Science.gov

Sample records for access management techniques

  1. Managing Information Resources for Accessibility.

    ERIC Educational Resources Information Center

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

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

  2. Practical Behavior-Management Techniques to Close the Accessibility Gap for Students Who Are Culturally and Linguistically Diverse

    ERIC Educational Resources Information Center

    Cartledge, Gwendolyn; Singh, Angella; Gibson, Lenwood

    2008-01-01

    Students from culturally and linguistically diverse backgrounds are disproportionately identified for special education in the most restrictive placements. These students tend to have the least access to the general education curriculum and experience the greatest levels of school failure. Educators see an obvious need to change this pattern.…

  3. Access Techniques for Document Image Databases.

    ERIC Educational Resources Information Center

    Walker, Frank L.; Thoma, George R.

    1990-01-01

    Describes access and retrieval techniques implemented as part of a research and development program in electronic imaging applied to document storage and retrieval at the National Library of Medicine. Design considerations for large image databases are discussed. (six references) (EAM)

  4. Remotely Accessible Management System (RAMS).

    ERIC Educational Resources Information Center

    Wood, Rex

    Oakland Schools, an Intermediate School District for Administration, operates a Remotely Accessible Management System (RAMS). RAMS is composed of over 100 computer programs, each of which performs procedures on the files of the 28 local school districts comprising the constituency of Oakland Schools. This regional service agency covers 900 square…

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

    SciTech Connect

    Zhuang, Kun Da; Tan, Seck Guan; Tay, Kiang Hiong

    2012-08-15

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

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

    ERIC Educational Resources Information Center

    Bruhn, Mark; Gettes, Michael; West, Ann

    2003-01-01

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

  7. Aerospace management techniques: Commercial and governmental applications

    NASA Technical Reports Server (NTRS)

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

    1971-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Dessouky, Khaled

    1989-01-01

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

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

    ERIC Educational Resources Information Center

    Gardner, David; Miller, Lindsay

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Harris, Colleen S.

    2010-01-01

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

  11. Public access management as an adaptive wildlife management tool

    USGS Publications Warehouse

    Ouren, Douglas S.; Watts, Raymond D.

    2005-01-01

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

  12. Classroom Management Techniques and Student Discipline.

    ERIC Educational Resources Information Center

    Doyle, Walter

    This paper reviews concepts and research findings on classroom management techniques and explores how these techniques are related to student discipline strategies. The first section surveys descriptive and experimental research recently accumulated on classroom management practice, concentrating on strategies for monitoring and guiding classroom…

  13. Systems management techniques and problems

    NASA Technical Reports Server (NTRS)

    1971-01-01

    Report is reviewed which discusses history and trends of systems management, its basic principles, and nature of problems that lend themselves to systems approach. Report discusses systems engineering as applied to weapons acquisition, ecology, patient monitoring, and retail merchandise operations.

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

    PubMed

    Cwiak, Carol L

    2014-01-01

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

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

    SciTech Connect

    Whelan, Gene; Tenney, Nathan D.; Pelton, Mitchell A.; Coleman, Andre M.; Ward, Duane L.; Droppo, James G.; Meyer, Philip D.; Dorow, Kevin E.; Taira, Randal Y.

    2009-06-17

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

  16. Modern Reservoir Sedimentation Management Techniques with Examples

    NASA Astrophysics Data System (ADS)

    Annandale, G. W.

    2014-12-01

    Implementation of reservoir sedimentation management approaches results in a win-win scenario, it assists in enhancing the environment by preserving river function downstream of dams while concurrently providing opportunities to sustainably manage water resource infrastructure. This paper summarizes the most often used reservoir sedimentation management techniques with examples of where they have been implemented. Three categories can be used to classify these technologies, i.e. catchment management, sediment routing and sediment removal. The objective of catchment management techniques is to minimize the amount of sediment that may discharge into a reservoir, thereby reducing the loss of storage space due to sedimentation. Reservoir routing is a set of techniques that aim at minimizing the amount of sediment that may deposit in a reservoir, thereby maximizing the amount of sediment that may be passed downstream. The third group consists of techniques that may be used to remove previously deposited sediment from reservoirs. The selection of reservoir sedimentation management approaches is site specific and depends on various factors, including dam height, reservoir volume, reservoir length, valley shape, valley slope, sediment type and hydrology. Description of the different reservoir sedimentation management techniques that are used in practice will be accompanied by case studies, including video, illustrating criteria that may be used to determine the potential success of implementing the techniques.

  17. Image guided portal vein access techniques in TIPS creation and considerations regarding their use

    PubMed Central

    2016-01-01

    Transjugular intrahepatic portosystemic shunt (TIPS) is a difficult procedure to perform and accessing the portal vein is a very challenging step. There are three broad categories of image guided TIPS creation techniques. Each technique has its advantages and disadvantages. TIPS procedure carries some risk of complications regardless of the guidance technique employed. The technology for TIPS has evolved in parallel with the expanding indications for TIPS. Ultrasound guidance technique offers a safe option, particularly for patients with challenging anatomy. Patient safety should always come first and the US guided technique should be more routinely used. Experience is the main factor in the success of TIPS. Other factors to consider in reducing the all-cause morbidity and mortality are patient selection, patient management and the clinical setting. PMID:27385392

  18. Optical multiple access techniques for on-board routing

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  19. Stress Management Techniques for Young Children.

    ERIC Educational Resources Information Center

    Piper, Francesca M.

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

  20. Lenses for learning: visual techniques in natural resource management.

    PubMed

    Petheram, L; High, C; Campbell, B M; Stacey, N

    2011-10-01

    In this study, we explored the use of selected visual techniques (e.g. video, photography, diagramming) in facilitating learning among Indigenous communities living in remote protected areas at sites in Vietnam and Australia. The techniques were employed during interviews and workshops aimed at accessing and enhancing local peoples' perspectives on their landscape and on specific natural resource management issues. The effectiveness of the different techniques for enabling learning varied markedly with the context, highlighting the need for facilitator skill and flexibility in application of techniques. Visual techniques helped to engage participants; encourage unrestrained and lateral thinking; provide opportunities for self-expression and reflection; and to expose participants to perspectives of other community members. Valuable insights emerged on broad aspects of learning and these were incorporated into a simple model that highlights three types of conceptualisation found to be important in these processes.

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

    NASA Astrophysics Data System (ADS)

    Wang, Li

    2004-04-01

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

  2. Managed Access by Controlled Sensing (MACS)

    SciTech Connect

    Curtiss, J.A.; Indusi, J.P.

    1994-08-01

    During chemical weapons challenge inspections, the CWC treaty allows ``alternate means`` of access to be proposed by the nation challenged. BNL`s Safeguards, Safety and Nonproliferation Division is funded by the Defense Nuclear Agency to develop a system to provide the challenge inspection team with a ``virtual presence`` within the facility while denying personal access. A general purpose configuration of a mobile station manned by site personnel and a base station manned by the challenge inspector, supported by a flexible communication system, will allow facility personnel to tailor the basic model to their site. Design of the MACS system is based on maximum use of commercial equipment that is available on the international market. Design requirements for the MACS system include methods of establishing geographical position, distance measuring equipment for use in verifying dimensions on floor plans, video and two-way audio links between the mobile unit and the base station, and portability and versatility of the equipment. The MACS platform will also support deployment of selected instrumentation which the site may offer to the challenge inspection team. This paper describes the design and construction of the prototype MACS system.

  3. Minimal access surgery in the management of pediatric urolithiasis

    PubMed Central

    Fragoso, Ana Catarina; Steyaert, Henry; Arnaud, Pierre; Estevao-Costa, Jose´; Valla, Jean-Stephane

    2016-01-01

    Background In contrast to adult patients, a relatively large number of open surgical procedures are still needed in the treatment of urolithiasis in children. Since almost all open surgical techniques may be reproduced by minimal access surgery (MAS), there is a rationale to apply the latter in the management of pediatric urolithiasis. Our study aimed to assess the feasibility and outcome of MAS in the treatment of pediatric urinary calculi. Methods The charts of patients with urolithiasis submitted to MAS between 1994 and 2007 were retrospectively reviewed. The inclusion criteria were contraindication for and failure of lithotripsy or endourology techniques. Demographic data, lithiasis characterization (location, dimension, composition), predisposing factors (anatomic or metabolic) and surgical approach (technique and outcome) were evaluated. Results Fifteen consecutive patients (eight girls, seven boys) with a median age of 108 months (range: 10–297 months) were elected for MAS. Eleven (73%) children had associated urogenital malformations and three (20%) presented metabolic abnormalities. A total of 17 procedures were performed laparoscopically: three nephrolithotomy (one transperitoneal, two by retroperitoneoscopy), four pyelolithotomies (retro), three ureterolithotomy (trans) and seven cystolithotomies (suprapubic approach). Five patients underwent concomitant correction of urological anomalies (three calyceal diverticula, one obstructive megaureter, one ureteropelvic junction obstruction). Complete removal of calculi was accomplished in 14 (82%) procedures. There were two perioperative complications (one intraperitoneal vesical perforation and one perivesical urinoma). At a median follow up of 4 years (range, 1 month to 11 years), four patients have developed recurrence. Conclusions MAS is an effective and safe approach for urolithiasis in children who are not candidates for minimally invasive modalities. PMID:27867850

  4. Advanced Synchrotron Techniques at High Pressure Collaborative Access Team (HPCAT)

    NASA Astrophysics Data System (ADS)

    Shen, G.; Sinogeikin, S. V.; Chow, P.; Kono, Y.; Meng, Y.; Park, C.; Popov, D.; Rod, E.; Smith, J.; Xiao, Y.; Mao, H.

    2012-12-01

    High Pressure Collaborative Access Team (HPCAT) is dedicated to advancing cutting-edge, multidisciplinary, high-pressure science and technology using synchrotron radiation at Sector 16 of the Advanced Photon Source (APS) of Argonne National Laboratory. At HPCAT an array of novel x-ray diffraction and spectroscopic techniques has been integrated with high pressure and extreme temperature instrumentation for studies of structure and materials properties at extreme conditions.. HPCAT consists of four active independent beamlines performing a large range of various experiments at extreme conditions. 16BM-B beamline is dedicated to energy dispersive and white Laue X-ray diffraction. The majority of experiments are performed with a Paris-Edinburgh large volume press (to 7GPa and 2500K) and include amorphous and liquid structure measurement, white beam radiography, elastic sound wave velocity measurement of amorphous solid materials, with viscosity and density measurement of liquid being under development. 16BM-D is a monochromatic diffraction beamline for powder and single crystal diffraction at high pressure and high (resistive heating) / low (cryostats) temperature. The additional capabilities include high-resolution powder diffraction and x-ray absorption near edge structure (XANES) spectroscopy. The insertion device beamline of HPCAT has two undulators in canted mode (operating independently) and LN cooled Si monochromators capable of providing a large range of energies. 16IDB is a microdiffraction beamline mainly focusing on high-pressure powder and single crystal diffraction in DAC at high temperatures (double-sided laser heating and resistive heating) and low temperature (various cryostats). The modern instrumentation allows high-quality diffraction at megabar pressures from light element, fast experiments with pulsed laser heating, fast dynamic experiments with Pilatus detector, and so on. 16ID-D beamline is dedicated to x-ray scattering and spectroscopy research

  5. Remotely Accessed Vehicle Traffic Management System

    NASA Astrophysics Data System (ADS)

    Al-Alawi, Raida

    2010-06-01

    The ever increasing number of vehicles in most metropolitan cities around the world and the limitation in altering the transportation infrastructure, led to serious traffic congestion and an increase in the travelling time. In this work we exploit the emergence of novel technologies such as the internet, to design an intelligent Traffic Management System (TMS) that can remotely monitor and control a network of traffic light controllers located at different sites. The system is based on utilizing Embedded Web Servers (EWS) technology to design a web-based TMS. The EWS located at each intersection uses IP technology for communicating remotely with a Central Traffic Management Unit (CTMU) located at the traffic department authority. Friendly GUI software installed at the CTMU will be able to monitor the sequence of operation of the traffic lights and the presence of traffic at each intersection as well as remotely controlling the operation of the signals. The system has been validated by constructing a prototype that resembles the real application.

  6. Managing difficult polyps: techniques and pitfalls

    PubMed Central

    Tholoor, Shareef; Tsagkournis, Orestis; Basford, Peter; Bhandari, Pradeep

    2013-01-01

    There is no standardized definition of difficult polyps. However, polyps become difficult and challenging to remove endoscopically when they are large in size, flat in nature, situated in a high-risk location and when access to them is very awkward. Recently, an SMSA (Size, Morphology, Site, Access) classification has been proposed that helps to qualify the degree of difficulty by scoring on the above parameters. This article reviews the features that make polyps difficult to remove and provides some practical tips in managing these difficult polyps. We believe that ‘difficult polyp’ is a relative term and each endoscopist should define their own level of difficulty and what they would be able to handle safely. However, in expert trained hands, most difficult polyps can be safely removed by an endoscopic approach. PMID:24714799

  7. Current techniques in the management of cervical myelopathy and radiculopathy.

    PubMed

    Gerard, Carter S; O'Toole, John E

    2014-04-01

    Posterior decompressive procedures are a fundamental component of the surgical treatment of symptomatic cervical degenerative disease. Posterior approaches have the appeal of avoiding complications associated with anterior approaches such as esophageal injury, recurrent laryngeal nerve paralysis, dysphagia, and adjacent-level disease after fusion. Although open procedures are effective, the extensive subperiosteal stripping of the paraspinal musculature leads to increased blood loss, longer hospital stays, and more postoperative pain, and potentially contributes to instability. Minimally invasive access has been developed to limit approach-related morbidity. This article reviews current techniques in minimally invasive surgical management of cervical myelopathy and radiculopathy.

  8. Search Hanford accessible reports electronically system configuration management plan

    SciTech Connect

    White, E.L.

    1995-01-01

    This Software Configuration Management Plan (SCMP) provides the requirements for control of the Search Hanford Accessible Reports Electronically (SHARE) software and documentation. The SHARE system consists of the TOPIC Text Search and Retrieval software and the programs necessary to extract information from other sources to be placed in SHARE.

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  10. Particle data management--turning data into accessible information.

    PubMed

    Bonniface, J; Coppins, G J

    2007-09-01

    The UKAEA has assigned significant resources to the monitoring and retrieval of particles from the vicinity of its site at Dounreay in the north of Scotland. The monitoring, retrieval and analytical processes each generate information that is required for interpretative and record purposes. As significant resources are made available for studying and retrieving particles, the information collected must be managed in a logical, stable and accessible manner to protect the investment in information. If suitable data management procedures are not in place there is a high risk of data loss and duplication, and stakeholders may be unable to discover what information is already available or be unable to access the existing information. UKAEA Dounreay operates a geographic information system (GIS) that interfaces with a data management system known as IMAGES. These systems are used to securely store and access a wide range of environmental data including those relating to particles. A case study is presented illustrating the processes and systems involved with the collection, storage, analysis and distribution of particle data. The advantages gained through use of the GIS system are considered in relation to alternative types of record management system such as paper, and electronic non-spatial systems. It is considered that the GIS system offers very significant benefits in terms of standardisation of data capture, security of storage and increased accessibility of data compared with other systems.

  11. Applying public access programming techniques to astronomical image display

    NASA Astrophysics Data System (ADS)

    Mandel, Eric

    1996-03-01

    The X Public Access (XPA) mechanism allows an Xt program to define named public access points through which data and commands can be exchanged with other programs. We will discuss our design goals for XPA, the technical challenges we faced--including extensions to the Xt selection implementation--and the user interface and application programming interface that we developed to meet these challenges. We also will describe our application of XPA to a new version of the popular SAOimage astronomical image display program. XPA makes possible external control of the program's main function, including image display, image zoom and pan, colormap manipulation, cursor/region definition, and frame selection. It also supports `public access' to internal algorithms such as image file access and scaling. Finally, we will describe how XPA is used to support user-configurable analysis of image data and bi- directional communication with other processes.

  12. (Low-level radioactive waste management techniques)

    SciTech Connect

    Van Hoesen, S.D.; Kennerly, J.M.; Williams, L.C.; Lingle, W.N.; Peters, M.S.; Darnell, G.R.; USDOE Oak Ridge Operations Office, TN; Du Pont de Nemours and Co., Aiken, SC . Savannah River Plant; Idaho National Engineering Lab., Idaho Falls, ID )

    1988-08-08

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

  13. Opportunities for Process Monitoring Techniques at Delayed Access Facilities

    SciTech Connect

    Curtis, Michael M.; Gitau, Ernest TN; Johnson, Shirley J.; Schanfein, Mark; Toomey, Christopher

    2013-09-20

    Except for specific cases where the International Atomic Energy Agency (IAEA) maintains a continuous presence at a facility (such as the Japanese Rokkasho Reprocessing Plant), there is always a period of time or delay between the moment a State is notified or aware of an upcoming inspection, and the time the inspector actually enters the material balance area or facility. Termed by the authors as “delayed access,” this period of time between inspection notice and inspector entrance to a facility poses a concern. Delayed access also has the potential to reduce the effectiveness of measures applied as part of the Safeguards Approach for a facility (such as short-notice inspections). This report investigates the feasibility of using process monitoring to address safeguards challenges posed by delayed access at a subset of facility types.

  14. The Accessible Pantry: Food Identification Tips, Tools, and Techniques

    ERIC Educational Resources Information Center

    Sokol-McKay, Debra A.; Michels, Dianne

    2006-01-01

    For individuals with visual impairments, poorly designed labels can be barriers to receiving safe and independent access to important information about products in daily use. The authors discuss how organization and proper lighting can reduce the amount of labeling needed on food products and indicate how individuals with visual impairments can…

  15. Alternative multiple-access techniques for mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Smith, Patrick O.; Geraniotis, Evaggelos

    1989-01-01

    The use of Code Division Multiple Access (CDMA) to satisfy the diverse requirements of a generic (land, maritime, aeronautical) mobile satellite system (MSS) network design is discussed. Comparisons between CDMA and Frequency Division Multiple Access (FDMA) show that a CDMA network design can support significantly more voice channel allocations than FDMA when relatively simple CDMA correlation receivers are employed, provided that there is sufficient space segment equivalent isotropically radiated power (EIRP). The use of more advanced CDMA receivers can improve the spectral and power efficiency. Although the use of CDMA may not gain immediate and widespread support in the international MSS community, provision for the use of CDMA for a domestic system in the U.S., and possibly for a regional system throughout North America, is likely.

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

    NASA Astrophysics Data System (ADS)

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

    2001-10-01

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

  17. JUGULAR CENTRAL VENOUS CATHETER PLACEMENT THROUGH A MODIFIED SELDINGER TECHNIQUE FOR LONG-TERM VENOUS ACCESS IN CHELONIANS.

    PubMed

    Pardo, Mariana A; Divers, Stephen

    2016-03-01

    Long-term or repeated venous access in chelonians is difficult to obtain and manage, but can be critically important for administration of medications and blood sampling in hospitalized patients. Jugular catheterization provides the most rapid and secure route for vascular access, but catheters can be difficult to place, and maintaining catheter patency may be challenging. Long multilumen polyurethane catheters provide flexibility and sampling access, and minimize difficulties, such as catheter displacement, that have been encountered with traditional over-the-needle catheters. We describe placement of 4 Fr. 13-cm polyurethane catheters in three chelonians with the use of a modified Seldinger technique. Venous access was obtained with the use of an over-the-needle catheter, which allowed placement of a 0.018-in.-diameter wire, over which the polyurethane catheter was placed. Indwelling time has ranged between 1 and 4 mo currently. All tortoises were sedated for this procedure. Polyurethane central catheters provide safe, long-term venous access that allows clinicians to perform serial blood sampling as well as intravenous administration of medications, anesthetic agents, and fluids. A jugular catheter can also allow central venous pressure measurement. Utilization of central line catheters was associated with improvements in diagnostic efficiency and therapeutic case management, with minimal risks and complications.

  18. Data Management Techniques for Acoustical Planetary Data

    NASA Astrophysics Data System (ADS)

    Eichelberger, Hans; Prattes, Gustav; Schwingenschuh, Konrad; Tokano, T.; Jernej, I.; Stachel, Manfred; Besser, B. P.; Aydogar, Oe.

    We discuss data management techniques for acoustical data obtained from future atmospheric planetary in-situ probes with the aim of event oriented scientific analysis. The immediate objec-tive is the localisation (acoustic wave telescope) and characterisation of acoustic phenomena of atmospheres and surfaces, e.g. in the frame of the proposed NASA/ESA Titan Saturn System Mission (TSSM) with the Acoustic Sensor Package (ACU) multi-microphone array. Contrary to huge amounts of source data obtained through the electromagnetic windows, acoustical sig-nals are seldom recorded and few files exist. One example is pressure sensor data from the instrument HASI/PWA during Huygens descent, mission Cassini-Huygens. Nevertheless, a lot of acoustic point and noise sources, e.g. caused by rain, drizzle or wind abound in Titan's atmosphere. In almost all cases, due to limitations in telemetry rate, a careful strategy for onboard event handling and data reduction -the first step in data management -has to be selected, e.g. sampling rates in kHz range or averaging in the frequency domain. This pre-processing together with complementary investigations at the space segment directly influences the scientific data return in terms of long-term continuous or short-term event based studies. The database at the ground segment with science data and metadata entries after final calibra-tion has to support the combined investigations with other instruments. This second step in data management fully explores the acoustic environment of planetary atmospheres in terms of background noise and spacecraft generated disturbances, location and characterisation of source regions and correlation between the experiments. Currently we're running databases for magnetic field data from various ground-based and satellite related experiments, historical balloon data included. Comparisons of data between experiments are possible. This framework based on dependability considerations with several different

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

    DTIC Science & Technology

    1981-09-01

    could also be classified as a "style" of management. A management technique according to John Argenti is "a recognized method of analyzing or solving a...toward Accountability for Performance. Homewood, Illinois: Ricnard D. Irwin, Inc., 1978, pp. 82-87. 3. Argenti , John. Management Techniques: A Practical

  20. 75 FR 69791 - Risk Management Controls for Brokers or Dealers With Market Access

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... CFR Part 240 Risk Management Controls for Brokers or Dealers With Market Access; Final Rule #0;#0... 3235-AK53 Risk Management Controls for Brokers or Dealers With Market Access AGENCY: Securities and... alternative trading system (``ATS''), including those providing sponsored or direct market access to...

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... COMMISSION 17 CFR Part 240 RIN 3235-AK53 Risk Management Controls for Brokers or Dealers With Market Access... market access to customers or other persons, to implement risk management controls and supervisory... growing popularity of sponsored or direct market access arrangements where broker-dealers allow...

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

    NASA Astrophysics Data System (ADS)

    Hilt, Attila; Pozsonyi, László

    2012-09-01

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

  3. Fault Management Techniques in Human Spaceflight Operations

    NASA Technical Reports Server (NTRS)

    O'Hagan, Brian; Crocker, Alan

    2006-01-01

    This paper discusses human spaceflight fault management operations. Fault detection and response capabilities available in current US human spaceflight programs Space Shuttle and International Space Station are described while emphasizing system design impacts on operational techniques and constraints. Preflight and inflight processes along with products used to anticipate, mitigate and respond to failures are introduced. Examples of operational products used to support failure responses are presented. Possible improvements in the state of the art, as well as prioritization and success criteria for their implementation are proposed. This paper describes how the architecture of a command and control system impacts operations in areas such as the required fault response times, automated vs. manual fault responses, use of workarounds, etc. The architecture includes the use of redundancy at the system and software function level, software capabilities, use of intelligent or autonomous systems, number and severity of software defects, etc. This in turn drives which Caution and Warning (C&W) events should be annunciated, C&W event classification, operator display designs, crew training, flight control team training, and procedure development. Other factors impacting operations are the complexity of a system, skills needed to understand and operate a system, and the use of commonality vs. optimized solutions for software and responses. Fault detection, annunciation, safing responses, and recovery capabilities are explored using real examples to uncover underlying philosophies and constraints. These factors directly impact operations in that the crew and flight control team need to understand what happened, why it happened, what the system is doing, and what, if any, corrective actions they need to perform. If a fault results in multiple C&W events, or if several faults occur simultaneously, the root cause(s) of the fault(s), as well as their vehicle-wide impacts, must be

  4. Percutaneous endoscopic gastrostomy: Indications, technique, complications and management

    PubMed Central

    Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

    2014-01-01

    Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues

  5. Percutaneous endoscopic gastrostomy: indications, technique, complications and management.

    PubMed

    Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

    2014-06-28

    Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the "pull" technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues

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

    PubMed Central

    Clair, Daniel G; Beach, Jocelyn M

    2015-01-01

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

  7. Venous access in haemophilic children: choice and management.

    PubMed

    Santagostino, E; Mancuso, M E

    2010-01-01

    Current haemophilia treatment in children is based on regular intravenous infusions of concentrates for prolonged periods, according to prophylaxis regimens or immune tolerance induction treatment, in cases of inhibitor development. Therefore, a stable and uncomplicated venous access is required and as such peripheral veins represent the preferred option. However, frequent infusions in the home setting can be problematic in very young children and for this reason, central venous access devices (CVADs) have been widely used to improve treatment feasibility. Unfortunately CVADs' use is associated with a high rate of complications, and infections and thrombotic occlusion can influence treatment outcome by causing unwanted treatment interruption. CVADs can be grouped into three main categories: external non-tunnelled, external tunnelled and fully implantable devices known as ports. The management of CVADs at home often represents a challenge because a strict adherence to sterile procedures is required. Indeed, the incidence of infections with ports is much lower than that reported for external devices; however, ports carry the inconvenience of needle sticks. More recently, arteriovenous fistula was shown to be a suitable alternative to CVADs because it is easy to use and is associated with a lower rate of complication.

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

    NASA Astrophysics Data System (ADS)

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

    2008-04-01

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

  9. A Combined Polling and Random Access Technique for Enhanced Anti-Collision Performance in RFID Systems

    NASA Astrophysics Data System (ADS)

    Kim, Jeong Geun

    In this paper we propose a novel RFID anti-collision technique that intelligently combines polling and random access schemes. These two fundamentally different medium access control protocols are coherently integrated in our design while functionally complementing each other. The polling mode is designed to enable fast collision-free identification for the tags that exist within reader's coverage across the sessions. In contrast, the random access mode attempts to read the tags uncovered by the polling mode. Our proposed technique is particularly suited for a class of RFID applications in which a stationary reader periodically attempts to identify the tags with slow mobility. Numerical results show that our proposed technique yields much faster identification time against the existing approaches under various operating conditions.

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

    PubMed

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

    2016-12-01

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

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

    ERIC Educational Resources Information Center

    Golyagina, Alena; Valuckas, Danielius

    2016-01-01

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

  12. A technique for re-utilizing catheter insertion sites in children with difficult central venous access.

    PubMed

    Johnson, S M; Garnett, G M; Woo, R K

    2017-01-01

    Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down." A separate exit site is then created for the new catheter and it is tunneled to the "cut-down" site per routine. The non-functioning catheter is then removed from the surgical field. The proximal fibrous sheath is finally cannulated either directly with the new catheter or with a wire/dilator system. This technique effectively re-uses the same venous access point while allowing for a complete change of the physical line and external site. Twenty attempts at this technique were made in twelve patients; six patients underwent the site re-utilization procedure multiple times. Re-using the fibrous tunnel to re-cycle the internal catheter site was successful in seventeen of twenty attempts. All patients had chronic conditions leading to difficult long-term central venous access [short bowel syndrome (6), hemophilia (2), cystic fibrosis (1), chronic need for central IV access (3)]. Indications for catheter replacement included catheter occlusion/mechanical failure/breakage (9), dislodgement (6), infection (1), and inadequate catheter length due to patient growth (4). Broviac/Hickman catheter sites were most commonly re-used (13; one failure); re-using a portcath site was successful in 5 of 7 attempts. There were no short term infections or mechanical complications. We describe a novel technique for salvaging tunneled central venous catheter access sites. This technique is well suited

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

    USGS Publications Warehouse

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

    1992-01-01

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

  14. Rehabilitation techniques to maximize spasticity management.

    PubMed

    Logan, Lynne Romeiser

    2011-01-01

    Improvement in functional skills is typically a goal of spasticity management. Spasticity management alone will improve the positive signs of the upper motor neuron syndrome without functional change. In this review, we demonstrate that a variety of therapy modalities are required to facilitate these improvements and impact the negative signs of the upper motor neuron syndrome. The evidence for neuromuscular electrical stimulation, surface electromyography training, serial casting, body weight-supported treadmill training, constraint-induced movement therapy, strengthening, and endurance training is reviewed as it relates to spasticity management.

  15. Techniques for Efficiently Managing Large Geosciences Data Sets

    NASA Astrophysics Data System (ADS)

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

    2007-12-01

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

  16. Economic Techniques of Occupational Health and Safety Management

    NASA Astrophysics Data System (ADS)

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

    2016-10-01

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

  17. [Application of ultrasonography in central venous catheterization; access sites and procedure techniques].

