conversion of Center-unique standards for Agency wide use. One major element of the Program is the review of NSA technical standards products and replacement with non-Government Voluntary Consensus Standards in accordance with directions issued by the Office of Management and Budget. As part of the Program s function, it developed a NASA Integrated Technical Standards Initiative that consists of and Agency wide full-text system, standards update notification system, and lessons learned - standards integration system. The Program maintains a "one stop-shop" Website for technical standards ad related information on aerospace materials, etc. This paper provides information on the development, current status, and plans for the NAS Technical Standards Program along with metrics on the utility of the products provided to both users within the nasa.gov Domain and the Public Domain.

  12. From conventional drainage to sustainable stormwater management: Beyond the technical challenges.

    PubMed

    Goulden, Shula; Portman, Michelle E; Carmon, Naomi; Alon-Mozes, Tal

    2018-08-01

    Countries and cities are increasingly recognizing the value of adopting Sustainable Stormwater Management (SSWM) goals and measures. SSWM serves multiple hydrological, ecological, social and economic goals and can replace substantial parts of conventional drainage infrastructure. Following international experience in the socio-technical nature of transitions in stormwater management, this research investigates how socio-institutional factors enable the transition from conventional to sustainable stormwater management over time. The research is based on analysing available relevant documents, semi-structured interviews and focus groups, all in a single country case study (Israel). We found significant changes in professional awareness and discourse, some advances in professional standards of work and changes to the regulative system, supporting infiltration practices in particular. We concluded that the three-pillared socio-institutional framework, composed of cultural-cognitive, normative and regulative changes, was insightful for mapping factors supporting transition from conventional drainage to SSWM. Elements within the three pillars can work simultaneously and synergistically to achieve widespread change. At the same time, while SSWM always strives to achieve multiple goals, the order of priority of the various goals may differ from place to place and may change over time. Thus the transition process across the socio-institutional pillars should be renewed if and when the priority of goals changes. The urban and regional planning system can play a crucial role in enhancing the transition process from conventional to sustainable stormwater management. These conclusions may be relevant to other localities and countries that are struggling with such transitions to sustainability. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. EPA'S GROUND WATER TECHNICAL SUPPORT CENTER

    EPA Science Inventory

    The purpose and the services provided by EPA's Ground Water Technical Support Center (GWTSC) will be presented. In 1987 the Office of Solid Waste and Emergency Response, Regional Waste Management Offices, and ORD established the Technical Support Project (TSP)

    The purpos...

  14. Army Blast Claims Evaluation Procedures

    DTIC Science & Technology

    1994-03-01

    ARMY RESEARCH LABORATORY ARL-MR-131 Army Blast Claims Evaluation Procedures William P. Wright APPROVED FOR PUBUC RELEASE; DISTRIBtmON IS...NUMBERS Anny Blast Claims Evaluation Procedures 4G061-304-U2 6. AUTHOR(S) William P. Wrisht 1. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8...of the technical review process which bas been instituted to develop an opinion as to Army responsibility. 14. SUBJECT TERMS blast effects. muzzle

  15. Training Manuals and Technical Publications.

    ERIC Educational Resources Information Center

    Army Test and Evaluation Command, Aberdeen Proving Ground, MD.

    The objective of the Materiel Test Procedure is to describe methods for determining the need for adequacy of comprehensiveness, and clarity of training manuals and technical publications (or other pertinent types of literature) relating to the ammunition or ammunition components being tested. (Author)

  16. 77 FR 32013 - Truck Size and Weight; Technical Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-31

    ...-2012-0037] RIN 2125-AF45 Truck Size and Weight; Technical Correction AGENCY: Federal Highway...: This rule makes a technical correction to the regulations that govern Longer Combination Vehicles (LCV... INFORMATION CONTACT: John Nicholas, Truck Size and Weight Program Manager, Office of Freight Management and...

  17. 48 CFR 642.271 - Government Technical Monitor (GTM).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Government Technical... MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contract Administration Services 642.271 Government Technical Monitor (GTM). (a) Policy. The contracting officer may appoint a Government Technical Monitor (GTM...

  18. Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

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

    Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juleiengarnon@gmail.com; Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com

    ObjectiveTo describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.Materials and MethodsBetween May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioningmore » a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.ResultsMean FB size was 23 mm (range 8–74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.ConclusionPercutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.« less

  19. Radial access for cerebrovascular procedures: Case report and technical note.

    PubMed

    Satti, Sudhakar R; Vance, Ansar Z; Sivapatham, Thinesh

    2016-04-01

    Advantages of radial access over brachial/axillary or femoral access have been well described for several decades and include decreased cost, patient preference, and decreased major access site complications. Despite these advantages, radial access is rarely employed or even considered for neurointerventional procedures. This attitude should be reconsidered given several recent large, randomized, controlled trials from the cardiovascular literature proving that radial access is associated with statistically lower costs, decreased incidence of myocardial infarctions, strokes, and even decreased mortality. Radial access is now considered the standard of care for percutaneous coronary interventions in most US centers. Although radial access has been described for neurovascular procedures in the past, overall experience is limited. The two major challenges are the unique anatomy required to access the cerebral vasculature given very acute angles between the arm and craniocervical vessels and limitations in available technology. We present a simplified approach to radial access for cerebrovascular procedures and provide a concise step-by-step approach for patient selection, ultrasound-guided single-wall access, recommended catheters/wires, and review of patent hemostasis. Additionally, we present a complex cerebrovascular intervention in which standard femoral access was unsuccessful, while radial access was quickly achieved to highlight the importance of familiarity with the radial approach for all neurointerventionalists. We have found that the learning curve is not too steep and that the radial access approach can be adopted smoothly for a large percentage of diagnostic and interventional neuroradiologic procedures. Radial access should be considered in all patients undergoing a cerebrovascular procedure. © The Author(s) 2015.

  20. Habitat Evaluation Procedures (HEP) Report : Hellsgate Project, 1999-2000 Technical Report.

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

    Berger, Matthew

    2000-05-01

    A Habitat Evaluation Procedure (HEP) study was conducted on lands acquired and/or managed (4,568 acres total) by the Hellsgate Big Game Winter Range Wildlife Mitigation Project (Hellsgate project) to mitigate some of the losses associated with the original construction and operation of Grand Coulee Dam and inundation of habitats behind the dams. Three separate properties, totaling 2,224 acres were purchased in 1998. One property composed of two separate parcels, mostly grassland lies southeast of the town of Nespelem in Okanogan County (770 acres) and was formerly called the Hinman property. The former Hinman property lies within an area the Tribesmore » have set aside for the protection and preservation of the sharp-tailed grouse (Agency Butte unit). This special management area minus the Hinman acquisition contains 2,388 acres in a long-term lease with the Tribes. The second property lies just south of the Silver Creek turnoff (Ferry County) and is bisected by the Hellsgate Road (part of the Friedlander unit). This parcel contains 60 acres of riparian and conifer forest cover. The third property (now named the Sand Hills unit) acquired for mitigation (1,394 acres) lies within the Hellsgate Reserve in Ferry County. This new acquisition links two existing mitigation parcels (the old Sand Hills parcels and the Lundstrum Flat parcel, all former Kuehne purchases) together forming one large unit. HEP team members included individuals from the Colville Confederated Tribes Fish and Wildlife Department (CTCR), Washington Department of Fish and Wildlife (WDFW), and Bureau of Land Management (BLM). The HEP team conducted a baseline habitat survey using the following HEP species models: mule deer (Odocoileus hemionus), mink (Mustela vison), downy woodpecker (Picoides pubescens), bobcat (Lynx rufus), yellow warbler (Dendroica petechia), and sharp-tailed grouse (Tympanuchus phasianellus columbianus). HEP analysis and results are discussed within the body of the text. The

  1. Technical Publications

    Science.gov Websites

    peer-reviewed journal Conference reports Technical memos documenting equipment or other technology Science, HEP User Facility. Fermilab is managed by Fermi Research Alliance, LLC (FRA), acting under data, apparatus, product, or process disclosed, or represents that its use would not infringe privately

  2. "Puestow modified procedure in the era of advanced endoscopic interventions for the management of chronic lithiasic pancreatitis. A two cases report".

    PubMed

    Fragulidis, Georgios P; Vezakis, Αntonios; Dellaportas, Dionissios; Sotirova, Ira; Koutoulidis, Vassilis; Kontis, Elliseos; Polydorou, Andreas

    2015-01-01

    Pancreatic duct calculi in chronic pancreatitis (CP) patients are the main cause of intractable pain which is their main symptom. Decompression options of for the main pancreatic duct are both surgical and advanced endoscopic procedures. A 64-year-old male with known CP due to alcohol consumption and a 36-year-old female with known idiopathic CP and pancreatic duct calculi were managed recently in our hospital where endoscopic procedures were unsuccessful. A surgical therapy was considered and a longitudinal pancreaticojejunostomy (modified Puestow procedure) in both patients was performed with excellent results. Over the last 30 years, endoscopic procedures are developed to manage pancreatic duct strictures and calculi of the main pancreatic duct in CP patients. In both of our cases endoscopic therapy was first attempted but failed to extract the pancreatic duct stones, due to their size and speculations. Modified Puestow procedure was performed for both and it was successful for long term pain relief. Despite advancement in endoscopic interventions and less invasive therapies for the management of chronic lithiasic pancreatitis we consider that classic surgical management can be appropriate in certain cases. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. NetView technical research

    NASA Technical Reports Server (NTRS)

    1993-01-01

    This is the Final Technical Report for the NetView Technical Research task. This report is prepared in accordance with Contract Data Requirements List (CDRL) item A002. NetView assistance was provided and details are presented under the following headings: NetView Management Systems (NMS) project tasks; WBAFB IBM 3090; WPAFB AMDAHL; WPAFB IBM 3084; Hill AFB; McClellan AFB AMDAHL; McClellan AFB IBM 3090; and Warner-Robins AFB.

  4. 44 CFR 18.300 - Professional and technical services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and technical services” shall be limited to advice and analysis directly applying any professional or... and analysis directly applying their professional or technical expertise and unless the advice or... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Professional and technical...

  5. 44 CFR 18.300 - Professional and technical services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and technical services” shall be limited to advice and analysis directly applying any professional or... and analysis directly applying their professional or technical expertise and unless the advice or... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Professional and technical...

  6. 48 CFR 935.010 - Scientific and technical reports.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... information. The DOE Order 241.1B Scientific and Technical Information Management, or its successor version... conveyed in scientific and technical information (STI) shall include an instruction requiring the.... Department of Energy (DOE), Office of Scientific and Technical Information (OSTI), using the DOE Energy Link...

  7. 48 CFR 935.010 - Scientific and technical reports.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... information. The DOE Order 241.1B Scientific and Technical Information Management, or its successor version... conveyed in scientific and technical information (STI) shall include an instruction requiring the.... Department of Energy (DOE), Office of Scientific and Technical Information (OSTI), using the DOE Energy Link...

  8. 48 CFR 935.010 - Scientific and technical reports.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... information. The DOE Order 241.1B Scientific and Technical Information Management, or its successor version... conveyed in scientific and technical information (STI) shall include an instruction requiring the.... Department of Energy (DOE), Office of Scientific and Technical Information (OSTI), using the DOE Energy Link...

  9. 48 CFR 935.010 - Scientific and technical reports.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... information. The DOE Order 241.1B Scientific and Technical Information Management, or its successor version... conveyed in scientific and technical information (STI) shall include an instruction requiring the.... Department of Energy (DOE), Office of Scientific and Technical Information (OSTI), using the DOE Energy Link...

  10. 48 CFR 935.010 - Scientific and technical reports.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... information. The DOE Order 241.1B Scientific and Technical Information Management, or its successor version... conveyed in scientific and technical information (STI) shall include an instruction requiring the.... Department of Energy (DOE), Office of Scientific and Technical Information (OSTI), using the DOE Energy Link...

  11. 40 CFR 53.23 - Test procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Test procedures. 53.23 Section 53.23... Methods SO2, CO, O3, and NO2 § 53.23 Test procedures. (a) Range—(1) Technical definition. Nominal minimum... specified at the lower and upper range limits in concentration units, for example, 0-0.5 p/m. (2) Test...

  12. 40 CFR 53.23 - Test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Test procedures. 53.23 Section 53.23... Methods SO2, CO, O3, and NO2 § 53.23 Test procedures. (a) Range—(1) Technical definition. Nominal minimum... specified at the lower and upper range limits in concentration units, for example, 0-0.5 p/m. (2) Test...

  13. NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR PROBLEM MANAGEMENT (G06)

    EPA Science Inventory

    The purpose of this SOP is to describe problem management, and to define a set of reporting actions to be taken in the event of a problem during any phase of the study. This procedure outlines the steps for making a problem known in order that it may be systematically resolved b...

  14. The unique contribution of the nursing intervention pain management on length of stay in older patients undergoing hip procedures.

    PubMed

    Kerr, Peg; Shever, Leah; Titler, Marita G; Qin, Rui; Kim, Taikyoung; Picone, Debra M

    2010-02-01

    The purpose of this study was to examine the unique contribution of the nursing intervention pain management on length of stay (LOS) for 568 older patients hospitalized for hip procedures. Propensity-score-adjusted analysis was used to determine the effect of pain management on LOS. The LOS for hospitalizations that received pain management was 0.78 day longer than that for hospitalizations that did not receive pain management. Other variables that were predictors of LOS included several context-of-care variables (e.g., time spent in the intensive care unit, registered nurse skill mix, etc.), number of medical procedures and unique medications, and several other nursing interventions. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Modified Puestow procedure for the management of chronic pancreatitis in children.

    PubMed

    Laje, Pablo; Adzick, N Scott

    2013-11-01

    To present our experience with the modified Puestow procedure in the management of children with chronic pancreatitis. Retrospective chart review of patients treated between 2003 and 2012. Six patients underwent a modified Puestow procedure (lateral pancreaticojejunostomy) for the management of chronic pancreatitis, three females and three males. Four patients had hereditary pancreatitis (three with confirmed N34S mutation in the SPINK1 gene), one patient had chronic pancreatitis of unknown etiology, and one patient with annular pancreas developed obstructive chronic pancreatitis. The pancreatic duct was dilated in all cases, with a maximum diameter of 5 to 10mm. Median time between onset of pain and surgery was 4 years (range: 1-9). Median age at surgery was 7.5 years (range: 5-15). Median hospital stay was 12 days (range: 9-28). Median follow up was 4.5 years (range: 5 months to 9 years). All patients had temporary postoperative improvement of their abdominal pain. In two patients the pain recurred at 6 months and 2 years postoperatively and eventually required total pancreatectomy to treat intractable pain, 3 and 8 years after surgery. Two patients were pain free for two years and subsequently developed occasional episodes of pain. The two most recent patients are pain free at 1 year (obstructive chronic pancreatitis) and 5 months (hereditary pancreatitis) follow-up. Two patients developed type I diabetes mellitus 10 and 12 months postoperatively (one with hereditary and one with idiopathic chronic pancreatitis). We conclude that the modified Puestow procedure in children is feasible and safe. It seems to provide definitive pain control and prevent further damage to the pancreas in patients with obstructive chronic pancreatitis. However, in patients with hereditary pancreatitis, pain control outcomes are variable and the operation may not abrogate the progression of disease to pancreatic insufficiency. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?

    PubMed

    Krage, Ralf; Zwaan, Laura; Tjon Soei Len, Lian; Kolenbrander, Mark W; van Groeningen, Dick; Loer, Stephan A; Wagner, Cordula; Schober, Patrick

    2017-11-01

    Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stressful conditions when individuals are distracted from their tasks, and investigated the relationship between non-technical and technical skills under control conditions and when external stressors are present. In this simulator-based randomised cross-over study, 30 anaesthesiologists and anaesthesia residents from the VU University Medical Center, Amsterdam, the Netherlands, participated in two different CPR scenarios in random order. In one scenario, external stressors (radio noise and a distractive scripted family member) were added, while the other scenario without stressors served as control condition. Non-technical performance of the team leader and technical performance of the team were measured using the 'Anaesthetists' Non-technical Skill' score and a recently developed technical skills score. Analysis of variance and Pearson correlation coefficients were used for statistical analyses. Non-technical performance declined when external stressors were present (adjusted mean difference 3.9 points, 95% CI 2.4 to 5.5 points). A significant correlation between non-technical and technical performance scores was observed when external stressors were present (r=0.67, 95% CI 0.40 to 0.83, p<0.001), while no evidence for such a relationship was observed under control conditions (r=0.15, 95% CI -0.22 to 0.49, p=0.42). This was equally true for all individual domains of the non-technical performance score (task management, team working, situation awareness, decision

  17. Adaptive management: The U.S. Department of the Interior technical guide

    USGS Publications Warehouse

    Williams, B K; Szaro, Robert C.; Shapiro, Carl D.

    2009-01-01

    The purpose of this technical guide is to present an operational definition of adaptive management, identify the conditions in which adaptive management should be considered, and describe the process of using adaptive management for managing natural resources. The guide is not an exhaustive discussion of adaptive management, nor does it include detailed specifications for individual projects. However, it should aid U.S. Department of the Interior (DOI) managers and practitioners in determining when and how to apply adaptive management. Adaptive management is framed within the context of structured decision making, with an emphasis on uncertainty about resource responses to management actions and the value of reducing that uncertainty to improve management. Though learning plays a key role in adaptive management, it is seen here as a means to an end, namely good management, and not an end in itself. The operational definition used in the guide is adopted from the National Research Council, which characterizes adaptive management as an iterative learning process producing improved understanding and improved management over time: Adaptive management [is a decision process that] promotes flexible decision making that can be adjusted in the face of uncertainties as outcomes from management actions and other events become better understood. Careful monitoring of these outcomes both advances scientific understanding and helps adjust policies or operations as part of an iterative learning process. Adaptive management also recognizes the importance of natural variability in contributing to ecological resilience and productivity. It is not a ‘trial and error’ process, but rather emphasizes learning while doing. Adaptive management does not represent an end in itself, but rather a means to more effective decisions and enhanced benefits. Its true measure is in how well it helps meet environmental, social, and economic goals, increases scientific knowledge, and reduces

  18. 41 CFR 105-50.001-5 - Specialized or technical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., technical tests and evaluations, technical information, training activities, surveys, reports, documents... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Specialized or technical... TECHNICAL SERVICES TO STATE AND LOCAL UNITS OF GOVERNMENT § 105-50.001-5 Specialized or technical services...