    PubMed

    Czyzewska, Dorota; Ustymowicz, Andrzej; Klukowski, Mark

    2016-08-05

    Central venous catheterization is commonly performed in clinical practice. Traditional procedural technique is based on anatomical landmarks, but is associated with a high risk of failure and complications. To decrease their incidence European and American societies recommend application of ultrasonography. Preliminary ultrasonographic examination allows for assessment of local anatomical relations as well as vessel morphology (diameter, patency), while real-time ultrasonography increases chances of successful needle insertion. This paper presents the most common venous access sites and procedure techniques.

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

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Gastwirth, David

    2007-01-01

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

  20. Project management techniques for highly integrated programs

    NASA Technical Reports Server (NTRS)

    Stewart, J. F.; Bauer, C. A.

    1983-01-01

    The management and control of a representative, highly integrated high-technology project, in the X-29A aircraft flight test project is addressed. The X-29A research aircraft required the development and integration of eight distinct technologies in one aircraft. The project management system developed for the X-29A flight test program focuses on the dynamic interactions and the the intercommunication among components of the system. The insights gained from the new conceptual framework permitted subordination of departments to more functional units of decisionmaking, information processing, and communication networks. These processes were used to develop a project management system for the X-29A around the information flows that minimized the effects inherent in sampled-data systems and exploited the closed-loop multivariable nature of highly integrated projects.

  1. NASA Project Icon Image Access and Management, year 2

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Viewgraphs used in a presentation of the NASA Project Icon Image Access and Management are given. The viewgraphs depict the opening screen that allows the user to start searching the thesaurus; a schematic of the the NASA image input/output workstation; the main term screen that allows the user to view the term and the associated pictures, enter the term into the search buffer, and go to one of the linked terms; the main input screen that allows the user to enter new terms, edit terms, and add pictures and links between terms; the term index that allows the user to select a term by scrolling through an alphabetic list of all the terms in the thesaurus; the results screen that shows the results of the search on the external database; the screen buffer that displays a list of all the search terms collected while browsing through the thesaurus; and the picture index that allows the user to select a term by scrolling through the list of pictures stored in the visual thesaurus.

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

    ERIC Educational Resources Information Center

    San Nicolas-Rocca, Tonia

    2010-01-01

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

  3. Optimization Techniques for College Financial Aid Managers

    ERIC Educational Resources Information Center

    Bosshardt, Donald I.; Lichtenstein, Larry; Palumbo, George; Zaporowski, Mark P.

    2010-01-01

    In the context of a theoretical model of expected profit maximization, this paper shows how historic institutional data can be used to assist enrollment managers in determining the level of financial aid for students with varying demographic and quality characteristics. Optimal tuition pricing in conjunction with empirical estimation of…

  4. IceBridge Data Management and Access Strategies at NSIDC

    NASA Astrophysics Data System (ADS)

    Oldenburg, J.; Tanner, S.; Collins, J. A.; Lewis, S.; FitzGerrell, A.

    2013-12-01

    NASA's Operation IceBridge (OIB) mission, initiated in 2009, collects airborne remote sensing measurements over the polar regions to bridge the gap between NASA's Ice, Cloud and Land Elevation satellite (ICESat) mission and the upcoming ICESat-2 mission in 2016. OIB combines an evolving mix of instruments to gather data on topography, ice and snow thickness, high-resolution photography, and other properties that are more difficult or impossible to measure via satellite. Once collected, these data are stored and made available at the National Snow and Ice Data Center (NSIDC) in Boulder, Colorado. To date, there are nearly 90 terabytes of data available, and there are about three more years of data collection left. The main challenges faced in data management at NSIDC are derived from the quantity and heterogeneity of the data. To deal with the quantity of data, the technical teams at NSIDC have significantly automated the data ingest, metadata generation, and other required data management steps. Heterogeneity of data and the evolution of the Operation over time make technical automation complex. To limit complexity, the IceBridge team has agreed to such practices as using specific data file formats, limiting file sizes, using specific filename templates, etc. These agreements evolve as Operation IceBridge moves forward. The metadata generated about the flights and the data collected thereon make the storage of the data more robust, and enable data discoverability. With so much metadata, users can search the vast collection with ease using specific parameters about the data they seek. An example of this in action is the IceBridge data portal developed at NSIDC, http://nsidc.org/icebridge/portal/. This portal uses the GPS data from the flights projected onto maps as well as other flight and instrument metadata to help the user find the exact data file they seek. This implementation is only possible with dependable data management beneath the surface. The data files

  5. An evolutionary outlook of air traffic flow management techniques

    NASA Astrophysics Data System (ADS)

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

    2017-01-01

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

  6. Optical Techniques for Space Environment Management

    NASA Astrophysics Data System (ADS)

    Greene, B.; Bennett, J.; Smith, C.

    2016-09-01

    The Space Environment Research Centre (SERC) is a fully-funded multi-national research collaboration for the management and mitigation of space debris using optical technologies. SERC is tasked with developing mitigation strategies for the many debris objects not amenable to space-based interventions. SERC research leverages very accurate information from a new optical space tracking network to develop viable near-term strategies to manage debris using only ground-based infrastructure. SERC has sufficient resources to conduct full-scale on-orbit testing of candidate approaches. We report on SERC progress in astrodynamics, precision catalogs, conjunction processing, adaptive optics and high power lasers as well as the architecture of the research effort.

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

    NASA Technical Reports Server (NTRS)

    O'Neil, Daniel A.

    2008-01-01

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

  8. Retroperitoneal Laparoscopy in Dogs: Access Technique, Working Space, and Surgical Anatomy

    PubMed Central

    Jeong, Junemoe; Ko, Jonghyeok; Lim, Hyunjoo; Kweon, Oh‐Kyeong

    2016-01-01

    Objective To develop and describe a laparoscopic retroperitoneal access technique, investigate working space establishment, and describe the surgical anatomy in the retroperitoneal space as an initial step for clinical application of retroperitoneal laparoscopy in dogs. Study Design Cadaveric and experimental study. Animals Cadaveric (n=8) and healthy (n=6) adult dogs. Methods The retroperitoneal access technique was developed in 3 cadavers based on the human technique and transperitoneal observation. Its application and working space establishment with carbon dioxide (CO2) insufflation alone was evaluated in 5 cadavers by observing with a transperitoneal telescope and in 6 live dogs by repeated computed tomography (CT) scans at pressure of 0, 5, 10, and 15 mmHg. Recordings of retroperitoneoscopy as well as working space volume and linear dimensions measured on CT images were analyzed. Results Retroperitoneal access and working space establishment with CO2 insufflation alone were successfully performed in all 6 live dogs. The only complication observed was in 1 dog that developed subclinical pneumomediastinum. As pressure increased, working space was established from the ipsilateral to the contralateral side, and peritoneal tearing eventually developed. Working space volume increased significantly from 5 mmHg and linear dimensions increased significantly from 0 to 10 mmHg. With pneumo‐retroperitoneum above 5 mmHg, retroperitoneal organs, including kidneys and adrenal glands, were easily visualized. Conclusion The retroperitoneal access technique and working space establishment with CO2 insufflation starting with 5 mmHg and increasing to 10 mmHg provided adequate working space and visualization of retroperitoneal organs, which may allow direct access for retroperitoneal laparoscopy in dogs. PMID:27731512

  9. Autonomous management of distributed information systems using evolutionary computation techniques

    NASA Astrophysics Data System (ADS)

    Oates, Martin J.

    1999-03-01

    As the size of typical industrial strength information systems continues to rise, particularly in the arena of Internet based management information systems and multimedia servers, the issue of managing data distribution over clusters or `farms' to overcome performance and scalability issues is becoming of paramount importance. Further, where access is global, this can cause points of geographically localized load contention to `follow the sun' during the day. Traditional site mirroring is not overly effective in addressing this contention and so a more dynamic approach is being investigated to tackle load balancing. The general objective is to manage a self-adapting, distributed database so as to reliably and consistently provide near optimal performance as perceived by client applications. Such a management system must be ultimately capable of operating over a range of time varying usage profiles and fault scenarios, incorporate considerations for communications network delays, multiple updates and maintenance operations. It must also be shown to be capable of being scaled in a practical fashion to ever larger sized networks and databases. Two key components of such an automated system are an optimiser capable of efficiently finding new configuration options, and a suitable model of the system capable of accurately reflecting the performance (or any other required quality of service metric) of the real world system. As conditions change in the real world system, these are fed into the model. The optimiser is then run to find new configurations which are tested in the model prior to implementation in the real world. The model therefore forms an evaluation function which the optimiser utilises to direct its search. Whilst it has already been shown that Genetic Algorithms can provide good solutions to this problem, there are a number of issues associated with this approach. In particular, for industrial strength applications, it must be shown that the GA employed

  10. The effect of buttonhole cannulation vs. rope-ladder technique on hemodialysis access patency.

    PubMed

    Chan, Micah R; Shobande, Olatokunbo; Vats, Hemender; Wakeen, Maureen; Meyer, Xinliu; Bellingham, Janet; Astor, Brad C; Yevzlin, Alexander S

    2014-03-01

    The rope-ladder (RL) technique is the most common technique used for cannulation of arteriovenous fistulae (AVF). Buttonhole cannulation (BHC), or constant-site technique, is recommended by the National Kidney Foundation's Kidney Disease Outcome Quality Initiative (NKF/KDOQI) vascular access guidelines. We compared outcomes of primary patency, episodes of bacteremia, access blood flow (Qa), and quality of life (QoL) scores between RL and BHC patients. Using a prospectively collected, vascular access database, a total of 45 prevalent dialysis patients using BHC were compared with 38 patients using the RL technique over a median of 12 months (inter-quartile range: 4-27 months). The two groups did not differ significantly in demographics except that diabetes was more common in those using BHC as compared to rope-ladder (69% vs. 34%; p = 0.002). Risk factors associated with lack of primary patency were age (hazards ratio [HR] = 1.02 per decade; 95% CI: 1.00-1.03; p = 0.04) and female gender (HR = 1.92; 95% CI: 1.08-3.40; p = 0.03). Use of the buttonhole technique was not associated with improved primary patency (HR = 1.22, 95% CI: 0.65-2.28; p = 0.53). Episodes of bacteremia and mean scores from KDQOL-36 did not differ significantly between the groups. This study demonstrates for the first time that BHC use is not associated with improved access patency.

  11. Management of pulp canal obliteration using the Modified-Tip instrument technique

    PubMed Central

    Siddiqui, Shoaib Haider

    2014-01-01

    The incidence of pulp canal obliteration following dental trauma has been reported to be approximately 4 – 24% and its management can be quite challenging for the practitioner. Locating the canal and negotiating it to full working length may lead to iatrogenic errors such as fractured instrument and perforation. This case report deals with such a case using the modified tip instrument technique to gain access and negotiate the canal to the apex followed by conventional root canal preparation and obturation. PMID:25780361

  12. PBPC collections: Management, techniques and risks.

    PubMed

    Gašová, Zdenka; Bhuiyan-Ludvíková, Zdeňka; Böhmová, Martina; Marinov, Iuri; Vacková, Blanka; Pohlreich, David; Trněný, Marek

    2010-10-01

    We evaluated the efficiency, safety and risks of three techniques which were used for autologous PBPC collections: (a) large-volume leukapheresis (LVL), (b) standard collections, and (c) a new modified technique which was named as "Mixed" collections. In spite of the fact that the standard and LVL collection techniques are used routinely, there may occur special conditions in which the procedures cannot be recommended. Some patients may suffer from serious clinical complications and they cannot tolerate either standard procedures with administration of higher doses of ACD-A, or the high extent of procedure in the course of LVL. We tried to find the safe and efficient collection technique which could help this group of patients to overcome their problems. The "Mixed" collection technique could be such a choice. The numbers of 136 autologous PBPC collections were performed in 98 patients who suffered from hemato-oncological diseases. We evaluated the results of (a) 93 LVL (more than 3 TBV, total blood volumes of the patients were processed; anticoagulation: ACD-A and Heparin), (b) 16 Standard procedures (less than 3 TBV were processed; anticoagulation: ACD-A), and (c) 27 "Mixed" collections (less than 3 TBV of patients were processed; anticoagulation: ACD-A+ Heparin). Collections were performed by the use of separator Cobe Spectra, Caridian. In patients (a) with a good effect of mobilization (precollection CD 34+ cells in blood higher than 20×10(3)/mL) we prepared almost the same median dose of CD 34+ cells from the standard and "Mixed" collections, 3.8 and 4×10(6)/kg, respectively. In LVL the median yield of CD 34+ cells was 8.2×10(6)/kg. In patients (b) who were mobilized weakly (precollection CD 34+ cells in blood lower than 20×10(3)/mL), LVL enabled to prepare 1.5×10(6) of CD 34+/kg from one collection, while the median yield of CD 34+ cells from the standard and "Mixed" collections was 0.9 and 1.2×10(6)/kg. All the standard, LVL and "Mixed" procedures were

  13. Living with lipoedema: reviewing different self-management techniques.

    PubMed

    Fetzer, Amy; Wise, Christine

    2015-10-01

    At present, there is no proven cure for lipoedema. Nevertheless, much can be done to help improve symptoms and prevent progression. Many of these improvements can be achieved by patients using self-management techniques. This article describes the range of self-management techniques that community nurses can discuss with patients, including healthy eating, low-impact exercise, compression garments, self-lymphatic drainage, and counselling.

  14. Management of Intracranial Meningiomas Using Keyhole Techniques

    PubMed Central

    Burks, Joshua D; Conner, Andrew K; Bonney, Phillip A; Archer, Jacob B; Christensen, Blake; Smith, Jacqueline; Safavi-Abbasi, Sam

    2016-01-01

    Background: Keyhole craniotomies are increasingly being used for lesions of the skull base. Here we review our recent experience with these approaches for resection of intracranial meningiomas. Methods: Clinical and operative data were gathered on all patients treated with keyhole approaches by the senior author from January 2012 to June 2013. Thirty-one meningiomas were resected in 27 patients, including 9 supratentorial, 5 anterior fossa, 7 middle fossa, 6 posterior fossa, and 4 complex skull base tumors. Twenty-nine tumors were WHO Grade I, and 2 were Grade II.  Results: The mean operative time was 8 hours, 22 minutes (range, 2:55-16:14) for skull-base tumors, and 4 hours, 27 minutes (range, 1:45-7:13) for supratentorial tumors. Simpson Resection grades were as follows: Grade I = 8, II = 8, III = 1, IV = 15, V = 0. The median postoperative hospital stay was 4 days (range, 1-20 days). In the 9 patients presenting with some degree of visual loss, 7 saw improvement or complete resolution. In the 6 patients presenting with cranial nerve palsies, 4 experienced improvement or resolution of the deficit postoperatively. Four patients experienced new neurologic deficits, all of which were improved or resolved at the time of the last follow-up. Technical aspects and surgical nuances of these approaches for management of intracranial meningiomas are discussed.  Conclusions: With careful preoperative evaluation, keyhole approaches can be utilized singly or in combination to manage meningiomas in a wide variety of locations with satisfactory results. PMID:27284496

  15. Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue.

    PubMed

    Pecoraro, Felice; Krishnaswamy, Mayur; Steuer, Johnny; Puippe, Gilbert; Mangialardi, Nicola; Pfammatter, Thomas; Rancic, Zoran; Veith, Frank J; Cayne, Neal S; Lachat, Mario

    2017-01-01

    Purpose Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access. In all patients, a percutaneous transluminal angioplasty balloon was used to predilate the scar tissue and the femoral artery or the synthetic vascular graft after preclosing (ProGlide®; Abbott Vascular, Santa Clara, CA, USA). In 10 patients, requiring a 20 Fr sheath, a 6 mm percutaneous transluminal angioplasty balloon was used; and in the remaining 15, requiring a 24 Fr sheath, an 8 mm percutaneous transluminal angioplasty balloon. Preclosing was exclusively performed using ProGlide®. Mean follow-up was 15 months. Results In all cases, stent-graft deployment was successful. There was one surgical conversion (4%; 1/25) due to bleeding from a femoral anastomosis. Two cases required additional percutaneous maneuvers (postclosing with another system in one patient and endoluminal shielding with stent-graft in the other patient). No pseudoaneurysm or access complication occurred during the follow-up. Conclusions Percutaneous access in redo groins with scar tissue and/or synthetic vascular graft using ultrasound-guided punction, preclosing with ProGlide® system and predilation with percutaneous transluminal angioplasty balloon to introduce large size sheath as used for endovascular aortic repair showed to be

  16. Electric power emergency management mechanism considering the access of new energy and renewable energy

    NASA Astrophysics Data System (ADS)

    Zhang, Baoqun; Ma, Longfei; Gong, Cheng; Jiao, Ran; Shi, Rui; Chi, Zhongjun; Ding, Yifeng

    2017-01-01

    Scholars at home and abroad have had a thorough research about the theory system and the frame of emergency management on the background of traditional grid, but for the improvement of the emergency mechanism when new energy and renewable energy access the grid, more work should be done. This paper will summarize the predecessors' work on emergency management, discuss the impact of emergency management while new energy and renewable energy access the grid and some suggestions are given.

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

    ERIC Educational Resources Information Center

    Lewis, Ramon; Roache, Joel; Romi, Shlomo

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Belanger, Gary K.; Tilliss, Terri S.

    1993-01-01

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

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

    EPA Science Inventory

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

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

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Ferinden, William E., Jr.

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

  3. Capitalizing on Stress Management Techniques in Developmental Classes.

    ERIC Educational Resources Information Center

    Price, Elsa C.

    Mastering stress management techniques can help college developmental class educators protect themselves from burnout. These techniques can also be taught to students in developmental classes to enable them to maximize the benefits from these classes. This paper outlines the causes of stress, identifies stressors, describes responses to stress,…

  4. Calcaneal Fracture Management: Extensile Lateral Approach Versus Small Incision Technique.

    PubMed

    Kiewiet, Nathan J; Sangeorzan, Bruce J

    2017-03-01

    Calcaneal fracture management has historically been a controversial topic and represents an area of sustained interest over the past several decades. The authors review current methods for calcaneal fracture fixation with an extensile lateral approach and small incision techniques. Early reports of small incision techniques have reported promising outcomes and reduced risks for complications. These techniques may be beneficial to reduce the risk of soft tissue complications and improve the rate of recovery.

  5. Advanced thermal management techniques for space power electronics

    NASA Astrophysics Data System (ADS)

    Reyes, Angel Samuel

    1992-01-01

    Modern electronic systems used in space must be reliable and efficient with thermal management unaffected by outer space constraints. Current thermal management techniques are not sufficient for the increasing waste heat dissipation of novel electronic technologies. Many advanced thermal management techniques have been developed in recent years that have application in high power electronic systems. The benefits and limitations of emerging cooling technologies are discussed. These technologies include: liquid pumped devices, mechanically pumped two-phase cooling, capillary pumped evaporative cooling, and thermoelectric devices. Currently, liquid pumped devices offer the most promising alternative for electronics thermal control.

  6. Contingency Management: Development of Management Problems X Techniques Matrix.

    DTIC Science & Technology

    1980-05-01

    develops preventive actions to avoid those adverse consequences. B-3 15. Organizational Mirror This technique (a) identifies a target group and two or...more other groups to serve as "mirrors" for this group, (b) collects data concerning perceptions of human processes in the target group , (c) analyzes...34 groups discuss their perceptions of the target group in the presence of the target group , but without its involvement, to clarify, understand, and

  7. Accessibility

    EPA Pesticide Factsheets

    Federal laws, including Section 508 of the Rehabilitation Act, mandate that people with disabilities have access to the same information that someone without a disability would have. 508 standards cover electronic and information technology (EIT) products.

  8. 76 FR 38293 - Risk Management Controls for Brokers or Dealers With Market Access

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-30

    ... COMMISSION 17 CFR Part 240 RIN 3235-AK53 Risk Management Controls for Brokers or Dealers With Market Access... establish, document, and maintain a system of risk management controls and supervisory procedures that... develop, test, and implement the relevant risk management controls and supervisory procedures...

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

    PubMed

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

    2014-08-01

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

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

    PubMed Central

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

    2009-01-01

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

  11. Perceived access in a managed care environment: determinants of satisfaction.

    PubMed

    Akinci, F; Sinay, T

    2003-05-01

    With increasing competition in the local and regional healthcare markets, and growing interest in assessing the effectiveness of services and patient outcomes, satisfaction measures are becoming prominent in evaluating the performance of the healthcare system. This study examines the independent effect of predisposing, enabling and medical need factors on perceived access to care with particular focus on insurance plans. A survey questionnaire is developed to investigate access limitations at three levels: (1) the health plan, (2) the individual provider(s) and (3) the healthcare organization. In addition, shortage of providers, residents' perceptions of their health status, satisfaction with access to care and socio-demographic indicators are incorporated into the analysis. Multivariate logistic regression is used to assess the independent effects of the above factors on a dichotomous dependent variable--residents' overall satisfaction with access to healthcare services. The most salient determinants of overall satisfaction with access to care were the type of health insurance plan, cost of insurance premiums, co-payments, difficulty with obtaining referrals, self-rated general health, the opportunity cost of taking time to see a provider (measured by the loss of hourly wages), marital status and the age factor over 80 years.

  12. Code division multiple-access techniques in optical fiber networks. II - Systems performance analysis

    NASA Astrophysics Data System (ADS)

    Salehi, Jawad A.; Brackett, Charles A.

    1989-08-01

    A technique based on optical orthogonal codes was presented by Salehi (1989) to establish a fiber-optic code-division multiple-access (FO-CDMA) communications system. The results are used to derive the bit error rate of the proposed FO-CDMA system as a function of data rate, code length, code weight, number of users, and receiver threshold. The performance characteristics for a variety of system parameters are discussed. A means of reducing the effective multiple-access interference signal by placing an optical hard-limiter at the front end of the desired optical correlator is presented. Performance calculations are shown for the FO-CDMA with an ideal optical hard-limiter, and it is shown that using a optical hard-limiter would, in general, improve system performance.

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

    NASA Technical Reports Server (NTRS)

    Hawkins, Gerald W.

    1987-01-01

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

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

    ERIC Educational Resources Information Center

    Lee, Leslie A.; Wu, Michelle M.

    2003-01-01

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

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

    ERIC Educational Resources Information Center

    Jetton, Lora Lennertz; Bailey, Alberta S.

    2010-01-01

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

  16. Power Management Techniques for Data Centers: A Survey

    SciTech Connect

    Mittal, Sparsh

    2014-07-01

    With growing use of internet and exponential growth in amount of data to be stored and processed (known as ``big data''), the size of data centers has greatly increased. This, however, has resulted in significant increase in the power consumption of the data centers. For this reason, managing power consumption of data centers has become essential. In this paper, we highlight the need of achieving energy efficiency in data centers and survey several recent architectural techniques designed for power management of data centers. We also present a classification of these techniques based on their characteristics. This paper aims to provide insights into the techniques for improving energy efficiency of data centers and encourage the designers to invent novel solutions for managing the large power dissipation of data centers.

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

    PubMed

    Tennant, C; Roberts, P A

    2000-01-01

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

  18. Access Services: Organization and Management. SPEC Kit #179.

    ERIC Educational Resources Information Center

    Steel, Virginia, Comp.

    This Systems and Exchange Center (SPEC) kit begins with a summary by Virginia Steel of the findings of a survey of Association of Research Libraries (ARL) member libraries that was conducted in 1991 to determine the prevalence of the organizational model of access services--i.e., a department or division responsible for the services and operations…

  19. Making Data Management Accessible in the Undergraduate Chemistry Curriculum

    ERIC Educational Resources Information Center

    Reisner, Barbara A.; Vaughan, K. T. L.; Shorish, Yasmeen L.

    2014-01-01

    In the age of "big data" science, data management is becoming a key information literacy skill for chemistry professionals. To introduce this skill in the undergraduate chemistry major, an activity has been developed to familiarize undergraduates with data management. In this activity, students rename and organize cards that represent…

  20. Analysis of multiple access techniques in multi-satellite and multi-spot mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Corazza, Giovanni E.; Ferrarelli, Carlo; Vatalaro, Francesco

    1995-01-01

    In this paper the analysis of mobile satellite systems adopting constellations of multi-spot satellites over non-geostationary orbits is addressed. A link design procedure is outlined, taking into account system spectrum efficiency, probability of bit error and outage probability. A semi-analytic approach to the evaluation of outage probability in the presence of fading and imperfect power control is described, and applied to single channel per carrier (SCPC) and code division multiple access (CDMA) techniques. Some results are shown for the Globalstar, Iridium and Odyssey orbital configurations.

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

    ERIC Educational Resources Information Center

    Babu, Rakesh; Singh, Rahul

    2013-01-01

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

  2. Advanced endoscopic ultrasound management techniques for preneoplastic pancreatic cystic lesions

    PubMed Central

    Arshad, Hafiz Muhammad Sharjeel; Bharmal, Sheila; Duman, Deniz Guney; Liangpunsakul, Suthat; Turner, Brian G

    2017-01-01

    Pancreatic cystic lesions can be benign, premalignant or malignant. The recent increase in detection and tremendous clinical variability of pancreatic cysts has presented a significant therapeutic challenge to physicians. Mucinous cystic neoplasms are of particular interest given their known malignant potential. This review article provides a brief but comprehensive review of premalignant pancreatic cystic lesions with advanced endoscopic ultrasound (EUS) management approaches. A comprehensive literature search was performed using PubMed, Cochrane, OVID and EMBASE databases. Preneoplastic pancreatic cystic lesions include mucinous cystadenoma and intraductal papillary mucinous neoplasm. The 2012 International Sendai Guidelines guide physicians in their management of pancreatic cystic lesions. Some of the advanced EUS management techniques include ethanol ablation, chemotherapeutic (paclitaxel) ablation, radiofrequency ablation and cryotherapy. In future, EUS-guided injections of drug-eluting beads and neodymium:yttrium aluminum agent laser ablation is predicted to be an integral part of EUS-guided management techniques. In summary, International Sendai Consensus Guidelines should be used to make a decision regarding management of pancreatic cystic lesions. Advanced EUS techniques are proving extremely beneficial in management, especially in those patients who are at high surgical risk. PMID:27574295

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

    NASA Astrophysics Data System (ADS)

    Tsaur, Woei-Jiunn; Pai, Haw-Tyng

    2008-11-01

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

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

    PubMed Central

    2012-01-01

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

  5. Protection Versus Public Access: Two Concepts Compared within the Italian Underwater Cultural Heritage Management System

    NASA Astrophysics Data System (ADS)

    Secci, Massimiliano

    2011-12-01

    The concepts of protection and public access relating to underwater cultural heritage are often taken as two contrasting notions in the Italian underwater cultural heritage management panorama. This contribution aims to review these concepts with the objective of emphasizing the possibility of sound and scientifically compelling public access to the underwater cultural heritage, keeping protection principles intact. With the support of in-the-field examples successfully produced worldwide, this paper will attempt to underline how scientifically sound public access activities in the field of underwater cultural heritage management can benefit the protection of such heritage.

  6. The 1000 Genomes Project: data management and community access.

    PubMed

    Clarke, Laura; Zheng-Bradley, Xiangqun; Smith, Richard; Kulesha, Eugene; Xiao, Chunlin; Toneva, Iliana; Vaughan, Brendan; Preuss, Don; Leinonen, Rasko; Shumway, Martin; Sherry, Stephen; Flicek, Paul

    2012-04-27

    The 1000 Genomes Project was launched as one of the largest distributed data collection and analysis projects ever undertaken in biology. In addition to the primary scientific goals of creating both a deep catalog of human genetic variation and extensive methods to accurately discover and characterize variation using new sequencing technologies, the project makes all of its data publicly available. Members of the project data coordination center have developed and deployed several tools to enable widespread data access.

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

    NASA Astrophysics Data System (ADS)

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

    2004-05-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

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

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

    SciTech Connect

    Walser, Eric M.

    2012-08-15

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

  10. USING SPMDS TO ACCESS MANAGEMENT STRATEGIES FOR PCB CONTAMINATED SEDIMENTS

    EPA Science Inventory

    Dredging, in-place treatment, capping and monitored natural recovery, used together or separately are the primary approaches for managing contaminated sediment risks. Understanding how well different approaches work in different environments is critical for choosing an appropria...

  11. USING SPMDS TO ACCESS MANAGMENT STRATEGIES FOR PCB CONTAMINATED SEDIMENTS

    EPA Science Inventory

    Dredging, in-place treatment, capping and monitored natural recovery, used together or separately are the primary approaches for managing contaminated sediment risks. Understanding how well different approaches work in different environments is critical for choosing an appropria...

  12. [Access to care, access to rights, and health education: stakes of the global management fo patients].

    PubMed

    Moutel, G; Hervé, C

    2001-04-21

    Together with primary care physicians, the public health clinic of the Max Fourestier Hospital (Nanterre, France) initiated a pilot experience within the framework of its access to health care network (ADES). In addition to full access to traditional health care, patients who agree to participate in this unique network benefit from a medical and social risk screening and prevention program. This program is proposed to all patients who, by definition, have one or more medical or social risk factors. At each visit, targeted history taking and the physical exam can lead to individualized propositions for a global approach to screening and prevention, whatever the initial reason for consulting. In addition, patients who require permanent care benefit from the dose link between the medical care and social care teams. Over the last year, this experience has involved 3430 consultations in a polyvalent clinic that has provided global care including health education and screening for health risks. Our analysis of the medical and ethical issues involved points out the importance of a global approach to health care.

  13. Self Management Techniques and Disclosure of Sero Status

    ERIC Educational Resources Information Center

    Falaye, Ajibola; Afolayan, Joel Adeleke

    2015-01-01

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

  14. Structured Information Management Using New Techniques for Processing Text.

    ERIC Educational Resources Information Center

    Gibb, Forbes; Smart, Godfrey

    1990-01-01

    Describes the development of a software system, SIMPR (Structured Information Management: Processing and Retrieval), that will process documents by indexing them and classifying their subjects. Topics discussed include information storage and retrieval, file inversion techniques, modelling the user, natural language searching, automatic indexing,…

  15. Conflict Management Techniques for Kindergarten through Fourth Grade.

    ERIC Educational Resources Information Center

    Conn, Edith Janell Rudd

    An elementary school teacher discusses conflict management techniques appropriate for use with children in kindergarten through the fourth grade. Discussion first recapitulates developmental theory from several perspectives, including those of Freud, Erikson, Piaget, and profiles conflict theory. Illustrative contemporary social problems that…

  16. New technique for the management of vesicorectal fistulas

    SciTech Connect

    Leifer, G.; Jacobs, W.H.

    1988-08-01

    We report a new technique for the management of the complications of vesicorectal fistulas. The patient we present had a fistula and severe skin excoriation. The fistula was caused by carcinoma of the prostate that had been treated by radiation therapy. The fistula was patched with a rectal prosthesis similar to that used to patch esophageal-tracheal and esophageal-bronchial fistulas.

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Julien Sealey, Beverley

    2011-01-01

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

  19. Efficient identity management and access control in cloud environment

    NASA Astrophysics Data System (ADS)

    Gloster, Jonathan

    2013-05-01

    As more enterprises are enticed to move data to a cloud environment to enhance data sharing and reduce operating costs by exploiting shared resources, concerns have risen over the ability to secure information within the cloud. This paper examines how a traditional Identity and Access Control (IDAM) architecture can be adapted to address security concerns of a cloud environment. We propose changing the paradigm of IDAM form a pure trust model to a risk based model will enable information to be protected securely in a cloud environment without impacting efficiencies of cloud environments.

  20. Access as a managed care marketing outcomes measure.

    PubMed

    Montoya, I D; Perez, B A

    2000-01-01

    As their position in the health care market diminishes, HMOs are feeling the pinch from the competition. Purchasers of health plans have many more options available today than in the past. Employers can select from single or consolidated health plans, plans offered by coalitions, or plans offered by provider systems. Following closely behind the withstanding issue of controlling costs is quality of care and customer satisfaction. The bad press surrounding managed care is making employers demand assurances that employees will receive the best quality of care their money can buy. To assist in this endeavor managed care companies are focusing more on their customers. To this end marketers use report cards to assess purchaser and enrollee satisfactions, with the hope that if they have a happy customer, s/he will be a loyal one. This paper reviews current marketing strategies of managed care companies and their level of usefulness with respect to sustaining customers and hence market share.

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

    SciTech Connect

    Nijs, Els L. F.; Cahill, Anne Marie

    2010-12-15

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

  2. Science Information Storage and Access: Data Management Using Appleworks.

    ERIC Educational Resources Information Center

    Schlenker, Richard M.

    This report describes a data management process that provides users with a systematic approach to document identification, and to information storage and retrieval using the AppleWorks database subprogram and a simple organizational scheme. The functions of this scheme are described and include: (1) taking the user from general to specific…

  3. Access to opioids: a global pain management crisis.

    PubMed

    Buitrago, Rosa

    2013-03-01

    The lack of availability of opioids in many countries has created a pain management crisis. Because the Single Convention on Narcotic Drugs requires governments to report annual opioid statistics, there is a need for methods to calculate individual nations' opioid needs. Ways to address this need are discussed.

  4. Records access and management on closure of a medical practice.

    PubMed

    Carter, David J

    2015-07-20

    Despite uneven regulation, health practitioners registered with the Australian Health Practitioner Regulation Agency have immediate and continuing obligations to patients when contemplating practice closure. Recent enforcement actions by regulators highlight the importance of knowledge and compliance with requirements relating to record management.

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

    PubMed

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

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

  6. Associative programming language and virtual associative access manager

    NASA Technical Reports Server (NTRS)

    Price, C.

    1978-01-01

    APL provides convenient associative data manipulation functions in a high level language. Six statements were added to PL/1 via a preprocessor: CREATE, INSERT, FIND, FOR EACH, REMOVE, and DELETE. They allow complete control of all data base operations. During execution, data base management programs perform the functions required to support the APL language. VAAM is the data base management system designed to support the APL language. APL/VAAM is used by CADANCE, an interactive graphic computer system. VAAM is designed to support heavily referenced files. Virtual memory files, which utilize the paging mechanism of the operating system, are used. VAAM supports a full network data structure. The two basic blocks in a VAAM file are entities and sets. Entities are the basic information element and correspond to PL/1 based structures defined by the user. Sets contain the relationship information and are implemented as arrays.

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

    NASA Technical Reports Server (NTRS)

    Scaife, Bradley James

    1999-01-01

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

  8. Risk Management Techniques and Practice Workshop Workshop Report

    SciTech Connect

    Quinn, T; Zosel, M

    2008-12-02

    At the request of the Department of Energy (DOE) Office of Science (SC), Lawrence Livermore National Laboratory (LLNL) hosted a two-day Risk Management Techniques and Practice (RMTAP) workshop held September 18-19 at the Hotel Nikko in San Francisco. The purpose of the workshop, which was sponsored by the SC/Advanced Scientific Computing Research (ASCR) program and the National Nuclear Security Administration (NNSA)/Advanced Simulation and Computing (ASC) program, was to assess current and emerging techniques, practices, and lessons learned for effectively identifying, understanding, managing, and mitigating the risks associated with acquiring leading-edge computing systems at high-performance computing centers (HPCCs). Representatives from fifteen high-performance computing (HPC) organizations, four HPC vendor partners, and three government agencies attended the workshop. The overall workshop findings were: (1) Standard risk management techniques and tools are in the aggregate applicable to projects at HPCCs and are commonly employed by the HPC community; (2) HPC projects have characteristics that necessitate a tailoring of the standard risk management practices; (3) All HPCC acquisition projects can benefit by employing risk management, but the specific choice of risk management processes and tools is less important to the success of the project; (4) The special relationship between the HPCCs and HPC vendors must be reflected in the risk management strategy; (5) Best practices findings include developing a prioritized risk register with special attention to the top risks, establishing a practice of regular meetings and status updates with the platform partner, supporting regular and open reviews that engage the interests and expertise of a wide range of staff and stakeholders, and documenting and sharing the acquisition/build/deployment experience; and (6) Top risk categories include system scaling issues, request for proposal/contract and acceptance testing, and

  9. Management of segmental skeletal defects by the induced membrane technique

    PubMed Central

    El-Alfy, Barakat Sayed; Ali, Ayman M

    2015-01-01

    Background: Surgical reconstruction of segmental skeletal defects represents a true challenge for the orthopedic surgeons. Recently, Masquelet et al. described a two-stage technique for reconstruction of bone defects, known as the induced membrane technique. The aim of this study is to assess the results of the induced membrane technique in the management of segmental skeletal defects resulting from debridement of bone infection. Materials and Methods: Seventeen patients with segmental skeletal defects were treated in our institution by the induced membrane technique. The average age of the patients was 43 years (range 26- 58 years). The causes of the defects were infected gap nonunion in 12 cases and debridement of osteomyelitis in 5 cases. The defects were located in the tibia (n = 13) and the femur (n = 4). The mean defect was 7 cm (range 4 cm - 11 cm). All cases were treated by the induced membrane technique in two-stages. Results: Bone union happened in 14 patients. The limb length discrepancy did not exceed 2.5 cm in the healed cases. The mean time of healing was 10 months (range 6-19 months). The complications included nonunion of the graft in five cases, failure of graft maturation in two cases, reactivation of infection in two cases and refracture after removal of the frame in one case. These complications were managed during the course of treatment and they did not affect the final outcome in all patients except three. Conclusion: The induced membrane technique is a valid option for the management of segmental skeletal defects. It is a simple and straight forward procedure, but the time required for growth and maturation of the graft is relatively long. PMID:26806972

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

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

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

  11. Virtual queueing techniques for UBR+ service in ATM with fair access and minimum bandwidth guarantee

    SciTech Connect

    Siu, K.Y.; Wu, Y.; Ren, W.

    1998-11-01

    The ATM Forum is currently discussing the need for a new best-effort service called UBR+, which is an enhancement to the existing UBR service, to support data traffic. The objective of the UBR+ service is to provide each user with a minimum service rate guarantee and a fair access to any excess available bandwidth. In this paper, the authors present a new efficient scheme for supporting this service. The key advantage of the scheme is that it employs only FIFO queueing (instead of per-VC queueing) and admits simple implementation in ATM switches. The ideas involve a simple scheduling mechanism that is based on per-VC queueing and incorporate the virtual queueing technique that can efficiently emulate per-VC queueing on a shared FIFO queue. Simulation results are presented to show that the schemes can deliver almost ideal performance for supporting the new service requirements of UBR+.

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

    NASA Technical Reports Server (NTRS)

    1990-01-01

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

  13. Modified Surgical Techniques for Managing Intraoperative Floppy Iris Syndrome

    PubMed Central

    Charukamnoetkanok, Puwat

    2016-01-01

    Purpose. To report a modified surgical strategy in the management of intraoperative floppy iris syndrome-associated iris prolapse. Methods. Prolapsed iris is left as is and a new corneal incision near the original wound but at a different site is created. Depending on the location of the original incision and the surgeon's preference, this additional incision can be used as a new port for phacoemulsification tip or can be the new site for the iris to securely prolapse, allowing for the surgery to proceed safely. Results. We present 2 cases of iris prolapse and inadequate pupil dilation in patients with IFIS. Along with our modified technique, additional iris retractors were placed to increase the workspace for the phacoemulsification tip. The cataract surgery was performed successfully without further complications in both cases. Conclusion. This surgical technique could be an adjunct to allow the surgeons to expand the armamentarium for the management of IFIS-associated iris prolapse. PMID:27999697

  14. Double-Step Image Superimposition Technique for Fabricating a Drilling Guide to Access the Abutment Screw in Implant Prostheses.

    PubMed

    Mai, Hang-Nga; Kim, Kyung-Rok; Lee, Du-Hyeong

    2016-01-01

    Limited retrievability is a major disadvantage of cement-retained implant restorations. Despite great progress in locating the abutment screw within crowns, the existing techniques are based on prior data or prefabricated devices and require significant work. This study introduces a new procedure for fabricating a guide template to drill a screw access hole using a double-step superimposition technique that incorporates intraoral optical scanning, cone beam computed tomography, and dental design software. The double-step superimposition technique with computer-aided design/computer-assisted manufacturing technology can enhance the convenience and accuracy of drilling the screw-access hole.

  15. A prosthetic management technique for osteopetrosis affecting the maxilla.

    PubMed

    Dewan, Karun; Bishop, Karl; Hollisey-Mclean, David

    2007-06-01

    Bony anatomical anomalies can complicate the construction and successful wearing of removable prostheses. Osteopetrosis is a group of diseases that affect the growth and continuous remodelling of bone which in turn can result in gross irregular alveolar bone morphology. This paper describes the management of a patient with this problem and emphasises the challenges in constructing a successful complete maxillary removable prosthesis. The utilisation of a flexible base plate material as an alternative to traditional materials will be highlighted. Irregular bony morphology is a recognised potential obstacle to the successful construction of removable prostheses. In most cases the problem can be overcome but in extreme and less common circumstances, management of these features can be more problematic. This paper describes a technique used to manage extreme alveolar irregularity which may perhaps be applied to those problems more commonly encountered in every day clinical practice but are less extreme then those described in this paper.

  16. Wetland assessment, monitoring and management in India using geospatial techniques.

    PubMed

    Garg, J K

    2015-01-15

    Satellite remote sensing and GIS have emerged as the most powerful tools for inventorying, monitoring and management of natural resources and environment. In the special context of wetland ecosystems, remotely sensed data from orbital platforms have been extensively used in India for the inventory, monitoring and preparation of action plans for conservation and management. First scientific inventory of wetlands in India was carried out in 1998 by Space Applications Centre (ISRO), Ahmedabad using indigenous IRS (Indian Remote Sensing Satellite) data of 1992-93 timeframe, which stimulated extensive use of geospatial techniques for wetland conservation and management. Subsequently, with advances in GIS, studies were carried out for development of Wetland Information System for a state (West Bengal) and for Loktak lake wetland (a Ramsar site) as a prelude to National Wetland Information System. Research has also been carried out for preparation of action plans especially for Ramsar sites in the country. In a novel research, use of the geospatial technology has also been demonstrated for biodiversity conservation using landscape ecological metrics. A country-wide estimate of emission of methane, a Green House Gas, from wetlands has also been made using MODIS data. Present article critically reviews the work carried out in India for wetland conservation and management using geospatial techniques.

  17. Managing tissue bank access to the OR for tissue recovery.

    PubMed

    Trim, Robert S

    2011-08-01

    Hospitals often have tissue recovery service agreements with regional tissue banks to facilitate the donation process. The agreements that outline the tissue bank-hospital relationship frequently allow tissue bank personnel to perform tissue recovery procedures in the referring hospital's OR and may or may not specify any preparatory orientation or any written protocols for tissue bank staff members to follow. This creates the potential for unintentional breaches of protocol that can affect operation of equipment or result in contamination that may put surgical patients and staff members at risk. The OR manager is responsible for establishing appropriate orientation plans for tissue bank employees to ensure they understand and adhere to the hospital's protocols.

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

    NASA Astrophysics Data System (ADS)

    Sikorsky, Charles S.

    1997-05-01

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

  19. Access to the brain parenchyma using endovascular techniques and a micro-working channel.

    PubMed

    Lundberg, Johan; Johansson, Carina B; Jonsson, Stefan; Holmin, Staffan

    2017-02-01

    OBJECTIVE Several older studies report a low risk for parenchymal access to the CNS by surgical techniques. In more recent studies, including those with post-puncture CT scans, there are indications that the risk of bleeding might approach 8%. New therapies, such as those that use viral vectors, modified mRNA, or cell transplantation, will probably warrant more parenchymal access to the CNS. Other minimally invasive routes might then be tempting to explore. This study was designed in 2 parts to address the possibility of using the endovascular route. The first aim was to test the ability to create a parenchymal micro-working channel to the CNS in macaque monkeys through the vessel wall. Second, the biocompatibility of a device-associated, detached, distal securing plug that was made of nitinol was investigated in swine for 1 year. METHODS Trans-vessel wall intervention in the middle cerebral artery and associated cerebral parenchyma was performed in 4 rhesus macaque monkeys using a full clinical angiography suite. A contrast agent and methylene blue were injected to test the working channel and then detached at the distal end to act as a securing plug through the vessel wall. One-year follow-ups were also performed using angiography and histological analysis in 10 swine with 24 implants that were distributed in the external carotid artery tree. RESULTS The cerebral interventions were performed without acute bleeding. Both the contrast agent and methylene blue were infused into the brain parenchyma and subarachnoidal space via the endovascular micro-working channel (7 injections in 4 animals). In the 1-year follow-up period, the implant that was left in the external carotid vessel wall in the swine was covered by the endothelium, which was followed by dislodgement just outside the blood vessel with thin capsule formation. No stenosis in the artery was detected on 1-year angiography. The animals showed normal behavior and blood sample results during the follow

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

    PubMed Central

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

    2004-01-01

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

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

    PubMed Central

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

    2002-01-01

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

  2. Mercury- Distributed Metadata Management, Data Discovery and Access System

    NASA Astrophysics Data System (ADS)

    Palanisamy, Giri; Wilson, Bruce E.; Devarakonda, Ranjeet; Green, James M.

    2007-12-01

    Mercury is a federated metadata harvesting, search and retrieval tool based on both open source and ORNL- developed software. It was originally developed for NASA, and the Mercury development consortium now includes funding from NASA, USGS, and DOE. Mercury supports various metadata standards including XML, Z39.50, FGDC, Dublin-Core, Darwin-Core, EML, and ISO-19115 (under development). Mercury provides a single portal to information contained in disparate data management systems. It collects metadata and key data from contributing project servers distributed around the world and builds a centralized index. The Mercury search interfaces then allow the users to perform simple, fielded, spatial and temporal searches across these metadata sources. This centralized repository of metadata with distributed data sources provides extremely fast search results to the user, while allowing data providers to advertise the availability of their data and maintain complete control and ownership of that data. Mercury supports various projects including: ORNL DAAC, NBII, DADDI, LBA, NARSTO, CDIAC, OCEAN, I3N, IAI, ESIP and ARM. The new Mercury system is based on a Service Oriented Architecture and supports various services such as Thesaurus Service, Gazetteer Web Service and UDDI Directory Services. This system also provides various search services including: RSS, Geo-RSS, OpenSearch, Web Services and Portlets. Other features include: Filtering and dynamic sorting of search results, book-markable search results, save, retrieve, and modify search criteria.

  3. Environmental Information Management For Data Discovery and Access System

    NASA Astrophysics Data System (ADS)

    Giriprakash, P.

    2011-01-01

    Mercury is a federated metadata harvesting, search and retrieval tool based on both open source software and software developed at Oak Ridge National Laboratory. It was originally developed for NASA, and the Mercury development consortium now includes funding from NASA, USGS, and DOE. A major new version of Mercury was developed during 2007 and released in early 2008. This new version provides orders of magnitude improvements in search speed, support for additional metadata formats, integration with Google Maps for spatial queries, support for RSS delivery of search results, and ready customization to meet the needs of the multiple projects which use Mercury. For the end users, Mercury provides a single portal to very quickly search for data and information contained in disparate data management systems. It collects metadata and key data from contributing project servers distributed around the world and builds a centralized index. The Mercury search interfaces then allow ! the users to perform simple, fielded, spatial and temporal searches across these metadata sources. This centralized repository of metadata with distributed data sources provides extremely fast search results to the user, while allowing data providers to advertise the availability of their data and maintain complete control and ownership of that data.

  4. Measuring access to urban health services using Geographical Information System (GIS): a case study of health service management in Bandar Abbas, Iran

    PubMed Central

    Masoodi, Mehdi; Rahimzadeh, Mahsa

    2015-01-01

    Background: The current distribution of and access to health services along with the future health needs of the population have prompted wide application of Geographic Information Systems (GISs). During recent years, GIS has been used in public health management for planning and organization of healthcare services. This study investigates geographical accessibility of residential areas in Bandar Abbas, Iran to healthcare services. Methods: Accessibility was evaluated by using Floating Catchment Area (FCA), minimum distance methods and Response Time (RT) accessibility technique. Results: More accurate measures of distances in Bandar Abbas, illustrated that Euclidean distances were not strongly correlated with network distances. The RT accessibility technique that utilizes shortest network path and time distances, presented detailed information about all the possible positions of the patients with respect to available healthcare services based on optimum and critical response times. Conclusion: Locations of public health services in Bandar Abbas were not related to the sites of populations. The RT accessibility technique provides a reasonably sensitive and robust evaluation of accessibility. PMID:26188808

  5. Public managed care and service access in outpatient substance abuse treatment units.

    PubMed

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A

    2011-10-01

    The continued growth of public managed behavioral health care has raised concerns about possible effects on services provided. This study uses a national sample of outpatient substance abuse treatment units surveyed in 2005 to examine associations between public managed care and service access, measured as both the types of services provided and the amount of treatment received by clients. The percentage of clients funded through public managed care versus other types of public funding was positively associated with treatment units' odds of providing some types of resource-intensive services and with the odds of providing transportation to clients, but was negatively associated with the average number of individual therapy sessions clients received over the course of treatment. In general, public managed care does not appear to restrict access to outpatient substance abuse treatment, although states should monitor these contracts to ensure clients receive adequate courses of individual treatment.

  6. Hemostatic Techniques for Laparoscopic Management of Cornual Pregnancy: Double-Impact Devascularization Technique.

    PubMed

    Afifi, Yousri; Mahmud, Ayesha; Fatma, Alfia

    2016-02-01

    Cornual pregnancy is a rare form of ectopic pregnancy, accounting for up to 2% to 4% of all ectopic pregnancies, with a mortality range of 2.0% to 2.5%. Hemorrhage is a key concern in the management of such pregnancies. Traditional treatment options include a conservative approach, failing which patients are offered surgical options such as cornual resection at laparotomy, which carries a high risk of hysterectomy. In recent years newer laparoscopic cornual resection or cornuotomy techniques have been used successfully to achieve better outcomes with fewer complications. We present the double-impact devascularization (DID) technique for laparoscopic management of cornual ectopic pregnancies. This technique permits hemostatic control by compression effect, which in turn allows reduction in procedure-related patient morbidity and mortality. We also provide an overview of other reported methods of hemostatic control used in similar laparoscopic procedures. DID appears to be a useful, safe, minimally invasive technique that can be used in both laparoscopic and open surgical procedures.

  7. Ureteroscopy for management of stone disease: an up to date on surgical technique and disposable devices.

    PubMed

    Torricelli, Fabio C; Marchini, Giovanni S; Pedro, Renato N; Monga, Manoj

    2016-12-01

    The surgical management of urinary stone disease developed substantially over the past decades and advanced minimally invasive techniques have been successfully introduced into clinical practice. Retrograde ureteroscopy and ureterorrenoscopy have become the first-line option for treatment of ureteral and renal stones worldwide with high success rates allied with a low morbidity profile. In this review, we will discuss some key points in ureteroscopy for stone disease, such as the access to upper urinary tract, including balloon and catheter dilation; how to choose and use some disposable devices (hydrophilic versus PTFE guide wires, ureteral catheters, and laser fiber setting); and lastly present and compare different techniques for kidney or ureteral stone treatment (dusting versus basketing).

  8. CytoAccess, a relational laboratory information management system for a clinical cytogenetics laboratory.

    PubMed

    Xiang, Bixia; Li, Peining; Hemingway, Susan S; Qumsiyeh, Mazin

    2006-01-01

    We developed a CytoAccess laboratory management system based on the widely used Microsoft Access software to facilitate data processing, result reporting, and quality management for a full-service cytogenetics laboratory. The CytoAccess system consists of four functional modules. The data entry module is for logging in patient information. The result entry module is used to generate chromosome, fluorescent in situ hybridization (FISH), and array comparative genomic hybridization (aCGH) reports. The administrative module enables periodic monitoring of quality control and quality improvement (QA/QI) parameters and produces billing forms. The maintenance module allows users to update clinical demographics, report templates, code tables, and to refresh data links. We have integrated into this system over 15,000 chromosome and FISH results from prenatal, postnatal, and cancer cases for the past six years. This system is cost-effective, user-friendly, flexible in updating, and potentially adaptable for data mining.

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  10. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  11. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  12. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Suwannawut, Nantanoot

    2014-01-01

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

  14. Choice of FDMA/SCPC access technique for aeronautical satellite voice system

    NASA Technical Reports Server (NTRS)

    Smith, G. K.

    1989-01-01

    A worldwide aeronautical mobile satellite system is about to become operational. The system architecture and access methods have been debated extensively, resulting in the selection of Time Division Multiplexing/Time Division Multiple Access (TDM/TDMA) access for packet data, and Single Channel Per Carrier (SCPC) for voice. These have become standards for airline use, and also satisfy the known requirements of ICAO for safety related communications. Voice communications are expected to absorb a high proportion of satellite bandwidth and power in the future. Here, it is explained why INMARSAT selected Frequency Division Multiple Access/SCPC satellite access for this application.

  15. An improved coding technique for image encryption and key management

    NASA Astrophysics Data System (ADS)

    Wu, Xu; Ma, Jie; Hu, Jiasheng

    2005-02-01

    An improved chaotic algorithm for image encryption on the basis of conventional chaotic encryption algorithm is proposed. Two keys are presented in our technique. One is called private key, which is fixed and protected in the system. The other is named assistant key, which is public and transferred with the encrypted image together. For different original image, different assistant key should be chosen so that one could get different encrypted key. The updated encryption algorithm not only can resist a known-plaintext attack, but also offers an effective solution for key management. The analyses and the computer simulations show that the security is improved greatly, and can be easily realized with hardware.

  16. Surgical management of abdominal compartment syndrome; indications and techniques

    PubMed Central

    Leppäniemi, Ari

    2009-01-01

    The indications for surgical decompression of abdominal compartment syndrome (ACS) are not clearly defined, but undoubtedly some patients benefit from it. In patients without recent abdominal incisions, it can be achieved with full-thickness laparostomy (either midline, or transverse subcostal) or through a subcutaneous linea alba fasciotomy. In spite of the improvement in physiological variables and significant decrease in IAP, however, the effects of surgical decompression on organ function and outcome are less clear. Because of the significant morbidity associated with surgical decompression and the management of the ensuing open abdomen, more research is needed to better define the appropriate indications and techniques for surgical intervention. PMID:19366442

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

    NASA Technical Reports Server (NTRS)

    Fernandez, J. P.; Mills, D.

    1991-01-01

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

  18. 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.

  19. Comparison of thermal management techniques for semiconductor disk lasers

    NASA Astrophysics Data System (ADS)

    Giet, S.; Kemp, A. J.; Burns, D.; Calvez, S.; Dawson, M. D.; Suomalainen, S.; Harkonen, A.; Guina, M.; Okhotnikov, O.; Pessa, M.

    2008-02-01

    Semiconductor Disk Lasers (SDLs) are compact lasers suitable for watt to multi-watt direct generation in the 670- 2350nm waveband and frequency-doubled operation in the ultraviolet and visible regions. This is, however, critically dependent on the thermal management strategy used as, in this type of laser, the pump is absorbed over micrometer lengths and the gain and loss are temperature sensitive. In this paper, we compare the two heat dissipation techniques that have been successfully deployed to-date: the "thin device" approach where the semiconductor active mirror is bonded onto a heatsink and its substrate subsequently removed, and the "heatspreader" technique where a high thermal conductivity platelet is directly bonded onto the active part of the unprocessed epilayer. We show that for SDLs emitting at 1060nm with pump spots of ~80µm diameter, the heatspreader approach outperforms the thin-device alternative, with the best results being obtained with a diamond heatspreader. Indeed, the thermal resistances are measured to be 4.9, 10.4 and 13.0 K/W for diamond-bonded, SiC-bonded and flip-chip devices respectively. It is also observed, as expected, that the thermal management strategy indirectly affects the optimum output coupling and thus the overall performance of these lasers.

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

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

  1. An efficient key-management scheme for hierarchical access control in e-medicine system.

    PubMed

    Wu, Shuhua; Chen, Kefei

    2012-08-01

    In e-medicine system, the sharing of patients' medical histories scattered among medical institutions through the Internet is highly desirable. The most immediate cryptographic need certainly is an efficient key management method to solve dynamic access problems in a user hierarchy. In this paper, we propose a practical solution for dynamic access problem in a user hierarchy based on hybrid cryptosystems. When compared with Nikooghadam et al.'s scheme proposed most recently, the time complexity and the required storage space is reduced significantly. Moreover, it provides provable security, and is easy to implement. Therefore, our scheme is more suitable for e-medicine system.

  2. Introducing Risk Management Techniques Within Project Based Software Engineering Courses

    NASA Astrophysics Data System (ADS)

    Port, Daniel; Boehm, Barry

    2002-03-01

    In 1996, USC switched its core two-semester software engineering course from a hypothetical-project, homework-and-exam course based on the Bloom taxonomy of educational objectives (knowledge, comprehension, application, analysis, synthesis, and evaluation). The revised course is a real-client team-project course based on the CRESST model of learning objectives (content understanding, problem solving, collaboration, communication, and self-regulation). We used the CRESST cognitive demands analysis to determine the necessary student skills required for software risk management and the other major project activities, and have been refining the approach over the last 5 years of experience, including revised versions for one-semester undergraduate and graduate project course at Columbia. This paper summarizes our experiences in evolving the risk management aspects of the project course. These have helped us mature more general techniques such as risk-driven specifications, domain-specific simplifier and complicator lists, and the schedule as an independent variable (SAIV) process model. The largely positive results in terms of review of pass / fail rates, client evaluations, product adoption rates, and hiring manager feedback are summarized as well.