  19. Managing Information On Technical Requirements

    NASA Technical Reports Server (NTRS)

    Mauldin, Lemuel E., III; Hammond, Dana P.

    1993-01-01

    Technical Requirements Analysis and Control Systems/Initial Operating Capability (TRACS/IOC) computer program provides supplemental software tools for analysis, control, and interchange of project requirements so qualified project members have access to pertinent project information, even if in different locations. Enables users to analyze and control requirements, serves as focal point for project requirements, and integrates system supporting efficient and consistent operations. TRACS/IOC is HyperCard stack for use on Macintosh computers running HyperCard 1.2 or later and Oracle 1.2 or later.

  20. Airport Managers' Perspectives on Security and Safety Management Systems in Aviation Operations: A Multiple Case Study

    NASA Astrophysics Data System (ADS)

    Brown, Willie L., Jr.

    Global terrorism continues to persist despite the great efforts of various countries to protect and safely secure their citizens. As airports form the entry and exit ports of a country, they are one of the most vulnerable locations to terror attacks. Managers of international airports constantly face similar challenges in developing and implementing airport security protocols. Consequently, the technological advances of today have brought both positive and negative impacts on security and terrorism of airports, which are mostly managed by the airport managers. The roles of the managers have greatly increased over the years due to technological advances. The developments in technology have had different roles in security, both in countering terrorism and, at the same time, increasing the communication methods of the terrorists. The purpose of this qualitative multiple case study was to investigate the perspectives of airport managers with regard to societal security and social interactions in the socio-technical systems of the National Terrorism Advisory System (NTAS). Through the data gained regarding managers' perception and experiences, the researcher hoped to enable the development of security measures and policies that are appropriate for airports as socio-technical systems. The researcher conducted interviews with airport managers to gather relevant data to fulfill the rationale of the study. Ten to twelve airport managers based in three commercial aviation airports in Maryland, United States participated in the study. The researcher used a qualitative thematic analysis procedure to analyze the data responses of participants in the interview sessions.

  1. A Model for the Management of Technical Risk in New Technology Development Programs

    DTIC Science & Technology

    1989-09-01

    Heppenheimer , T. A . "Requiem for a Heavy-weight," Air and Snace/Smithsonian, 4: 50-55-- June/July 1989). 91. Jane’s Information Group, Inc. Jane’s...8217-- A MODEL FOR THE MANAGEMENT OF TECHNICAL RISK IN NEW TECHNOLOGY DEVELOPMENT PROGRAMS THESIS Peter B. King Captain, USA~F A FIT /G SM /L SR /89...S-22 1 DISI~1UT0N TAEMEN𔃻 A , S’o11 _44110h, eea;EL ECTE EApproVed 0 ulcrl~;DC2 0 1989 Dis-,irbuticf Unlimited D DEPARTMENT OF THE AIR FORCE-- - AIR

  2. Department of Defense Technical Architecture Framework for Information Management. Volume 1-8: Overview. Version 3.0.

    DTIC Science & Technology

    1996-04-30

    CJCS Chairman of the Joint Chiefs of Staff CMP Configuration Management Plan COTS Commercial-off-the-Shelf DA Data Administrator DASD (IM) Deputy...Staff ( CJCS ) representing the unified combatant commands. " Technical: The system can evolve (migrate) to be supported by the integrated, standards...s) (PSAs), or CJCS , having functional responsibility for the missions and functions supported by the system, with the participation of affected DoD

  3. Integrated Project Management: A Case Study in Integrating Cost, Schedule, Technical, and Risk Areas

    NASA Technical Reports Server (NTRS)

    Smith, Greg

    2004-01-01

    This viewgraph presentation describes a case study as a model for integrated project management. The ISS Program Office (ISSPO) developed replacement fluid filtration cartridges in house for the International Space Station (ISS). The presentation includes a step-by-step procedure and organizational charts for how the fluid filtration problem was approached.

  4. Environmental effects of dredging. Documentation of the dyecon module for ADDAMS: Determining the hydraulic retention and efficiency of confined disposal facilities. Technical note

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

    Hayes, D.F.; Schroeder, P.R.; Engler, R.M.

    This technical note describes procedures for determining mean hydraulic retention time and efficiency of a confined disposal facility (CDF) from a dye tracer slug test. These parameters are required to properly design a CDF for solids retention and for effluent quality considerations. Detailed information on conduct and analysis of dye tracer studies can be found in Engineer Manual 1110-2-5027, Confined Dredged Material Disposal. This technical note documents the DYECON computer program which facilitates the analysis of dye tracer concentration data and computes the hydraulic efficiency of a CDF as part of the Automated Dredging and Disposal Alternatives Management System (ADDAMS).

  5. 14 CFR 1240.109 - Hearing procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held... and arguments in support of the application. Evidence may be presented through means of such witnesses...

  6. 14 CFR 1240.109 - Hearing procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held... and arguments in support of the application. Evidence may be presented through means of such witnesses...

  7. 14 CFR 1240.109 - Hearing procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held... and arguments in support of the application. Evidence may be presented through means of such witnesses...

  8. Technical Handbook for Facilities Engineering and Construction Manual, Part 2: Federally Assisted Activities. Guide for Project Applicants-Construction Management Services. Department Technical Handbook Series.

    ERIC Educational Resources Information Center

    Department of Health , Education, and Welfare, Washington., DC. Office of the Secretary.

    This handbook provides a basis for consideration of acceptable approaches which are available and may be used to initiate the use of construction management services in the planning, design, and construction of federally assisted construction projects. It includes the mandatory federal requirements as well as acceptable procedures for selecting…

  9. An adequate level of training for technically competent colonoscopic polypectomy.

    PubMed

    Boo, Sun-Jin; Jung, Ji Hoon; Park, Jae Ho; Na, Soo-Young; Kim, Seon Ok; Park, Sang Hyoung; Yang, Dong-Hoon; Kim, Kyung-Jo; Ye, Byong Duk; Myung, Seung-Jae; Yang, Suk-Kyun; Kim, Jin-Ho; Byeon, Jeong-Sik

    2015-07-01

    The purpose of this study is to investigate the learning curve for colonoscopic polypectomy (CP) by trainee endoscopists. The amount of training required to achieve technical competence for CP is uncertain. The CP times and en bloc resection rates of three experienced colonoscopists were obtained from 240 procedures. These data were compared to those of three gastroenterology trainees who performed 750 CP procedures. A trainee procedure was deemed to be a success if en bloc resection was obtained and the CP time was within twice the median CP time of the experienced colonoscopists. Trainees were deemed to be technically competent when they achieved a CP success rate of greater than or equal to 80%. The median CP times and en bloc resection rates for the experienced colonoscopists and trainees were 79 s (range, 20-301 s) and 99.6% (239/240), and 118 s (range, 36-1051 s) and 95.6% (717/750), respectively. The trainee success rate of CP was 72% (540/750). The success rate of the procedure was associated with increased trainee experience (p = 0.003) and reached 80% after 250 procedures. The CP time significantly decreased (p < 0.001) and en bloc resection rate significantly increased (p = 0.011) as trainee experience accumulated. The level of experience was an independent predictor for successful CP. The achievement of technical competence with CP was associated with an accumulation of approximately 250 procedures. These findings suggest that dedicated education and training programs for CP are warranted.

  10. Comparison of transhepatic and extrahepatic routes for EUS-guided rendezvous procedure for distal CBD obstruction.

    PubMed

    Dhir, Vinay; Bhandari, Suryaprakash; Bapat, Mukta; Joshi, Nitin; Vivekanandarajah, Suhirdan; Maydeo, Amit

    2013-04-01

    EUS-guided rendezvous procedure (EUS-RV) can be done by the transhepatic (TH) or the extrahepatic (EH) route. There is no data on the preferred access route when both routes are available. To compare the success, complications, and duration of hospitalization for patients undergoing EUS-RV by the TH or the EH route. Patients with distal common bile duct (CBD) obstruction, who failed selective cannulation, underwent EUS-RV by the TH route through the stomach or the EH route through the duodenum. A total of 35 patients were analysed (17 TH, 18 EH). The mean procedure time was significantly longer for the TH group (34.4 vs. 25.7 min; p = 0.0004). There was no difference in the technical success (94.1 vs. 100%). However, the TH group had a higher incidence of post-procedure pain (44.1 vs. 5.5%; p = 0.017), bile leak (11.7 vs. 0; p = 0.228), and air under diaphragm (11.7 vs. 0; p = 0.228). All bile leaks were small and managed conservatively. Duration of hospitalization was significantly higher for the TH group (2.52 vs. 0.17 days; p = 0.015). EUS-RV has similar success rate by the TH or the EH route. However, the TH route has higher post-procedure pain, longer procedure time, and longer duration of hospitalization. The EH route should be preferred for EUS-RV in patients with distal CBD obstruction when both access routes are technically feasible.

  11. Integrated Risk and Knowledge Management Program -- IRKM-P

    NASA Technical Reports Server (NTRS)

    Lengyel, David M.

    2009-01-01

    The NASA Exploration Systems Mission Directorate (ESMD) IRKM-P tightly couples risk management and knowledge management processes and tools to produce an effective "modern" work environment. IRKM-P objectives include: (1) to learn lessons from past and current programs (Apollo, Space Shuttle, and the International Space Station); (2) to generate and share new engineering design, operations, and management best practices through preexisting Continuous Risk Management (CRM) procedures and knowledge-management practices; and (3) to infuse those lessons and best practices into current activities. The conceptual framework of the IRKM-P is based on the assumption that risks highlight potential knowledge gaps that might be mitigated through one or more knowledge management practices or artifacts. These same risks also serve as cues for collection of knowledge particularly, knowledge of technical or programmatic challenges that might recur.

  12. NASA Risk Management Handbook. Version 1.0

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Maggio, Gaspare; Stamatelatos, Michael; Youngblood, Robert; Guarro, Sergio; Rutledge, Peter; Sherrard, James; Smith, Curtis; hide

    2011-01-01

    The purpose of this handbook is to provide guidance for implementing the Risk Management (RM) requirements of NASA Procedural Requirements (NPR) document NPR 8000.4A, Agency Risk Management Procedural Requirements [1], with a specific focus on programs and projects, and applying to each level of the NASA organizational hierarchy as requirements flow down. This handbook supports RM application within the NASA systems engineering process, and is a complement to the guidance contained in NASA/SP-2007-6105, NASA Systems Engineering Handbook [2]. Specifically, this handbook provides guidance that is applicable to the common technical processes of Technical Risk Management and Decision Analysis established by NPR 7123.1A, NASA Systems Engineering Process and Requirements [3]. These processes are part of the \\Systems Engineering Engine. (Figure 1) that is used to drive the development of the system and associated work products to satisfy stakeholder expectations in all mission execution domains, including safety, technical, cost, and schedule. Like NPR 7123.1A, NPR 8000.4A is a discipline-oriented NPR that intersects with product-oriented NPRs such as NPR 7120.5D, NASA Space Flight Program and Project Management Requirements [4]; NPR 7120.7, NASA Information Technology and Institutional Infrastructure Program and Project Management Requirements [5]; and NPR 7120.8, NASA Research and Technology Program and Project Management Requirements [6]. In much the same way that the NASA Systems Engineering Handbook is intended to provide guidance on the implementation of NPR 7123.1A, this handbook is intended to provide guidance on the implementation of NPR 8000.4A. 1.2 Scope and Depth This handbook provides guidance for conducting RM in the context of NASA program and project life cycles, which produce derived requirements in accordance with existing systems engineering practices that flow down through the NASA organizational hierarchy. The guidance in this handbook is not meant

  13. 14 CFR 1240.109 - Hearing procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held by the Board... arguments in support of the application. Evidence may be presented through means of such witnesses, exhibits...

  14. Cost Effective, Ultra Sensitive Groundwater Monitoring for Site Remediation and Management: Standard Operating Procedures with QA/QC

    DTIC Science & Technology

    2015-05-01

    in consultation with the site management . 4.0 DATA TYPES AND QUALITY CONTROL A sampling plan must account for the collection, handling, and...GUIDANCE DOCUMENT Cost-Effective, Ultra-Sensitive Groundwater Monitoring for Site Remediation and Management : Standard Operating Procedures...Groundwater Monitoring for Site Remediation and Management 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Halden, R.U., Roll, I.B. 5d

  15. 23 CFR 630.1012 - Project-level procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

  16. 23 CFR 630.1012 - Project-level procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

  17. 23 CFR 630.1012 - Project-level procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

  18. 23 CFR 630.1012 - Project-level procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

  19. Some technical writing skills industry needs

    NASA Technical Reports Server (NTRS)

    Smith, F. R.

    1981-01-01

    It is suggested that engineers and other technical students be taught three classes of skills in technical writing. First, "Big Picture Things", which includes: the importance of clear writing, the wide scope of writing, the wide scope of writing tasks that will be faced in industry, and the principles of organization of technical materials such as; how to analyze, classify, partition, and interpret. Second, "Writing Procedures", which encompasses: how to get words on paper efficiently and team-write. Third, "Writing Details", in which two considerations are important: how to achieve precision in the use of language and the aspects of style. Three problems in style are cited: the problem of sentence transition, overuse of attributive adjectives, and verbosity in paragraph structure. The most important thing in technical writing is considered to be functionality, economy and clarity.

  20. Impact of Automation on Technical Services.

    ERIC Educational Resources Information Center

    Rooks, Dana C.; Thompson, Linda L.

    1988-01-01

    Discusses the impact of automation on library technical services, and the need for library managers to be aware of the issues involved and to plan for future developments. The discussion focuses on the areas of job related concerns of technical staff, organizational structures, recruitment and training, and ergonomic considerations. (CLB)

  1. Initial experience of using high field strength intraoperative MRI for neurosurgical procedures.

    PubMed

    Raheja, Amol; Tandon, Vivek; Suri, Ashish; Sarat Chandra, P; Kale, Shashank S; Garg, Ajay; Pandey, Ravindra M; Kalaivani, Mani; Mahapatra, Ashok K; Sharma, Bhawani S

    2015-08-01

    We report our initial experience to optimize neurosurgical procedures using high field strength intraoperative magnetic resonance imaging (IOMRI) in 300 consecutive patients as high field strength IOMRI rapidly becomes the standard of care for neurosurgical procedures. Three sequential groups (groups A, B, C; n=100 each) were compared with respect to time management, complications and technical difficulties to assess improvement in these parameters with experience. We observed a reduction in the number of technical difficulties (p<0.001), time to induction (p<0.001) and total anesthesia time (p=0.007) in sequential groups. IOMRI was performed for neuronavigation guidance (n=252) and intraoperative validation of extent of resection (EOR; n=67). Performing IOMRI increased the EOR over and beyond the primary surgical attempt in 20.5% (29/141) and 18% (11/61) of patients undergoing glioma and pituitary surgery, respectively. Overall, EOR improved in 59.7% of patients undergoing IOMRI (40/67). Intraoperative tractography and real time navigation using re-uploaded IOMRI images (accounting for brain shift) helps in intraoperative planning to reduce complications. IOMRI is an asset to neurosurgeons, helping to augment the EOR, especially in glioma and pituitary surgery, with no significant increase in morbidity to the patient. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 44 CFR 78.7 - Grant application procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...

  3. 44 CFR 78.7 - Grant application procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...

  4. 44 CFR 78.7 - Grant application procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...

  5. 44 CFR 78.7 - Grant application procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...

  6. 44 CFR 78.7 - Grant application procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...

  7. Computer-Managed Instruction: Development and Evaluation of Student Skill Modules to Reduce Training Time.

    ERIC Educational Resources Information Center

    McCombs, Barbara L.; And Others

    The Computer Managed Instruction (CMI) Student Skills Project was developed and evaluated within the context of the Air Force Advanced Instructional System (AIS), with student study skill modules designed as short packages to be assigned near the beginning of any military technical training course; strategies or procedures included were expected…

  8. A management system for evaluating the Virginia periodic motor vehicle inspection program : software manual and implementation procedures : final report.

    DOT National Transportation Integrated Search

    1978-01-01

    This report deals with the Periodic Motor Vehicle Inspection Management Evaluation System software documentation and implementation procedures. A companion report entitled "A Management System for Evaluating the Virginia Periodic Motor Vehicle Inspec...

  9. CDC Support for Global Public Health Emergency Management.

    PubMed

    Brencic, Daniel J; Pinto, Meredith; Gill, Adrienne; Kinzer, Michael H; Hernandez, Luis; Pasi, Omer G

    2017-12-01

    Recent pandemics and rapidly spreading outbreaks of infectious diseases have illustrated the interconnectedness of the world and the importance of improving the international community's ability to effectively respond. The Centers for Disease Control and Prevention (CDC), building on a strong foundation of lessons learned through previous emergencies, international recognition, and human and technical expertise, has aspired to support nations around the world to strengthen their public health emergency management (PHEM) capacity. PHEM principles streamline coordination and collaboration in responding to infectious disease outbreaks, which align with the core capacities outlined in the International Health Regulations 2005. CDC supports PHEM by providing in-country technical assistance, aiding the development of plans and procedures, and providing fellowship opportunities for public health emergency managers. To this end, CDC partners with US agencies, international partners, and multilateral organizations to support nations around the world to reduce illness and death from outbreaks of infectious diseases.

  10. 75 FR 12740 - Wyoming Interstate Company, Inc.; Notice of Technical Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

    ... additional technical, engineering, and operational support for its proposed gas quality allocation procedures... should be prepared to support its position with adequate technical, engineering, and operational information. FERC conferences are accessible under section 508 of the Rehabilitation Act of 1973. For...

  11. “Puestow modified procedure in the era of advanced endoscopic interventions for the management of chronic lithiasic pancreatitis. A two cases report”

    PubMed Central

    Fragulidis, Georgios P.; Vezakis, Αntonios; Dellaportas, Dionissios; Sotirova, Ira; Koutoulidis, Vassilis; Kontis, Elliseos; Polydorou, Andreas

    2015-01-01

    Introduction Pancreatic duct calculi in chronic pancreatitis (CP) patients are the main cause of intractable pain which is their main symptom. Decompression options of for the main pancreatic duct are both surgical and advanced endoscopic procedures. Presentation of cases A 64-year-old male with known CP due to alcohol consumption and a 36-year-old female with known idiopathic CP and pancreatic duct calculi were managed recently in our hospital where endoscopic procedures were unsuccessful. A surgical therapy was considered and a longitudinal pancreaticojejunostomy (modified Puestow procedure) in both patients was performed with excellent results. Discussion Over the last 30 years, endoscopic procedures are developed to manage pancreatic duct strictures and calculi of the main pancreatic duct in CP patients. In both of our cases endoscopic therapy was first attempted but failed to extract the pancreatic duct stones, due to their size and speculations. Modified Puestow procedure was performed for both and it was successful for long term pain relief. Conclusion Despite advancement in endoscopic interventions and less invasive therapies for the management of chronic lithiasic pancreatitis we consider that classic surgical management can be appropriate in certain cases. PMID:26318135

  12. Demand management in plastic surgery for low priority procedures: the Welsh experience.

    PubMed

    Hunter, J E; Laing, J H E; Carroll, G

    2010-11-01

    Health Commission Wales (Specialist Services) [HCW] are responsible for resource allocation and demand management in plastic surgery for the population of Wales (2.9 M). Since 2004, all low priority plastic surgery referrals have been screened by a single HCW Case Officer against clinical inclusion criteria before the referral is passed to the provider. Only patients fulfilling these criteria proceed to an outpatient appointment, although there is an appeals procedure. Revised guidelines were introduced in 2006. Our aim was to investigate the effectiveness of the process and the impact of the revised criteria. The Case Officer's database was used to determine numbers of index procedures referred and those disallowed before and after the policy change. Since 2004 9,654 referrals have been screened. In 2005-6, 32.5% failed to meet the inclusion criteria and were disallowed. In the year after the policy revision fewer low priority patients were referred (1720 vs. 2013) and more (46.6%) were declined. Body contouring / abdominoplasty were particularly affected with 73.2% not compliant with funding criteria. The Welsh model is an efficient, effective and equitable system for demand management, which amounts to thousands of requests per year. After 2006, tighter guidelines have resulted in a higher proportion of patients not meeting the criteria for funding, particularly for body contouring / abdominoplasty procedures. Difficulties remain however in determining reproducible and clinically appropriate criteria for patients seeking plastic surgery following massive weight-loss. Whilst this process streamlines the provision of NHS plastic surgery for the people of Wales, there is a potential impact on specialist training. Copyright © 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Automatic management system for dose parameters in interventional radiology and cardiology.

    PubMed

    Ten, J I; Fernandez, J M; Vaño, E

    2011-09-01

    The purpose of this work was to develop an automatic management system to archive and analyse the major study parameters and patient doses for fluoroscopy guided procedures performed in cardiology and interventional radiology systems. The X-ray systems used for this trial have the capability to export at the end of the procedure and via e-mail the technical parameters of the study and the patient dose values. An application was developed to query and retrieve from a mail server, all study reports sent by the imaging modality and store them on a Microsoft SQL Server data base. The results from 3538 interventional study reports generated by 7 interventional systems were processed. In the case of some technical parameters and patient doses, alarms were added to receive malfunction alerts so as to immediately take appropriate corrective actions.

  14. 44 CFR 65.3 - Requirement to submit new technical data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... technical data. 65.3 Section 65.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... IDENTIFICATION AND MAPPING OF SPECIAL HAZARD AREAS § 65.3 Requirement to submit new technical data. A community's base flood elevations may increase or decrease resulting from physical changes affecting flooding...

  15. Transperitoneal Laparoscopic Approach to the Perinephric Area in Children: Technical Report and Lessons Learned.

    PubMed

    Mattioli, Girolamo; Avanzini, Stefano; Pio, Luca; Costanzo, Sara; Faticato, Maria Grazia; Montobbio, Giovanni; Disma, Nicola; Buffa, Piero

    2015-10-01

    This study presents a technical report of a standardized approach to the perinephric area in a series of pediatric patients, demonstrating that whatever renal or suprarenal surgery is planned, this can be approached and accomplished laparoscopically with an identical or very similar port triangulation, thus facilitating the learning curve within the same surgical team. All patients undergoing renal and adrenal gland surgery with a minimally invasive approach in the period from October 2008 to November 2013 were retrospectively reviewed and included in the study. Technical details and clinical outcomes are described. In total, 68 patients matched the inclusion criteria and were therefore retrospectively examined. No major intraoperative complication occurred. Two patients developed recurrent pelvic-ureteric junction obstruction and were managed with double J stent positioning and laparoscopic dismembered pyeloplasty, respectively. Two patients presenting with adrenal mass experienced a moderate bleeding that could be treated conservatively. Thanks to the reproducibility of the procedure and on the grounds of the presented experience, we support the proposal that the transperitoneal laparoscopic approach to the kidney and the adrenal gland could represent a relatively easy and safe way to quickly achieve confidence and skill in the management of related diseases.

  16. Experimental Null Method to Guide the Development of Technical Procedures and to Control False-Positive Discovery in Quantitative Proteomics.

    PubMed

    Shen, Xiaomeng; Hu, Qiang; Li, Jun; Wang, Jianmin; Qu, Jun

    2015-10-02

    Comprehensive and accurate evaluation of data quality and false-positive biomarker discovery is critical to direct the method development/optimization for quantitative proteomics, which nonetheless remains challenging largely due to the high complexity and unique features of proteomic data. Here we describe an experimental null (EN) method to address this need. Because the method experimentally measures the null distribution (either technical or biological replicates) using the same proteomic samples, the same procedures and the same batch as the case-vs-contol experiment, it correctly reflects the collective effects of technical variability (e.g., variation/bias in sample preparation, LC-MS analysis, and data processing) and project-specific features (e.g., characteristics of the proteome and biological variation) on the performances of quantitative analysis. To show a proof of concept, we employed the EN method to assess the quantitative accuracy and precision and the ability to quantify subtle ratio changes between groups using different experimental and data-processing approaches and in various cellular and tissue proteomes. It was found that choices of quantitative features, sample size, experimental design, data-processing strategies, and quality of chromatographic separation can profoundly affect quantitative precision and accuracy of label-free quantification. The EN method was also demonstrated as a practical tool to determine the optimal experimental parameters and rational ratio cutoff for reliable protein quantification in specific proteomic experiments, for example, to identify the necessary number of technical/biological replicates per group that affords sufficient power for discovery. Furthermore, we assessed the ability of EN method to estimate levels of false-positives in the discovery of altered proteins, using two concocted sample sets mimicking proteomic profiling using technical and biological replicates, respectively, where the true

  17. 41 CFR 105-69.205 - Professional and technical services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... section, “professional and technical services” shall be limited to advice and analysis directly applying... this section unless they provide advice and analysis directly applying their professional or technical... technical services. 105-69.205 Section 105-69.205 Public Contracts and Property Management Federal Property...

  18. Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research

    PubMed Central

    Nordquist, Rebecca E.; van der Staay, Franz Josef; van Eerdenburg, Frank J. C. M.; Velkers, Francisca C.; Fijn, Lisa; Arndt, Saskia S.

    2017-01-01

    Simple summary Intensive farming systems are confronted with a number of animal welfare issues such as injuries from horns in cattle and feather pecking in poultry. To solve these problems, mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are applied routinely. These and other procedures such as early maternal separation, overcrowding, and barren housing conditions impair animal welfare. Scientific underpinning of the efficacy of these interventions and management practices is poor. We advocate that all stakeholders, in particular animal scientists and veterinarians, take the lead in evaluating common, putative mutilating and welfare reducing procedures and management practices to develop better, scientifically supported alternatives, focused on adaptation of the environment to the animals, to ensure uncompromised animal welfare. Abstract A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting “robust” animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific

  19. Quality management of Body Donation Program at the University of Padova.

    PubMed

    Porzionato, Andrea; Macchi, Veronica; Stecco, Carla; Mazzi, Anna; Rambaldo, Anna; Sarasin, Gloria; Parenti, Anna; Scipioni, Antonio; De Caro, Raffaele

    2012-01-01

    Quality management improvement has become a recent focus of attention in medical education. The program for the donation of bodies and body parts (Body Donation Program) at the University of Padova has recently been subjected to a global quality management standard, the ISO 9001:2008 certification. The aim of the present work is to show how the above standard is useful in enhancing the efficiency of body donation procedures and the quality and output of medical education. The program is managed by means of the following interlinked procedures: the collection of body donations, death certificates, data, and body parts from living donors; the transportation and identification of cadavers; the management of bodies, body parts, equipment, instruments, purchasing of necessary materials, and setting up anatomical training sessions; the management of preventive and corrective actions; the management of documents and registration; the management of internal and external quality audits; and the review of outcomes and improvement planning. Monitoring indicators are identified in the numbers of donors and of donated body parts per year, education sessions, and satisfaction of learners and donors, as evaluated by questionnaires. The process management approach, the integrated involvement of medical, technical, and administrative staff in defining procedures, and the application of monitoring indicators allow quality improvement in all aspects of the Body Donation Program. Copyright © 2012 American Association of Anatomists.

  20. Technical Note: Seasonality in alpine water resources management - a regional assessment

    NASA Astrophysics Data System (ADS)

    Vanham, D.; Fleischhacker, E.; Rauch, W.

    2008-01-01

    Alpine regions are particularly affected by seasonal variations in water demand and water availability. Especially the winter period is critical from an operational point of view, as being characterised by high water demands due to tourism and low water availability due to the temporal storage of precipitation as snow and ice. The clear definition of summer and winter periods is thus an essential prerequisite for water resource management in alpine regions. This paper presents a GIS-based multi criteria method to determine the winter season. A snow cover duration dataset serves as basis for this analysis. Different water demand stakeholders, the alpine hydrology and the present day water supply infrastructure are taken into account. Technical snow-making and (winter) tourism were identified as the two major seasonal water demand stakeholders in the study area, which is the Kitzbueheler region in the Austrian Alps. Based upon different geographical datasets winter was defined as the period from December to March, and summer as the period from April to November. By determining potential regional water balance deficits or surpluses in the present day situation and in future, important management decisions such as water storage and allocation can be made and transposed to the local level.

  1. Automatically inserted technical details improve radiology report accuracy.

    PubMed

    Abujudeh, Hani H; Govindan, Siddharth; Narin, Ozden; Johnson, Jamlik Omari; Thrall, James H; Rosenthal, Daniel I

    2011-09-01

    To assess the effect of automatically inserted technical details on the concordance of a radiology report header with the actual procedure performed. The study was IRB approved and informed consent was waived. We obtained radiology report audit data from the hospital's compliance office from the period of January 2005 through December 2009 spanning a total of 20 financial quarters. A "discordance percentage" was defined as the percentage of total studies in which a procedure code change was made during auditing. Using Chi-square analysis we compared discordance percentages between reports with manually inserted technical details (MITD) and automatically inserted technical details (AITD). The second quarter data of 2007 was not included in the analysis as the switch from MITD to AITD occurred during this quarter. The hospital's compliance office audited 9,110 studies from 2005-2009. Excluding the 564 studies in the second quarter of 2007, we analyzed a total of 8,546 studies, 3,948 with MITD and 4,598 with AITD. The discordance percentage in the MITD group was 3.95% (156/3,948, range per quarter, 1.5- 6.1%). The AITD discordance percentage was 1.37% (63/4,598, range per quarter, 0.0-2.6%). A Chi-square analysis determined a statistically significant difference between the 2 groups (P < 0.001). There was a statistically significant improvement in the concordance of a radiology report header with the performed procedure using automatically inserted technical details compared to manually inserted details. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. Are minimally invasive procedures harder to acquire than conventional surgical procedures?

    PubMed

    Hiemstra, Ellen; Kolkman, Wendela; le Cessie, Saskia; Jansen, Frank Willem

    2011-01-01

    It is frequently suggested that minimally invasive surgery (MIS) is harder to acquire than conventional surgery. To test this hypothesis, residents' learning curves of both surgical skills are compared. Residents had to be assessed using a general global rating scale of the OSATS (Objective Structured Assessment of Technical Skills) for every procedure they performed as primary surgeon during a 3-month clinical rotation in gynecological surgery. Nine postgraduate-year-4 residents collected a total of 319 OSATS during the 2 years and 3 months investigation period. These assessments concerned 129 MIS (laparoscopic and hysteroscopic) and 190 conventional (open abdominal and vaginal) procedures. Learning curves (in this study defined as OSATS score plotted against procedure-specific caseload) for MIS and conventional surgery were compared using a linear mixed model. The MIS curve revealed to be steeper than the conventional curve (1.77 vs. 0.75 OSATS points per assessed procedure; 95% CI 1.19-2.35 vs. 0.15-1.35, p < 0.01). Basic MIS procedures do not seem harder to acquire during residency than conventional surgical procedures. This may have resulted from the incorporation of structured MIS training programs in residency. Hopefully, this will lead to a more successful implementation of the advanced MIS procedures. Copyright © 2010 S. Karger AG, Basel.

  3. 21 CFR 1271.47 - What procedures must I establish and maintain?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Donor Eligibility § 1271.47 What procedures... technical manual prepared by another organization, provided that you have verified that the procedures are...

  4. 41 CFR 105-69.300 - Professional and technical services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., “professional and technical services” shall be limited to advice and analysis directly applying any professional... provide advice and analysis directly applying their professional or technical expertise and unless the... technical services. 105-69.300 Section 105-69.300 Public Contracts and Property Management Federal Property...

  5. Proceedings of the IUFRO technical session on geomorphic hazards in managed forests: 5-11 August 1990: Montreal, Canada

    Treesearch

    Raymond M. Rice

    1991-01-01

    The proceedings contains 11 the 17 papers presented at the technical session on geometric hazards in managed forests at the XIX World Congress, International Union of Forestry Research Organizations, August 5-11, 1990, Montreal, Canada, plus one paper not presented orally. Two papers report research on torrents, two are about snow, three concern landslides, and five...

  6. 76 FR 80226 - Technical Amendments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-23

    ... final rule, effective upon publication. Generally, the Administrative Procedure Act (APA) requires a.... Additionally, the APA requires that a final rule must have a delayed effective date of 30 days from the date of... delayed effective date requirement under the APA. 5 U.S.C. 553(d)(3). Again the technical change conforms...

  7. Planning a DSN support section technical library

    NASA Technical Reports Server (NTRS)

    Bailey, T.; Chatburn, C. C.

    1980-01-01

    The planning procedure being used to establish a technical library for the Deep Space Network support section is described. The inventory and survey methods employed are described and the preliminary results of these methods are discussed.

  8. [Apheresis in children: procedures and outcome].

    PubMed

    Tummolo, Albina; Colella, Vincenzo; Bellantuono, Rosa; Giordano, Mario; Messina, Giovanni; Puteo, Flora; Sorino, Palma; De Palo, Tommaso

    2012-01-01

    Apheresis procedures are used in children to treat an increasing number of conditions by removing different types of substances from the bloodstream. In a previous study we evaluated the first results of our experience in children, emphasizing the solutions adopted to overcome technical difficulties and to adapt adult apheresis procedures to a pediatric population. The aim of the present study is to present data on a larger number of patients in whom apheresis was the main treatment. Ninety-three children (50 m, 43 f) affected by renal and/or extrarenal diseases were included. They were treated with LDL apheresis, protein A immunoadsorption, or plasma exchange. Our therapeutic protocol was the same as described in the previous study. Renal diseases and immunological disorders remained the most common conditions requiring this therapeutic approach. However, hemolytic uremic syndrome (HUS) was no longer the most frequent renal condition to be treated, as apheresis is currently the first treatment option only in cases of atypical HUS. In this series we also treated small children, showing that low weight should no longer be considered a contraindication to apheresis procedures. The low rate of complications and the overall satisfactory clinical results with increasingly advanced technical procedures make a wider use of apheresis in children realistic in the years to come.

  9. Microbial ecology laboratory procedures manual NASA/MSFC

    NASA Technical Reports Server (NTRS)

    Huff, Timothy L.

    1990-01-01

    An essential part of the efficient operation of any microbiology laboratory involved in sample analysis is a standard procedures manual. The purpose of this manual is to provide concise and well defined instructions on routine technical procedures involving sample analysis and methods for monitoring and maintaining quality control within the laboratory. Of equal importance is the safe operation of the laboratory. This manual outlines detailed procedures to be followed in the microbial ecology laboratory to assure safety, analytical control, and validity of results.

  10. 19 CFR 115.30 - Technical requirements for containers by design type.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2011-04-01 2011-04-01 false Technical requirements for containers by design...

  11. 19 CFR 115.30 - Technical requirements for containers by design type.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2012-04-01 2012-04-01 false Technical requirements for containers by design...