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

    PubMed Central

    2010-01-01

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

  4. Phenotype and seed production among hyacinth bean (Lablab purpureus L. Sweet) accessions rescued using hydroponic techniques

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Hyacinth bean, Lablab purpureus L. (Sweet) is a legume used as a vegetable, forage, and in home gardens as an ornamental plant. Many accessions do not flower during their juvenile period in Byron, GA. Other hyacinth bean accessions produce few seed when regenerated in the field. This study was condu...

  5. A Novel Technique Using a Protection Filter During Fibrin Sheath Removal for Implanted Venous Access Device Dysfunction.

    PubMed

    Sotiriadis, Charalampos; Hajdu, Steven David; Degrauwe, Sophie; Barras, Heloise; Qanadli, Salah Dine

    2016-08-01

    With the increased use of implanted venous access devices (IVADs) for continuous long-term venous access, several techniques such as percutaneous endovascular fibrin sheath removal, have been described, to maintain catheter function. Most standard techniques do not capture the stripped fibrin sheath, which is subsequently released in the pulmonary circulation and may lead to symptomatic pulmonary embolism. The presented case describes an endovascular technique which includes stripping, capture, and removal of fibrin sheath using a novel filter device. A 64-year-old woman presented with IVAD dysfunction. Stripping was performed using a co-axial snare to the filter to capture the fibrin sheath. The captured fragment was subsequently removed for visual and pathological verification. No immediate complication was observed and the patient was discharged the day of the procedure.

  6. Fish discards management: pollution levels and best available removal techniques.

    PubMed

    Antelo, Luis T; Lopes, Carla; Franco-Uría, Amaya; Alonso, Antonio A

    2012-07-01

    Fish discards and by-catch issues are highly topical subjects that are permanently under a social focus. Two main approaches are being considered to address this discard problem: reducing the by-catch and increasing by-catch utilization. Interest in increased by-catch valorization may arise from a greater demand for fish products, such as the development of new markets for previously discarded species, the use of low-value specimens for aquaculture or the creation of value-added fish products for the food, pharmaceutical or cosmetic industries. However, contaminants present in fish discards may be transferred to their valorized products, leading to possible long-term bioaccumulation and subsequent adverse health effects. In this valorization framework, the aim is to promote responsible and sustainable management of marine resources. The pollutant levels in catches from European fisheries and the best available decontamination techniques for marine valorized discards/by-products are compiled and analyzed in this work.

  7. Role of Endoscopic Gastroplasty Techniques in the Management of Obesity

    PubMed Central

    Jung, Yunho

    2017-01-01

    Health and wellness represent a major global concern. Trends such as a lack of exercise and excessive consumption of calories are major causes of the rapid increase in obesity worldwide. Obesity should be controlled because it can result in other illnesses, such as diabetes, high blood pressure, high cholesterol, coronary artery disease, stroke, breathing disorders, or cancer. However, many people have difficulty in managing obesity through exercise, dietary control, behavioral modifications, and drug therapy. Bariatric surgery is not commonly used due to a variety of complications, even though it has been demonstrated to produce reliable results with respect to adequate weight loss when performed using an open or a laparoscopic approach. Endoscopic bariatric procedures are emerging techniques that are less invasive and safer compared with current surgical approaches. However, the evaluation of endoluminal procedures is limited by the small number of studies and their short-term follow-up. PMID:28147478

  8. Role of Endoscopic Gastroplasty Techniques in the Management of Obesity.

    PubMed

    Jung, Yunho

    2017-01-01

    Health and wellness represent a major global concern. Trends such as a lack of exercise and excessive consumption of calories are major causes of the rapid increase in obesity worldwide. Obesity should be controlled because it can result in other illnesses, such as diabetes, high blood pressure, high cholesterol, coronary artery disease, stroke, breathing disorders, or cancer. However, many people have difficulty in managing obesity through exercise, dietary control, behavioral modifications, and drug therapy. Bariatric surgery is not commonly used due to a variety of complications, even though it has been demonstrated to produce reliable results with respect to adequate weight loss when performed using an open or a laparoscopic approach. Endoscopic bariatric procedures are emerging techniques that are less invasive and safer compared with current surgical approaches. However, the evaluation of endoluminal procedures is limited by the small number of studies and their short-term follow-up.

  9. Racial and ethnic differences in access to medical care in managed care plans.

    PubMed Central

    Hargraves, J L; Cunningham, P J; Hughes, R G

    2001-01-01

    OBJECTIVE: To examine the extent to which access differences between racial/ethnic minorities and whites in managed care plans are greater than such differences in other types of health plans. DATA SOURCE: A nationally representative sample of 4,811 African American, 3,379 Hispanic, and 33,737 white nonelderly persons with public or private health insurance. STUDY DESIGN/DATA COLLECTION: A cross-sectional survey of households was conducted during 1996 and 1997. Commonly used measures of access to and utilization of medical care were constructed for individuals: (1) percentage of visits with a usual provider, (2) percentage with a regular provider, (3) visit with a physician in the past year, (4) hospital ER use, (5) last visit was to a specialist. PRINCIPAL FINDINGS: Fewer than 74 percent of Hispanics and African Americans had a regular provider compared to more than 78 percent of white Americans. Hispanics were least likely to have had their last doctor visit with a specialist (22 percent) compared to African Americans (26 percent) and whites (28 percent). Differences between ethnic/racial minorities and whites in managed care plans are similar to differences observed in non-managed care plans. Americans of all racial and ethnic backgrounds in managed care plans with gatekeeping are more likely to have a usual source of care, a regular provider, and lower use of specialists compared to persons in plans without gatekeeping. CONCLUSION: Although greater access to primary care was shown among African Americans and Hispanics in managed care plans, the extent of the disparities between racial/ethnic minorities and whites in managed care is similar to disparities in other types of health plans. PMID:11666107

  10. Behavioral approaches to anxiety and pain management for pediatric venous access.

    PubMed

    Cohen, Lindsey L

    2008-11-01

    Pediatric venous access causes unnecessary anxiety and pain in children and, in turn, can have detrimental consequences. Behavioral approaches to pediatric venous access distress management can be organized temporally. Specifically, preparation before the procedure includes providing children with sensory and procedural information in an age-appropriate manner and providing training in coping skills. It is important to consider the timing, format, and content of the approach to provide optimal preparation for the unique circumstances of the individual patient. In addition to the child patient, preparing parents and teaching them which specific behaviors might be most helpful to their child should prove valuable to both patient and parents. During the procedure, there are benefits to providing secure and comfortable positioning. In addition, researchers recommend that adults encourage children to cope and actively engage children in distracting activities. For infants, there is support for the distress-mitigation properties of swaddling, skin-to-skin contact, breastfeeding, and sucrose. After venous access, distraction and encouragement of coping should speed recovery. In sum, research in behavioral approaches to pediatric pain management has provided recommendations for minimizing children's anxiety and pain associated with venous access.

  11. SPIDR III: A Web Services Based System for Managing and Accessing Solar Terrestrial Physics Data

    NASA Astrophysics Data System (ADS)

    Redmon, R.; Kihn, E.; Zhizhin, M.

    2005-05-01

    We present SPIDR III, a web based data access, visualization and data management system for the space environment community, allowing a solar terrestrial physics customer to intelligently access and manage historical space physics data for integration with environmental models and space weather forecasts. SPIDR III is the newly redesigned Space Physics Interactive Resource (SPIDR) web application and was redesigned with input from it's user community via an intensive usability study. We will present on SPIDR III's new features, improved use and on lessons learned in usability and federating multi-source data. In 2004, SPIDR II underwent extensive rework yielding a completely redesigned interface for improved user interaction and the addition of many enhanced and complex features. The usability alterations were motivated in large part by a usability study performed by outside professional site reviewers and involving key data managers and current SPIDR II users. SPIDR III is built following the application direct to data archive paradigm, using Web Services both for internal and external exchange of data and information. It is now a framework and application set of Web Services. This application suite is fully open source and is designed to operate as a standalone VO as well as seamlessly integrate with other existing VOs. This extensible and open design yields easy mirroring worldwide for free and open exchange of scientific data and information. Data managed by SPIDR includes Geomagnetic Indices, GOES, Ionospheric, and DMSP which is archived/ingested from many data providers including WDC, IIWG, SAO, HDF, AFCCC, SEC, NASA, and this list is easily extendable. SPIDR III may be accessed via http://spidr.ngdc.noaa.gov/spidr/ A guest login is provided for convenience. Becoming a full access user, is free and only requires completing a short registration form.

  12. Options for venous access in ambulatory care: issues in selection and management.

    PubMed

    Herbst, S L

    1996-01-01

    As advances in VAD technology continue, the biggest challenge becomes the ability to stay abreast of all the emerging devices and the evolutions in management and care. Various resources are available which provide guidelines and standards to enable providers in the care of patients with VADs (see Table 6). It is incumbent upon caregivers to disseminate information as it is gained through observations and experience with VADs. The literature must remain current and accessible to all caregivers in order to ensure optimal management of patients with VADs.

  13. Crop management techniques to enhance harvest index in rice.

    PubMed

    Yang, Jianchang; Zhang, Jianhua

    2010-07-01

    A major challenge in rice (Oryza sativa L.) production is to enhance water use efficiency (WUE) and maintain or even increase grain yield. WUE, if defined as the biomass accumulation over water consumed, may be fairly constant for a given species in given climate. WUE can be enhanced by less irrigation. However, such enhancement is largely a trade-off against lower biomass production. If WUE is defined as the grain production per unit amount of water irrigated, it would be possible to increase WUE without compromising grain yield through the manipulation of harvest index. Harvest index has been shown to be a variable factor in crop production, and in many situations, it is closely associated with WUE and grain yield in cereals. Taking rice as an example, this paper discussed crop management techniques that can enhance harvest index. Several practices such as post-anthesis controlled soil drying, alternate wetting and moderate soil drying regimes during the whole growing season, and non-flooded straw mulching cultivation, could substantially enhance WUE and maintain or even increase grain yield of rice, mainly via improved canopy structure, source activity, sink strength, and enhanced remobilization of pre-stored carbon reserves from vegetative tissues to grains. All the work has proved that a proper crop management holds great promise to enhance harvest index and, consequently, achieve the dual goal of increasing grain production and saving water.

  14. Translocations of amphibians: Proven management method or experimental technique

    USGS Publications Warehouse

    Seigel, Richard A.; Dodd, C. Kenneth

    2002-01-01

    In an otherwise excellent review of metapopulation dynamics in amphibians, Marsh and Trenham (2001) make the following provocative statements (emphasis added): If isolation effects occur primarily in highly disturbed habitats, species translocations may be necessary to promote local and regional population persistence. Because most amphibians lack parental care, they areprime candidates for egg and larval translocations. Indeed, translocations have already proven successful for several species of amphibians. Where populations are severely isolated, translocations into extinct subpopulations may be the best strategy to promote regional population persistence. We take issue with these statements for a number of reasons. First, the authors fail to cite much of the relevant literature on species translocations in general and for amphibians in particular. Second, to those unfamiliar with current research in amphibian conservation biology, these comments might suggest that translocations are a proven management method. This is not the case, at least in most instances where translocations have been evaluated for an appropriate period of time. Finally, the authors fail to point out some of the negative aspects of species translocation as a management method. We realize that Marsh and Trenham's paper was not concerned primarily with translocations. However, because Marsh and Trenham (2001) made specific recommendations for conservation planners and managers (many of whom are not herpetologists or may not be familiar with the pertinent literature on amphibians), we believe that it is essential to point out that not all amphibian biologists are as comfortable with translocations as these authors appear to be. We especially urge caution about advocating potentially unproven techniques without a thorough review of available options.

  15. Surgical Tips in Frozen Abdomen Management: Application of Coliseum Technique.

    PubMed

    Kyriazanos, Ioannis D; Manatakis, Dimitrios K; Stamos, Nikolaos; Stoidis, Christos

    2015-01-01

    Wound dehiscence is a serious postoperative complication, with an incidence of 0.5-3% after primary closure of a laparotomy incision, and represents an acute mechanical failure of wound healing. Relatively recently the concept of "intentional open abdomen" was described and both clinical entities share common pathophysiological and clinical pathways ("postoperative open abdominal wall"). Although early reconstruction is the target, a significant proportion of patients will develop adhesions between abdominal viscera and the anterolateral abdominal wall, a condition widely recognized as "frozen abdomen," where delayed wound closure appears as the only realistic alternative. We report our experience with a patient who presented with frozen abdomen after wound dehiscence due to surgical site infection and application of the "Coliseum technique" for its definitive surgical management. This novel technique represents an innovative alternative to abdominal exploration, for cases of "malignant" frozen abdomen due to peritoneal carcinomatosis. Lifting the edges of the surgical wound upwards and suspending them under traction by threads from a retractor positioned above the abdomen facilitates approach to the peritoneal cavity, optimizes exposure of intra-abdominal organs, and prevents operative injury to the innervation and blood supply of abdominal wall musculature, a crucial step for subsequent hernia repair.

  16. Architectural Techniques For Managing Non-volatile Caches

    SciTech Connect

    Mittal, Sparsh

    2013-01-01

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

  17. Machine Learning Techniques for Decision Support in Intelligent Data Management

    NASA Astrophysics Data System (ADS)

    Lynnes, C.; Miller, J.; Ramapriyan, H.; Isaac, D.; Harberts, R.

    2002-12-01

    NASA's growth in remote sensing data volumes has kept pace with Moore's Law, i.e., doubling every 18 months, with future growth likely from new instruments. Also, advances in instrumental design (e.g., hyperspectral scanners) and science algorithms are enabling more near-real-time applications of the data. The confluence of low-latency requirements with high data volumes and numbers of files poses major challenges for archive data management. In order to make the right data available at the right time, an archive will need to apply knowledge of the data content in its data management decisions. This decision support domain includes aspects such as automatic quality assessment, feature detection to support caching decisions, and content-based metadata to support efficient data selection. In this study, we evaluate a variety of machine learning algorithms for use in several decision support roles in intelligent data management. Machine learning algorithms such as neural networks and clustering have been used for decision support in business and policy domains. These techniques have found some use in remote sensing, e.g., for cloud and land cover classification. Yet most research on remote sensing data rests on science-based algorithms, such as those based on radiative transfer equations. Machine learning for scientific applications faces challenges such as discretization constraints, non-physical basis, and the difficulty of assembling training sets. However, these difficulties may be less significant in the decision support role. For instance, it is often enough to know whether a data attribute exceeds a certain threshold when selecting it for an application, without knowing the exact value. The training data problem can be surmounted by using products output by the science-based algorithms. On the other hand, an advantage of machine learning algorithms for decision support is their speed once they have been trained. Data management decisions must be made while the

  18. Multidisciplinary management of vascular access for haemodialysis: from the preparation of the initial access to the treatment of stenosis and thrombosis.

    PubMed

    Reinhold, C; Haage, P; Hollenbeck, M; Mickley, V; Ranft, J

    2011-05-01

    In February 2008 a multidisciplinary study group was established in Germany to improve the treatment of patients with potential vascular access problems. As one of the first results of their work interdisciplinary recommendations for the management of vascular access were provided, from the creation of the initial access to the treatment of complications. As a rule the wrist arteriovenous fistula (AVF) is the access of choice due to its lower complication rate when compared to other types of access. The AVF should be created 3 months prior to the expected start of haemodialysis to allow for sufficient maturation. Second and third choice accesses are arteriovenous grafts (AVG) and central venous catheters (CVC). Ultrasound is a reliable tool for vessel selection before access creation, and also for the diagnosis of complications in AVF and grafts. Access stenosis and thrombosis can be treated surgically and interventionally. The comparison of both methods reveals advantages and disadvantages for each. The therapeutic decision should be based on the individual patients' constitution, and also on the availability and experience of the involved specialists.

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

    USGS Publications Warehouse

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

    2003-01-01

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

  20. 17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... establish, document, and maintain a system of risk management controls and supervisory procedures...

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  2. Random-access technique for modular bathymetry data storage in a continental shelf wave refraction program

    NASA Technical Reports Server (NTRS)

    Poole, L. R.

    1974-01-01

    A study was conducted of an alternate method for storage and use of bathymetry data in the Langley Research Center and Virginia Institute of Marine Science mid-Atlantic continental-shelf wave-refraction computer program. The regional bathymetry array was divided into 105 indexed modules which can be read individually into memory in a nonsequential manner from a peripheral file using special random-access subroutines. In running a sample refraction case, a 75-percent decrease in program field length was achieved by using the random-access storage method in comparison with the conventional method of total regional array storage. This field-length decrease was accompanied by a comparative 5-percent increase in central processing time and a 477-percent increase in the number of operating-system calls. A comparative Langley Research Center computer system cost savings of 68 percent was achieved by using the random-access storage method.

  3. Alternative techniques for gaining venous access. What to do when peripheral intravenous catheterization is not possible.

    PubMed

    Vyskocil, J J; Kruse, J A; Wilson, R F

    1993-03-01

    There are a number of therapeutic options for fluid administration in patients who lack usual venous access. Ways to establish this access include limb elevation and wrapping, the application of nitroglycerin ointment to dilate veins, and blood pressure cuff inflation. Ultrasonography can also be used to delineate vascular structures. Cutdown procedures are the oldest, most direct method to reach uncommon venous sites, such as the inferior epigastric, intercostal, iliac, and lateral thoracic veins. Today, cutdown procedures are regarded as the method of last resort, and they should be performed in operating suites or similar settings. Possible complications include inadvertent arterial puncture and hemorrhage.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  5. A Computer-Based Method for Teaching Catheter-Access Hemodialysis Management.

    PubMed

    Pun, Sut-Kam; Chiang, Vico Chung-Lim; Choi, Kup-Sze

    2016-10-01

    Patients undergoing hemodialysis are highly susceptible to infections, which could lead to morbidity and mortality. One of the major sources of infections stems from the mishandling of hemodialysis access sites. Although healthcare workers receive training on how to aseptically handle hemodialysis catheters, the increasing number of blood infections associated with dialysis suggests that the conventional approach to training may not be sufficient to ensure a clear understanding of the necessary knowledge and skills. With advancements in digital technology, computer-assisted learning has been gaining popularity as an approach to teaching clinical skills. The purpose of this study was to evaluate the effectiveness of a computer-based training system developed to teach healthcare workers catheter-access hemodialysis management. Forty nurses were recruited and randomly assigned into two groups: the control group, which received conventional training only; and the experimental group, which received both conventional and computer-based training. A knowledge test and a skills competence test were administered to both groups before and after the intervention to evaluate their performance. The results show that the performance of the nurses in the experimental group was significantly better than that in the control group, indicating that the proposed training system is an effective tool for supplementing the learning of catheter-access hemodialysis management.

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

    PubMed

    Taubman, Antony

    2010-01-19

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

  7. Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

    PubMed

    Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

    2011-01-01

    In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail.

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

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

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

  9. Injection techniques in the management of local pain.

    PubMed

    Fischer, A A

    1996-01-01

    This is a review of local anesthetic (LA) injections and infiltrations particularly combined with 'needling' for management of local musculoskeletal pain. New techniques are described including preinjection blocks (PIBs) which consist of blocking the sensory input from an area prior to giving an injection. PIBs prevent pain which would be caused by needle penetration of sensitive tissue. Needling and infiltration (N and I) with 1% lidocaine has been performed after PIB in 179 tender spots (TSs), trigger points (TrPs), and muscle spasms by the author, in 123 patients with the goal to relieve pain and promote healing. The immediate effect after the procedure as well as long-term results from 1 week to 7 months have been evaluated independently by a physiatrist experienced with injections (Dr. Tae Mo Chang). N and I extending over the entire taut band of abnormal muscle fibers, caused effective relief of pain and functional improvement in tender spots (TSs), trigger points (TrPs) and in muscle spasm caused by a variety of conditions including: acute and chronic sports and work injuries, motor vehicle accidents, muscle and ligament sprains (supraspinous, sacroiliac), overuse and repetitive stress syndromes, tennis elbow; local injuries or radicular irritation; and local inflammations such as bursitis, tendinitis, and osteoarthritis; and traumatic dystrophy, a type of reflex sympathetic dystrophy. Needling and infiltration of trigger areas and tender spots is effective treatment in several conditions. Pre-injection blocks allow the performance of the N and I of tender areas without pain.

  10. Applying Fourth Generation Management to Access Services: Reinventing Customer Service and Process Management

    ERIC Educational Resources Information Center

    Hasty, Douglas F.

    2004-01-01

    Are librarians doing all they can to ensure that customer services are delivered with the customer in mind? Librarians are great at helping, but we sometimes need help with identifying customers, defining their needs, developing services, and reviewing the processes behind the services. Fourth Generation Management provides new insight for…

  11. Secondary Use of Clinical Data to Enable Data-Driven Translational Science with Trustworthy Access Management.

    PubMed

    Mosa, Abu Saleh Mohammad; Yoo, Illhoi; Apathy, Nate C; Ko, Kelly J; Parker, Jerry C

    2015-01-01

    University of Missouri (MU) Health Care produces a large amount of digitized clinical data that can be used in clinical and translational research for cohort identification, retrospective data analysis, feasibility study, and hypothesis generation. In this article, the implementation of an integrated clinical research data repository is discussed. We developed trustworthy access-management protocol for providing access to both clinically relevant data and protected health information. As of September 2014, the database contains approximately 400,000 patients and 82 million observations; and is growing daily. The system will facilitate the secondary use of electronic health record (EHR) data at MU to promote data-driven clinical and translational research, in turn enabling better healthcare through research.

  12. Evidence-based practice in the management of vascular access devices for home parenteral nutrition therapy.

    PubMed

    Ryder, Marcia

    2006-01-01

    Catheter-related bloodstream infection and catheter occlusion are potential significant complications of parenteral nutrition therapy. The increased incidence and associated morbidity, mortality, increased costs, and quality-of-life issues experienced with these adverse events necessitate specialized management of vascular access devices. The host coagulation response to biomaterials and the associated development of biofilm on vascular devices are complex phenomena. Multiple interventions are required to prevent access of bacteria to both intraluminal and extraluminal catheter surfaces, and the occurrence of catheter occlusion. The discovery of the biofilm form of microbial life and the associated recalcitrance of biofilm bacteria to antimicrobials has provided insight into the failure of current prevention, diagnostic, and treatment protocols. Critical interventions are presented correlating current evidence with new discoveries in pathogenesis.

  13. The SCAR Standing Committee on Antarctic Data Management - new directions in access to Antarctic research data

    NASA Astrophysics Data System (ADS)

    de Bruin, T.

    2009-04-01

    The SCAR Standing Committee on Antarctic Data Management (SC-ADM) was established by the Scientific Committee on Antarctic Research (SCAR) and the Council of Managers of National Antarctic Programs (COMNAP), to assist in the fulfillment of the data management obligations imposed by the Antarctic Treaty (section III.1.c): "Scientific observations and results from Antarctica shall be exchanged and made freely available." SC-ADM comprises representatives of the National Antarctic Data Centres or national points of contact. Currently 31 nations around the world are represented in SC-ADM. So far, SC-ADM has been focussing on the coordination of the Antarctic Master Directory (AMD), the internationally accessible, web-based, searchable record of Antarctic and Southern Ocean data set descriptions. The AMD is directly integrated into the international Global Change Master Directory (GCMD) to help further merge Antarctic science into global science. The AMD is a resource for scientists to advertise the data they have collected and to search for data they may need. Currently, SC-ADM is in a transition phase, moving forward to provide data access. Existing systems and web services technology will be used as much as possible, to increase efficiency and prevent 're-inventing the wheel' This poster will give an overview of this process, the current status and the expected results.

  14. Resource reliability, accessibility and governance: pillars for managing water resources to achieve water security in Nepal

    NASA Astrophysics Data System (ADS)

    Biggs, E. M.; Duncan, J.; Atkinson, P.; Dash, J.

    2013-12-01

    As one of the world's most water-abundant countries, Nepal has plenty of water yet resources are both spatially and temporally unevenly distributed. With a population heavily engaged in subsistence farming, whereby livelihoods are entirely dependent on rain-fed agriculture, changes in freshwater resources can substantially impact upon survival. The two main sources of water in Nepal come from monsoon precipitation and glacial runoff. The former is essential for sustaining livelihoods where communities have little or no access to perennial water resources. Much of Nepal's population live in the southern Mid-Hills and Terai regions where dependency on the monsoon system is high and climate-environment interactions are intricate. Any fluctuations in precipitation can severely affect essential potable resources and food security. As the population continues to expand in Nepal, and pressures build on access to adequate and clean water resources, there is a need for institutions to cooperate and increase the effectiveness of water management policies. This research presents a framework detailing three fundamental pillars for managing water resources to achieve sustainable water security in Nepal. These are (i) resource reliability; (ii) adequate accessibility; and (iii) effective governance. Evidence is presented which indicates that water resources are adequate in Nepal to sustain the population. In addition, aspects of climate change are having less impact than previously perceived e.g. results from trend analysis of precipitation time-series indicate a decrease in monsoon extremes and interannual variation over the last half-century. However, accessibility to clean water resources and the potential for water storage is limiting the use of these resources. This issue is particularly prevalent given the heterogeneity in spatial and temporal distributions of water. Water governance is also ineffective due to government instability and a lack of continuity in policy

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

    PubMed

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

    2010-12-01

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

  16. Field of view extension using frequency division multiple access technique: numerical analysis

    NASA Astrophysics Data System (ADS)

    Kavehvash, Zahra; Mehrany, Khashayar; Bagheri, Saeed

    2011-06-01

    Integral imaging could be considered as one of the prospective methods for recording and displaying 3D images based on its distinct features. Some of the most important challenges with this approach are the field of view and resolution limitation. In this work we investigate using frequency division multiple access (FDMA) idea for solving this problem. Simulation results show an increase of more than ten percent in the performance of the 3D reconstructed images using the proposed method.

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

    SciTech Connect

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

    1996-08-31

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

  18. 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.

  19. Modern techniques and technologies for unbundled access in the local loop

    NASA Astrophysics Data System (ADS)

    Bacis Vasile, Irina Bristena; Schiopu, Paul; Marghescu, Cristina

    2015-02-01

    The efficient and unbundled use of the existing telecommunications infrastructure represents a major goal for the development of the services offered by telecommunications providers. A major telecommunications operator can provide services to a subscriber using a copper wire pair or part of the frequency spectrum of a copper wire pair, together with other operators, through a process of unbundling access in the local loop. Since access to the vocal band is an already solved problem, concerns turn to the broadband access with xDSL service delivery on ungrouped subscriber loops; besides the legal and economic aspects involved this has become an engineering problem also. The local loop unbundling methods have a substantial technical impact. This impact should be taken into account right from the design stage and then in the standardization stage of broadband systems intended to operate on copper wire pairs in the local loop. These systems are known under the generic term of xDSL and began to be analyzed in the late 90s. xDSL became the dominant solution for providing Internet at a reasonable price for both residential and business subscribers. In this massive development scenario, certain problems will arise from the early stages of deployment, and another type of problems will occur later on when a large number of systems will be installed in a single beam.

  20. Access, availability, and infrastructure deficiency: The current management of thyroid disease in the developing world.

    PubMed

    Fualal, Jane; Ehrenkranz, Joel

    2016-08-26

    Thyroid disease, a neglected tropical disease and the most common noncommunicable disease in the developing world, is overlooked, under-diagnosed, and inadequately managed. The spectrum of thyroid disorders in the developing world is qualitatively different from that found in industrialized countries. This qualitative difference has resulted in limited access to clinical, laboratory, and imaging resources that are necessary for the care of patients with thyroid disease. The management of thyroid disease in the developing world is comparable to the care provided for disorders of the thyroid in North America fifty years ago.This article reviews public health and clinical aspects of developing world medical and surgical thyroid disease. Topics covered include iodine deficiency disorders, congenital hypothyroidism, goiter, thyroid cancer, and hyper- and hypothyroidism. The review concludes with a description of programs based on smartphone technology to improve the availability, affordability, and quality of thyroid disease care.

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

    PubMed Central

    Lianas, Luca; Frexia, Francesca; Zanetti, Gianluigi

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1997-05-01

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

  4. Effective management of medical information through a novel blind watermarking technique.

    PubMed

    Das, Sudeb; Kundu, Malay Kumar

    2012-10-01

    Medical Data Management (MDM) domain consists of various issues of medical information like authentication, security, privacy, retrieval and storage etc. Medical Image Watermarking (MIW) techniques have recently emerged as a leading technology to solve the problems associated with MDM. This paper proposes a blind, Contourlet Transform (CNT) based MIW scheme, robust to high JPEG and JPEG2000 compression and simultaneously capable of addressing a range of MDM issues like medical information security, content authentication, safe archiving and controlled access retrieval etc. It also provides a way for effective data communication along with automated medical personnel teaching. The original medical image is first decomposed by CNT. The Low pass subband is used to embed the watermark in such a way that enables the proposed method to extract the embedded watermark in a blind manner. Inverse CNT is then applied to get the watermarked image. Extensive experiments were carried out and the performance of the proposed scheme is evaluated through both subjective and quantitative measures. The experimental results and comparisons, confirm the effectiveness and efficiency of the proposed technique in the MDM paradigm.

  5. A Code Phase Division Multiple Access (CPDMA) technique for VSAT satellite communications

    NASA Technical Reports Server (NTRS)

    Bruno, R.; Mcomber, R.; Weinberg, A.

    1991-01-01

    A reference concept and implementation relevant to the application of Code Phase Division Multiple Access (CPDMA) to a high capacity satellite communication system providing 16 Kbps single hop channels between Very Small Aperture Terminals (VSAT's) is described. The description includes a potential implementation of an onboard CPDMA bulk demodulator/converter utilizing programmable charge coupled device (CCD) technology projected to be available in the early 1990's. A high level description of the system architecture and operations, identification of key functional and performance requirements of the system elements, and analysis results of end-to-end system performance relative to key figures of merit such as spectral efficiency are also provided.

  6. Intensity distribution based space and time division multiple access technique for hybrid-LOS indoor optical wireless communication

    NASA Astrophysics Data System (ADS)

    Miyamoto, Shinichi; Kawamoto, Kenji; Sampei, Seiichi

    2010-02-01

    This paper proposes a space division and time division multiple access (SD/TDMA) technique based on intensity distributions for hybrid line-of-sight (hybrid-LOS) indoor optical wireless communication system. At first, a novel signal discrimination scheme for the spatially multiplexed optical signals is proposed and it is applied to a space division multiple access (SDMA) in hybrid-LOS system. In the proposed scheme, multiple terminals simultaneously transmit their optical signals to access point (AP) using on-off-keying (OOK) modulation, and the spatially multiplexed optical signals are received by a photodetectors array (PD-array), where multiple PDs are disposed to observe the spatial intensity distribution of optical signals. Because the terminals transmit their data using OOK modulation, the spatial intensity distribution observed by the AP equipped with PD-array is subject to the data transmitted from individual terminals, and the AP can identify the terminals transmitting the optical signal by determining the transmitted intensity distribution. Of course, the transmitted intensity distributions are not orthogonal signal and the discriminability of transmitted intensity distributions is much related to the differences of intensity distributions. This implies that the number of terminals that can simultaneously access to the AP will be limited and it is determined by the differences of the candidate intensity distributions. In order to enhance the discriminability of the transmitted intensity distributions, the proposed signal discrimination scheme is further applied to the SD/TDMA. In the SD/TDMA, the discriminability required to enable SDMA is ensured by introducing a scheduling algorithm in which terminals with higher discriminatory of transmitted intensity distributions are allocated to the same time slot. Numerical results show that SD/TDMA using proposed signal discrimination scheme increases the throughput and the number of terminals that can access to

  7. Access Nets: Modeling Access to Physical Spaces

    NASA Astrophysics Data System (ADS)

    Frohardt, Robert; Chang, Bor-Yuh Evan; Sankaranarayanan, Sriram

    Electronic, software-managed mechanisms using, for example, radio-frequency identification (RFID) cards, enable great flexibility in specifying access control policies to physical spaces. For example, access rights may vary based on time of day or could differ in normal versus emergency situations. With such fine-grained control, understanding and reasoning about what a policy permits becomes surprisingly difficult requiring knowledge of permission levels, spatial layout, and time. In this paper, we present a formal modeling framework, called AccessNets, suitable for describing a combination of access permissions, physical spaces, and temporal constraints. Furthermore, we provide evidence that model checking techniques are effective in reasoning about physical access control policies. We describe our results from a tool that uses reachability analysis to validate security policies.

  8. The IRIS Data Management Center: Providing Efficient Access to GSN data

    NASA Astrophysics Data System (ADS)

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

    2004-05-01

    The IRIS Data Management Center (DMC) in Seattle, Washington is the host of the largest seismological database of its kind in the world. The Global Seismic Network (GSN) lies at the center of the DMC holdings. The DMC relies heavily upon a petabyte mass storage system for waveform storage and Oracle for its relational data base infrastructure. During the past several years, emphasis has been placed upon the development and implementation of robust and effective technologies that allow access to the information at the IRIS DMC in a variety of ways. This talk will highlight the general structure of the IRIS DMC and the method we use to manage the gigabytes of information in Oracle as well more than 100 terabytes of time series data we have in our mass storage systems. An overview will be given of the methods through which users can access the information in our relational database systems as well as the mass storage systems in order to conduct their research using GSN and other data. A discussion of three distinctly different approaches will be presented. These include an email-based method, a web-based method as well as a multi-tier distributed computing environment we call the Data Handling Interface (DHI). The DHI is based upon Common Object Request Broker Architecture (CORBA) and provides direct connections between client applications, normally provided by IRIS, and data center servers established at several data centers within the United States. The DHI presently supports the distribution of information about seismic events, information about the seismic stations that record the time series and finally the time series (seismograms) themselves. The system is capable of transmitting seismic waveform data in real time. Waveform data and all associated metadata are available through this interface allowing direct access to information at the DMC within client applications running on a users workstation.

  9. Advanced techniques and technology for efficient data storage, access, and transfer

    NASA Technical Reports Server (NTRS)

    Rice, Robert F.; Miller, Warner

    1991-01-01

    Advanced techniques for efficiently representing most forms of data are being implemented in practical hardware and software form through the joint efforts of three NASA centers. These techniques adapt to local statistical variations to continually provide near optimum code efficiency when representing data without error. Demonstrated in several earlier space applications, these techniques are the basis of initial NASA data compression standards specifications. Since the techniques clearly apply to most NASA science data, NASA invested in the development of both hardware and software implementations for general use. This investment includes high-speed single-chip very large scale integration (VLSI) coding and decoding modules as well as machine-transferrable software routines. The hardware chips were tested in the laboratory at data rates as high as 700 Mbits/s. A coding module's definition includes a predictive preprocessing stage and a powerful adaptive coding stage. The function of the preprocessor is to optimally process incoming data into a standard form data source that the second stage can handle.The built-in preprocessor of the VLSI coder chips is ideal for high-speed sampled data applications such as imaging and high-quality audio, but additionally, the second stage adaptive coder can be used separately with any source that can be externally preprocessed into the 'standard form'. This generic functionality assures that the applicability of these techniques and their recent high-speed implementations should be equally broad outside of NASA.

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

    ERIC Educational Resources Information Center

    Adamson, John; Brown, Howard

    2012-01-01

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

  11. Biliary Interventions: Tools and Techniques of the Trade, Access, Cholangiography, Biopsy, Cholangioscopy, Cholangioplasty, Stenting, Stone Extraction, and Brachytherapy.

    PubMed

    Ahmed, Osman; Mathevosian, Sipan; Arslan, Bulent

    2016-12-01

    Therapeutic access to the biliary system is generally limited to endoscopic or percutaneous approaches. A variety of percutaneous transhepatic biliary interventions are applicable for the diagnosis and treatment of biliary system pathologies, the majority of which may be performed in conjunction with one another. The backbone of nearly all of these interventions is percutaneous transhepatic cholangiography for opacification of the biliary tree, after which any number of therapeutic or diagnostic modalities may be pursued. We describe an overview of the instrumentation and technical approaches for several fundamental interventional procedures, including percutaneous transhepatic cholangiography and internal/external biliary drainage, endobiliary biopsy techniques, cholangioscopy, cholangioplasty and biliary stenting, biliary stone extraction, and intraluminal brachytherapy.

  12. Jihadist Terrorist Use of Strategic Communication Management Techniques

    DTIC Science & Technology

    2008-12-01

    terrorism studies, defense planning, arms control, peacekeeping, crisis management, regional and cooperative security. The Marshall Center...and with our partners and allies, to harmonize international efforts in the global war on terror within a grand strategy ( Opheim & Bowen 2008). This...Perceptions and the Future Perspectives of Strategic Information Management. The Development of Crisis Communication from the Kosovo Operation “Allied

  13. Utilizing Project Management Techniques in the Design of Instructional Materials.

    ERIC Educational Resources Information Center

    Murphy, Charles

    1994-01-01

    Discussion of instructional design in large organizations highlights a project management approach. Topics addressed include the role of the instructional designer; project team selection; role of the team members; role of the project manager; focusing on what employees need to know; types of project teams; and monitoring time and responsibility.…

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

    ERIC Educational Resources Information Center

    Elleh, Festus U.

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Tran, Van Dat

    2015-01-01

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

  16. The European Court legitimates access of Italian couples to assisted reproductive techniques and to pre-implantation genetic diagnosis.

    PubMed

    Turillazzi, Emanuela; Frati, Paola; Busardò, Francesco Paolo; Gulino, Matteo; Fineschi, Vittorio

    2015-07-01

    On 28 August 2012, the European Court of Human Rights (ECHR) issued a judgment regarding the requirements for the legitimate access of couples to assisted reproductive techniques (ART) and to pre-implantation genetic diagnosis (PGD). This judgment concerns the case of an Italian couple who found out after their first child was born with cystic fibrosis that they were healthy carriers of the disease. When the woman became pregnant again in 2010 and underwent fetal screening, it was found that the unborn child also had cystic fibrosis, whereupon she had the pregnancy terminated on medical grounds. In order to have the embryo genetically screened prior to implantation under the procedure of PGD, the couple sought to use in vitro fertilisation to have another child. Since article 1 of the Italian law strictly limits access to ART to sterile/infertile couples or those in which the man has a sexually transmissible disease, the couple appealed to the European court, raising the question of the violation of articles 8 and 14 of the European Convention on Human Rights. The applicants lodged a complaint that they were not allowed legitimate access to ART and to PGD to select an embryo not affected by the disease. The European Court affirmed that the prohibition imposed by Italian law violated article 8 of the European Convention on Human Rights. Focusing on important regulatory and legal differences among EU Nations in providing ART treatments and PGD, we derived some important similarities and differences.

  17. Comprehensive and Conservative Management of Talon Cusp: A New Technique

    PubMed Central

    Lodha, Surendra

    2016-01-01

    Talon cusp is a common dental anomaly affecting maxillary central incisors. Gradual grinding of this additional cusp is commonly followed now. Advocated below is a new technique explaining the use of air abrasion and putty index during the stepwise reduction of the cusp. The technique is advantageous in preventing patient discomfort and tracking the amount of reduction in a predictable way. PMID:28105377

  18. Study of systems and techniques for data base management

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Data management areas were studied to identify pertinent problems and issues that will affect future NASA data users in terms of performance and cost. Specific topics discussed include the identifications of potential NASA data users other than those normally discussed, consideration affecting the clustering of minicomputers, low cost computer system for information retrieval and analysis, the testing of minicomputer based data base management systems, ongoing work related to the use of dedicated systems for data base management, and the problems of data interchange among a community of NASA data users.

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

    NASA Technical Reports Server (NTRS)

    Reph, M. G.

    1983-01-01

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

  20. Assisting vascular access surgery planning for hemodialysis by using MR, image segmentation techniques, and computer simulations.

    PubMed

    Merkx, M A G; Bode, A S; Huberts, W; Oliván Bescós, J; Tordoir, J H M; Breeuwer, M; van de Vosse, F N; Bosboom, E M H

    2013-08-01

    The surgical creation of a vascular access, used for hemodialysis treatment of renal patients, has considerable complication rates (30-50 %). Image-based computational modeling might assist the surgeon in planning by enhanced analysis of preoperative hemodynamics, and in the future might serve as platform for outcome prediction. The objective of this study is to investigate preoperative personalization of the computer model using magnetic resonance (MR). MR-angiography and MR-flow data were obtained for eight patients and eight volunteers. Blood vessels were extracted for model input by a segmentation algorithm. Windkessel elements were added at the ends to represent the peripheral beds. Monte Carlo-based calibration was used to estimate the most influential non-measurable parameters. The predicted flow waveforms were compared with the MR-flow measurements for framework evaluation. The vasculature of all subjects were segmented in on average <5 min. The Monte Carlo-calibrated simulations showed a deviation between measured and simulated flow waveforms of 9 and 10 % for volunteers and patients, respectively. The presented method accurately mimics the preoperative hemodynamic state. Furthermore, the surgeon can interactively explore the hemodynamics at any vascular tree position. This integration of measurements in a modeling approach can provide the surgeon with additional information for preoperative planning.

  1. An investigation of a sterile access technique for the repair and adjustment of sterile spacecraft

    NASA Technical Reports Server (NTRS)

    Farmer, F. H.; Fuller, H. V.; Hueschen, R. M.

    1973-01-01

    A description is presented of a unique system for the sterilization and sterile repair of spacecraft and the results of a test program designed to assess the biological integrity and engineering reliability of the system. This trailer-mounted system, designated the model assembly sterilizer for testing (MAST), is capable of the dry-heat sterilization of spacecraft and/or components less than 2.3 meters in diameter at temperatures up to 433 K and the steam sterilization of components less than 0.724 meter in diameter. Sterile access to spacecraft is provided by two tunnel suits, called the bioisolator suit systems (BISS), which are contiguous with the walls of the sterilization chambers. The test program was designed primarily to verify the biological and engineering reliability of the MAST system by processing simulated space hardware. Each test cycle simulated the initial sterilization of a spacecraft, sterile repair of a failed component, removal of the spacecraft from the MAST for mating with the bus, and a sterile recycle repair.

  2. Management of excessive movable tissue: a modified impression technique.

    PubMed

    Shum, Michael H C; Pow, Edmond H N

    2014-08-01

    Excessive movable tissue is a challenge in complete denture prosthetics. A modified impression technique is presented with polyvinyl siloxane impression material and a custom tray with relief areas and perforations in the area of the excessive movable tissue.

  3. Magnamosis: a novel technique for the management of rectal atresia

    PubMed Central

    Russell, Katie W; Rollins, Michael D; Feola, G Peter; Scaife, Eric R

    2014-01-01

    We report a case of rectal atresia treated using magnets to create a rectal anastomosis. This minimally invasive technique is straightforward and effective for the treatment of rectal atresia in children. PMID:25096648

  4. [Assessment of exposure to cancerogenic aromatic hydrocarbon during controlled-access highways management activities].

    PubMed

    Martinotti, I; Cirla, A M; Cottica, D; Cirla, P E

    2011-01-01

    The purpose of this study was an integrated assessment of exposure to benzene and Polycyclic Aromatic Hydrocarbons (PAH) in 29 workers employed to manage a controlled-access highways. A campaign was performed in summertime by environmental monitoring (active and passive airborne personal sampler), as well as by biological monitoring (urine samples of the beginning and of the end of daily shift, baseline after two days of vacation). The measured environmental levels did not differ from background environmental concentrations found in a metropolitan area (i.e. benzo[a]pyrene < 1 ng/m3; benzene < 5 mcg/m3), and the results of biological monitoring were in agreement and were compatible with extra-professional habits of the investigated subjects (1-hydroxipyrene 50-990 ng/g creatinine; unmetabolized benzene 15-2010 ng/I; t-t muconic acid < 4-222 mcg/g creatinine).

  5. Fracture and migration of implantable venous access port catheters: Cause analysis and management of 4 cases.

    PubMed

    Xiao, Shu-ping; Xiong, Bin; Chu, Jun; Li, Xiao-fang; Yao, Qi; Zheng, Chuan-sheng

    2015-10-01

    This study aimed to investigate the causes and managements of the fractures and migrations of the implantable venous access port catheter (IVAPC). The fracture or migration of IVAPC occurred in 4 patients who were treated between May 2012 and January 2014 in Union Hospital, Wuhan, China. The port catheter leakage was found in 2 cases during drug infusion. Catheters that dislodged to the superior vena cava and right atrium were confirmed by port angiogram. The two dislodged catheters were successfully retrieved by interventional procedures. Catheter fracture occurred in two cases during port removal. One catheter was eventually removed from the subclavian vein through right clavicle osteotomy and subclavian venotomy, and the other removed by external jugular venotomy. Flushing the port in high pressure and injury of the totally implantable venous access port (TIVP) during implantation are usually responsible for catheter displacement. Interventional retrieval procedure can be used if the catheter dislodges to the vena cava and right atrium. Catheter fracture may occur during removal if clipping syndrome occurs or the catheter is sutured very tight during implantation.

  6. Hypertension Detection, Management, Control and Associated Factors Among Residents Accessing Community Health Services In Beijing

    PubMed Central

    JIANG, Bin; LIU, Hongmei; RU, Xiaojuan; ZHANG, Hui; WU, Shengping; WANG, Wenzhi

    2014-01-01

    The aim of this study was to analyse high blood pressure detection, management, control and associated factors among residents accessing community health services (CHSs) in Beijing. We screened for HBP in 9524 individuals aged 50 years or older who accessed care in four Beijing CHSs. Among the 9397 residents with questionnaire responses that qualified them for inclusion in the study, 5029 patients with HBP were identified, 1510 (i.e., 30% of the HBP patient group) of whom were newly identified cases. The rate of hypertension detection was 53.5%. Among the 5029 HBP patients, the rates of awareness, treatment and control of hypertension were 70.0%, 62.1% and 29.6%, respectively. In general, the rate of hypertension control was higher when the rates of hypertension awareness and treatment were higher in subgroups stratified by different sociodemographic and risk factors, except for the overweight and obesity subgroups. In conclusion, suboptimal HBP awareness, treatment, and control are still major problems confronting CHSs in Beijing. Control of hypertension in the population may be improved by increasing awareness and improving the treatment of hypertension in CHSs. PMID:24784167

  7. Hypertension detection, management, control and associated factors among residents accessing community health services in Beijing.

    PubMed

    Jiang, Bin; Liu, Hongmei; Ru, Xiaojuan; Zhang, Hui; Wu, Shengping; Wang, Wenzhi

    2014-05-02

    The aim of this study was to analyse high blood pressure detection, management, control and associated factors among residents accessing community health services (CHSs) in Beijing. We screened for HBP in 9524 individuals aged 50 years or older who accessed care in four Beijing CHSs. Among the 9397 residents with questionnaire responses that qualified them for inclusion in the study, 5029 patients with HBP were identified, 1510 (i.e., 30% of the HBP patient group) of whom were newly identified cases. The rate of hypertension detection was 53.5%. Among the 5029 HBP patients, the rates of awareness, treatment and control of hypertension were 70.0%, 62.1% and 29.6%, respectively. In general, the rate of hypertension control was higher when the rates of hypertension awareness and treatment were higher in subgroups stratified by different sociodemographic and risk factors, except for the overweight and obesity subgroups. In conclusion, suboptimal HBP awareness, treatment, and control are still major problems confronting CHSs in Beijing. Control of hypertension in the population may be improved by increasing awareness and improving the treatment of hypertension in CHSs.

  8. An improved technique for gaining radial artery access in endovascular interventions.

    PubMed

    Rigatelli, Gianluca; Magro, Beatrice; Maronati, Lorenza; Tranquillo, Milan; Oliva, Laura; Panin, Stefano; Bedendo, Emiliano

    2006-01-01

    We present a simple technique to avoid time loss and potential dangerous maneuvers for catheterization of the radial artery in endovascular interventions. If any difficulties are encountered when advancing the guide wire after the arterial puncture using standard transradial kits, we found it useful to routinely use a 60-mm polyethylene radial pressure line catheter like the Leader Cath (Vygon, Ecquen, France), which is more flexible and less traumatic than short catheters and are usually available in the standard hydrophilic transradial kit. With the 20-gauge needle within the arterial lumen, it is sufficient to advance the guide wire 3 or 4 cm, followed by the insertion of the radial pressure line catheter for administering a vasodilator cocktail. The contrast injection through the catheter is safer than through the needle, and visualization of the underling problems may avoid any time loss and complications. The standard sheath insertion is facilitated by the pressure line catheter that acts as a dilator. This technique, especially when performing coronary or peripheral interventions in which large introducers are needed, may avoid potentially dangerous vascular complications and improve the success rate.

  9. Research to Develop Effective Teaching and Management Techniques for Severely Disturbed and Retarded Children. Final Report.

    ERIC Educational Resources Information Center

    Kauffman, James M.; Birnbrauer, Jay S.

    The final report of a project on teaching and management techniques with severely disturbed and/or retarded children presents analysis of single subject research using contingent imitation of the child as an intervention technique. The effects of this technique were examined on the following behaviors: toyplay and reciprocal imitation, self…

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

    PubMed

    Echeverria, Angela; Krajcer, Zvonimir

    2016-01-01

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

  11. Surgical management of metastatic long bone fractures: principles and techniques.

    PubMed

    Scolaro, John Alan; Lackman, Richard D

    2014-02-01

    Management of metastatic long bone fractures requires identification of the lesion and the use of sound fracture fixation principles to relieve pain and restore function. The treating surgeon must understand the principles of pathologic fracture fixation before initiating treatment. Because these fractures occur in the context of a progressive systemic disease, management typically involves a multidisciplinary approach. When considering surgical stabilization of these fractures, the abnormal (or absent) healing environment associated with diseased bone and the overall condition of the patient must be taken into account. The goal of surgery is to obtain a rigid mechanical construct, which allows for early mobility and weight bearing. This can be achieved using internal fixation with polymethyl methacrylate cement or segmental resection and joint reconstruction. Prosthetic joint arthroplasty is a more reliable means of fracture management when insufficient bone is present for fixation. Prophylactic stabilization of impending pathologic fractures can reduce the morbidity associated with metastatic lesions.

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

    SciTech Connect

    Mittal, Sparsh

    2014-09-01

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

  13. 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,…

  14. Virtual venue management users manual : access grid toolkit documentation, version 2.3.

    SciTech Connect

    Judson, I. R.; Lefvert, S.; Olson, E.; Uram, T. D.; Mathematics and Computer Science

    2007-10-24

    An Access Grid Venue Server provides access to individual Virtual Venues, virtual spaces where users can collaborate using the Access Grid Venue Client software. This manual describes the Venue Server component of the Access Grid Toolkit, version 2.3. Covered here are the basic operations of starting a venue server, modifying its configuration, and modifying the configuration of the individual venues.

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

    PubMed

    Oliver, Kelly; Manton, David John

    2015-01-01

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

  16. Maintaining Sanity in the Classroom. Classroom Management Techniques. Second Edition.

    ERIC Educational Resources Information Center

    Dreikurs, Rudolf; Brunwald, Bernice Bronia; Pepper, Floy C.

    This book, based on Adlerian psychology, applies the techniques of motivation modification to realistic classroom problems, dealing step-by-step with handling behavior difficulties and providing the background that enables student teachers to understand the group dynamics of various classroom situations. The book is divided into five parts with 30…

  17. Regional environmental analysis and management: New techniques for current problems

    NASA Technical Reports Server (NTRS)

    Honea, R. B.; Paludan, C. T. N.

    1974-01-01

    Advances in data acquisition and processing procedures for regional environmental analysis are discussed. Automated and semi-automated techniques employing Earth Resources Technology Satellite data and conventional data sources are presented. Experiences are summarized. The ERTS computer compatible tapes provide a very complete and flexible record of earth resources data and represent a viable medium to enhance regional environmental analysis research.

  18. Comprehensive Flood Plain Studies Using Spatial Data Management Techniques.

    DTIC Science & Technology

    1978-06-01

    and subbasin hydraulic length. The technique adopted is a modest extension and automation of the method developed for San Diego County (Franziniet al...land classified as 14 I ____.4_ natural vegetation under existing conditions is 272 acres while the total amount of landA classified as natural

  19. Variable weight Khazani-Syed code using hybrid fixed-dynamic technique for optical code division multiple access system

    NASA Astrophysics Data System (ADS)

    Anas, Siti Barirah Ahmad; Seyedzadeh, Saleh; Mokhtar, Makhfudzah; Sahbudin, Ratna Kalos Zakiah

    2016-10-01

    Future Internet consists of a wide spectrum of applications with different bit rates and quality of service (QoS) requirements. Prioritizing the services is essential to ensure that the delivery of information is at its best. Existing technologies have demonstrated how service differentiation techniques can be implemented in optical networks using data link and network layer operations. However, a physical layer approach can further improve system performance at a prescribed received signal quality by applying control at the bit level. This paper proposes a coding algorithm to support optical domain service differentiation using spectral amplitude coding techniques within an optical code division multiple access (OCDMA) scenario. A particular user or service has a varying weight applied to obtain the desired signal quality. The properties of the new code are compared with other OCDMA codes proposed for service differentiation. In addition, a mathematical model is developed for performance evaluation of the proposed code using two different detection techniques, namely direct decoding and complementary subtraction.

  20. Fever in a child with cerebrospinal fluid access device or shunt: a pragmatic approach to management.

    PubMed

    Cleave, Betsy; Cartmill, Maria; Soo, Shiu Shing; Vyas, Harish

    2016-10-20

    Children with shunts commonly present with fever, and often the focus of infection will be unrelated to their shunt. However, as shunt infections may present with few or even no specific symptoms, evaluation of a child with a shunt presenting with fever should be careful and comprehensive to ensure shunt infections are not missed. Treatment of an infected shunt involves removal of the shunt followed by a long course of antibiotics; missing or partially treating shunt infections can result in significant morbidity and potentially even mortality. Our experience of managing children with shunts presenting with fever is that many non-specialist clinicians have little experience in this area so initial management may not always be appropriate. Those children who are most at risk of shunt infection are those who within the preceding 8 weeks have had insertion, revision or access of their shunt or chemotherapy device, or have had abdominal surgery in the presence of a ventriculoperitoneal shunt. We have chosen 8 weeks as a pragmatic time point, as in our experience the vast majority of children who have had shunt infections have presented within this period. The caveat is that this should not be used as an absolute cut-off where there is strong suspicion of shunt infection or no clear focus at a later time point.

  1. Improved outage management techniques for better plant availability

    SciTech Connect

    Bemer, J.P.

    1989-01-01

    To maintain high availability of nuclear generating units is one of the most important management objectives. The duration of outages-whether planned or unplanned-is the main parameter impacting on plant availability, but the planned outages, and essentially the refueling outages, are the most important in this respect, and they also have a heavy impact on the economics of plant operation. The following factors influence the duration of the outages: (1) modifications; (2) preventive maintenance operations; and (3) corrective maintenance operations of generic faults. In this paper, the authors examine how the outage management organization of Electricite de France (EdF) plants is tending to optimize the solutions to the above-mentioned points.

  2. Charles bonnet syndrome, management with simple behavioral technique.

    PubMed

    Issa, Baba Awoye; Yussuf, Abdullahi Dasliva

    2013-01-01

    Charles Bonnet syndrome occurs in visually impaired but cognitively normal individuals. This report describes a condition of vivid visual hallucination (phantom images) in an 85-year-old conscious man, who had been blind by bilateral progressively worsening glaucoma. This common, but rarely reported, condition was managed by behavioral approach of repeated blinking, intermittent eyes closure, and reassurance. While emotional, mood and cognitive disorders need to be ruled out, the condition, though frightening to the afflicted, is benign and remediable with simple, inexpensive approach. Health workers managing people with terminal blindness should always ask for the presence of hallucinations from their patients to forestall a preventable distress resulting from wrong perception without visual stimulus.

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  4. Blepharoplasty techniques in the management of orbito-temporal neurofibromatosis.

    PubMed

    Li, Jin; Lin, Ming; Shao, Chunyi; Ge, Shengfang; Fan, Xianqun

    2014-11-01

    We aimed to present blepharoplasty techniques we used for severe orbito-temporal neurofibromatosis (NF). A retrospective noncomparative single-center case study was undertaken on patients with orbito-temporal NF. Twenty-two patients with orbito-temporal NF treated at the Department of Ophthalmology of Shanghai Ninth People's Hospital between 2007 and 2011 participated in the study. They underwent a standard ophthalmologic assessment for orbito-temporal NF involving both the orbito-temporal soft tissue and bony orbits. The orbits were examined with three-dimensional computed tomography (CT) and all 22 patients underwent tumor debulking, blepharoplasty, and orbital reconstruction. We modified the conventional procedures. Our reconstructive techniques included eyelid reduction; lateral canthal reattachment; for patients with collapse of the lateral orbital margin, reconstruction of the orbital margin to be performed before reattaching the lateral canthus to the implanted titanium mesh; anterior levator resection; and frontalis suspension according to preoperative levator muscle function. Visual acuity, tumor recurrence, and postoperative palpebral fissure and orbital appearance were evaluated to assess outcomes. Acceptable cosmetic results were obtained in 22 patients after debulking of the orbito-temporal NF and surgical reconstruction. There was no loss of vision or visual impairment postoperatively. All patients did not display recrudescence after a follow-up period of >1 year. Three patients with residual ptosis were successfully treated with a second ptosis repair. We believe that the blepharoplasty techniques described in the treatment of orbito-palpebral NF may provide both functional and esthetic benefits.