  12. 19 CFR 115.30 - Technical requirements for containers by design type.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2014-04-01 2014-04-01 false Technical requirements for containers by design...

  13. 19 CFR 115.30 - Technical requirements for containers by design type.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2010-04-01 2010-04-01 false Technical requirements for containers by design...

  14. 19 CFR 115.30 - Technical requirements for containers by design type.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2013-04-01 2013-04-01 false Technical requirements for containers by design...

  15. Project management training : [technical summary].

    DOT National Transportation Integrated Search

    2011-01-01

    In 2005, the Indiana Department of Transportation (INDOT) went through a complete reorganization of its operations going from centralized to decentralized (District) management. This reorganization gave Districts autonomy to manage construction proje...

  16. Use of Paley Classification and SUPERankle Procedure in the Management of Fibular Hemimelia.

    PubMed

    Kulkarni, Ruta M; Arora, Nitish; Saxena, Sagar; Kulkarni, Sujay M; Saini, Yadwinder; Negandhi, Rajiv

    2017-05-26

    Fibular hemimelia is the most common deficiency involving the long bones. Paley classification is based on the ankle joint morphology, identifies the basic pathology, and helps in planning the surgical management. Reconstruction surgery encompasses foot deformity correction and limb length equalization. The SUPERankle procedure is a combination of bone and soft tissue procedures that stabilizes the foot and addresses all deformities. We retrospectively reviewed 29 consecutive patients (29 limb segments), surgically treated between December 2000 and December 2014. Among the 29 patients, 27 were treated with reconstructive procedures. Type 1 (8 patients) cases were treated with only limb lengthening, and correction of tibial deformities. Type 2 (7 patients) cases were treated by distal tibial medial hemiepiphysiodesis or supramalleolar varus osteotomy. In type 3 (10 patients) cases, the foot deformity was corrected using the SUPERankle procedure. Type 4 (2 patients) cases were treated with supramalleolar osteotomy along with posteromedial release and lateral column shortening. In a second stage, limb lengthening was performed, using the Ilizarov technique. In the remaining 2 patients (type 3A and type 3C), amputation was performed using Syme technique as a first choice of treatment. The results were evaluated using Association for the Study and Application of Methods of Ilizarov scoring. Excellent results were obtained in 15 of 27 (55%) patients. Six (22%) patients had good results, 4 (14.8%) had fair results, and 2 (7%) had poor results. Mean limb length discrepancy at initial presentation was 3.55 cm (range: 2 to 5.5 cm) which significantly improved to 1.01 cm (range: 0 to 3 cm) after treatment (P=0.015). Our results and a review of the literature clearly suggest that limb reconstruction according to Paley classification, is an excellent option in the management of fibular hemimelia. Our 2-staged procedure (SUPERankle procedure followed by limb lengthening) helps

  17. 42 CFR 493.1838 - Training and technical assistance for unsuccessful participation in proficiency testing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Training and technical assistance for unsuccessful... REQUIREMENTS Enforcement Procedures § 493.1838 Training and technical assistance for unsuccessful participation... may require the laboratory to undertake training of its personnel, or to obtain necessary technical...

  18. 25 CFR 1200.42 - Who can provide technical assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Who can provide technical assistance? 1200.42 Section 1200.42 Indians OFFICE OF THE SPECIAL TRUSTEE FOR AMERICAN INDIANS, DEPARTMENT OF THE INTERIOR AMERICAN INDIAN TRUST FUND MANAGEMENT REFORM ACT Technical Assistance § 1200.42 Who can provide technical...

  19. Characterization of technical surfaces by structure function analysis

    NASA Astrophysics Data System (ADS)

    Kalms, Michael; Kreis, Thomas; Bergmann, Ralf B.

    2018-03-01

    The structure function is a tool for characterizing technical surfaces that exhibits a number of advantages over Fourierbased analysis methods. So it is optimally suited for analyzing the height distributions of surfaces measured by full-field non-contacting methods. The structure function is thus a useful method to extract global or local criteria like e. g. periodicities, waviness, lay, or roughness to analyze and evaluate technical surfaces. After the definition of line- and area-structure function and offering effective procedures for their calculation this paper presents examples using simulated and measured data of technical surfaces including aircraft parts.

  20. Setting technical standards for visual assessment procedures

    Treesearch

    Kenneth H. Craik; Nickolaus R. Feimer

    1979-01-01

    Under the impetus of recent legislative and administrative mandates concerning analysis and management of the landscape, governmental agencies are being called upon to adopt or develop visual resource and impact assessment (VRIA) systems. A variety of techniques that combine methods of psychological assessment and landscape analysis to serve these purposes is being...

  1. 14 CFR § 1240.109 - Hearing procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CONTRIBUTIONS Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral... present evidence and arguments in support of the application. Evidence may be presented through means of...

  2. INDOT Technical Training Plan

    DOT National Transportation Integrated Search

    2012-04-01

    The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations : for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and E...

  3. Exploration studies technical report, FY1988 status. Volume 1: Technical summary

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The Office of Exploration (OEXP) at NASA Headquarters has been tasked with defining and recommending alternatives for an early 1990's nationaL decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Lyndon B. Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report, produced by the MASE, describes the process that has been developed in a case study approach. The four case studies developed in FY88 include: (1) Human Expedition to Phobos; (2) Human Expedition to Mars; (3) Lunar Observatory; and (4) Lunar Outpost to Early Mars Evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work.

  4. Contracting Officer's Technical Representatives

    NASA Technical Reports Server (NTRS)

    Brisbin, Steve

    1997-01-01

    The Breakout Session is a traditional conference instrument used by the NASA Occupational Health Program (OHP) as a method to convene people with common interests. Typically these sessions provide discussion of current topics of high priority and currency and allow multiple views and opinions to be shared and evaluated by all participants. Since the Contracting Officer's Technical Representatives (COTRs) occupy the technical focus of support contract management, this particular group, attended by 20 representatives, addressed issues and topics at the forefront of operational concerns.

  5. Models and Procedures for Improving the Planning, Management, and Evaluation of Cooperative Education Programs. Final Report. Volume I.

    ERIC Educational Resources Information Center

    Blaschke, Charles L.; Steiger, JoAnn

    This report of a project to design a set of training guidelines for planning, managing, and evaluating cooperative education programs describes briefly the procedures used in developing the guidelines and model; discusses the various components of the planning, management, and evaluation process; and presents guidelines and criteria for designing…

  6. Parents' Use of Nonpharmacologic Methods to Manage Procedural Pain in Infants.

    PubMed

    Pölkki, Tarja; Korhonen, Anne; Laukkala, Helena

    2018-01-01

    To describe parents' use of nonpharmacologic methods to manage infant procedural pain in the NICU and determine the demographic factors related to such use. A cross-sectional and descriptive study design. Level III and Level II NICUs (seven units) of four University Hospitals in Finland. Parents (N = 178) whose infants were treated in Finnish NICUs. Parents were asked to respond to a structured questionnaire during their infants' hospitalizations. We analyzed the data using the nonparametric Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test. Most parents reported that they used physical methods, such as touching, holding, and positioning, nearly always/always (86%, 76%, and 55%, respectively). However, less commonly used strategies included recorded music (2%), breastfeeding (2%), and non-nutritive sucking with oral sucrose (6%). Many characteristics of the infants, such as their gestational ages and their conditions, were significantly related to the implementation of nonpharmacologic methods. There is a clear need to extend parents' use of nonpharmacologic methods to manage their infants' procedural pain in the NICU. Because many methods were not considered as pain-relieving strategies, it is important to increase knowledge about the effectiveness of these interventions among parents and nurses. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  7. [In search of results of technical cooperation].

    PubMed

    Jourdan Hidalgo, L; Manuel Sotelo, J

    1999-06-01

    For the Pan American Health Organization (PAHO), technical cooperation (TC) is the process by which the PAHO Member States work with the Organization, as equal partners, to identify and reach their own health goals and to promote self-sufficiency in health development, through programs that respond to those countries' needs and national priorities. Since 1978, PAHO has used the American Regional Planning, Programming, Monitoring, and Evaluation System (AMPES) to establish management procedures and to facilitate decision-making in health TC. As part of AMPES, PAHO uses a "logical approach to project management" to structure the work program of the Organization and to identify the expected results from TC activities and TC resource investments. This project management approach, which replaces the "functional approaches" system used to date, also helps establish a causative relationship between the programmed activities and the results that PAHO expects, and between the activities and the hoped-for outcomes in the countries. As part of an ongoing process of rethinking international health TC, several years ago PAHO began a four-phase study on the usefulness and validity of functional approaches and on the need to propose new ones or to modify existing ones. The results of the initial phase showed it was difficult to classify the activities because the functional-approaches categories were not mutually exclusive and the TC activities were complex. Further, the expected results did not specify the product for which the PAHO Secretariat was accountable within a certain time frame nor the Secretariat's level of responsibility. Thus, a new and more flexible classification of expected results was proposed, with the following categories: cooperation networks and alliances; surveillance and information systems; standards and guidelines; research and evaluation studies; plans, projects, and policies; methods, models, and technologies; training programs; promotional campaigns

  8. Energy Conservation: A Management Report for State and Local Governments and A Technical Guide for State and Local Governments.

    ERIC Educational Resources Information Center

    Public Technology, Inc., Washington, DC.

    This technical guide is part of a packet of tools designed to assist state or local government practitioners in organizing and managing an energy conservation program. It gives information on adapting energy conservation methods to existing public buildings and on designing new public buildings with energy conservation in mind. It also discusses…

  9. The results of Scarf osteotomy combined with distal soft tissue procedure are mostly satisfactory in surgical management of moderate to severe hallux valgus.

    PubMed

    Şaylı, Uğur; Akman, Budak; Tanrıöver, Altuğ; Kaspar, Çiğdem; Güven, Melih; Özler, Turhan

    2017-05-29

    Intrinsically stable diaphyseal osteotomy gained popularity in recent years for symptomatic hallux valgus deformities. In this study, Scarf osteotomy results, in surgical management of moderate to severe hallux valgus, are presented. Study group consisted of 40 feet of 32 (28 females, four males) patients surgically managed by Scarf osteotomy between September 2009 and 2011, with a mean age of 52,98 (range, 31-75) years at the time of surgery. Patient satisfaction and VAS were used for subjective evaluation while for objective measures AOFAS score, first metatarsophalangeal joint ROM and radiological measurements (intermetatarsal, hallux valgus and distal metatarsal articular angles) were evaluated. Mean follow-up period was 38 (range, 24-60) months. Sixteen feet (40%) were reported as very satisfied, 19 (47,5%) as satisfied and the remaining five (12,5%) as unsatisfied resulting with a total of 35 (87,5%) satisfaction. The mean preoperative VAS and AOFAS forefoot scores improved from 8,13±0,791 to 2,68±1,228 (p=0,0001) and from 58,25±6,15 to 78,25±8,13 (p=0,0001) on the final follow-up, respectively. The postoperative change of first metatarsophalangeal joint ROM was not statistically significant (p=0,281). On the radiological evaluation; intermetatarsal and hallux valgus angles improved from a mean value of 14,77±1,76 to 8,13±1,52° (p=0,0001) and from 35,28±5,86 to 20,10±5,55° (p=0,0001), respectively. Distal metatarsal articular angle did not show any statistically significant change (p=0,195). Scarf osteotomy combined with distal soft tissue procedure is a technically demanding procedure. The osteotomy is intrinsically stable and the correction power is high and the results are mostly satisfactory. Copyright © 2017. Published by Elsevier Ltd.

  10. Involvement of Individuals in the Development of Technical Solutions and Rules of Management for Building Renovation Projects: A Case Study of Latvia

    NASA Astrophysics Data System (ADS)

    Pukite, I.; Grekis, A.; Geipele, I.; Zeltins, N.

    2017-08-01

    In March 2016, the Latvian government approved a new support program for increasing energy efficiency in residential apartment buildings. For the support of renovation of apartment buildings in the period from 2016 to 2023, 166 470 588 EUR will be available. Different persons, such as energy auditors, designers, architects, project managers and builders, will be involved in the process of planning, development and implementation of building renovation. At the development stage of the building renovation project, special attention should be devoted to the first stage - energy audit and technical project development. The problem arises due to the fact that each of these individuals, during the development of technical building documentation, does not work as a completely unified system. The implementation of construction project planning and organisational management system is one of the most important factors to guarantee that the quality of building renovation project is ensured in accordance with the laws and regulatory standards. The paper studies mutual cooperation, professionalism and the role of information feedback of personnel involved in the planning stage of building renovation, which is an essential prerequisite for the renovation process in order to achieve high quality of work and reduce the energy performance indicator. The present research includes the analysis of different technical solutions and their impact on energy efficiency. Mutual harmonisation of technical specifications is also investigated.

  11. Using Three-Dimensional Interactive Graphics To Teach Equipment Procedures.

    ERIC Educational Resources Information Center

    Hamel, Cheryl J.; Ryan-Jones, David L.

    1997-01-01

    Focuses on how three-dimensional graphical and interactive features of computer-based instruction can enhance learning and support human cognition during technical training of equipment procedures. Presents guidelines for using three-dimensional interactive graphics to teach equipment procedures based on studies of the effects of graphics, motion,…

  12. Rapid bedside coagulometry prior to urgent neurosurgical procedures in anticoagulated patients.

    PubMed

    Beynon, Christopher; Jakobs, Martin; Rizos, Timolaos; Unterberg, Andreas W; Sakowitz, Oliver W

    2014-01-01

    With the increased use of oral anticoagulation with vitamin K antagonists, emergency physicians encounter a growing number of patients requiring a rapid reversal of anticoagulant effects in order to perform urgent surgical procedures. Initiation of these procedures can be delayed because the coagulation status has to be assessed through examination of blood samples in central laboratories (CL). This delay may lead to negative effects, especially in potentially life-threatening conditions such as intracranial haemorrhage. Point-of-care (POC) devices for assessment of international normalized ratio (POC INR) have improved the management of anticoagulation therapy in the outpatient setting. The use of these devices may also have beneficial effects in the treatment of anticoagulated patients requiring urgent neurosurgical procedures. The primary aim of this study was to analyse the potential of POC-guided assessment of INR to reduce time to potentially life-saving neurosurgery in this setting. Feasibility and accuracy as well as the gain of time through the use of this device were analysed. The POC coagulometer CoaguChek XS(®) was used in 17 patients with a history of anticoagulant use and a condition requiring urgent anticoagulant reversal prior to neurosurgical procedures (burr-hole trepanation: n = 8, craniotomy: n = 7, laminectomy: n = 2). No technical difficulties occurred and rapid assessment of INR was achieved in all cases within 2 min. POC INR values correlated well with CL INR assessment with a mean INR deviation of 0.036 ± 0.12. The mean gain of time through the use of the POC INR device compared with CL assessment of INR was 47 ± 6 min (range: 37-61 min). Our initial experiences with a POC INR device in anticoagulated patients undergoing urgent neurosurgical procedures demonstrate that its use may contribute to an improved management of these patients.

  13. Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory.

    PubMed

    Hilário, Thamires de Souza; Santos, Simone Marques Dos; Kruger, Juliana; Goes, Martha Georgina; Casco, Márcia Flores; Rabelo-Silva, Eneida Rejane

    2017-05-25

    To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Cross-sectional study with retrospective data collection. Overall, 345 patients were included; 116 (34%) experienced post-procedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. Describir cómo se evalúa el dolor (características, localización e intensidad) y su manejo en la práctica clínica en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterización. Estudio transversal con recolección retrospectiva de datos. En total, se incluyeron 345 pacientes; 116 (34%) experimentaron dolor post-procedimiento; en 107 (92%), no se registraron las características del dolor; la localización del dolor se informó en el 100% de los pacientes, y su intensidad en 111 (96%); el manejo fue en gran medida farmacológico; de los pacientes que recibieron algún tipo de tratamiento (n=71), 42 (59%) fueron sometidos a reevaluación del dolor. La ubicación y la intensidad del dolor se informan bien en la práctica clínica. El manejo farmacológico del dolor sigue siendo frecuente. Se necesitan esfuerzos adicionales para asegurar el registro de las características del dolor y su reevaluación después de las intervenciones.

  14. Innovations in interventional pain management of chronic spinal pain.

    PubMed

    Manchikanti, Laxmaiah; Boswell, Mark V; Hirsch, Joshua A

    2016-09-01

    Interventional pain management dates back to 1901, with significant innovations, which include the definition, literature synthesis, pathophysiology, and technical interventions. Interventional pain management and interventional techniques include neural blockade, neural ablative procedures, spinal cord and peripheral nerve stimulation, intrathecal drug delivery systems, minimally invasive lumbar decompression (MILD®), percutaneous endoscopic spinal decompression, and regenerative medicine. In addition, advances are also related to the evidence synthesis of comparative effectiveness research. Expert commentary: Multiple innovations in interventional pain management and potential innovations may reduce costs and improve care and outcomes with proper evidence synthesis and application of principles of evidence-based medicine. Innovations in interventional pain management in managing chronic spinal pain depend on extensive research and appropriate evidence synthesis. Innovations should be developed in conjunction with health care policy based on principles of evidence-based medicine.