  5. A Comparison of Perceived Crisis Training Management and Optimum Training Management Techniques in the Army

    DTIC Science & Technology

    1980-08-27

    Ambiguity and Time Management relating to crisis management are key issues for consideration in the development of this investigation. These concepts are...themselves to be optimum-management-oriented. The study indicates the possibility of continuing problems in the areas of time management contributing to

  6. Techniques for cash management in scheduling manufacturing operations

    NASA Astrophysics Data System (ADS)

    Morady Gohareh, Mehdy; Shams Gharneh, Naser; Ghasemy Yaghin, Reza

    2016-10-01

    The objective in traditional scheduling is usually time based. Minimizing the makespan, total flow times, total tardi costs, etc. are instances of these objectives. In manufacturing, processing each job entails a cost paying and price receiving. Thus, the objective should include some notion of managing the flow of cash. We have defined two new objectives: maximization of average and minimum available cash. For single machine scheduling, it is demonstrated that scheduling jobs in decreasing order of profit ratios maximizes the former and improves productivity. Moreover, scheduling jobs in increasing order of costs and breaking ties in decreasing order of prices maximizes the latter and creates protection against financial instability.

  7. Efficient Consistency Achievement of Federated Identity and Access Management Based on a Novel Self-Adaptable Approach

    NASA Astrophysics Data System (ADS)

    Cha, Shi-Cho; Chang, Hsiang-Meng

    Federated identity and access management (FIAM) systems enable a user to access services provided by various organizations seamlessly. In FIAM systems, service providers normally stipulate that their users show assertions issued by allied parties to use their services as well as determine user privileges based on attributes in the assertions. However, the integrity of the attributes is important under certain circumstances. In such a circumstance, all released assertions should reflect modifications made to user attributes. Despite the ability to adopt conventional certification revocation technologies, including CRL or OCSP, to revoke an assertion and request the corresponding user to obtain a new assertion, re-issuing an entirely new assertion if only one attribute, such as user location or other environmental information, is changed would be inefficient. Therefore, this work presents a self-adaptive framework to achieve consistency in federated identity and access management systems (SAFIAM). In SAFIAM, an identity provider (IdP), which authenticates users and provides user attributes, should monitor access probabilities according to user attributes. The IdP can then adopt the most efficient means of ensuring data integrity of attributes based on related access probabilities. While Internet-based services emerge daily that have various access probabilities with respect to their user attributes, the proposed self-adaptive framework significantly contributes to efforts to streamline the use of FIAM systems.

  8. The IRIS Data Management Center: Enabling Access to Observational Time Series Spanning Decades

    NASA Astrophysics Data System (ADS)

    Ahern, T.; Benson, R.; Trabant, C.

    2009-04-01

    are of acceptably high quality. The formats and data structures used by the seismological community are esoteric. IRIS and its FDSN partners are developing web services that can transform the data holdings to structures that are more easily used by broader scientific communities. For instance, atmospheric scientists are interested in using global observations of microbarograph data but that community does not understand the methods of applying instrument corrections to the observations. Web processing services under development at IRIS will transform these data in a manner that allows direct use within such analysis tools as MATLAB® already in use by that community. By continuing to develop web-service based methods of data discovery and access, IRIS is enabling broader access to its data holdings. We currently support data discovery using many of the Open Geospatial Consortium (OGC) web mapping services. We are involved in portal technologies to support data discovery and distribution for all data from the EarthScope project. We are working with computer scientists at several universities including the University of Washington as part of a DataNet proposal and we intend to enhance metadata, further develop ontologies, develop a Registry Service to aid in the discovery of data sets and services, and in general improve the semantic interoperability of the data managed at the IRIS DMC. Finally IRIS has been identified as one of four scientific organizations that the External Research Division of Microsoft wants to work with in the development of web services and specifically with the development of a scientific workflow engine. More specific details of current and future developments at the IRIS DMC will be included in this presentation.

  9. Proceedings of the National Conference on Energy Resource Management. Volume 1: Techniques, Procedures and Data Bases

    NASA Technical Reports Server (NTRS)

    Brumfield, J. O. (Editor); Schiffman, Y. M. (Editor)

    1982-01-01

    Topics dealing with the integration of remotely sensed data with geographic information system for application in energy resources management are discussed. Associated remote sensing and image analysis techniques are also addressed.

  10. Techniques for early diagnosis and management of cervicofacial necrotising fasciitis

    PubMed Central

    Lee, Judy W; Immerman, Sara B; Morris, Luc GT

    2010-01-01

    Background Cervicofacial necrotising fasciitis carries high rates of morbidity and mortality, and is not often initially suspected due to its rarity and misleadingly innocuous presentation. We propose an algorithm for the timely diagnosis and management of cervicofacial necrotising fasciitis. Methods Retrospective review of seven patients ultimately diagnosed with cervicofacial necrotising fasciitis. Results In these seven patients, common presenting symptoms included sore throat, fever and neck pain. On initial examination and imaging, only three had obvious findings. One patient’s diagnosis was facilitated via a bedside cut-down procedure. Six patients underwent surgical debridement. Four required tracheotomy, and five wounds closed via secondary intention. There were two deaths. Conclusion The severity of cervical necrotising fasciitis and its rapid spread necessitate early diagnosis and timely surgical management. The presentation often appears benign. A high index of clinical suspicion should be maintained in cases of neck cellulitis with nonspecific clinical findings, especially in diabetic or otherwise immunocompromised patients. A normal computed tomography scan does not rule out necrotising fasciitis. A cut-down procedure may be critical to early diagnosis in some cases. PMID:20298644

  11. Statistical and Economic Techniques for Site-specific Nematode Management.

    PubMed

    Liu, Zheng; Griffin, Terry; Kirkpatrick, Terrence L

    2014-03-01

    Recent advances in precision agriculture technologies and spatial statistics allow realistic, site-specific estimation of nematode damage to field crops and provide a platform for the site-specific delivery of nematicides within individual fields. This paper reviews the spatial statistical techniques that model correlations among neighboring observations and develop a spatial economic analysis to determine the potential of site-specific nematicide application. The spatial econometric methodology applied in the context of site-specific crop yield response contributes to closing the gap between data analysis and realistic site-specific nematicide recommendations and helps to provide a practical method of site-specifically controlling nematodes.

  12. 76 FR 13438 - AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc... is a lack of current and accurate information concerning the securities of DME Interactive...

  13. How old is too old? A contribution to the discussion on age limits for assisted reproduction technique access.

    PubMed

    Kocourková, Jiřina; Konečná, Hana; Burcin, Boris; Kučera, Tomáš

    2015-05-01

    In 2012, the Czech Republic established the women's age limit for access to assisted reproduction techniques at age 49 years. In this paper, the acceptability of this age limit from the children's perspective in the Czech Republic is assessed. Although the necessity of balancing the interests of parents and children is acknowledged, little research has taken children's interests into account. We have attempted to map out 'children's interests', asking older children and adolescents (aged 11-25 years) how old they would prefer their parents to be: Czech respondents would prefer to have younger parents. This finding is consistent with the optimal biological childbearing age rather than with the current postponement to a later age. So far, assisted reproduction techniques have been largely regarded as a medical treatment justifying the current women's age limit of 49 years. Had the children's perspective been taken into account, this age limit might have been lower than 49 years. We propose that reproductive health policy should adequately reflect multiple perspectives as an integral part of a multi-layered support system of a society.

  14. Thermal Management Techniques for Oil-Free Turbomachinery Systems

    NASA Technical Reports Server (NTRS)

    Radil, Kevin; DellaCorte, Chris; Zeszotek, Michelle

    2006-01-01

    Tests were performed to evaluate three different methods of utilizing air to provide thermal management control for compliant journal foil air bearings. The effectiveness of the methods was based on bearing bulk temperature and axial thermal gradient reductions during air delivery. The first method utilized direct impingement of air on the inner surface of a hollow test journal during operation. The second, less indirect method achieved heat removal by blowing air inside the test journal to simulate air flowing axially through a hollow, rotating shaft. The third method emulated the most common approach to removing heat by forcing air axially through the bearing s support structure. Internal bearing temperatures were measured with three, type K thermocouples embedded in the bearing that measured general internal temperatures and axial thermal gradients. Testing was performed in a 1 atm, 260 C ambient environment with the bearing operating at 60 krpm and supporting a load of 222 N. Air volumetric flows of 0.06, 0.11, and 0.17 cubic meters per minute at approximately 150 to 200 C were used. The tests indicate that all three methods provide thermal management but at different levels of effectiveness. Axial cooling of the bearing support structure had a greater effect on bulk temperature for each air flow and demonstrated that the thermal gradients could be influenced by the directionality of the air flow. Direct air impingement on the journal's inside surface provided uniform reductions in both bulk temperature and thermal gradients. Similar to the direct method, indirect journal cooling had a uniform cooling effect on both bulk temperatures and thermal gradients but was the least effective of the three methods.

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) around entire key. Little Mullet Key No-access buffer zone (300 feet) around entire key. Big Mullet Key No-motor zone (300 feet) around entire key. Crocodile Lake No-access buffer zone (100 feet) along shoreline between March 1 and October 1. East Harbor Key No-access buffer zone (300 feet)...

  16. 15 CFR Appendix III to Subpart P... - Wildlife Management Areas Access Restrictions

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) around entire key. Little Mullet Key No-access buffer zone (300 feet) around entire key. Big Mullet Key No-motor zone (300 feet) around entire key. Crocodile Lake No-access buffer zone (100 feet) along shoreline between March 1 and October 1. East Harbor Key No-access buffer zone (300 feet)...

  17. Flight test configuration for verifying inertial sensor redundancy management techniques

    NASA Technical Reports Server (NTRS)

    Bryant, W. H.; Morrell, F. R.; Bailey, M. L.

    1984-01-01

    The Redundant Strapdown Inertial Measurement Unit presently tested in flight configuration consists of a semioctahedral array of four dynamically tuned, two-degree-of-freedom (TDOF) gyros and four TDOF accelerometers which can provide dual, fail-operational performance for integrated avionics systems. Attention is given to the multilevel algorithm used for the detection and isolation of three ranges of sensor failure in an integrated avionics context. A technique for the generation of accelerometer and gyro error thresholds which is sensitive to dynamic sensor errors and separation effects is presented, together with simulation results. Emphasis is placed on the ensuring of highly reliable data for flight control/navigation functions, while minimizing false or missed alarms.

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

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

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

    ERIC Educational Resources Information Center

    Tsai, Bor-sheng

    2003-01-01

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

  20. Teaching Natural Resource Management-Teaching Techniques and Difficulties in Greek Vocational Lyceum: A Case Study

    ERIC Educational Resources Information Center

    Koutsoukos, Marios; Mouratidis, Antonios

    2016-01-01

    The aim of the present study is to investigate the teaching techniques applied, as well as the difficulties, with which educators in teaching Natural Resource Management are confronted. For research purposes, a case study was conducted on teaching Natural Resource Management in the Third Grade of Vocational Lyceum (EPAL) in Northern Greece. It was…

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

    ERIC Educational Resources Information Center

    Berger, Ellie D.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-07-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Remote sensing techniques for monitoring and managing irrigated lands

    NASA Astrophysics Data System (ADS)

    Allan, J. A.

    Agriculture in semi-arid tracts of the world depends on water to sustain its irrigation systems. Such agricultural systems either derive from government investments in the control of surface flow or they have been developed through the exploitation of groundwater sometimes by a large community of unsupervised individuals seeking to maximise their own advantage without concern for the resource upon which they depend in the medium and long term. In both cases government agencies need data on the area irrigated and the volume of water used. In countries with highly developed scientific and agricultural institutions the contribution of remote sensing, though significant, may only provide between five and ten per cent of the data required to guide regional and national managers. In countries without such institutions the proportion contributed by remote sensing can be very much higher, as shown in a recent study in North Africa. The paper will emphasise the importance of carefully structured sampling procedures, both to improve the areal estimates from satellite imagery and the estimates of water use based upon them. The role of satellite imagery in providing information on the status of water resources, on trends in water use and in the implementation of policies to extend or diminish irrigated land are discussed.

  6. Investment, regulation, and uncertainty: managing new plant breeding techniques.

    PubMed

    Smyth, Stuart J; McDonald, Jillian; Falck-Zepeda, Jose

    2014-01-01

    As with any technological innovation, time refines the technology, improving upon the original version of the innovative product. The initial GM crops had single traits for either herbicide tolerance or insect resistance. Current varieties have both of these traits stacked together and in many cases other abiotic and biotic traits have also been stacked. This innovation requires investment. While this is relatively straight forward, certain conditions need to exist such that investments can be facilitated. The principle requirement for investment is that regulatory frameworks render consistent and timely decisions. If the certainty of regulatory outcomes weakens, the potential for changes in investment patterns increases.   This article provides a summary background to the leading plant breeding technologies that are either currently being used to develop new crop varieties or are in the pipeline to be applied to plant breeding within the next few years. Challenges for existing regulatory systems are highlighted. Utilizing an option value approach from investment literature, an assessment of uncertainty regarding the regulatory approval for these varying techniques is undertaken. This research highlights which technology development options have the greatest degree of uncertainty and hence, which ones might be expected to see an investment decline.

  7. Pregnancy termination: techniques, risks, and complications and their management.

    PubMed

    Castadot, R G

    1986-01-01

    This article outlines the current modalities of pregnancy termination, as well as their risks and complications, in 3 phases of pregnancy: 1) up to 49 days past the last menstrual period, 2) 8-15 weeks, and 3) 16-24 weeks. Before 8 weeks of pregnancy, suction dilatation and curettage (D and C) is the preferred method. However, a medical approach, possibly self-administered, is viewed as more satisfactory and requires only an improvement in side effects. From 8-15 weeks' gestation, suction D and C and dilatation and evacuation (D and E) are the methods of choice. The use of laminaria tents improves both the facility and safety of these procedures in nulliparous patients and perhaps in multiparous patients. Priming of the cervix with prostaglandin could further decrease the difficulty and risks of these procedures. The use of a hydrogel compound is especially worthy of consideration. There is controversy about the preferred method between 16-20 weeks' gestation. D and E appears to have fewer complications and to be more cost-effective than hypertonic saline injection. Urea-prostaglandin has fewer and less severe complications than saline injection, and seems to be more cost-effective than saline injection in terms of duration of hospitalization. The high frequency of failure and side effects, combined with the possibility of expulsion of a live fetus, make prostaglandin-only injection less desirable. After 20 weeks' gestation, urea-prostaglandin injection is probably the safer method. Given the rapid increase in complications with passing weeks, any delay in providing late abortion services should be avoided. 2nd trimester pregnancy terminations, especially those after 18 weeks' gestation, are associated with increased mortality and morbidity and should be performed at specialized centers where providers are better equipped to manage complications.

  8. The IEO Data Center Management System: Tools for quality control, analysis and access marine data

    NASA Astrophysics Data System (ADS)

    Casas, Antonia; Garcia, Maria Jesus; Nikouline, Andrei

    2010-05-01

    manage the wide variety of marine information as common vocabularies, Catalogues (CSR & EDIOS), Data and Metadata. 3.Other tools for analysis and data management - Import_DB: Script to import data and metadata from the Medatlas ASCII files into the database. - SelDamar/Selavi: interface with the database for local and web access. Allows selective retrievals applying the criteria introduced by the user, as geographical bounds, data responsible, cruises, platform, time periods, etc. Includes also statistical reference values calculation, plotting of original and mean profiles together with vertical interpolation. - ExtractDAMAR: Script to extract data when they are archived in ASCII files that meet the criteria upon an user request through SelDamar interface and export them in ODV format, making also a unit conversion.

  9. Informing Parents about the Pharmacological and Invasive Behavior Management Techniques Used in Pediatric Dentistry.

    PubMed

    Paryab, Mehrysa; Afshar, Hossein; Mohammadi, Razie

    2014-01-01

    Background and aims. Parental acceptance and consent are important parameters in selecting the required behavior management technique during pediatric dental treatment. The present study sought to assess the effect of three different informing methods on the parental acceptance, consent and concern regarding the pharmacological and invasive behavior management techniques used in pediatric dentistry. Materials and methods. Ninety mothers of 3-6-year-old uncooperative children were selected and randomly assigned to three study groups. The parents in each group were initially asked to answer three questions related to their levels of 'acceptance','consent', and 'concern' toward the five behavior management techniques. Then, the information about the techniques was presented through a piece of writing in group I, verbal presentation in group II and showing a film in group III. At last, the parents answered the same three questions again. Score changes were analyzed by using ANOVA, correlations, Mann-Whitney U and Kruskal-Wallis methods. Results. There were no statistically significant differences in score changes of parental acceptance, consent and concern between the three groups, overall and in relation to each behaviour management technique (P > 0.05). Mothers with aca-demic education revealed more statistically significant concern following presentation of information by film (P < 0.05). Conclusion. None of the presentation methods had a significant preference over the others; in selecting the behavioral management techniques, it is advisable to observe individual factors, such as the level of education of the mothers.

  10. Challenges in the transfer of contingency management techniques: comment on Silverman et al. (2001).

    PubMed

    Petry, N M

    2001-02-01

    This article critiques K. Silverman, D. Svikis, E. Robles, M. L. Stitzer, and G. E. Bigelow's (2001) study of a contingency management intervention for reinforcing development of job-related skills in substance abusing women. The strengths of Silverman et al.'s study include studying a patient population of major public health concern, expanding contingency management techniques to a vocational training setting, reinforcing gradual approximations, implementing the intervention for a long duration, and carefully designing and executing the experimental procedures. However, many of these strengths may also be interpreted as weaknesses if the ultimate goal is to apply contingency management techniques in self-sustaining, community-based settings. The need to evaluate long-term cost-effectiveness of these procedures is described, and the difficulties in transferring contingency management techniques to real-world settings is discussed.

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

    DOE PAGES

    Mittal, Sparsh

    2016-04-07

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

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

    SciTech Connect

    Mittal, Sparsh

    2016-04-07

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

  13. Access control and privilege management in electronic health record: a systematic literature review.

    PubMed

    Jayabalan, Manoj; O'Daniel, Thomas

    2016-12-01

    This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.

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

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

    Prepared as part of Platte Technical Community College's project to help managers and supervisors develop practical, up-to-date managerial skills in a relatively short time, this instructional workbook provides information and exercises applicable to on-the-job situations encountered by independent business owner/managers. Unit I provides…

  15. Data Management for Flexible Access - Implementation and Lessons Learned from work with Multiple User Communities

    NASA Astrophysics Data System (ADS)

    Benedict, K. K.; Scott, S.; Hudspeth, W. B.

    2012-12-01

    There is no shortage of community-specific and generic data discovery and download platforms and protocols (e.g. CUAHSI HIS, DataONE, GeoNetwork Open Source, GeoPortal, OGC CSW, OAI PMH), documentation standards (e.g. FGDC, ISO 19115, EML, Dublin Core), data access and visualization standards and models (e.g. OGC WxS, OpenDAP), and general-purpose web service models (i.e. REST & SOAP) upon which Geo-informatics cyberinfrastructure (CI) may be built. When attempting to develop a robust platform that may service a wide variety of users and use cases the challenge is one of identifying which existing platform (if any) may support those current needs while also allowing for future expansion for additional capabilities. In the case of the implementation of a data storage, discovery and delivery platform to support the multiple projects at the Earth Data Analysis Center at UNM, no single platform or protocol met the joint requirements of two initial applications (the New Mexico Resource Geographic Information System [http://rgis.unm.edu] and the New Mexico EPSCoR Data Portal [http://nmepscor.org/dataportal]) and furthermore none met anticipated additional requirements as new applications of the platform emerged. As a result of this assessment three years ago EDAC embarked on the development of the Geographic Storage, Transformation, and Retrieval Engine (GSToRE) platform as a general purpose platform upon which n-tiered geospatially enabled data intensive applications could be built. When initially released in 2010 the focus was on the publication of dynamically generated Open Geospatial Consortium services based upon a PostgreSQL/PostGIS backend database. The identification of additional service interface requirements (implementation of the DataONE API and CUAHSI WaterML services), use cases provided by the NM EPSCoR education working group, and expanded metadata publication needs have led to a significant update to the underlying data management tier for GSToRE - the

  16. Focused suggestion with somatic anchoring technique: rapid self-hypnosis for pain management.

    PubMed

    Donatone, Brooke

    2013-04-01

    This article details a self-hypnosis technique designed to teach patients how to manage acute or chronic pain through directed focus. The focused suggestion with somatic anchoring technique has been used with various types of pain, including somatic pain (arthritis, post-injury pain from bone breaks, or muscle tears), visceral pain (related to irritable bowel disease), and neuropathic pain (related to multiple sclerosis). This technique combines cognitive restructuring and mindfulness meditation with indirect and direct suggestions during hypnosis. The case examples demonstrate how the focused suggestion with somatic anchoring technique is used with both acute and chronic pain conditions when use of long-term medication has been relatively ineffective.

  17. An Overview of Public Access Computer Software Management Tools for Libraries

    ERIC Educational Resources Information Center

    Wayne, Richard

    2004-01-01

    An IT decision maker gives an overview of public access PC software that's useful in controlling session length and scheduling, Internet access, print output, security, and the latest headaches: spyware and adware. In this article, the author describes a representative sample of software tools in several important categories such as setup…

  18. Design, methods, and evaluation directions of a multi-access service for the management of diabetes mellitus patients.

    PubMed

    Bellazzi, Riccardo; Arcelloni, Marco; Bensa, Giuliana; Blankenfeld, Hannes; Brugués, Eulàlia; Carson, Ewart; Cobelli, Claudio; Cramp, Derek; D'Annunzio, Giuseppe; De Cata, Pasquale; De Leiva, Alberto; Deutsch, Tibor; Fratino, Pietro; Gazzaruso, Carmine; Garcìa, Angel; Gergely, Tamás; Gómez, Enrique; Harvey, Fiona; Ferrari, Pietro; Hernando, Elena; Boulos, Maged Kamel; Larizza, Cristiana; Ludekke, Hans; Maran, Alberto; Nucci, Gianluca; Pennati, Cristina; Ramat, Stefano; Roudsari, Abdul; Rigla, Mercedes; Stefanelli, Mario

    2003-01-01

    Recent advances in information and communication technology allow the design and testing of new models of diabetes management, which are able to provide assistance to patients regardless of their distance from the health care providers. The M2DM project, funded by the European Commission, has the specific aim to investigate the potential of novel telemedicine services in diabetes management. A multi-access system based on the integration of Web access, telephone access through interactive voice response systems, and the use of palmtops and smart modems for data downloading has been implemented. The system is based on a technological platform that allows a tight integration between the access modalities through a middle layer called the multi-access organizer. Particular attention has been devoted to the design of the evaluation scheme for the system: A randomized controlled study has been defined, with clinical, organizational, economic, usability, and users' satisfaction outcomes. The evaluation of the system started in January 2002. The system is currently used by 67 patients and seven health care providers in five medical centers across Europe. After 6 months of usage of the system no major technical problems have been encountered, and the majority of patients are using the Web and data downloading modalities with a satisfactory frequency. From a clinical viewpoint, the hemoglobin A1c (HbA1c) of both active patients and controls decreased, and the variance of HbA1c in active patients is significantly lower than the control ones. The M2DM system allows for the implementation of an easy-to-use, user-tailored telemedicine system for diabetes management. The first clinical results are encouraging and seem to substantiate the hypothesis of its clinical effectiveness.

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

    NASA Astrophysics Data System (ADS)

    Impemba, Ernesto; Inzerilli, Tiziano

    2003-07-01

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

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

    SciTech Connect

    Chu, Hee Ho; Kim, Hyo-Cheol Jae, Hwan Jun; Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk; Chung, Jin Wook; Park, Jae Hyung

    2012-12-15

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

  1. Central venous access.

    PubMed

    Ganeshan, Arul; Warakaulle, Dinuke R; Uberoi, Raman

    2007-01-01

    Central venous access plays an important role in the management of an ever-increasing population of patients ranging from those that are critically ill to patients with difficult clinical access. Interventional radiologists are key in delivering this service and should be familiar with the wide range of techniques and catheters now available to them. A comprehensive description of these catheters with regard to indications, technical aspects of catheterization, success rates, and associated early and late complications, as well as a review of various published guidelines on central venous catheter insertion are given in this article.

  2. Prevention and management of postoperative nausea and vomiting: a look at complementary techniques.

    PubMed

    Mamaril, Myrna E; Windle, Pamela E; Burkard, Joseph F

    2006-12-01

    Complementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse's plan of care to prevent or manage PONV.

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

    PubMed Central

    Ozyigit, Gokhan; Gultekin, Melis

    2014-01-01

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

  4. Selection and management of central venous access devices in the home setting.

    PubMed

    Cole, D

    1999-01-01

    In the last decade new central venous access devices (CVADs) inserted for long-term therapy have replaced conventional peripheral venous access devices. This shift contributes to the need for additional education as technological advances result in additional options for central venous access. Healthcare's transition from the hospital to a community-based system has increased the use of CVADs in the home setting. Issues that confront the patient with a CVAD in the home setting must be examined more closely than ever before.

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

    ERIC Educational Resources Information Center

    Ferguson, Albert S.

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

  6. Mercury: An Example of Effective Software Reuse for Metadata Management, Data Discovery and Access

    SciTech Connect

    Devarakonda, Ranjeet

    2008-01-01

    Mercury is a federated metadata harvesting, data discovery and access tool based on both open source packages and custom developed software. Though originally developed for NASA, the Mercury development consortium now includes funding from NASA, USGS, and DOE. Mercury supports the reuse of metadata by enabling searching across a range of metadata specification and standards including XML, Z39.50, FGDC, Dublin-Core, Darwin-Core, EML, and ISO-19115. Mercury provides a single portal to information contained in distributed data management systems. It collects metadata and key data from contributing project servers distributed around the world and builds a centralized index. The Mercury search interfaces then allow the users to perform simple, fielded, spatial and temporal searches across these metadata sources. One of the major goals of the recent redesign of Mercury was to improve the software reusability across the 12 projects which currently fund the continuing development of Mercury. These projects span a range of land, atmosphere, and ocean ecological communities and have a number of common needs for metadata searches, but they also have a number of needs specific to one or a few projects. To balance these common and project-specific needs, Mercury's architecture has three major reusable components; a harvester engine, an indexing system and a user interface component. The harvester engine is responsible for harvesting metadata records from various distributed servers around the USA and around the world. The harvester software was packaged in such a way that all the Mercury projects will use the same harvester scripts but each project will be driven by a set of project specific configuration files. The harvested files are structured metadata records that are indexed against the search library API consistently, so that it can render various search capabilities such as simple, fielded, spatial and temporal. This backend component is supported by a very flexible

  7. Mercury: An Example of Effective Software Reuse for Metadata Management, Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Devarakonda, Ranjeet; Palanisamy, Giri; Green, James; Wilson, Bruce E.

    2008-12-01

    Mercury is a federated metadata harvesting, data discovery and access tool based on both open source packages and custom developed software. Though originally developed for NASA, the Mercury development consortium now includes funding from NASA, USGS, and DOE. Mercury supports the reuse of metadata by enabling searching across a range of metadata specification and standards including XML, Z39.50, FGDC, Dublin-Core, Darwin-Core, EML, and ISO-19115. Mercury provides a single portal to information contained in distributed data management systems. It collects metadata and key data from contributing project servers distributed around the world and builds a centralized index. The Mercury search interfaces then allow the users to perform simple, fielded, spatial and temporal searches across these metadata sources. One of the major goals of the recent redesign of Mercury was to improve the software reusability across the 12 projects which currently fund the continuing development of Mercury. These projects span a range of land, atmosphere, and ocean ecological communities and have a number of common needs for metadata searches, but they also have a number of needs specific to one or a few projects. To balance these common and project-specific needs, Mercury's architecture has three major reusable components; a harvester engine, an indexing system and a user interface component. The harvester engine is responsible for harvesting metadata records from various distributed servers around the USA and around the world. The harvester software was packaged in such a way that all the Mercury projects will use the same harvester scripts but each project will be driven by a set of project specific configuration files. The harvested files are structured metadata records that are indexed against the search library API consistently, so that it can render various search capabilities such as simple, fielded, spatial and temporal. This backend component is supported by a very flexible

  8. Results of a Survey Software Development Project Management in the U.S. Aerospace Industry. Volume II. Project Management Techniques, Procedures and Tools.

    DTIC Science & Technology

    1979-12-18

    PROJECT MANAGEMENT IN THE U.S. AEROSPACE INDUSTRY Volume I1 PROJECT MANAGEMENT TECHNIQUES, PROCEDURES AND TOOLS RICHARD Hf. THAYER SACRAMENTO AIR...MANAGEMENT TECHNIQUES AND PROCEDURES USED IN SOFTWARE DEVELOPMENT PROJECTS BY THE US AEROSPACE INDUSTRY BY Richard H. Thayer and John H. Lehman This report...contains the results of a survey conducted in 1977 and 1978 on how the US Aerospace Industry manages its software development projects. The sample of

  9. Review of Budgeting Techniques in Academic and Research Libraries. ARL Management Supplement Volume One, Number Two.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Univ. Library Management Studies.