  15. An analysis of technical aspects of the arthroscopic Bankart procedure as performed in the United States.

    PubMed

    Burks, Robert T; Presson, Angela P; Weng, Hsin-Yi

    2014-10-01

    The purpose of this study was to investigate the intersurgeon variation in technical aspects of performing an arthroscopic Bankart repair. A unique approach with experienced equipment representatives from 3 different arthroscopic companies was used. Experienced representatives were identified by DePuy Mitek, Smith & Nephew, and Arthrex and filled out questionnaires on how their surgeons performed arthroscopic Bankart procedures. This was performed in a blinded fashion with no knowledge of the identities of the specific surgeons or representatives by us. A video on different aspects of the procedure was observed by each representative before filling out the questionnaire to help standardize responses. Data were collected using REDCap (Research Electronic Data Capture). Data were analyzed as an infrequent observation with 0% to 30% of representatives reporting the observation; sometimes, 31% to 70% reporting the observation; and often, greater than 70% of representatives reporting. Seventy-six percent of representatives had 6 or more years of arthroscopic experience. Forty-three percent of representatives reported that their surgeons use 3 portals for the procedure often. Forty-four percent reported that viewing was performed exclusively from the posterior portal while the surgeon was performing the repair. Seventy-three percent reported that the Hill-Sachs lesion was observed often, and 61% reported that the posterior labrum was evaluated often before the repair. Only 25% of representatives reported that the Bankart lesion was extensively released and mobilized often. Thirty-three percent reported 3 anchors as being used often. Seventy-five percent reported biocomposite anchors as being used often. Single-loaded anchors were reported as being used often by 47%. Eighty-one percent reported that sutures were placed in a simple fashion. Eighty-three percent reported the use of any posterior sutures or anchors for additional plication as infrequent. There is significant

  16. 43 CFR 2711.3 - Procedures for sale.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Procedures for sale. 2711.3 Section 2711.3..., DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) SALES: FEDERAL LAND POLICY AND MANAGEMENT ACT Sales: Procedures § 2711.3 Procedures for sale. ...

  17. 43 CFR 2711.3 - Procedures for sale.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Procedures for sale. 2711.3 Section 2711.3..., DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) SALES: FEDERAL LAND POLICY AND MANAGEMENT ACT Sales: Procedures § 2711.3 Procedures for sale. ...

  18. 43 CFR 2711.3 - Procedures for sale.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Procedures for sale. 2711.3 Section 2711.3..., DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) SALES: FEDERAL LAND POLICY AND MANAGEMENT ACT Sales: Procedures § 2711.3 Procedures for sale. ...

  19. Comparison of Technical and Clinical Outcome of Transjugular Portosystemic Shunt Placement Between a Bare Metal Stent and a PTFE-Stentgraft Device.

    PubMed

    Lauermann, J; Potthoff, A; Mc Cavert, M; Marquardt, S; Vaske, B; Rosenthal, H; von Hahn, T; Wacker, F; Meyer, B C; Rodt, Thomas

    2016-04-01

    To analyse technical and clinical success of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension and compare a stent and a stentgraft with regard to clinical and technical outcome and associated costs. 170 patients (56 ± 12 years, 32.9% females) treated with TIPS due to portal hypertension were reviewed. 80 patients received a stent (group 1) and 83 a stentgraft (group 2), and seven interventions were unsuccessful. Technical data, periprocedural imaging, follow-up ultrasound and clinical data were analysed with focus on technical success, patency, clinical outcome and group differences. Cost analysis was performed. Portal hypertension was mainly caused by ethyltoxic liver cirrhosis with ascites as dominant symptom (80%). Technical success was 93.5% with mean portosystemic gradient decrease from 16.1 ± 4.8 to 5.1 ± 2.1 mmHg. No significant differences in technical success and portosystemic gradient decrease between the groups were observed. Kaplan-Meier analysis yielded significant differences in primary patency after 14 days, 6 months and 2 years in favour of the stentgraft. Both groups showed good clinical results without significant difference in 1-year survival and hepatic encephalopathy rate. Costs to establish TIPS and to manage 2-year follow-up with constant patency and clinical success were 8876 € (group 1) and 9394 € (group 2). TIPS is a safe and effective procedure to manage portal hypertension. Stent and stentgraft enabled good technical and clinical results with a low complication rate. Primary patency rates are clearly in favour of the stentgraft, whereas the stent was more cost effective with similar clinical results in both groups.

  20. Crew Transportation Technical Management Processes

    NASA Technical Reports Server (NTRS)

    Mckinnie, John M. (Compiler); Lueders, Kathryn L. (Compiler)

    2013-01-01

    Under the guidance of processes provided by Crew Transportation Plan (CCT-PLN-1100), this document, with its sister documents, International Space Station (ISS) Crew Transportation and Services Requirements Document (CCT-REQ-1130), Crew Transportation Technical Standards and Design Evaluation Criteria (CCT-STD-1140), Crew Transportation Operations Standards (CCT STD-1150), and ISS to Commercial Orbital Transportation Services Interface Requirements Document (SSP 50808), provides the basis for a National Aeronautics and Space Administration (NASA) certification for services to the ISS for the Commercial Provider. When NASA Crew Transportation System (CTS) certification is achieved for ISS transportation, the Commercial Provider will be eligible to provide services to and from the ISS during the services phase.

  1. Major System Source Evaluation and Selection Procedures.

    DTIC Science & Technology

    1987-04-02

    A-RIBI I" MAJOR SYSTEM SOURCE EVALUATION AND SELECTION PROCEDURES / (U) BUSINESS MANAGEMENT RESEARCH ASSOCIATES INC ARLINGTON VA 02 APR 6? ORMC-5...BRMC-85-5142-1 0 I- MAJOR SYSTEM SOURCE EVALUATION AND SELECTION PROCEDURES o I Business Management Research Associates, Inc. 1911 Jefferson Davis...FORCE SOURCE EVALUATION AND SELECTI ON PROCEDURES Prepared by Business Management Research Associates, Inc., 1911 Jefferson Davis Highway, Arlington

  2. Wolffian duct derivative anomalies: technical considerations when encountered during robot-assisted radical prostatectomy.

    PubMed

    Acharya, Sujeet S; Gundeti, Mohan S; Zagaja, Gregory P; Shalhav, Arieh L; Zorn, Kevin C

    2009-04-01

    Although malformations of the genitourinary tract are typically identified during childhood, they can remain silent until incidental detection in evaluation and treatment of other pathologies during adulthood. The advent of the minimally invasive era in urologic surgery has given rise to unique challenges in the surgical management of anomalies of the genitourinary tract. This article reviews the embryology of anomalies of Wolffian duct (WD) derivatives with specific attention to the seminal vesicles, vas deferens, ureter, and kidneys. This is followed by a discussion of the history of the laparoscopic approach to WD derivative anomalies. Finally, we present two cases to describe technical considerations when managing these anomalies when encountered during robotic-assisted radical prostatectomy. The University of Chicago Robotic Laparoscopic Radical Prostatectomy (RLRP) database was reviewed for cases where anomalies of WD derivatives were encountered. We describe how modifications in technique allowed for completion of the procedure without difficulty. None Of the 1230 RLRP procedures performed at our institution by three surgeons, only two cases (0.16%) have been noted to have a WD anomaly. These cases were able to be completed without difficulty by making simple modifications in technique. Although uncommon, it is important for the urologist to be familiar with the origin and surgical management of WD anomalies, particularly when detected incidentally during surgery. Simple modifications in technique allow for completion of RLRP without difficulty.

  3. Surgical perspectives in the management of atrial fibrillation

    PubMed Central

    Kyprianou, Katerina; Pericleous, Agamemnon; Stavrou, Antonio; Dimitrakaki, Inetzi A; Challoumas, Dimitrios; Dimitrakakis, Georgios

    2016-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia and a huge public health burden associated with significant morbidity and mortality. For decades an increasing number of patients have undergone surgical treatment of AF, mainly during concomitant cardiac surgery. This has sparked a drive for conducting further studies and researching this field. With the cornerstone Cox-Maze III “cut and sew” procedure being technically challenging, the focus in current literature has turned towards less invasive techniques. The introduction of ablative devices has revolutionised the surgical management of AF, moving away from the traditional surgical lesions. The hybrid procedure, a combination of catheter and surgical ablation is another promising new technique aiming to improve outcomes. Despite the increasing number of studies looking at various aspects of the surgical management of AF, the literature would benefit from more uniformly conducted randomised control trials. PMID:26839656

  4. Procedural pain management for neonates using nonpharmacological strategies: Part 1: sensorial interventions.

    PubMed

    Fernandes, Ananda; Campbell-Yeo, Marsha; Johnston, C Celeste

    2011-08-01

    Neonates who are born preterm and are admitted to neonatal intensive care units endure frequent procedures that may be painful. Nonpharmacological interventions that have been studied to relieve their pain may be categorized in 2 main groups according to their nature: interventions that focus on creating a favorable environment and offering pleasant sensorial stimuli and interventions that are centered on maternal care. These interventions may be considered within the philosophy of developmental care, since they are aimed at adjusting the environment to the needs of the neonate and involve family-centered care. In this article, the first of a 2-part series, we will synthesize the evidence from experimental studies of interventions that focus on the environment and on tactile and gustatory stimulation. The mechanisms suggested by researchers as possible explanations for the efficacy of these interventions are pointed, and the implications for procedural pain management in neonatal care are drawn.

  5. Technical Reference Suite Addressing Challenges of Providing Assurance for Fault Management Architectural Design

    NASA Technical Reports Server (NTRS)

    Fitz, Rhonda; Whitman, Gerek

    2016-01-01

    Research into complexities of software systems Fault Management (FM) and how architectural design decisions affect safety, preservation of assets, and maintenance of desired system functionality has coalesced into a technical reference (TR) suite that advances the provision of safety and mission assurance. The NASA Independent Verification and Validation (IVV) Program, with Software Assurance Research Program support, extracted FM architectures across the IVV portfolio to evaluate robustness, assess visibility for validation and test, and define software assurance methods applied to the architectures and designs. This investigation spanned IVV projects with seven different primary developers, a wide range of sizes and complexities, and encompassed Deep Space Robotic, Human Spaceflight, and Earth Orbiter mission FM architectures. The initiative continues with an expansion of the TR suite to include Launch Vehicles, adding the benefit of investigating differences intrinsic to model-based FM architectures and insight into complexities of FM within an Agile software development environment, in order to improve awareness of how nontraditional processes affect FM architectural design and system health management.

  6. Engineering Technical Review Planning Briefing

    NASA Technical Reports Server (NTRS)

    Gardner, Terrie

    2012-01-01

    The general topics covered in the engineering technical planning briefing are 1) overviews of NASA, Marshall Space Flight Center (MSFC), and Engineering, 2) the NASA Systems Engineering(SE) Engine and its implementation , 3) the NASA Project Life Cycle, 4) MSFC Technical Management Branch Services in relation to the SE Engine and the Project Life Cycle , 5) Technical Reviews, 6) NASA Human Factor Design Guidance , and 7) the MSFC Human Factors Team. The engineering technical review portion of the presentation is the primary focus of the overall presentation and will address the definition of a design review, execution guidance, the essential stages of a technical review, and the overall review planning life cycle. Examples of a technical review plan content, review approaches, review schedules, and the review process will be provided and discussed. The human factors portion of the presentation will focus on the NASA guidance for human factors. Human factors definition, categories, design guidance, and human factor specialist roles will be addressed. In addition, the NASA Systems Engineering Engine description, definition, and application will be reviewed as background leading into the NASA Project Life Cycle Overview and technical review planning discussion.

  7. Professional technical standards in colleges and schools of pharmacy.

    PubMed

    Berry, Tricia M; Chichester, Clinton O; Lundquist, Lisa M; Sanoski, Cynthia A; Woodward, Donald A; Worley, Marcia M; Early, Johnnie L

    2011-04-11

    To determine the prevalence, characteristics, and use of professional technical standards among colleges and schools of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE). The Web site of every college and school of pharmacy accredited by ACPE was searched to identify information regarding the availability, content, and use of technical standards and to obtain demographic information. Information was obtained from all of the 114 colleges and schools of pharmacy and 67 (59%) had technical standards in place. Common themes for technical standards were: observation; communication; motor; intellectual, conceptual, integrative and quantitative abilities; and behavioral and social attributes. Of those colleges and schools with technical standards, 61 (91%) had standards that addressed all 5 of these themes and 34 (51%) specified that the technical standards were used in their admission, progression, and graduation procedures. More than half of the colleges and schools of pharmacy examined in this study have technical standards; however, 41% have yet to develop and implement them. Colleges and schools of pharmacy looking for guidance in technical standards development could use the technical standards themes identified in this study.

  8. Simulated procedure rehearsal is more effective than a preoperative generic warm-up for endovascular procedures.

    PubMed

    Willaert, Willem I M; Aggarwal, Rajesh; Daruwalla, Farhad; Van Herzeele, Isabelle; Darzi, Ara W; Vermassen, Frank E; Cheshire, Nicholas J

    2012-06-01

    Patient-specific simulated rehearsal (PsR) of a carotid artery stenting procedure (CAS) enables the interventionalist to rehearse the case before performing the procedure on the actual patient by incorporating patient-specific computed tomographic data into the simulation software. This study aimed to evaluate whether PsR of a CAS procedure can enhance the operative performance versus a virtual reality (VR) generic CAS warm-up procedure or no preparation at all. During a 10-session cognitive/technical VR course, medical residents were trained in CAS. Thereafter, in a randomized crossover study, each participant performed a patient-specific CAS case 3 times on the simulator, preceded by 3 different tasks: a PsR, a generic case, or no preparation. Technical performances were assessed using simulator-based metrics and expert-based ratings. Twenty medical residents (surgery, cardiology, radiology) were recruited. Training plateaus were observed after 10 sessions for all participants. Performances were significantly better after PsR than after a generic warm-up or no warm-up for total procedure time (16.3 ± 0.6 vs 19.7 ± 1.0 vs 20.9 ± 1.1 minutes, P = 0.001) and fluoroscopy time (9.3 ± 0.1 vs 11.2 ± 0.6 vs 11.2 ± 0.5 minutes, P = 0.022) but did not influence contrast volume or number of roadmaps used during the "real" case. PsR significantly improved the quality of performance as measured by the expert-based ratings (scores 28 vs 25 vs 25, P = 0.020). Patient-specific simulated rehearsal of a CAS procedure significantly improves operative performance, compared to a generic VR warm-up or no warm-up. This technology requires further investigation with respect to improved outcomes on patients in the clinical setting.

  9. 41 CFR 109-27.5007-1 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-INVENTORY MANAGEMENT 27.50-Inventory Management Policies, Procedures, and Guidelines § 109-27.5007-1 Procedures. The following procedures shall be established for taking physical inventory of stocks subjected to quantity controls as well as those under financial control: (a) Completion of a physical inventory...

  10. Surgeon and type of anesthesia predict variability in surgical procedure times.

    PubMed

    Strum, D P; Sampson, A R; May, J H; Vargas, L G

    2000-05-01

    Variability in surgical procedure times increases the cost of healthcare delivery by increasing both the underutilization and overutilization of expensive surgical resources. To reduce variability in surgical procedure times, we must identify and study its sources. Our data set consisted of all surgeries performed over a 7-yr period at a large teaching hospital, resulting in 46,322 surgical cases. To study factors associated with variability in surgical procedure times, data mining techniques were used to segment and focus the data so that the analyses would be both technically and intellectually feasible. The data were subdivided into 40 representative segments of manageable size and variability based on headers adopted from the common procedural terminology classification. Each data segment was then analyzed using a main-effects linear model to identify and quantify specific sources of variability in surgical procedure times. The single most important source of variability in surgical procedure times was surgeon effect. Type of anesthesia, age, gender, and American Society of Anesthesiologists risk class were additional sources of variability. Intrinsic case-specific variability, unexplained by any of the preceding factors, was found to be highest for shorter surgeries relative to longer procedures. Variability in procedure times among surgeons was a multiplicative function (proportionate to time) of surgical time and total procedure time, such that as procedure times increased, variability in surgeons' surgical time increased proportionately. Surgeon-specific variability should be considered when building scheduling heuristics for longer surgeries. Results concerning variability in surgical procedure times due to factors such as type of anesthesia, age, gender, and American Society of Anesthesiologists risk class may be extrapolated to scheduling in other institutions, although specifics on individual surgeons may not. This research identifies factors associated

  11. A Review of Cash Management Policies, Procedures and Practices of Mississippi's Institutions of Higher Learning.

    ERIC Educational Resources Information Center

    Mississippi State Legislature, Jackson. Performance Evaluation and Expenditure Review Committee.

    This report to the Mississippi Legislature presents the findings of a review of the cash management policies, procedures, and practices of the State Board of Trustees of Institutions of Higher Learning (IHL). The methodology involved review of: applicable Mississippi statutes; standards promulgated by the National Association of College and…

  12. Improving Curriculum Development Practices in a Technical Vocational Community College: Examining Effects of a Professional Development Arrangement for Middle Managers

    ERIC Educational Resources Information Center

    Albashiry, Nabeel M.; Voogt, Joke M.; Pieters, Jules M.

    2015-01-01

    Learning about curriculum development is critical for middle managers of technical vocational institutions in order to assume curriculum leadership in maintaining and enhancing the quality and relevance of their educational programs. This case study reports on the design and effects of a professional development arrangement (PDA), with such a…

  13. High fidelity simulation based team training in urology: a preliminary interdisciplinary study of technical and nontechnical skills in laparoscopic complications management.