    Recent years have seen increased interest in extending the concept of budgeting to include activities related to planning, coordinating, and monitoring the entire operation of a library. There is strong evidence that the budgeting technique used can affect management potential. About 80% of total libraries use traditional line item or lump sum…

  10. Management of Giant Cell Tumour Radius in a Three Year old Child with an Improvised Technique

    PubMed Central

    Puri, Ajay; Gulia, Ashish; Sharma, Seema; Verma, Amit K

    2014-01-01

    Giant cell tumours of immature skeleton have a very low incidence and epi-metaphyseal location. We are presenting giant cell tumour distal radius in a skeletally immature patient; an uncontained defect with a large soft tissue component which was managed by wide excision and reconstruction with an improvised technique. PMID:25654002

  11. Techniques of Document Management: A Review of Text Retrieval and Related Technologies.

    ERIC Educational Resources Information Center

    Veal, D. C.

    2001-01-01

    Reviews present and possible future developments in the techniques of electronic document management, the major ones being text retrieval and scanning and OCR (optical character recognition). Also addresses document acquisition, indexing and thesauri, publishing and dissemination standards, impact of the Internet, and the document management…

  12. The Use of Contingency Management Techniques--An Applied Classroom Project

    ERIC Educational Resources Information Center

    Carter, Dianne Knotts; And Others

    1970-01-01

    Describes a Title I project whose purpose was "to determine if a series of three group and three individual instruction sessions with classroom teachers were adequate to train them in the use of basic behavioral modification techniques, by judging whether or not this instruction was evidenced by their management of children in the classroom."…

  13. Cultural Variations in Mothers' Acceptance of and Intent to Use Behavioral Child Management Techniques

    ERIC Educational Resources Information Center

    Mah, Janet W. T.; Johnston, Charlotte

    2012-01-01

    We examined cultural differences in mothers' acceptance of and intent to use behavioral parenting techniques for managing disruptive child behavior, and the possible roles of parenting styles and implicit theories in explaining these cultural differences. A community sample of 117 Euro-Canadian and Chinese-immigrant mothers of boys aged 4- to…

  14. An examination of the potential applications of automatic classification techniques to Georgia management problems

    NASA Technical Reports Server (NTRS)

    Rado, B. Q.

    1975-01-01

    Automatic classification techniques are described in relation to future information and natural resource planning systems with emphasis on application to Georgia resource management problems. The concept, design, and purpose of Georgia's statewide Resource AS Assessment Program is reviewed along with participation in a workshop at the Earth Resources Laboratory. Potential areas of application discussed include: agriculture, forestry, water resources, environmental planning, and geology.

  15. Classroom Management: Teaching Techniques and Strategies for Dealing with Discipline Problems.

    ERIC Educational Resources Information Center

    Atlanta Teacher Corps Consortium, GA.

    Techniques and activities for effective classroom management are presented in this module. The stated objectives of the module are to promote appropriate student behavior, to develop good interpersonal relationships and a positive socioemotional climate, and to establish and maintain a productive classroom organization. Samples of pre-post…

  16. Laparoscopic Heller Myotomy and Dor Fundoplication for Esophageal Achalasia: Technique and Perioperative Management.

    PubMed

    Andolfi, Ciro; Fisichella, P Marco

    2016-11-01

    Surgical correction of achalasia using laparoscopic Heller myotomy with Dor fundoplication is argued to be the gold standard treatment for patients with achalasia. The goal of this technical report is to illustrate our preferred approach to patients with achalasia and to provide the reader with a detailed description of our operative technique, its rationale, and our pre and postoperative management.

  17. Increasing Acceptance of Behavioral Child Management Techniques: What Do Parents Say?

    ERIC Educational Resources Information Center

    Pemberton, Joy R.; Borrego, Joaquin

    2007-01-01

    Consumers' willingness to accept treatments is an important concern of clinicians and clinical researchers, particularly when treating children. However, few studies have directly asked parents to give reasons for accepting or refusing treatments. In the current study, 82 parents read descriptions of six behavioral child management techniques,…

  18. What systems participants know about access and service entry and why managers should listen.

    PubMed

    Duncombe, Rohena

    2016-08-29

    Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point.Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group.Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services.Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity.What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing.What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level.What are the implications for practitioners

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

    PubMed Central

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

    2014-01-01

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

  20. Mobility Based Key Management Technique for Multicast Security in Mobile Ad Hoc Networks

    PubMed Central

    Madhusudhanan, B.; Chitra, S.; Rajan, C.

    2015-01-01

    In MANET multicasting, forward and backward secrecy result in increased packet drop rate owing to mobility. Frequent rekeying causes large message overhead which increases energy consumption and end-to-end delay. Particularly, the prevailing group key management techniques cause frequent mobility and disconnections. So there is a need to design a multicast key management technique to overcome these problems. In this paper, we propose the mobility based key management technique for multicast security in MANET. Initially, the nodes are categorized according to their stability index which is estimated based on the link availability and mobility. A multicast tree is constructed such that for every weak node, there is a strong parent node. A session key-based encryption technique is utilized to transmit a multicast data. The rekeying process is performed periodically by the initiator node. The rekeying interval is fixed depending on the node category so that this technique greatly minimizes the rekeying overhead. By simulation results, we show that our proposed approach reduces the packet drop rate and improves the data confidentiality. PMID:25834838

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

    PubMed

    Madhusudhanan, B; Chitra, S; Rajan, C

    2015-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1982-01-01

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

  3. A Typology of Intellectual Property Management for Public Health Innovation and Access: Design Considerations for Policymakers§

    PubMed Central

    Taubman, Antony

    2010-01-01

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

  4. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients.

    PubMed

    Prabhakar, A R; Marwah, N; Raju, O S

    2007-01-01

    Pain is not the sole reason for fear of dentistry. Anxiety or the fear of unknown during dental treatment is a major factor and it has been the major concern for dentists for a long time. Therefore, the main aim of this study was to evaluate and compare the two distraction techniques, viz, audio distraction and audiovisual distraction, in management of anxious pediatric dental patients. Sixty children aged between 4-8 years were divided into three groups. Each child had four dental visits--screening visit, prophylaxis visit, cavity preparation and restoration visit, and extraction visit. Child's anxiety level in each visit was assessed using a combination of four measures: Venham's picture test, Venham's rating of clinical anxiety, pulse rate, and oxygen saturation. The values obtained were tabulated and subjected to statistical analysis. It was concluded that audiovisual distraction technique was more effective in managing anxious pediatric dental patient as compared to audio distraction technique.

  5. A Novel Surgical Pre-suturing Technique for the Management of Ankyloglossia.

    PubMed

    Khairnar, Mayur; Pawar, Babita; Khairnar, Darshana

    2014-01-01

    Ankyloglossia or "tongue-tie" is a congenital anomaly caused by tight lingual frenulum that abnormally connects the tongue base to the floor of the mouth. Ankyloglossia can results in difficulty during speech and deglutition. This case series presents a novel surgical technique in the management of ankyloglossia in using presuturing technique in which different sets of sutures are given on lingual frenum before severing it. This results in reduced opening of the wound, minimal bleeding, pain and discomfort. Two male patients with severe ankyloglossia had been managed with this technique and after 2 years of follow-up of these cases showed satisfactory protrusive and lateral movement of the tongue with minimal scarring and discomfort.

  6. A Novel Surgical Pre-suturing Technique for the Management of Ankyloglossia

    PubMed Central

    Khairnar, Mayur; Pawar, Babita; Khairnar, Darshana

    2014-01-01

    Ankyloglossia or “tongue-tie” is a congenital anomaly caused by tight lingual frenulum that abnormally connects the tongue base to the floor of the mouth. Ankyloglossia can results in difficulty during speech and deglutition. This case series presents a novel surgical technique in the management of ankyloglossia in using presuturing technique in which different sets of sutures are given on lingual frenum before severing it. This results in reduced opening of the wound, minimal bleeding, pain and discomfort. Two male patients with severe ankyloglossia had been managed with this technique and after 2 years of follow-up of these cases showed satisfactory protrusive and lateral movement of the tongue with minimal scarring and discomfort. PMID:25598942

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

    PubMed

    Gerardi, Debra

    2004-01-01

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

  8. A novel approach to early sickness absence management: The EASY (Early Access to Support for You) way

    PubMed Central

    Demou, Evangelia; Brown, Judith; Sanati, Kaveh; Kennedy, Mark; Murray, Keith; Macdonald, Ewan B.

    2015-01-01

    BACKGROUND: Sickness absence (SA) is multi-causal and remains a significant problem for employees, employers and society. This makes it necessary to concurrently manage a particular disabling condition and consider the working environment and employee-employer relationship. OBJECTIVE: To describe and examine the components of a novel SA management service Early Access to Support for You (EASY) and discuss their potential influence on the intervention. METHODS: A new sickness absence model, starting from day one of absence, was created called EASY. EASY is planned to support both employees and managers and comprises elements already found to be associated with reduction of SA, such as maintaining regular contact; early biopsychosocial case-management; physiotherapy; mental-health counselling; work modification; phased return-to-work; and health promotion activities. RESULTS: During the EASY implementation period, the SA rate at a health board reversed its trend of being one of the highest rates in the Scottish National Health Service (NHS) and EASY was considered helpful by both managers and employees. CONCLUSIONS: This paper describes an innovative occupational health intervention to sickness absence management based on the bio-psychosocial model to provide early intervention, and discusses the pros and cons of applying cognitive behavioural principles at an early stage in sickness-absence events, in order to improve return-to-work outcomes. PMID:26409380

  9. Resistance Management Techniques of Milton H. Erickson, M.D.: An Application to Nonhypnotic Mental Health Counseling.

    ERIC Educational Resources Information Center

    Otani, Akira

    1989-01-01

    Delineates five selected hypnotically based techniques of client resistance management pioneered by Milton H. Erickson: acceptance; paradoxical encouragement; reframing; displacement; dissociation. Explains how techniques can be applied to nonhypnotic mental health counseling. Discusses relevant clinical, theoretical, and empirical issues related…

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

    PubMed

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

    2017-04-01

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

  11. Using economic valuation techniques to inform water resources management: a survey and critical appraisal of available techniques and an application.

    PubMed

    Birol, Ekin; Karousakis, Katia; Koundouri, Phoebe

    2006-07-15

    The need for economic analysis for the design and implementation of efficient water resources management policies is well documented in the economics literature. This need is also emphasised in the European Union's recent Water Framework Directive (2000/60/EC), and is relevant to the objectives of Euro-limpacs, an EU funded project which inter alia, aims to provide a decision-support system for valuing the effects of future global change on Europe's freshwater ecosystems. The purpose of this paper is to define the role of economic valuation techniques in assisting in the design of efficient, equitable and sustainable policies for water resources management in the face of environmental problems such as pollution, intensive land use in agriculture and climate change. The paper begins with a discussion of the conceptual economic framework that can be used to inform water policy-making. An inventory of the available economic valuation methods is presented and the scope and suitability of each for studying various aspects of water resources are critically discussed. Recent studies that apply these methods to water resources are reviewed. Finally, an application of one of the economic valuation methods, namely the contingent valuation method, is presented using a case study of the Cheimaditida wetland in Greece.

  12. Mercury: Reusable software application for Metadata Management, Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Devarakonda, Ranjeet; Palanisamy, Giri; Green, James; Wilson, Bruce E.

    2009-12-01

    Mercury is a federated metadata harvesting, data discovery and access tool based on both open source packages and custom developed software. It was originally developed for NASA, and the Mercury development consortium now includes funding from NASA, USGS, and DOE. Mercury is itself a reusable toolset for metadata, with current use in 12 different projects. Mercury also supports the reuse of metadata by enabling searching across a range of metadata specification and standards including XML, Z39.50, FGDC, Dublin-Core, Darwin-Core, EML, and ISO-19115. Mercury provides a single portal to information contained in distributed data management systems. It collects metadata and key data from contributing project servers distributed around the world and builds a centralized index. The Mercury search interfaces then allow the users to perform simple, fielded, spatial and temporal searches across these metadata sources. One of the major goals of the recent redesign of Mercury was to improve the software reusability across the projects which currently fund the continuing development of Mercury. These projects span a range of land, atmosphere, and ocean ecological communities and have a number of common needs for metadata searches, but they also have a number of needs specific to one or a few projects To balance these common and project-specific needs, Mercury’s architecture includes three major reusable components; a harvester engine, an indexing system and a user interface component. The harvester engine is responsible for harvesting metadata records from various distributed servers around the USA and around the world. The harvester software was packaged in such a way that all the Mercury projects will use the same harvester scripts but each project will be driven by a set of configuration files. The harvested files are then passed to the Indexing system, where each of the fields in these structured metadata records are indexed properly, so that the query engine can perform

  13. Remote access to medical specialists: home care interactive patient management system

    NASA Astrophysics Data System (ADS)

    Martin, Peter J.; Draghic, Nicole; Wiesmann, William P.

    1999-07-01

    Diabetes management involves constant care and rigorous compliance. Glucose control is often difficult to maintain and onset of complications further compound health care needs. Status can be further hampered by geographic isolation from immediate medical infrastructures. The Home Care Interactive Patient Management System is an experimental telemedicine program that could improve chronic illness management through Internet-based applications. The goal of the system is to provide a customized, integrated approach to diabetes management to supplement and coordinate physician protocol while supporting routine patient activity, by supplying a set of customized automated services including health data collection, transmission, analysis and decision support.

  14. Accessing groundwater quality in lower part of Nagapattinam district, Southern India: using hydrogeochemistry and GIS interpolation techniques

    NASA Astrophysics Data System (ADS)

    Gnanachandrasamy, G.; Ramkumar, T.; Venkatramanan, S.; Vasudevan, S.; Chung, S. Y.; Bagyaraj, M.

    2015-03-01

    The aim of this present study was to evaluate groundwater quality in the lower part of Nagapattinam district, Tamil Nadu, Southern India. A detailed geochemical study of groundwater region is described, and the origin of the chemical composition of groundwater has been qualitatively evaluated, using observations over a period of two seasons premonsoon (June) and monsoon (November) in the year of 2010. To attempt this goal, samples were analysed for various physico-chemical parameters such as temperature, pH, salinity, Na+, Ca2+, K+, Mg2+, Cl-, HCO3 - and SO4 2-. The abundance of major cations concentration in groundwater is as Na > Ca > Mg > K, while that of anions is Cl > SO4 > HCO3. The Piper trilinear diagram indicates Ca-Cl2 facies, and according to USSL diagram, most of the sample exhibits high salinity hazard (C3S1) type in both seasons. It indicates that high salinity (C3) and low sodium (S1) are moderately suitable for irrigation purposes. Gibbs boomerang exhibits most of the samples mainly controlled by evaporation and weathering process sector in both seasons. Irrigation status of the groundwater samples indicates that it was moderately suitable for agricultural purpose. ArcGIS 9.3 software was used for the generation of various thematic maps and the final groundwater quality map. An interpolation technique inverse distance weighting was used to obtain the spatial distribution of groundwater quality parameters. The final map classified the ground quality in the study area. The results of this research show that the development of the management strategies for the aquifer system is vitally necessary.

  15. Managing an Open Access, Multi-Institutional, International Digital Library: The Digital Library of the Caribbean

    ERIC Educational Resources Information Center

    Wooldridge, Brooke; Taylor, Laurie; Sullivan, Mark

    2009-01-01

    Developing an Open Access, multi-institutional, multilingual, international digital library requires robust technological and institutional infrastructures that support both the needs of individual institutions alongside the needs of the growing partnership and ensure continuous communication and development of the shared vision for the digital…

  16. An Access Control and Trust Management Framework for Loosely-Coupled Multidomain Environments

    ERIC Educational Resources Information Center

    Zhang, Yue

    2010-01-01

    Multidomain environments where multiple organizations interoperate with each other are becoming a reality as can be seen in emerging Internet-based enterprise applications. Access control to ensure secure interoperation in such an environment is a crucial challenge. A multidomain environment can be categorized as "tightly-coupled" and…

  17. Management strategy evaluation of pheromone-baited trapping techniques to improve management of invasive sea lamprey

    USGS Publications Warehouse

    Dawson, Heather; Jones, Michael L.; Irwin, Brian J.; Johnson, Nicholas; Wagner, Michael C.; Szymanski, Melissa

    2016-01-01

    We applied a management strategy evaluation (MSE) model to examine the potential cost-effectiveness of using pheromone-baited trapping along with conventional lampricide treatment to manage invasive sea lamprey. Four pheromone-baited trapping strategies were modeled: (1) stream activation wherein pheromone was applied to existing traps to achieve 10−12 mol/L in-stream concentration, (2) stream activation plus two additional traps downstream with pheromone applied at 2.5 mg/hr (reverse-intercept approach), (3) trap activation wherein pheromone was applied at 10 mg/hr to existing traps, and (4) trap activation and reverse-intercept approach. Each new strategy was applied, with remaining funds applied to conventional lampricide control. Simulating deployment of these hybrid strategies on fourteen Lake Michigan streams resulted in increases of 17 and 11% (strategies 1 and 2) and decreases of 4 and 7% (strategies 3 and 4) of the lakewide mean abundance of adult sea lamprey relative to status quo. MSE revealed performance targets for trap efficacy to guide additional research because results indicate that combining lampricides and high efficacy trapping technologies can reduce sea lamprey abundance on average without increasing control costs.

  18. A novel technique of otic barotrauma management using modified intravenous cannulae.

    PubMed

    Zhang, Qi; Banks, Catherine; Choroomi, Sim; Kertesz, Thomas

    2013-09-01

    This article provides the first detailed description and systematic evaluation of the management of otic barotrauma using modified intravenous cannulae. A 24-gauge IC cannula was modified as a tool for tympanostomy tube placement and middle ear ventilation. The medical records of 271 ears of 156 adult patients (median age 49 years) who underwent this procedure were reviewed retrospectively. Hundred and ninty-one tubes were placed for otalgia because of hyperbaric oxygen therapy, 58 tubes were inserted for air travel prophylaxis and 22 tubes were placed for management of otic barotrauma post-flight. All the patients who had this procedure for prophylaxis experienced regular otic barotrauma symptoms during air travel prior to tube placement. All patients were reviewed 6 weeks (range 2-9 weeks) post-procedure. This technique of otic barotrauma management worked effectively in 99 % of treated patients. On follow-up, 88 % of tubes were found to be extruded and non-extruded tubes were removed in clinic without any anaesthesia. 99.6 % of tympanic membrane had healed completely and spontaneously without sequelae. Given the safety, effectiveness, low risk of complications associated with this novel tympanostomy technique, it provided a simple yet effective therapeutic option for the management of otic barotrauma. Finally, this technique can be easily applied in all health settings as it only requires medical supplies readily available in hospitals, therefore there is no additional cost.

  19. Negotiating Narratives, Accessing Asylum: Evaluating Language Policy as Multi-Level Practice, Beliefs and Management

    ERIC Educational Resources Information Center

    Smith-Khan, Laura

    2017-01-01

    Theories of language policy increasingly emphasise focusing on the specific contexts in which language management occurs. In government settings, policy seeks to shape how individuals interact with officials. Australian asylum procedure is an area where policy aims at tight control. I examine how communication is managed in this setting, in which…

  20. Creating Access to Invisible Special Collections: Using Participatory Management to Reduce a Backlog

    ERIC Educational Resources Information Center

    Lundy, M. Winslow; Hollis, Deborah R.

    2004-01-01

    The University of Colorado at Boulder Libraries used participatory management to reduce a special collections backlog. Without an increase in budget or staffing, technical and public services departments designed a pilot project to redeploy internal human resources in a collaborative manner. The process of backlog management is discussed.

  1. 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 .

  2. Novel anaesthetic approach for surgical access and haemodynamic management during off-pump coronary artery bypass through a left thoracotomy.

    PubMed

    Maddali, Madan Mohan; Al-Jadidi, Abdullah M; Zacharias, Sunny

    2012-01-01

    For myocardial revascularization on a beating heart through a thoracotomy, a properly deployed endobronchial blocker (EBB) provides ideal conditions for surgical access. In addition, adequate volume replacement to achieve optimal cardiac performance is a primary goal of haemodynamic management in patients undergoing off-pump coronary artery bypass grafting. To achieve both these ends, this case report describes the combined use of a left-sided EBB along with a volumetric pulmonary artery catheter in a patient who underwent a successful off-pump coronary artery bypass surgery through an anterolateral thoracotomy.

  3. Advanced techniques in IR thermography as a tool for the pest management professional

    NASA Astrophysics Data System (ADS)

    Grossman, Jon L.

    2006-04-01

    Within the past five years, the Pest Management industry has become aware that IR thermography can aid in the detection of pest infestations and locate other conditions that are within the purview of the industry. This paper will review the applications that can be utilized by the pest management professional and discuss the advanced techniques that may be required in conjunction with thermal imaging to locate insect and other pest infestations, moisture within structures, the verification of data and the special challenges associated with the inspection process.

  4. Developing nondestructive techniques for managing conflicts between fisheries and double-crested cormorant colonies

    USGS Publications Warehouse

    Suzuki, Yasuko; Roby, Daniel D.; Lyons, Donald E.; Courtot, Karen; Collis, Ken

    2015-01-01

    Double-crested cormorants (Phalacrocorax auritus) have been identified as the source of significant mortality to juvenile salmonids (Oncorhynchus spp.) in the Columbia River Basin. Management plans for reducing the size of a large colony on East Sand Island (OR, USA) in the Columbia River estuary are currently being developed. We evaluated habitat enhancement and social attraction as nondestructive techniques for managing cormorant nesting colonies during 2004–2007. We tested these techniques on unoccupied plots adjacent to the East Sand Island cormorant colony. Cormorants quickly colonized these plots and successfully raised young. Cormorants also were attracted to nest and raised young on similar plots at 2 islands approximately 25 km from East Sand Island; 1 island had a history of successful cormorant nesting whereas the other was a site where cormorants had previously nested unsuccessfully. On a third island with no history of cormorant nesting or nesting attempts, these techniques were unsuccessful at attracting cormorants to nest. Our results suggest that some important factors influencing attraction of nesting cormorants using these techniques include history of cormorant nesting, disturbance, and presence of breeding cormorants nearby. These techniques may be effective in redistributing nesting cormorants away from areas where fish stocks of conservation concern are susceptible to predation, especially if sites with a recent history of cormorant nesting are available within their foraging or dispersal range. Published 2015. Wiley Periodicals, Inc. This article is a US Government work and, as such, is in the public domain in the United States of America.

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

    PubMed Central

    Ramasamy, P R

    2017-01-01

    Background: Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult. Materials and Methods: Thirty six Gustilo Anderson III B open tibial fractures managed between June 2002 and December 2013 with “fix and shift” technique were retrospectively reviewed. All the 36 patients managed by this technique had open wounds measuring >5 cm (post debridement). Under fix and shift technique, stable fixation involved primary external fixator application or primary intramedullary nailing of the tibial fracture and immediate soft tissue cover involved septocutaneous shift, i.e., shifting of fasciocutaneous segments based on septocutaneous perforators. Results: Primary fracture union rate was 50% and reoperation rate (bone stimulating procedures) was 50%. Overall fracture union rate was 100%. The rate of malunion was 14% and deep infection was 16%. Failure of septocutaneous shift was 2.7%. There was no incidence of amputation. Conclusion: Management of Gustilo Anderson III B open tibial fractures with “fix and shift” technique has resulted in better outcome in terms of skeletal factors (primary fracture union, overall union, and time for union and malunion) and soft tissue factors (wound healing, flap failure, access to secondary procedures, and esthetic appearance) when compared to standard methods adopted earlier. Hence, “fix and shift” could be recommended as one of the treatment modalities for open III B tibial fractures. PMID:28216752

  6. Truncal blocks for perioperative pain management: a review of the literature and evolving techniques.

    PubMed

    Go, Ramon; Huang, Yolanda Y; Weyker, Paul D; Webb, Christopher Aj

    2016-10-01

    As the American healthcare system continues to evolve and reimbursement becomes tied to value-based incentive programs, perioperative pain management will become increasingly important. Regional anesthetic techniques are only one component of a successful multimodal pain regimen. In recent years, the use of peripheral and paraneuraxial blocks to provide chest wall and abdominal analgesia has gained popularity. When used within a multimodal regimen, truncal blocks may provide similar analgesia when compared with other regional anesthetic techniques. While there are other reviews that cover this topic, our review will also highlight the emerging role for serratus plane blocks, pectoral nerve blocks and quadratus lumborum blocks in providing thoracic and abdominal analgesia.

  7. Advances in Surgical Reconstructive Techniques in the Management of Penile, Urethral, and Scrotal Cancer.

    PubMed

    Bickell, Michael; Beilan, Jonathan; Wallen, Jared; Wiegand, Lucas; Carrion, Rafael

    2016-11-01

    This article reviews the most up-to-date surgical treatment options for the reconstructive management of patients with penile, urethral, and scrotal cancer. Each organ system is examined individually. Techniques and discussion for penile cancer reconstruction include Mohs surgery, glans resurfacing, partial and total glansectomy, and phalloplasty. Included in the penile cancer reconstruction section is the use of penile prosthesis in phalloplasty patients after penectomy, tissue engineering in phallic regeneration, and penile transplantation. Reconstruction following treatment of primary urethral carcinoma and current techniques for scrotal cancer reconstruction using split-thickness skin grafts and flaps are described.

  8. A modified technique for the laparoscopic management of large gastric bezoars

    PubMed Central

    Ulukent, Suat C.; Ozgun, Yigit M.; Sahbaz, Nuri A.

    2016-01-01

    Bezoar is an intraluminal mass formed by the accumulation of undigested material anywhere in the gastrointestinal system. Most of small bezoars are removed by gastrointestinal endoscopy, while the best approach for the larger ones is surgical removal. Currently, laparoscopic technique is successfully used in the treatment of bezoars, which are used to be managed by open surgery. In the laparoscopic treatment of bezoars, contamination of peritoneal cavity is a major problem. We describe a modified laparoscopic technique in which an endobag is placed in the stomach instead of the peritoneal cavity in order to avoid spillage of the bezoar during laparoscopic removal. PMID:27570860

  9. The diagnosis and management of pre-invasive breast disease: The role of new diagnostic techniques

    PubMed Central

    Nerurkar, Ashutosh; Osin, Peter

    2003-01-01

    In recent years we have seen significantly increased use of minimally invasive diagnostic techniques in the management of breast disease. There is wide recognition of fine needle aspiration and core biopsy as the principal diagnostic methods. However, concerns exist regarding their reliability. This article provides a brief overview of the major diagnostic issues related to use of fine needle aspiration, core biopsy and ductal lavage. It summarizes areas of use for each technique, outlines the main diagnostic pitfalls and their causes, and provides a perspective on future developments in the field. PMID:14580247

  10. Acoustic Metadata Management and Transparent Access to Networked Oceanographic Data Sets

    DTIC Science & Technology

    2015-09-30

    Transparent Access to Networked Oceanographic Data Sets Marie A. Roch Dept. of Computer Science San Diego State University 5500 Campanile Drive San...derived from these recordings (metadata of the recordings) becomes crucial in order to combine data across disparate studies to provide information...The period over which effort was invested may not be the same as that of the acoustic data itself. Examples of this include gaps due to

  11. Percutaneous endovascular management of occluded HeRO dialysis access device.

    PubMed

    Vasquez, Julio C; DeLaRosa, Jacob; Leon, Juan J; Rahim, Naeem; Rahim, Fahim

    2010-01-01

    The Hemodialysis Reliable Outflow (HeRO) device is a novel alternative for dialysis access in patients with no suitable veins in the upper extremities. We placed a HeRO device in a 67-year-old woman with end-stage renal disease and 2 months later, it was being used for hemodialysis. After 1 month of uneventful use, the device thrombosed and it was rescued with a percutaneous endovascular approach. The device remains patent 6 months after the intervention.