    PubMed

    Lee, Jason Y; Mucksavage, Phillip; Canales, Cecilia; McDougall, Elspeth M; Lin, Sharon

    2012-04-01

    Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales. A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p=0.004) and blood loss during renal vein injury management (p=0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p=0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p=0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments. Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents

  14. Human-Centered Technologies and Procedures for Future Air Traffic Management: A Preliminary Overview of 1996 Studies and Results

    NASA Technical Reports Server (NTRS)

    Smith, Philip; McCoy, Elaine; Denning, Rebecca; Woods, David; Sarter, Nadine; Dekker, Sidney; Billings, Charles

    1996-01-01

    In this project, we have been exploring the use of a general methodology to predict the impact of future Air Traffic Management (ATM) concepts and technologies. In applying this methodology, our emphasis has been on the importance of modeling coordination and cooperation among the multiple agents within this system, and on understanding how the interactions among these agents will be influenced as new roles, responsibilities, procedures and technologies are introduced. To accomplish this, we have been collecting data on performance under the current air traffic management system, trying to identify critical problem areas and looking for exemplars suggestive of general approaches for solving such problems. Based on the results of these field studies, we have developed a set of scenarios centered around potential future system designs, and have conducted studies using these scenarios involving a total 40 controllers, dispatchers, pilots and traffic managers. The purpose of this report is to provide NASA with an early summary of the major recommendations that have resulted from our research under the AATT Program thus far. Recommendations 1-3 deal with general approaches that our findings suggest should be incorporated in future AATT Program activities, while Recommendations 4-11 identify some specific topics and technologies that merit research and development activities. Detailed technical reports containing supporting data, as well as the results of our still ongoing analyses, will be provided at a later date. The remainder of this report is organized as follows. Section 1 briefly describes the general design philosophy supported by our empirical studies. Section 2 presents the research methods we have used for identifying requirements for future system designs and for evaluating alternative design solutions. Section 3 discusses preliminary results from an initial set of investigations that we have conducted using these research methods. Section 4 then provides an

  15. Independent technical review, handbook

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

    Not Available

    Purpose Provide an independent engineering review of the major projects being funded by the Department of Energy, Office of Environmental Restoration and Waste Management. The independent engineering review will address questions of whether the engineering practice is sufficiently developed to a point where a major project can be executed without significant technical problems. The independent review will focus on questions related to: (1) Adequacy of development of the technical base of understanding; (2) Status of development and availability of technology among the various alternatives; (3) Status and availability of the industrial infrastructure to support project design, equipment fabrication, facility construction,more » and process and program/project operation; (4) Adequacy of the design effort to provide a sound foundation to support execution of project; (5) Ability of the organization to fully integrate the system, and direct, manage, and control the execution of a complex major project.« less

  16. Management of acute maxillary sinusitis after sinus bone grafting procedures with simultaneous dental implants placement - a retrospective study.

    PubMed

    Chirilă, Lucian; Rotaru, Cristian; Filipov, Iulian; Săndulescu, Mihai

    2016-03-08

    The sinus lift was first described in 1974 and it has proven to be a predictable procedure ever since. The complications of this surgical procedure are reported in the literature to be low, and can include acute maxillary sinusitis, scattering of the grafting material into the sinus cavity, wound dehiscence and Schneiderian membrane perforations. We aimed to evaluate the rate of acute maxillary sinusitis after sinus lift procedures and the appropriate management strategies. Between 2013 and 2015, 245 dental implants were placed in 116 patients (76 males and 40 females) with concomitant bone augmentation of the maxillary sinus floor. The sinus lifting procedure was bilateral in 35 patients and unilateral in 81 patients (a total of 151 sinuses). Maxillary sinusitis occurred in 5 patients (4.3 %). The clinical signs of infection were: headache, locoregional pain, cacosmia, inflammation of the oral buccal mucosa and rhinorrhea or unilateral nasal discharge. A mucosal fistula was observed during inspection in one patient. The management included only the removal of the grafting material in 3 patients, in 1 patient the grafting material was removed together with all the implants, and in 1 patient only 2 implants and the grafting material were removed, 1 implant being left in place. The sinus cavity was irrigated with metronidazole solution and antibiotic therapy with clindamycin and metronidazole was prescribed for 10 days. Subsequently, all signs of infection disappeared within 5 to 7 days and normal sinus function and drainage were restored. Although sinus lift is regarded as a safe and reliable procedure, acute sinusitis is a possible complication which has to be managed immediately in order to reduce the risk of further complications like pansinusitis, osteomyelitis of the maxillary bone, and spreading of the infection in the infratemporal space or orbital cavity. To minimize risk, caution must be taken with all the steps of the procedure, in order not to

  17. Technical Evaluation Motor No. 10 (TEM-10)

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Technical Evaluation Motor No. 10 (TEM-10) was static fired on 27 Apr. 1993 at the Thiokol Corporation full-scale motor static test bay, T-24. This final test report documents the procedures, performance, and results of the static test firing of TEM-10. All observations, discussions, conclusions, and recommendations contained are final. Included is a presentation and discussion of TEM-10 performance, anomalies, and test results in concurrence with the objectives outlined in CTP-0110, Revision D, Space Shuttle Technical Evaluation Motor No. 10 (TEM-10) Static Fire Test Plan.

  18. How to manage without being a manager

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

    Sweeney, M.A.

    1997-06-01

    In the author`s current position at Sandia National Laboratories within the Pulsed Power Sciences Center, much of the author`s time is spent in composing short (one page) technical reports and long (> 20 page) technical contracts and program plans for transmission to the Department of Energy and to upper management and also in reviewing long technical documents for accuracy. A major requirement of these efforts is to complete them on a timely basis, often within a few hours or a few days. In this talk, the author reveals some communication {open_quotes}secrets{close_quotes} that have been learned. The idea behind these twelvemore » {open_quotes}secrets{close_quotes} is to get the answers you, as a nonmanager, need quickly from a manager without creating stress either on your part or the manager`s part.« less

  19. PRODUCTION OF HEAVY WATER SAVANNAH RIVER AND DANA PLANTS. Technical Manual

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

    Bebbington, W.P.; Thayer, V.R. eds.; Proctor, J.F. comp.

    1959-07-01

    A summary is presented of the basic technical iniormation that pertains to processes that are used at the Dana and Savannah River Plants for the production of heavy water. The manual is intended primarily for plant operating and technical personnel and was prepared to supplement and provide technical support for detailed operating procedures. Introductory sections contain some background information on the history, uses, available processes, and analytical procedures for heavy water. They also include a general comparison of the design and laserformance of the two plants and an analysis of their differences. The technology of the heavy water separation processesmore » used, namely hydrogen sulfide exchange, distillation of water, and electrolysis is discussed in detail. The manufacture and storage of hydrogen sulfide gas and the process water treatment facilities are also discussed. (auth)« less

  20. Engineering directorate technical facilities catalog

    NASA Technical Reports Server (NTRS)

    Maloy, Joseph E.

    1993-01-01

    The Engineering Directorate Technical Facilities Catalog is designed to provide an overview of the technical facilities available within the Engineering Directorate at the National Aeronautics and Space Administration (NASA), Lyndon B. Johnson Space Center (JSC) in Houston, Texas. The combined capabilities of these engineering facilities are essential elements of overall JSC capabilities required to manage and perform major NASA engineering programs. The facilities are grouped in the text by chapter according to the JSC division responsible for operation of the facility. This catalog updates the facility descriptions for the JSC Engineering Directorate Technical Facilities Catalog, JSC 19295 (August 1989), and supersedes the Engineering Directorate, Principle test and Development Facilities, JSC, 19962 (November 1984).

  1. Technical assistance for hazardous-waste reduction

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

    Thompson, F.M.; McComas, C.A.

    1987-12-01

    Minnesota's Waste Management Board has established, developed, and funded the Minnesota Technical Assistance Program (MnTAP). The MnTAP programs offers technical assistance to generators of hazardous waste by offering telephone and onsite consultation, a waste reduction resource bank, information dissemination, a student intern program, and research awards for waste reduction projects. The program has completed three years of successful operation. The increasing interest in and use of MnTAP's services by hazardous-waste generators has justified the belief that state technical assistance programs have an important role to play in helping generators to reduce their waste production.

  2. Coding for urologic office procedures.

    PubMed

    Dowling, Robert A; Painter, Mark

    2013-11-01

    This article summarizes current best practices for documenting, coding, and billing common office-based urologic procedures. Topics covered include general principles, basic and advanced urologic coding, creation of medical records that support compliant coding practices, bundled codes and unbundling, global periods, modifiers for procedure codes, when to bill for evaluation and management services during the same visit, coding for supplies, and laboratory and radiology procedures pertinent to urology practice. Detailed information is included for the most common urology office procedures, and suggested resources and references are provided. This information is of value to physicians, office managers, and their coding staff. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. 47 CFR 15.611 - General technical requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false General technical requirements. 15.611 Section 15.611 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Access... shut-off procedure, by the use of a non-volatile memory, or some other method, to immediately restore...

  4. Technical pitfalls and tips for the valve-in-valve procedure

    PubMed Central

    2017-01-01

    Transcatheter aortic valve implantation (TAVI) has emerged as a viable treatment modality for patients with severe aortic valve stenosis and multiple co-morbidities. More recent indications include the use of transcatheter heart valves (THV) to treat degenerated bioprosthetic surgical heart valves (SHV), which are failing due to stenosis or regurgitation. Valve-in-valve (VIV) procedures in the aortic position have been performed with a variety of THV devices, although the balloon-expandable SAPIEN valve platform (Edwards Lifesciences Ltd, Irvine, CA, USA) and self-expandable CoreValve platform (Medtronic Inc., MN, USA) have been used in majority of the patients. VIV treatment is appealing as it is less invasive than conventional surgery but optimal patient selection is vital to avoid complications such as malposition, residual high gradients and coronary obstruction. To minimize the risk of complications, thorough procedural planning is critical. The first step is identification of the degenerated SHV, including its model, size, fluoroscopic appearance. Although label size and stent internal diameter (ID) are provided by the manufacturer, it is important to note the true ID. The true ID is the ID of a SHV after the leaflets are mounted and helps determine the optimal size of THV. The second step is to determine the type and size of the THV. Although this is determined in the majority of the cases by user preference, in certain situations one THV may be more suitable than another. As the procedure is performed under fluoroscopy, the third step is to become familiarized with the fluoroscopic appearance of both the SHV and THV. This helps to determine the landmarks for optimal positioning, which in turn determines the gradients and fixation. The fourth step is to assess the risk of coronary obstruction. This is performed with either aortic root angiography or ECG-gated computerised tomography (CT). Finally, the route of approach must be carefully planned. Once these

  5. Endoscopic surgical management of sinonasal inverted papilloma extending to frontal sinuses.

    PubMed

    Takahashi, Yukiko; Shoji, Fumi; Katori, Yukio; Hidaka, Hiroshi; Noguchi, Naoya; Abe, Yasuhiro; Kakuta, Risako Kakuta; Suzuki, Takahiro; Suzuki, Yusuke; Ohta, Nobuo; Kakehata, Seiji; Okamoto, Yoshitaka

    2016-11-10

    Sinonasal inverted papilloma has been traditionally managed with external surgical approaches. Advances in imaging guidance systems, surgical instrumentation, and intraoperative multi-visualization have led to a gradual shift from external approaches to endoscopic surgery. However, for anatomical and technical reasons, endoscopic surgery of sinonasal inverted papilloma extending to the frontal sinuses is still challenging. Here, we present our experience in endoscopic surgical management of sinonasal inverted papilloma extending to one or both frontal sinuses. We present 10 cases of sinonasal inverted papilloma extending to the frontal sinuses and successfully removed by endoscopic median drainage (Draf III procedure) under endoscopic guidance without any additional external approach. The whole cavity of the frontal sinuses was easily inspected at the end of the surgical procedure. No early or late complications were observed. No recurrence was identified after an average follow-up period of 39.5 months. Use of an endoscopic median drainage approach to manage sinonasal inverted papilloma extending to one or both frontal sinuses is feasible and seems effective.

  6. Engineering Technical Support Center Annual Report Fiscal ...

    EPA Pesticide Factsheets

    The United States Environmental Protection Agency (EPA or Agency) Office of Research and Development (ORD) created the Engineering Technical Support Center (ETSC) in 1987, one of several technical support centers created as part of the Technical Support Project (TSP). ETSC provides engineering expertise to Agency program and regional offices and remediation teams working at contaminated sites across the country. The ETSC is operated within ORD’s Land Remediation and Pollution Control Division (LRPCD) of the National Risk Management Research Laboratory (NRMRL) in Cincinnati, Ohio. The ETSC’s mission is to provide site-specific scientific and engineering technical support to Remedial Project Managers, On-Scene Coordinators, and other remediation personnel at contaminated sites. This allows local, regional, or national authorities to work more quickly, efficiently, and cost effectively, while also increasing the technical experience of the remediation team. Since its inception, the ETSC has supported countless projects across all EPA Regions in almost all states and territories. This report highlights significant projects the ETSC supported in fiscal year 2015 (FY15). These projects addressed an array of environmental scenarios, such as remote mining contamination, expansive landfill waste, cumulative impacts from multiple contamination sources, and persistent threats from abandoned industrial sites. Constructing and testing new and innovative treatment technol

  7. Obtaining Technical Support for Superfund, RCRA and Brownfields Site Issues Fact Sheet

    EPA Pesticide Factsheets

    EPA’s Technical Support Centers (TSCs) and other technical support services are available to Regional RemedialProject Managers, Corrective Action Staff, and On-Scene Coordinators needing specialized technical expertisefor specific tasks or projects.

  8. 44 CFR 67.8 - Appeal procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... technical or scientific data submitted by the community that tend to negate or contradict the information... FLOOD ELEVATION DETERMINATIONS § 67.8 Appeal procedure. (a) If a community appeals the proposed flood... to an independent scientific body or appropriate Federal agency for advice. (c) The final...

  9. 44 CFR 67.8 - Appeal procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... technical or scientific data submitted by the community that tend to negate or contradict the information... FLOOD ELEVATION DETERMINATIONS § 67.8 Appeal procedure. (a) If a community appeals the proposed flood... to an independent scientific body or appropriate Federal agency for advice. (c) The final...

  10. The PDS-based Data Processing, Archiving and Management Procedures in Chang'e Mission

    NASA Astrophysics Data System (ADS)

    Zhang, Z. B.; Li, C.; Zhang, H.; Zhang, P.; Chen, W.

    2017-12-01

    PDS is adopted as standard format of scientific data and foundation of all data-related procedures in Chang'e mission. Unlike the geographically distributed nature of the planetary data system, all procedures of data processing, archiving, management and distribution are proceeded in the headquarter of Ground Research and Application System of Chang'e mission in a centralized manner. The RAW data acquired by the ground stations is transmitted to and processed by data preprocessing subsystem (DPS) for the production of PDS-compliant Level 0 Level 2 data products using established algorithms, with each product file being well described using an attached label, then all products with the same orbit number are put together into a scheduled task for archiving along with a XML archive list file recoding all product files' properties such as file name, file size etc. After receiving the archive request from DPS, data management subsystem (DMS) is provoked to parse the XML list file to validate all the claimed files and their compliance to PDS using a prebuilt data dictionary, then to exact metadata of each data product file from its PDS label and the fields of its normalized filename. Various requirements of data management, retrieving, distribution and application can be well met using the flexible combination of the rich metadata empowered by the PDS. In the forthcoming CE-5 mission, all the design of data structure and procedures will be updated from PDS version 3 used in previous CE-1, CE-2 and CE-3 missions to the new version 4, the main changes would be: 1) a dedicated detached XML label will be used to describe the corresponding scientific data acquired by the 4 instruments carried, the XML parsing framework used in archive list validation will be reused for the label after some necessary adjustments; 2) all the image data acquired by the panorama camera, landing camera and lunar mineralogical spectrometer should use an Array_2D_Image/Array_3D_Image object to store

  11. Technical aspects of cardiac PET/MRI.

    PubMed

    Masuda, Atsuro; Nemoto, Ayaka; Takeishi, Yasuchika

    2018-06-01

    PET/MRI is a novel modality that enables to combine PET and MR images, and has significant potential to evaluate various cardiac diseases through the combination of PET molecular imaging and MRI functional imaging. Precise management of technical issues, however, is necessary for cardiac PET/MRI. This article describes several technical points, including patient preparation, MR attenuation correction, parallel acquisition of PET with MRI, clinical aspects, and image quality control.

  12. From Management to Negotiation: Technical and Institutional Innovations for Integrated Water Resource Management in the Upper Comoé River Basin, Burkina Faso

    NASA Astrophysics Data System (ADS)

    Roncoli, Carla; Kirshen, Paul; Etkin, Derek; Sanon, Moussa; Somé, Léopold; Dembélé, Youssouf; Sanfo, Bienvenue J.; Zoungrana, Jacqueline; Hoogenboom, Gerrit

    2009-10-01

    This study focuses on the potential role of technical and institutional innovations for improving water management in a multi-user context in Burkina Faso. We focus on a system centered on three reservoirs that capture the waters of the Upper Comoé River Basin and servicing a diversity of users, including a sugar manufacturing company, a urban water supply utility, a farmer cooperative, and other downstream users. Due to variable and declining rainfall and expanding users’ needs, drastic fluctuations in water supply and demand occur during each dry season. A decision support tool was developed through participatory research to enable users to assess the impact of alternative release and diversion schedules on deficits faced by each user. The tool is meant to be applied in the context of consultative planning by a local user committee that has been created by a new national integrated water management policy. We contend that both solid science and good governance are instrumental in realizing efficient and equitable water management and adaptation to climate variability and change. But, while modeling tools and negotiation platforms may assist users in managing climate risk, they also introduce additional uncertainties into the deliberative process. It is therefore imperative to understand how these technological and institutional innovations frame water use issues and decisions to ensure that such framing is consistent with the goals of integrated water resource management.

  13. Professional Technical Standards in Colleges and Schools of Pharmacy

    PubMed Central

    Berry, Tricia M.; Chichester, Clinton O.; Sanoski, Cynthia A.; Woodward, Donald A.; Worley, Marcia M.; Early, Johnnie L.

    2011-01-01

    Objective To determine the prevalence, characteristics, and use of professional technical standards among colleges and schools of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE). Methods The Web site of every college and school of pharmacy accredited by ACPE was searched to identify information regarding the availability, content, and use of technical standards and to obtain demographic information. Results Information was obtained from all of the 114 colleges and schools of pharmacy and 67 (59%) had technical standards in place. Common themes for technical standards were: observation; communication; motor; intellectual, conceptual, integrative and quantitative abilities; and behavioral and social attributes. Of those colleges and schools with technical standards, 61 (91%) had standards that addressed all 5 of these themes and 34 (51%) specified that the technical standards were used in their admission, progression, and graduation procedures. Conclusion More than half of the colleges and schools of pharmacy examined in this study have technical standards; however, 41% have yet to develop and implement them. Colleges and schools of pharmacy looking for guidance in technical standards development could use the technical standards themes identified in this study. PMID:21655404

  14. 48 CFR 642.271 - Government Technical Monitor (GTM).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Government Technical Monitor (GTM). 642.271 Section 642.271 Federal Acquisition Regulations System DEPARTMENT OF STATE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contract Administration Services 642.271 Government Technical Monitor (GTM). (a) Policy. The...

  15. The future of volcanic ash-aircraft interactions from technical and policy perspectives

    NASA Astrophysics Data System (ADS)

    Casadevall, T. J.; Guffanti, M.

    2010-12-01

    Since the advent of jet-powered flight in the 1960s, the threat of volcanic ash to aviation operations has become widely recognized and the mitigation of this threat has received concerted international attention. At the same time the susceptibility to operational disruption has grown. Technical improvements to airframes, engines, and avionic systems have been made in response to the need for improved fuel efficiency and the demand for increased capacity for passenger and freight traffic. Operational demands have resulted in the growth of extended overseas flight operations (ETOPS), increased flight frequency on air traffic routes, and closer spacing of aircraft on heavily traveled routes. The net result has been great advances in flight efficiency, but also increased susceptibility to flight disruption, especially in heavily traveled regions such as North Atlantic-Europe, North America, and the North Pacific. Advances in ash avoidance procedures, pilot and air manager training, and in detection of ash-related damage and maintenance of aircraft and engines have been spurred by noteworthy eruptions such as Galunggung, Indonesia, 1982; Redoubt, Alaska, 1989-1990; and Pinatubo, Philippines, 1991. Comparable advances have been made in the detection and tracking of volcanic ash clouds using satellite-based remote sensing and numerical trajectory forecast models. Following the April 2010 eruption of Eyjafjallajökull volcano, Iceland, the global aviation community again focused attention on the issue of safe air operations in airspace affected by volcanic ash. The enormous global disruption to air traffic in the weeks after the Eyjafjallajökull eruption has placed added emphasis for the global air traffic management system as well as on the equipment manufacturers to reevaluate air operations in ash-affected airspace. Under the leadership of the International Civil Aviation Organization and the World Meteorological Organization, efforts are being made to address this

  16. Simulation center training as a means to improve resident performance in percutaneous noncontinuous CT-guided fluoroscopic procedures with dose reduction.

    PubMed

    Mendiratta-Lala, Mishal; Williams, Todd R; Mendiratta, Vivek; Ahmed, Hafeez; Bonnett, John W

    2015-04-01

    The purpose of this study was to evaluate the effectiveness of a multifaceted simulation-based resident training for CT-guided fluoroscopic procedures by measuring procedural and technical skills, radiation dose, and procedure times before and after simulation training. A prospective analysis included 40 radiology residents and eight staff radiologists. Residents took an online pretest to assess baseline procedural knowledge. Second-through fourth-year residents' baseline technical skills with a procedural phantom were evaluated. First-through third-year residents then underwent formal didactic and simulation-based procedural and technical training with one of two interventional radiologists and followed the training with 1 month of supervised phantom-based practice. Thereafter, residents underwent final written and practical examinations. The practical examination included essential items from a 20-point checklist, including site and side marking, consent, time-out, and sterile technique along with a technical skills portion assessing pedal steps, radiation dose, needle redirects, and procedure time. The results indicated statistically significant improvement in procedural and technical skills after simulation training. For residents, the median number of pedal steps decreased by three (p=0.001), median dose decreased by 15.4 mGy (p<0.001), median procedure time decreased by 4.0 minutes (p<0.001), median number of needle redirects decreased by 1.0 (p=0.005), and median number of 20-point checklist items successfully completed increased by three (p<0.001). The results suggest that procedural skills can be acquired and improved by simulation-based training of residents, regardless of experience. CT simulation training decreases procedural time, decreases radiation dose, and improves resident efficiency and confidence, which may transfer to clinical practice with improved patient care and safety.

  17. Report: EPA Needs Policies and Procedures to Manage Public Pesticide Petitions in a Transparent and Efficient Manner

    EPA Pesticide Factsheets

    Report #16-P-0019, October 27, 2015. OPP’s lack of policies and procedures to manage public pesticide petitions in a transparent and efficient manner can result in unreasonable delay lawsuits costing the agency time and resources.

  18. Comparison of Technical and Clinical Outcome of Transjugular Portosystemic Shunt Placement Between a Bare Metal Stent and a PTFE-Stentgraft Device

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

    Lauermann, J., E-mail: jostlauermann@gmail.com; Potthoff, A.; Mc Cavert, M.

    PurposeTo analyse technical and clinical success of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension and compare a stent and a stentgraft with regard to clinical and technical outcome and associated costs.Materials and Methods170 patients (56 ± 12 years, 32.9 % females) treated with TIPS due to portal hypertension were reviewed. 80 patients received a stent (group 1) and 83 a stentgraft (group 2), and seven interventions were unsuccessful. Technical data, periprocedural imaging, follow-up ultrasound and clinical data were analysed with focus on technical success, patency, clinical outcome and group differences. Cost analysis was performed.ResultsPortal hypertension was mainly caused by ethyltoxicmore » liver cirrhosis with ascites as dominant symptom (80 %). Technical success was 93.5 % with mean portosystemic gradient decrease from 16.1 ± 4.8 to 5.1 ± 2.1 mmHg. No significant differences in technical success and portosystemic gradient decrease between the groups were observed. Kaplan–Meier analysis yielded significant differences in primary patency after 14 days, 6 months and 2 years in favour of the stentgraft. Both groups showed good clinical results without significant difference in 1-year survival and hepatic encephalopathy rate. Costs to establish TIPS and to manage 2-year follow-up with constant patency and clinical success were 8876 € (group 1) and 9394 € (group 2).ConclusionTIPS is a safe and effective procedure to manage portal hypertension. Stent and stentgraft enabled good technical and clinical results with a low complication rate. Primary patency rates are clearly in favour of the stentgraft, whereas the stent was more cost effective with similar clinical results in both groups.« less

  19. Technical assistance development soil management policy in Croatia

    NASA Astrophysics Data System (ADS)

    Spruyt, Eva; Helsen, Stefan; Hambach, Patrick; Cuyvers, Lars

    2014-05-01

    As from the first of July 2013, Croatia became a EU member country and therefore has to comply with all the EU-rules (the "acquis") as defined in the European Council in Copenhagen in 1993. One of the aspects of this acquis is the protection and conservation of the soil and groundwater and the remediation of contaminated sites that cause human and environmental risks. On behalf of the Department of Environment, Nature and Energy of the Flemish government together with the Public Waste Agency of Flanders(OVAM), ECOREM was assigned to carry out this study. The scope of this study therefore focuses on the aspect of soil management that can be divided into two main policies, beïng the policy for the prevention of soil contamination from new activities(1) and the policy for the management and remediation of historical soil contamination from local sources like industrial sites(2). To form a soil management policy, Croatia must start from the legal obligations enforced by the European Union. One of the European Directives regulating the monitoring and protection of soil and groundwater is the new Industrial Emission Directive ('IED' - 2010/78/EU) from the 24th of November 2010. Whereas the framework of the Directive is larger than contamination of soil , the focus of this study was limited to soil contamination only. In order to comply with the existing EU policy contributing to soil protection, the regulations in the IED, the Croatian government needs to adapt existing legislations or apply new regulations regarding soil monitoring for the industrial activities. Also other EU Directives enforce actions contributing to soil protection. Therefore, a questionnaire with different sorts of questions was sent to the different stakeholders (environmental institutes, agencies, ministries,…). The results were interpreted and allowed Ecorem, being the environmental consultant, to evaluate the gaps in the environmental and soil management policy. This study gives advice on how

  20. Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

    PubMed

    Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

    2012-10-01

    To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores. Hands-on training helps to achieve a significant

  1. 'Buildings in Use' Study. Technical Factors.

    ERIC Educational Resources Information Center

    Wisconsin Univ., Milwaukee. School of Architecture and Urban Planning.

    The second report of the 'Buildings in Use' study documents the results of over 100 field tests conducted at four elementary schools, as well as discussion of these results and relevant technical specifications and details. The procedural framework used in the Field Tests Manual is followed and test results are rated numerically wherever possible.…

  2. Fox Valley Technical Institute Economic Development Plan.

    ERIC Educational Resources Information Center

    Fox Valley Technical Inst., Appleton, WI.

    Designed as an operating blueprint for Fox Valley Technical Institute's (FVTI's) economic development efforts, this guide incorporates the necessary operation procedures, descriptions, and resources for those involved in FVTI's effort to assist existing businesses to expand and to attract new businesses to the area. Introductory material describes…

  3. Exploring Senior Residents' Intraoperative Error Management Strategies: A Potential Measure of Performance Improvement.

    PubMed

    Law, Katherine E; Ray, Rebecca D; D'Angelo, Anne-Lise D; Cohen, Elaine R; DiMarco, Shannon M; Linsmeier, Elyse; Wiegmann, Douglas A; Pugh, Carla M

    The study aim was to determine whether residents' error management strategies changed across 2 simulated laparoscopic ventral hernia (LVH) repair procedures after receiving feedback on their initial performance. We hypothesize that error detection and recovery strategies would improve during the second procedure without hands-on practice. Retrospective review of participant procedural performances of simulated laparoscopic ventral herniorrhaphy. A total of 3 investigators reviewed procedure videos to identify surgical errors. Errors were deconstructed. Error management events were noted, including error identification and recovery. Residents performed the simulated LVH procedures during a course on advanced laparoscopy. Participants had 30 minutes to complete a LVH procedure. After verbal and simulator feedback, residents returned 24 hours later to perform a different, more difficult simulated LVH repair. Senior (N = 7; postgraduate year 4-5) residents in attendance at the course participated in this study. In the first LVH procedure, residents committed 121 errors (M = 17.14, standard deviation = 4.38). Although the number of errors increased to 146 (M = 20.86, standard deviation = 6.15) during the second procedure, residents progressed further in the second procedure. There was no significant difference in the number of errors committed for both procedures, but errors shifted to the late stage of the second procedure. Residents changed the error types that they attempted to recover (χ 2 5 =24.96, p<0.001). For the second procedure, recovery attempts increased for action and procedure errors, but decreased for strategy errors. Residents also recovered the most errors in the late stage of the second procedure (p < 0.001). Residents' error management strategies changed between procedures following verbal feedback on their initial performance and feedback from the simulator. Errors and recovery attempts shifted to later steps during the second procedure. This may

  4. Evaluation of contract time estimation and contracting procedures : technical summary.

    DOT National Transportation Integrated Search

    1996-08-01

    The objective of this research was 1) to provide the DOTD with a systematic approach to the determination of contract duration, and 2) to explore innovative contracting procedures that may prove beneficial in DOTD projects. The innovative contracting...

  5. SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS

    PubMed Central

    GEBELLI, Jordi Pujol; de GORDEJUELA, Amador Garcia Ruiz; RAMOS, Almino Cardoso; NORA, Mario; PEREIRA, Ana Marta; CAMPOS, Josemberg Marins; RAMOS, Manoela Galvão; BASTOS, Eduardo Lemos de Souza; MARCHESINI, João Batista

    2016-01-01

    ABSTRACT Background: Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. Aim: To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Methods: Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. Results: A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). Conclusions: SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery. PMID:27683784

  6. Posterior capsular rent: Prevention and management.

    PubMed

    Chakrabarti, Arup; Nazm, Nazneen

    2017-12-01

    This review article deals with a potentially sight threatening complication - rupture of the posterior capsule - during cataract surgery. Cataract surgery is the most commonly performed surgical procedure in ophthalmology and despite tremendous technical and technological advancements, posterior capsular rent (PCR) still occurs. PCR occurs both in the hands of experienced senior surgeons and the neophyte surgeons, although with a higher frequency in the latter group. Additionally, certain types of cataracts are prone to this development. If managed properly in a timely manner the eventual outcome may be no different from that of an uncomplicated case. However, improper management may lead to serious complications with a higher incidence of permanent visual disability. The article covers the management of posterior capsular rent from two perspectives: 1. Identifying patients at higher risk and measures to manage such patients by surgical discipline, and 2. Intraoperative management of posterior capsular rent and various case scenarios to minimize long-term complications.This review is written for experienced and not-so-experienced eye surgeons alike to understand and manage PCR.

  7. Policies, Organisation and Procedures in the Technical Cooperation Program

    DTIC Science & Technology

    2009-03-10

    it  is normal  practise  for each Group to request  an annual report from their TPs and AGs. The aims of such a report are to allow  the Group to better...and validation  of such models and, where possible, conduct collaborative  laboratory  and/or  field experiments to fill data gaps.  Provide  expert...recommendation  from  a  flag  level  official or a  laboratory  director who understands and appreciates  the  technical  and  operational  significance

  8. Adrenal vein sampling: substantial need for technical improvement at regional referral centres.

    PubMed

    Elliott, Panda; Holmes, Daniel T

    2013-10-01

    Adrenal vein sampling (AVS) is the gold standard for localization of aldosterone producing adenoma. The anatomy of the right adrenal vein makes this procedure technically demanding and it may yield no clinical information if the adrenal veins are not adequately cannulated. Having frequently observed the technical failure of AVS, we undertook a review of 220 procedures in British Columbia, Canada. Subjects were retrospectively identified through the laboratory information system. The following were collected: demographics, screening aldosterone concentration and renin activity/mass, results of dynamic function tests, AVS aldosterone and cortisol results. Standard calculations were performed on AVS data and site-specific success rates were compared. The effect of adrenocorticotropin hormone (ACTH) stimulation on the selectivity index (SI) and lateralization index (LI) were explored. The overall technical success-rate of AVS procedures was only 44% in procedures where no ACTH-stimulation was used (n=200) but this rose significantly (p<0.01) to 82% for those employing ACTH (n=139). ACTH-stimulation significantly increased the median SI (left: 5.8 vs 36.7, p<0.01; right: 7.0 vs 51.2, p<0.01), and salvaged 36 procedures from yielding no information, 21 of which demonstrated lateralization of aldosterone production. In 64 cases showing lateralization both pre and post-stimulation, ACTH significantly decreased the median LI from 5.4 to 2.2, p<0.01, creating substantial risk for spurious loss of lateralization. The technical success of AVS is lower than reported elsewhere. Provided that effects on the LI are considered, the use of ACTH-stimulation during AVS assists in the identification of unilateral forms of PA. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  9. A model to determine payments associated with radiology procedures.

    PubMed

    Mabotuwana, Thusitha; Hall, Christopher S; Thomas, Shiby; Wald, Christoph

    2017-12-01

    Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards. The main challenge with current reporting systems is that the information is presented only at an aggregated level, and often not broken down further, for instance, by type of exam. As such, the primary objective of this research is to provide better visibility into payments associated with individual radiology procedures in order to better calibrate expense/capital structure of the imaging enterprise to the actual revenue or value-add to the organization it belongs to. We propose a methodology that can be used to determine technical payments at a procedure level. We use a proportion based model to allocate payments to individual radiology procedures based on total charges (which also includes non-radiology related charges). Using a production dataset containing 424,250 radiology exams we calculated the overall average technical charge for Radiology to be $873.08 per procedure and the corresponding average payment to be $326.43 (range: $48.27 for XR and $2750.11 for PET/CT) resulting in an average payment percentage of 37.39% across all exams. We describe how charges associated with a procedure can be used to approximate technical payments at a more granular level with a focus on Radiology. The methodology is generalizable to approximate payment for other services as well. Understanding payments associated with each procedure can be useful during strategic practice planning. Charge-to-total charge ratio can be used to

  10. 44 CFR 18.205 - Professional and technical services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... contract is allowable. However, communications with the intent to influence made by a professional (such as... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Professional and technical... Professional and technical services. (a) The prohibition on the use of appropriated funds, in § 18.100 (a...

  11. Percutaneous cecostomy in the management of organic fecal incontinence in children

    PubMed Central

    Donkol, Ragab Hani; Al-Nammi, Ahmed

    2010-01-01

    AIM: To assess the effectiveness and safety of imaging-guided percutaneous cecostomy in the management of pediatric patients with organic fecal incontinence. METHODS: Twenty three cecostomies were performed on 21 children with organic fecal incontinence (13 males, 8 females), aged from 5 to 16 years (mean 9.5 years). Thirteen patients had neurogenic fecal incontinence and 8 patients had anorectal anomalies. Procedures were performed under general anesthesia and fluoroscopic guidance. Effectiveness and complication data were obtained for at least 1 year after the procedure. RESULTS: Cecostomy was successful in 20 patients (primary technical success rate 95%). Cecostomy failed in one patient due to tube breakage (secondary technical success rate 100%). The tubes were in situ for an average of 18 mo (range 12-23 mo). Eighteen patients (87%) expressed satisfaction with the procedures. Resolution of soiling was achieved in all patients with neurogenic fecal incontinence (100%) and in 5 of 8 patients with anorectal anomalies (62.5%). Eleven patients (52%) experienced minor problems. No major complications were noted. CONCLUSION: Percutaneous cecostomy improves the quality of life in children with organic fecal incontinence. A satisfactory outcome is more prevalent in patients with neurogenic fecal incontinence than anorectal anomalies. PMID:21225001

  12. Technical Aspects Regarding the Management of Radioactive Waste from Decommissioning of Nuclear Facilities

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

    Dragolici, F.; Turcanu, C. N.; Rotarescu, G.

    2003-02-25

    The proper application of the nuclear techniques and technologies in Romania started in 1957, once with the commissioning of the Research Reactor VVR-S from IFIN-HH-Magurele. During the last 45 years, appear thousands of nuclear application units with extremely diverse profiles (research, biology, medicine, education, agriculture, transport, all types of industry) which used different nuclear facilities containing radioactive sources and generating a great variety of radioactive waste during the decommissioning after the operation lifetime is accomplished. A new aspect appears by the planning of VVR-S Research Reactor decommissioning which will be a new source of radioactive waste generated by decontamination, disassemblingmore » and demolition activities. By construction and exploitation of the Radioactive Waste Treatment Plant (STDR)--Magurele and the National Repository for Low and Intermediate Radioactive Waste (DNDR)--Baita, Bihor county, in Romania was solved the management of radioactive wastes arising from operation and decommissioning of small nuclear facilities, being assured the protection of the people and environment. The present paper makes a review of the present technical status of the Romanian waste management facilities, especially raising on treatment capabilities of ''problem'' wastes such as Ra-266, Pu-238, Am-241 Co-60, Co-57, Sr-90, Cs-137 sealed sources from industrial, research and medical applications. Also, contain a preliminary estimation of quantities and types of wastes, which would result during the decommissioning project of the VVR-S Research Reactor from IFIN-HH giving attention to some special category of wastes like aluminum, graphite and equipment, components and structures that became radioactive through neutron activation. After analyzing the technical and scientific potential of STDR and DNDR to handle big amounts of wastes resulting from the decommissioning of VVR-S Research Reactor and small nuclear facilities, the

  13. Ground Water Technical Considerations during the Five-Year Review Process

    EPA Pesticide Factsheets

    This issue paper has been developed to highlight technical considerations as well as technical resources available to Remedial Project Managers (RPMs) in conducting Five-Year Reviews (FYRs) at CERCLA1 sites with contaminated groundwater.

  14. 44 CFR 65.15 - List of communities submitting new technical data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... technical data. This section provides a cumulative list of communities where modifications of the base flood elevation determinations have been made because of submission of new scientific or technical data. Due to... submitting new technical data. 65.15 Section 65.15 Emergency Management and Assistance FEDERAL EMERGENCY...

  15. A Review of Legal Decisions Relevant to Technical Standards Used in Pharmacy School Admissions

    PubMed Central

    2017-01-01

    The implementation of an effective and legally sound technical standards procedure for pharmacy schools requires a proactive approach by admissions officers. Applicants with disabilities are accorded significant rights that must not be infringed during the admissions process in order to ensure compliance with applicable law. This article provides a review of applicable state cases, federal cases, and OCR decisions and guidance to help pharmacy schools identify procedures and implement technical standards into their admissions processes as required by ACPE Standards 2016. PMID:28381897

  16. Sustainable hydropower in Lower Mekong Countries: Technical assessment and training travel report

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

    Hadjerioua, Boualem; Witt, Adam M.

    . The mission of the ORNL Water Power Program is to develop technologies, decision-support tools, and methods of analysis that enable holistic management of water-dependent energy infrastructure and natural resources in support of the DOE Energy Efficiency and Renewable Energy Office (DOE-EERE), Federal hydropower agencies, Federal Energy Regulatory Commission (FERC), Nuclear Regulatory Commission (NRC), energy producers, and other entities. In support of SIM, ORNL completed technical assessments of two hydropower plants owned and operated by the Electricity Generating Authority of Thailand (EGAT): Vajiralongkorn (VRK), with an installed capacity of 300 MW, and Rajjaprabha (RPB), with an installed capacity of 240MW. Technical assessment is defined as the assessment of hydropower operation and performance, and the identification of potential opportunities for performance improvement through plant optimization. At each plant, the assessment included an initial analysis of hydropower operating and performance metrics, provided by dam owners. After this analysis, ORNL engaged with the plant management team in a skills exchange, where best practices, operational methods, and technical challenges were discussed. The technical assessment process was outlined to plant management followed by a presentation of preliminary results and analysis based on 50 days of operational data. EGAT has agreed to provide a full year of operational data so a complete and detailed assessment that captures seasonal variability can be completed. The results of these assessments and discussions will be used to develop a set of best practices, training, and procedure recommendations to improve the efficiency of the two assessed plants« less

  17. Development of an improved overlay procedure for Oregon : volume III, field manual.

    DOT National Transportation Integrated Search

    1987-12-01

    This report is the third in a three-volume series dealing with the development of an improved overlay design procedure for Oregon. This report presents technical guidelines for using the proposed overlay design procedure. Four areas are described, in...

  18. The application of surgical procedure manager (SPM): first experience with FESS.

    PubMed

    Feige, Katharina; Gollnick, Iris; Schmitz, Pia; Strauss, Gero

    2017-09-01

    In our hypothesis, the newly developed program SPM (surgical procedure manager) will ensure successful standardization and efficiency of the FESS (functional endoscopic sinus surgery) and therefore make a decisive contribution in terms of economization and improvement of intraoperative quality. Between 27th March 2015 and 8th October 2015, data from 259 FESS procedures were collected using the SPM. The study took place at the surgical desk, an operating room in the ACQUA clinic in Leipzig, Germany. 233 FESS (90%) of the total FESS (n = 259, 100%) were conducted entirely with SPM. 26 SPM terminations (10%) of 259 FESS remain, which are classified as actual SPM terminations-when the surgeon intentionally stops the SPM. The maximum time slot decreased clearly from 1 h 39 min (period A) to 1 h 10 min (period B). A time reduction can also be seen with the minimum duration of 13.5 min compared to 11 min. The variability of the time slot also decreases since the standard deviation is reduced by 4.5 min. On the basis of available recordings it can be postulated that the application of SPM is suitable for standardization for FESS. Standardization by means of SPM and minimal development can be recognized over a period of time. The SPM makes it possible to transfer the general advantages of mechanization on a concrete FESS and do not influence the medical processes nor even restrict the medical freedom. The users are still entirely free in the implementation of the respective procedure.

  19. Educational Accounting Procedures.

    ERIC Educational Resources Information Center

    Tidwell, Sam B.

    This chapter of "Principles of School Business Management" reviews the functions, procedures, and reports with which school business officials must be familiar in order to interpret and make decisions regarding the school district's financial position. Among the accounting functions discussed are financial management, internal auditing,…

  20. 41 CFR 109-50.205 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...

  1. 41 CFR 109-50.205 - Procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...

  2. 41 CFR 109-50.205 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...

  3. 41 CFR 109-50.205 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...

  4. 41 CFR 109-50.205 - Procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...

  5. Anesthetic management of neurosurgical procedures during pregnancy: a case series.

    PubMed

    Kazemi, Pooya; Villar, Giselle; Flexman, Alana M

    2014-07-01

    Neurosurgical disorders are rare during pregnancy and challenge the anesthesiologist with conflicting anesthetic considerations and little evidence to guide decision-making. Our objective was to review the anesthetic management of pregnant patients undergoing intracranial neurosurgery at our institution and to describe the perioperative complications and outcomes. We used our institutional Discharge Abstract Database to identify patients assigned both neurological and obstetrical International Classification of Disease 10-A codes between April 1, 2001 and March 1, 2012. Pregnant patients who underwent intracranial neurosurgical procedures underwent a detailed chart review to extract demographic data and details about their anesthetic management and outcome. Nine patients underwent full chart review with a median age of 28 (range, 17 to 35) years and a gestational age of 23 (range, 7 to 30) weeks. Patients underwent a craniotomy for vascular lesions (4), neoplasms (3), and traumatic brain injuries (2). One patient was hyperventilated (PaCO2 28 mmHg), and mannitol and furosemide were used in 6 and 3 patients, respectively, without complication. Maternal neurological outcomes were good in 5 patients (Glasgow Outcome Scale of >3), poor in 3 patients (Glasgow Outcome Scale 3), and 1 patient died. Fetal outcomes were good in 5 patients and poor in 4 patients (1 therapeutic abortion, 3 intrauterine fetal demises). All cases of fetal distress or demise were either remote or occurred before the anesthetic management. Pregnant patients undergoing neurosurgery experience a high rate of morbidity and mortality. There were no adverse outcomes directly attributed to the use of osmotic diuretics and hyperventilation in our series.

  6. [Error prevention through management of complications in urology: standard operating procedures from commercial aviation as a model].

    PubMed

    Kranz, J; Sommer, K-J; Steffens, J

    2014-05-01

    Patient safety and risk/complication management rank among the current megatrends in modern medicine, which has undoubtedly become more complex. In time-critical, error-prone and difficult situations, which often occur repeatedly in everyday clinical practice, guidelines are inappropriate for acting rapidly and intelligently. With the establishment and consistent use of standard operating procedures like in commercial aviation, a possible strategic approach is available. These medical aids to decision-making - quick reference cards - are short, optimized instructions that enable a standardized procedure in case of medical claims.

  7. Randomization Procedures Applied to Analysis of Ballistic Data

    DTIC Science & Technology

    1991-06-01

    test,;;15. NUMBER OF PAGES data analysis; computationally intensive statistics ; randomization tests; permutation tests; 16 nonparametric statistics ...be 0.13. 8 Any reasonable statistical procedure would fail to support the notion of improvement of dynamic over standard indexing based on this data ...AD-A238 389 TECHNICAL REPORT BRL-TR-3245 iBRL RANDOMIZATION PROCEDURES APPLIED TO ANALYSIS OF BALLISTIC DATA MALCOLM S. TAYLOR BARRY A. BODT - JUNE

  8. 34 CFR 86.302 - What are the procedures used by the Secretary for providing information or technical assistance?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... providing information or technical assistance? 86.302 Section 86.302 Education Office of the Secretary... information or technical assistance? (a) The Secretary provides information or technical assistance to an IHE in writing, through site visits, or by other means. (b) The IHE shall inform the Secretary of any...

  9. Student Services Program Planning and Evaluation: Responsibility, Procedures, Instrument, and Guidelines.

    ERIC Educational Resources Information Center

    Repp, Charles A.; Brach, Ronald C.

    The manual provides a rationale, procedural guidelines, time-schedules, instruments, and supporting documentation for student services program evaluation at SUNY Agricultural and Technical College, Delhi. Six procedural guidelines include: (1) all programs and services should be evaluated at least once every four years, with provision for annual…

  10. Life cycle management of analytical methods.

    PubMed

    Parr, Maria Kristina; Schmidt, Alexander H

    2018-01-05

    In modern process management, the life cycle concept gains more and more importance. It focusses on the total costs of the process from invest to operation and finally retirement. Also for analytical procedures an increasing interest for this concept exists in the recent years. The life cycle of an analytical method consists of design, development, validation (including instrumental qualification, continuous method performance verification and method transfer) and finally retirement of the method. It appears, that also regulatory bodies have increased their awareness on life cycle management for analytical methods. Thus, the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), as well as the United States Pharmacopeial Forum discuss the enrollment of new guidelines that include life cycle management of analytical methods. The US Pharmacopeia (USP) Validation and Verification expert panel already proposed a new General Chapter 〈1220〉 "The Analytical Procedure Lifecycle" for integration into USP. Furthermore, also in the non-regulated environment a growing interest on life cycle management is seen. Quality-by-design based method development results in increased method robustness. Thereby a decreased effort is needed for method performance verification, and post-approval changes as well as minimized risk of method related out-of-specification results. This strongly contributes to reduced costs of the method during its life cycle. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Technical writing versus technical writing

    NASA Technical Reports Server (NTRS)

    Dillingham, J. W.

    1981-01-01

    Two terms, two job categories, 'technical writer' and 'technical author' are discussed in terms of industrial and business requirements and standards. A distinction between 'technical writing' and technical 'writing' is made. The term 'technical editor' is also considered. Problems inherent in the design of programs to prepare and train students for these jobs are discussed. A closer alliance between industry and academia is suggested as a means of preparing students with competent technical communication skills (especially writing and editing skills) and good technical skills.

  12. Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research.

    PubMed

    Nordquist, Rebecca E; van der Staay, Franz Josef; van Eerdenburg, Frank J C M; Velkers, Francisca C; Fijn, Lisa; Arndt, Saskia S

    2017-02-21

    A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting "robust" animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific evidence about the welfare effects of current practices in farming such as mutilating procedures, management practices, and housing conditions is steadily growing, the gain in knowledge needs a boost through more scientific research. Considering the huge number of animals whose welfare is affected, all possible effort must be made to improve their welfare as quickly as possible in order to ban welfare-compromising procedures and practices as soon as possible.

  13. Biosecurity procedures for the environmental management of carcasses burial sites in Korea.

    PubMed

    Kim, Geon-Ha; Pramanik, Sudipta

    2016-12-01

    Avian influenza and foot-and-mouth disease are two main contagious pathogenic viral disease which are responsible for the massive burials of livestock in Korea since burial is the primary measure to control these outbreaks. Biosecurity is a set of preventive measures designed to prevent the risk of spreading of these infectious diseases. The main objective of this paper is to discuss about the requirements of biosecurity and develop protocol outlines for environmental management of burial sites in Korea. Current practice prescribes to minimize the potential for on-farm pollution and the spread of the infectious diseases. Specific biosecurity procedures such as proper assessment of leachate quality, safe handling and disposal of leachate, adequate leachate pollution monitoring, necessary seasonal management of burial site, and appropriate sterilization process must be carried out to prevent the indirect transmission of pathogens from the burial sites. Policy makers should acquire robust knowledge of biosecurity for establishing more effective future legislation for carcasses disposal in Korea.

  14. 25 CFR 1200.43 - How can a tribe apply for technical assistance?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false How can a tribe apply for technical assistance? 1200.43... AMERICAN INDIAN TRUST FUND MANAGEMENT REFORM ACT Technical Assistance § 1200.43 How can a tribe apply for technical assistance? (a) Tribes wishing technical assistance may request it by sending us a letter along...

  15. 47 CFR 22.150 - Standard pre-filing technical coordination procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... this procedure for specific channels and types of stations are contained in the subparts governing the..., emission type and polarization. (4) Transmitting antenna pattern and maximum gain. (5) Transmitting antenna..., even if no channel usage conflicts are anticipated. If any notified party fails to respond within 30...

  16. Pelvic denervation procedures for dysmenorrhea.

    PubMed

    Ramirez, Christina; Donnellan, Nicole

    2017-08-01

    Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

  17. Technical approaches for measurement of human errors

    NASA Technical Reports Server (NTRS)

    Clement, W. F.; Heffley, R. K.; Jewell, W. F.; Mcruer, D. T.

    1980-01-01

    Human error is a significant contributing factor in a very high proportion of civil transport, general aviation, and rotorcraft accidents. The technical details of a variety of proven approaches for the measurement of human errors in the context of the national airspace system are presented. Unobtrusive measurements suitable for cockpit operations and procedures in part of full mission simulation are emphasized. Procedure, system performance, and human operator centered measurements are discussed as they apply to the manual control, communication, supervisory, and monitoring tasks which are relevant to aviation operations.

  18. Scalable data management, analysis and visualization (SDAV) Institute. Final Scientific/Technical Report

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

    Geveci, Berk

    The purpose of the SDAV institute is to provide tools and expertise in scientific data management, analysis, and visualization to DOE’s application scientists. Our goal is to actively work with application teams to assist them in achieving breakthrough science, and to provide technical solutions in the data management, analysis, and visualization regimes that are broadly used by the computational science community. Over the last 5 years members of our institute worked directly with application scientists and DOE leadership-class facilities to assist them by applying the best tools and technologies at our disposal. We also enhanced our tools based on inputmore » from scientists on their needs. Many of the applications we have been working with are based on connections with scientists established in previous years. However, we contacted additional scientists though our outreach activities, as well as engaging application teams running on leading DOE computing systems. Our approach is to employ an evolutionary development and deployment process: first considering the application of existing tools, followed by the customization necessary for each particular application, and then the deployment in real frameworks and infrastructures. The institute is organized into three areas, each with area leaders, who keep track of progress, engagement of application scientists, and results. The areas are: (1) Data Management, (2) Data Analysis, and (3) Visualization. Kitware has been involved in the Visualization area. This report covers Kitware’s contributions over the last 5 years (February 2012 – February 2017). For details on the work performed by the SDAV institute as a whole, please see the SDAV final report.« less

  19. Continuation of advanced crew procedures development techniques

    NASA Technical Reports Server (NTRS)

    Arbet, J. D.; Benbow, R. L.; Evans, M. E.; Mangiaracina, A. A.; Mcgavern, J. L.; Spangler, M. C.; Tatum, I. C.

    1976-01-01

    An operational computer program, the Procedures and Performance Program (PPP) which operates in conjunction with the Phase I Shuttle Procedures Simulator to provide a procedures recording and crew/vehicle performance monitoring capability was developed. A technical synopsis of each task resulting in the development of the Procedures and Performance Program is provided. Conclusions and recommendations for action leading to the improvements in production of crew procedures development and crew training support are included. The PPP provides real-time CRT displays and post-run hardcopy output of procedures, difference procedures, performance data, parametric analysis data, and training script/training status data. During post-run, the program is designed to support evaluation through the reconstruction of displays to any point in time. A permanent record of the simulation exercise can be obtained via hardcopy output of the display data and via transfer to the Generalized Documentation Processor (GDP). Reference procedures data may be transferred from the GDP to the PPP. Interface is provided with the all digital trajectory program, the Space Vehicle Dynamics Simulator (SVDS) to support initial procedures timeline development.

  20. Surgical resident technical skill self-evaluation: increased precision with training progression.

    PubMed

    Quick, Jacob A; Kudav, Vishal; Doty, Jennifer; Crane, Megan; Bukoski, Alex D; Bennett, Bethany J; Barnes, Stephen L

    2017-10-01

    Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill. Copyright © 2017 Elsevier Inc. All rights reserved.