  12. Sub-Network Access Control Technology Demonstrator: Software Design of the Network Management System

    DTIC Science & Technology

    2002-08-01

    validdes. En d’autres mots, ce projet est une 6tape suppldmentaire dans le dessein de migrer ces technologies radio vers la Flotte Op ~ rationnelle ...Defence Research and Recherche et ddveloppement Development Canada pour la defense Canada DEFENCE • I7 DEFENSE Sub-Network Access Control...dans l’optique qu’ils op ~rent sur des liens avec une large bande passantes dont la topologie 6volue Tentement. Les produites con-nerciaux de gestion de

  13. Totally implantable venous access devices: retrospective analysis of different insertion techniques and predictors of complications in 796 devices implanted in a single institution

    PubMed Central

    2014-01-01

    Background The aim of this study was to assess the efficacy and safety of totally implanted vascular devices (TIVAD) using different techniques of insertion. Methods We performed a retrospective study using a prospective collected database of 796 consecutive oncological patients in which TIVADs were inserted. We focused on early and late complications following different insertion techniques (surgical cutdown, blind and ultrasound guided percutaneous) according to different techniques. Results Ultrasound guided technique was used in 646 cases, cephalic vein cutdown in 102 patients and percutaneous blind technique in 48 patients. The overall complication rate on insertion was 7.2% (57 of 796 cases). Early complications were less frequent using the ultrasound guided technique: arterial puncture (p = 0.009), technical failure (p = 0.009), access site change after first attempt (p = 0.002); pneumothorax occurred in 4 cases, all using the blind percutaneus technique. Late complications occurred in 49 cases (6.1%) which required TIVAD removal in 43 cases and included: sepsis (29 cases), thrombosis (3 cases), dislocation (7 cases), skin dehiscence (3 cases), and severe pain (1 case). Conclusion Ultrasound guided technique is the safest option for TIVAD insertion, with the lowest rates of immediate complications. PMID:24886342

  14. Using the Critical Incident Technique to Research Decision Making regarding Access to Training and Development in Medium-Sized Enterprises

    ERIC Educational Resources Information Center

    Coetzer, Alan; Redmond, Janice; Sharafizad, Jalleh

    2012-01-01

    Employees in small and medium-sized enterprises (SMEs) form part of a "disadvantaged" group within the workforce that receives less access to training and development (T&D) than employees in large firms. Prior research into reasons for the relatively low levels of employee participation in training and development has typically…

  15. Using Commercially Available Techniques to Make Organic Chemistry Representations Tactile and More Accessible to Students with Blindness or Low Vision

    ERIC Educational Resources Information Center

    Supalo, Cary A.; Kennedy, Sean H.

    2014-01-01

    Organic chemistry courses can present major obstacles to access for students with blindness or low vision (BLV). In recent years, efforts have been made to represent organic chemistry concepts in tactile forms for blind students. These methodologies are described in this manuscript. Further work being done at Illinois State University is also…

  16. Management strategies for infected total hip arthroplasty. A critical appreciation of problems and techniques.

    PubMed

    Karachalios, Theofilos; Koutalos, Antonios; Komnos, George

    2014-10-02

    Infection is a devastating complication of total hip arthroplasty (THA). Risk factors have been recognised and prevention is possible. The nature of the disease is heterogeneous and for satisfactory management one has to weigh factors related to pathogen, host, local soft tissue, bone stock, surgeon experience and financial resources. Available data in the current literature is of poor quality and there is a lack of data comparing different techniques. Referral of patients to dedicated departments with the appropriate facilities may be more appropriate.

  17. Arrow shaft injury of the wrist and hand: case report, management, and surgical technique.

    PubMed

    Launikitis, Robert A; Viegas, Steven F

    2009-01-01

    A case of accidental, self-inflicted injury to the hand from a hollow carbon shaft arrow which broke in its midshaft while attempting to shoot the arrow from a compound bow is presented. Basic knowledge of low velocity gunshot wounds and arrow injuries was applied in the treatment of this injury along with a unique management technique. The outcome, including hand function was good without any functional loss.

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

    PubMed

    Akyuz, Gulseren; Kenis, Ozge

    2014-03-01

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

  19. Task force: a management technique that produces quality decisions and employee commitment.

    PubMed

    Moore, C H; Kovach, K M

    1988-01-01

    A task force is a technique that can be used by the dietitian-manager to develop solutions for specific, identified problems. Because employees are directly involved in the decision-making process, better solutions--ones that are also more acceptable to the work group--result. To implement a task force, management must plan the strategy: Select a facilitator, explain the concept and problem to the work group, select task force participants, and make meeting arrangements. The task force meetings should be structured to maximize efficiency and productivity. The plan of action is developed by the task force members; all decisions are based upon input from the work group. Successful implementation of the solutions is the responsibility of the task force. Applications for task forces in both the clinical and food management areas are numerous and result in both tangible and intangible benefits.

  20. Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques

    NASA Technical Reports Server (NTRS)

    Saha, Bhaskar; Goebel, kai

    2007-01-01

    Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and theoretically sound approach to the modern Condition- Based Maintenance (CBM)/Prognostic Health Management (PHM) paradigm. The application of the Bayesian techniques to regression and classification in the form of Relevance Vector Machine (RVM), and to state estimation as in Particle Filters (PF), provides a powerful tool to integrate the diagnosis and prognosis of battery health. The RVM, which is a Bayesian treatment of the Support Vector Machine (SVM), is used for model identification, while the PF framework uses the learnt model, statistical estimates of noise and anticipated operational conditions to provide estimates of remaining useful life (RUL) in the form of a probability density function (PDF). This type of prognostics generates a significant value addition to the management of any operation involving electrical systems.

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

    PubMed

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

    2013-01-01

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

  2. An effective and secure key-management scheme for hierarchical access control in E-medicine system.

    PubMed

    Odelu, Vanga; Das, Ashok Kumar; Goswami, Adrijit

    2013-04-01

    Recently several hierarchical access control schemes are proposed in the literature to provide security of e-medicine systems. However, most of them are either insecure against 'man-in-the-middle attack' or they require high storage and computational overheads. Wu and Chen proposed a key management method to solve dynamic access control problems in a user hierarchy based on hybrid cryptosystem. Though their scheme improves computational efficiency over Nikooghadam et al.'s approach, it suffers from large storage space for public parameters in public domain and computational inefficiency due to costly elliptic curve point multiplication. Recently, Nikooghadam and Zakerolhosseini showed that Wu-Chen's scheme is vulnerable to man-in-the-middle attack. In order to remedy this security weakness in Wu-Chen's scheme, they proposed a secure scheme which is again based on ECC (elliptic curve cryptography) and efficient one-way hash function. However, their scheme incurs huge computational cost for providing verification of public information in the public domain as their scheme uses ECC digital signature which is costly when compared to symmetric-key cryptosystem. In this paper, we propose an effective access control scheme in user hierarchy which is only based on symmetric-key cryptosystem and efficient one-way hash function. We show that our scheme reduces significantly the storage space for both public and private domains, and computational complexity when compared to Wu-Chen's scheme, Nikooghadam-Zakerolhosseini's scheme, and other related schemes. Through the informal and formal security analysis, we further show that our scheme is secure against different attacks and also man-in-the-middle attack. Moreover, dynamic access control problems in our scheme are also solved efficiently compared to other related schemes, making our scheme is much suitable for practical applications of e-medicine systems.

  3. A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report

    PubMed Central

    Kumaresan, Ramesh; Mohammed, Faraz; Thapasum Fairozekhan, Arishiya

    2013-01-01

    ABSTRACT Mucocele, a common benign cystic lesion of minor salivary gland and associated ducts develops following extravasation or retention of mucous material in the subepithelial tissue. Occurrence of mucocele of tongue is considered less frequent when compared to a higher incidence of mucocele in the lower lip of young patients. Different modalities of treatment, such as conventional surgical excision followed by newer techniques like cryosurgery, electrocautery have been proposed to completely remove the lesion and reduce the chances of recurrence. Herewith, we report a novel treatment technique using alginate impression material to aid in complete excision of mucocele of glands of Blandin-Nuhn. How to cite this article: Kumaresan R, Karthikeyan P, Mohammed F, Fairozekhan TA. A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report. Int J Clin Pediatr Dent 2013;6(3):201-204. PMID:25206223

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

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

    The importance of using remote sensing techniques, in the visible and near-infrared ranges, for mapping, inventory, conservation and management of natural ecosystems is discussed. Some examples realized in Brazil or other countries are given to evaluate the products from orbital platform (MSS and RBV imagery of LANDSAT) and aerial level (photography) for ecosystems study. The maximum quantitative and qualitative information which can be obtained from each sensor, at different level, are discussed. Based on the developed experiments it is concluded that the remote sensing technique is a useful tool in mapping vegetation units, estimating biomass, forecasting and evaluation of fire damage, disease detection, deforestation mapping and change detection in land-use. In addition, remote sensing techniques can be used in controling implantation and planning natural/artificial regeneration.

  5. Interventional pain management for spinal disorders: a review of injection techniques.

    PubMed

    Wewalka, Mathias

    2016-02-01

    Chronic spinal pain has a high prevalence and a severe economic, societal and health impact. In the last decades the practice and research of interventional techniques for the diagnosis and treatment of spinal pain has increased sharply. The level of evidence of the most common techniques is well documented. With image-guided precise diagnostic blocks it is possible to identify the source of chronic spinal pain in well over 60% of the cases. Nonsurgical specialties such as PM&R increasingly resort to the possibilities of interventional pain management for musculoskeletal disorders. For many forms of spinal pain there is at least fair evidence for long-term pain relief after a guided therapeutic injection often reducing the intake of analgesic medication or the need for surgery. This review focuses on the evidence, the application spectrum and special considerations of injection techniques for the treatment of spinal disorders.

  6. A pilot study of the impact of stress management techniques on the classroom behavior of elementary school students.

    PubMed

    Petosa, R; Oldfield, D

    1985-02-01

    Intervention studies have demonstrated the benefit of stress management techniques on health-related variables among school-age children. It was hypothesized that teaching elementary school children stress management skills would promote appropriate classroom study behavior by enhancing student ability to attend to teacher assigned tasks. This pilot study supports the contention that stress management skills can increase classroom "on-task" behavior.

  7. Experimental demonstration of a DSP-based cross-channel interference cancellation technique for application in digital filter multiple access PONs.

    PubMed

    Al-Rawachy, E; Giddings, R P; Tang, J M

    2017-02-20

    A DSP-based cross-channel interference cancellation (CCIC) technique with initial condition-free, fast convergence and signal modulation format independence, is experimentally demonstrated in a two-channel point-to-point digital filter multiple access (DFMA) PON system based on intensity-modulation and direct-detection (IMDD). The CCIC-induced transmission performance improvements under various system conditions are fully investigated for the first time. It is shown that with one iteration only the CCIC technique can achieve a reduction in individual OFDM subcarrier BERs of more than 1000 times, an increase in transmission capacity by as much as 19 times and an increase in optical power budget by as much as 3.5dB. The CCIC technique thus has the potential to drastically improve the transmission performance of DFMA PONs.

  8. Best Practices in Community Garden Management to Address Participation, Water Access, and Outreach

    ERIC Educational Resources Information Center

    Drake, Luke; Lawson, Laura

    2015-01-01

    As community gardens expand across the U.S., Extension professionals can support them not only in horticultural education but also in planning and organization. Knowledge of community garden management is helpful in this regard. Existing research focuses on outcomes and criteria for successful gardens, but is less clear about how community gardens…

  9. Vascular access in oncology patients.

    PubMed

    Gallieni, Maurizio; Pittiruti, Mauro; Biffi, Roberto

    2008-01-01

    Adequate vascular access is of paramount importance in oncology patients. It is important in the initial phase of surgical treatment or chemotherapy, as well as in the chronic management of advanced cancer and in the palliative care setting. We present an overview of the available vascular access devices and of the most relevant issues regarding insertion and management of vascular access. Particular emphasis is given to the use of ultrasound guidance as the preferred technique of insertion, which has dramatically decreased insertion-related complications. Vascular access management has considerably improved after the publication of effective guidelines for the appropriate nursing of the vascular device, which has reduced the risk of late complications, such as catheter-related bloodstream infection. However, many areas of clinical practice are still lacking an evidence-based background, such as the choice of the most appropriate vascular access device in each clinical situation, as well as prevention and treatment of thrombosis. We suggest an approach to the choice of the most appropriate vascular access device for the oncology patient, based on the literature available to date.

  10. SeaDataNet - Pan-European infrastructure for marine and ocean data management: Unified access to distributed data sets

    NASA Astrophysics Data System (ADS)

    Schaap, D. M. A.; Maudire, G.

    2009-04-01

    SeaDataNet is an Integrated research Infrastructure Initiative (I3) in EU FP6 (2006 - 2011) to provide the data management system adapted both to the fragmented observation system and the users need for an integrated access to data, meta-data, products and services. Therefore SeaDataNet insures the long term archiving of the large number of multidisciplinary data (i.e. temperature, salinity current, sea level, chemical, physical and biological properties) collected by many different sensors installed on board of research vessels, satellite and the various platforms of the marine observing system. The SeaDataNet project started in 2006, but builds upon earlier data management infrastructure projects, undertaken over a period of 20 years by an expanding network of oceanographic data centres from the countries around all European seas. Its predecessor project Sea-Search had a strict focus on metadata. SeaDataNet maintains significant interest in the further development of the metadata infrastructure, but its primary objective is the provision of easy data access and generic data products. SeaDataNet is a distributed infrastructure that provides transnational access to marine data, meta-data, products and services through 40 interconnected Trans National Data Access Platforms (TAP) from 35 countries around the Black Sea, Mediterranean, North East Atlantic, North Sea, Baltic and Arctic regions. These include: National Oceanographic Data Centres (NODC's) Satellite Data Centres. Furthermore the SeaDataNet consortium comprises a number of expert modelling centres, SME's experts in IT, and 3 international bodies (ICES, IOC and JRC). Planning: The SeaDataNet project is delivering and operating the infrastructure in 3 versions: Version 0: maintenance and further development of the metadata systems developed by the Sea-Search project plus the development of a new metadata system for indexing and accessing to individual data objects managed by the SeaDataNet data centres. This

  11. Faculty Collaboration: How a Wiki Enhanced Communication, Organization, Accessibility, and Management of Writing a Book

    ERIC Educational Resources Information Center

    Wright, Vivian H.; Burnham, Joy J.; Hooper, Lisa M.

    2012-01-01

    Faculty members have collaborated on research studies, manuscripts, books, teaching pedagogies, and ideas for years. From exchanging marked-up paper copies to exchanging email attachments, as technology has progressed so have the techniques and methods of collaborating. However, often, faculty adhere to traditional methods of sharing work and thus…

  12. Accessing and managing open medical resources in Africa over the Internet

    NASA Astrophysics Data System (ADS)

    Hussein, Rada; Khalifa, Aly; Jimenez-Castellanos, Ana; de la Calle, Guillermo; Ramirez-Robles, Maximo; Crespo, Jose; Perez-Rey, David; Garcia-Remesal, Miguel; Anguita, Alberto; Alonso-Calvo, Raul; de la Iglesia, Diana; Barreiro, Jose M.; Maojo, Victor

    2014-10-01

    Recent commentaries have proposed the advantages of using open exchange of data and informatics resources for improving health-related policies and patient care in Africa. Yet, in many African regions, both private medical and public health information systems are still unaffordable. Open exchange over the social Web 2.0 could encourage more altruistic support of medical initiatives. We have carried out some experiments to demonstrate the feasibility of using this approach to disseminate open data and informatics resources in Africa. After the experiments we developed the AFRICA BUILD Portal, the first Social Network for African biomedical researchers. Through the AFRICA BUILD Portal users can access in a transparent way to several resources. Currently, over 600 researchers are using distributed and open resources through this platform committed to low connections.

  13. Comparative Analysis between Podography and Radiography in the Management of Idiopathic Clubfeet by Ponseti Technique

    PubMed Central

    Badhwar, Sumit; Dube, Abhay S

    2017-01-01

    Introduction Idiopathic clubfoot is one of the most common and oldest congenital foot anomalies. There are controversies regarding its optimum management protocol and methodologies to be employed for its functional outcome evaluation. This paper attempts to propose a simple, reasonable and easily reproducible technique of podography for clinical and functional evaluation of clubfoot treated by the popular Ponseti technique. Aim To compare the Foot Bimalleolar (FBM) angle method (podography) and radiography with respect to management of idiopathic clubfoot by Ponseti’s Technique and its functional evaluation. Materials and Methods Sixty feet of 48 patients with idiopathic clubfoot deformity were assessed in terms of FBM by podography (foot print on paper and FBM angle drawing) and radiologically; before starting treatment, after 6 weeks and at 6 monthly intervals with a maximum follow up period of 4.8 years (Range 1.2 to 4.8 years). Mean age at start of treatment was 1.5 years (2 months to 2.5 years). Functional evaluation was done by Magone’s scoring system. Results After treatment, 92 percent patients had good correction (FBM greater than 70 degrees) which correlated well with post treatment Magone’s score of greater than 80 (good to excellent) in nearly 85 percent of cases. Radiologically, talocalcaneal angles in both the views improved in only 60 percent of cases. Conclusion Radiological criteria show inconsistent correlation with functional outcome for feet treated by Ponseti’s Technique. Podography (FBM angle analysis) is a very simple, objective, cost effective, radiation free, easily reproducible and highly reliable clinical criterion for the assessment of deformity correction in club foot by Ponseti’s Technique with an excellent correlation with functional outcome.

  14. Balloon-Occlusion Technique for Managing Portal Vein Hemorrhage in Liver Transplantation

    PubMed Central

    Seal, John B.; Bohorquez, Humberto; Battula, Naren; DeGregorio, Lucia; Bugeaud, Emily; Bruce, David S.; Carmody, Ian C.; Cohen, Ari J.; Loss, George E.

    2017-01-01

    Background: Portal vein thrombosis (PVT) is relatively common among candidates for liver transplantation and can present significant intraoperative challenges. Depending on the extent of PVT, thromboendovenectomy (TEV), portal bypass, or systemic inflow may be required to restore portal inflow. While TEV is the most commonly used approach to restore anatomic portal inflow, portal vein injury and life-threatening hemorrhage are risks with this technique. Case Report: We present a salvage technique for managing portal vein injury during TEV using intraluminal balloon occlusion of the portal vein during portal vein repair and reconstruction. This alternative mode of bleeding control optimizes exposure to the retropancreatic space and avoids direct application of vascular clamps that can cause further injury to the vessel and surrounding tissue. Conclusion: Careful preoperative planning and anticipation of potential problems are essential for safe and effective management of complex PVT intraoperatively. The balloon-occlusion technique can facilitate safe and efficient repair of a portal vein injury during TEV for liver transplantation. PMID:28331452

  15. The state of the art in clinical knowledge management: An inventory of tools and techniques

    PubMed Central

    Sittig, Dean F.; Wright, Adam; Simonaitis, Linas; Carpenter, James D.; Allen, George O.; Doebbeling, Bradley N.; Sirajuddin, Anwar Mohammad; Ash, Joan S.; Middleton, Blackford

    2009-01-01

    Purpose To explore the need for, and use of, high-quality, collaborative, clinical knowledge management (CKM) tools and techniques to manage clinical decision support content. Methods In order to better understand the current state of the art in CKM, we developed a survey of potential CKM tools and techniques. We conducted an exploratory study by querying a convenience sample of respondents about their use of specific practices in CKM. Results The following tools and techniques should be priorities in organizations interested in developing successful computer-based provider order entry (CPOE) and clinical decision support (CDS) implementations: 1) A multidisciplinary team responsible for creating and maintaining the clinical content; 2) An external organizational repository of clinical content with web-based viewer that allows anyone in the organization to review it; 3) An online, collaborative, interactive, internet-based tool to facilitate content development; 4) An enterprise-wide tool to maintain the controlled clinical terminology concepts. Even organizations that have been successfully using Computer-based Provider Order Entry with advanced Clinical Decision Support features for well over 15 years are not using all of the CKM tools or practices that we identified. Conclusions If we are to further stimulate progress in the area of clinical decision support, we must continue to develop and refine our understanding and use of advanced CKM capabilities. PMID:19828364

  16. Comparison based on environmental effects of nitrogen management techniques in a manure digestate case study.

    PubMed

    Paccanelli, Nicola; Teli, Aronne; Scaglione, Davide; Insabato, Gabriele; Casula, Alessandro

    2015-01-01

    Due to climate issues and favourable energy market, biogas is spreading as a manure management technique. Digestate is rich in nutrient and has to be handled in order to respect the 'nitrate directive' that limits nitrogen field application in areas defined as vulnerable. In this study, we compared different nitrogen management scenarios: a non-treatment option, a biological short-cut nitrification, a complete autotrophic process (anammox) and ammonia stripping from membrane filtration concentrate. The environmental effect comparison was obtained with 'Cross media effects analysis' and life cycle assessment (LCA). The results were different in some aspects, especially the impacts on eutrophication. According to cross media, the best process is DENO 2, while LCA shows similar impacts for all techniques and the best solution would be the no-treatment option. The main reason to adopt a digestate treatment technique is the lack of area for a correct disposal. If LCA eutrophication results are multiplied with the hectares necessary for each technology, a result similar to that of cross media is obtained.

  17. Management of Congenital Talipes Equino Varus (CTEV) by Ponseti Casting Technique in Neonates: Our Experience

    PubMed Central

    Saif Ullah, Md; Shahjahan, Md; Abu Sayed, Sk

    2013-01-01

    Objective: The purpose of this study is to evaluate the results of Ponseti technique in the management of congenital Talipes Equino Varus (CTEV) in neonatal age group. Methods: It is a prospective observational study, conducted during the period of July 2010 to December 2011 at the Department of Pediatric Surgery in a tertiary hospital. All the neonates with CTEV were treated with Ponseti casting technique. Neonates with other congenital deformities, arthrogryposis and myelomeningocele were excluded. Results: Total 58 CTEV feet of 38 neonates were treated. Twenty six were males and 12 were females. Thirty seven (63.8%) feet were of rigid variety and 21(36.2 %) feet were of non-rigid variety. Twenty patients had bilateral and 18 had unilateral involvement. Mean pre-treatment Pirani score of study group was 5.57. Mean number of plaster casts required per CTEV was 3.75 (range: 2-6). Thirty five rigid and 15 non-rigid (total 86.2%) feet required percutaneous tenotomy. Out of 58 feet 56 (96.6%) were managed successfully. Three (5.2%) patients developed complications like skin excoriation and blister formation. Mean post-treatment Pirani score of the study group was: 0.36 ± 0.43. Conclusion: The Ponseti technique is an excellent, simple, effective, minimally invasive, and inexpensive procedure for the treatment CTEV deformity. Ideally it can be performed as a day case procedure without general anesthesia even in neonatal period. PMID:26023437

  18. Low level waste management: a compilation of models and monitoring techniques. Volume 1

    SciTech Connect

    Mosier, J.E.; Fowler, J.R.; Barton, C.J.

    1980-04-01

    In support of the National Low-Level Waste (LLW) Management Research and Development Program being carried out at Oak Ridge National Laboratory, Science Applications, Inc., conducted a survey of models and monitoring techniques associated with the transport of radionuclides and other chemical species from LLW burial sites. As a result of this survey, approximately 350 models were identified. For each model the purpose and a brief description are presented. To the extent possible, a point of contact and reference material are identified. The models are organized into six technical categories: atmospheric transport, dosimetry, food chain, groundwater transport, soil transport, and surface water transport. About 4% of the models identified covered other aspects of LLW management and are placed in a miscellaneous category. A preliminary assessment of all these models was performed to determine their ability to analyze the transport of other chemical species. The models that appeared to be applicable are identified. A brief survey of the state-of-the-art techniques employed to monitor LLW burial sites is also presented, along with a very brief discussion of up-to-date burial techniques.

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

    PubMed Central

    Hoffmann, Alexandra; Bleser, Gabriele

    2017-01-01

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

  20. A review of the surgical management of breast cancer: plastic reconstructive techniques and timing implications.

    PubMed

    Rosson, Gedge D; Magarakis, Michael; Shridharani, Sachin M; Stapleton, Sahael M; Jacobs, Lisa K; Manahan, Michele A; Flores, Jaime I

    2010-07-01

    The oncologic management of breast cancer has evolved over the past several decades from radical mastectomy to modern-day preservation of chest and breast structures. The increased rate of mastectomies over recent years made breast reconstruction an integral part of the breast cancer management. Plastic surgery now offers patients a wide variety of reconstruction options from primary closure of the skin flaps to performance of microvascular and autologous tissue transplantation. Well-coordinated partnerships between surgical oncologists, plastic surgeons, and patients address concerns of tumor control, cosmesis, and patients' wishes. The gamut of breast reconstruction options is reviewed, particularly noting state-of-the-art techniques, as well as the advantages and disadvantages of various timing modalities.

  1. Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

    NASA Astrophysics Data System (ADS)

    Ram Prabhakar, J.; Ragavan, K.

    2013-07-01

    This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

  2. Scientific or rule-of-thumb techniques of ground-water management--Which will prevail?

    USGS Publications Warehouse

    McGuinness, Charles Lee

    1969-01-01

    Emphasis in ground-water development, once directed largely to quantitatively minor (but sociologically vital) service of human and stock needs, is shifting: aquifers are treated as possible regulating reservoirs managed conjunctively with surface water. Too, emphasis on reducing stream pollution is stimulating interest in aquifers as possible waste-storage media. Such management of aquifers requires vast amounts of data plus a much better understanding of aquifer-system behavior than now exists. Implicit in this deficiency of knowledge is a need for much new research, lest aquifers be managed according to ineffective rule-of-thumb standards, or even abandoned as unmanageable. The geohydrologist's task is to define both internal and boundary characteristics of aquifer systems. Stratigraphy is a primary determinant of these characteristics, but stratigraphically minor features may make aquifers transcend stratigraphic boundaries. For example, a structurally insignificant fracture may carry more water than a major fault; a minor stratigraphic discontinuity may be a major hydrologic boundary. Hence, there is a need for ways of defining aquifer boundaries and quantifying aquifer and confining-bed characteristics that are very different from ordinary stratigraphic techniques. Among critical needs are techniques for measuring crossbed permeability; for extrapolating and interpolating point data on direction and magnitude of permeability in defining aquifer geometry; and for accurately measuring geochemical properties of water and aquifer material, and interpreting those measurements in terms of source of water, rate of movement, and waste-sorbing capacities of aquifers and of confining beds--in general, techniques adequate for predicting aquifer response to imposed forces whether static, hydraulic, thermal, or chemical. Only when such predictions can be made routinely can aquifer characteristics be inserted into a master model that incorporates both the hydrologic and

  3. A case series of patients using medicinal marihuana for management of chronic pain under the Canadian Marihuana Medical Access Regulations.

    PubMed

    Lynch, Mary E; Young, Judee; Clark, Alexander J

    2006-11-01

    The Canadian Marihuana Medical Access Regulations (MMAR) program allows Health Canada to grant access to marihuana for medical use to those who are suffering from grave and debilitating illnesses. This is a report on a case series of 30 patients followed at a tertiary care pain management center in Nova Scotia who have used medicinal marihuana for 1-5 years under the MMAR program. Patients completed a follow-up questionnaire containing demographic and dosing information, a series of 11-point numerical symptom relief rating scales, a side effect checklist, and a subjective measure of improvement in function. Doses of marihuana ranged from less than 1 to 5g per day via the smoked or oral route of administration. Ninety-three percent of patients reported moderate or greater pain relief. Side effects were reported by 76% of patients, the most common of which were increased appetite and a sense of well-being, weight gain, and slowed thoughts. Limitations of the study include self-selection bias, small size, and lack of a control group. The need for further study using controlled trials is discussed along with an overview of the MMAR program.

  4. Interventional Radiology in the Management of Visceral Artery Pseudoaneurysms: A Review of Techniques and Embolic Materials

    PubMed Central

    Venkatesh, Hosur Ananthashayana; Gamanagatti, Shivanand; Garg, Pramod; Srivastava, Deep Narayan

    2016-01-01

    Visceral artery pseudoaneurysms occur mostly as a result of inflammation and trauma. Owing to high risk of rupture, they require early treatment to prevent lethal complications. Knowledge of the various approaches of embolization of pseudoaneurysms and different embolic materials used in the management of visceral artery pseudoaneurysms is essential for successful and safe embolization. We review and illustrate the endovascular, percutaneous and endoscopic ultrasound techniques used in the treatment of visceral artery pseudoaneurysm and briefly discuss the embolic materials and their benefits and risks. PMID:27134524

  5. Incorporating Piaget's theories into behavior management techniques for the child dental patient.

    PubMed

    Delitala, G

    2000-01-01

    This presentation reviews psychologist Jean Piaget's contributions to knowledge of cognitive development in children, relating it to behavior management techniques. Piaget theorized that children's knowledge about reality is realized by touching and observing; he termed this constructivism. He recognized that there are stages of development in knowledge acquisition. Practitioners should try to stimulate these needs to develop a positive dental experience. Another Piaget model is egocentrism, wherein a child views the world subjectively. The dentist should let the child patient know what's going on and have an active part in treatment.

  6. The Application of Biomedical Engineering Techniques to the Diagnosis and Management of Tropical Diseases: A Review

    PubMed Central

    Ibrahim, Fatimah; Thio, Tzer Hwai Gilbert; Faisal, Tarig; Neuman, Michael

    2015-01-01

    This paper reviews a number of biomedical engineering approaches to help aid in the detection and treatment of tropical diseases such as dengue, malaria, cholera, schistosomiasis, lymphatic filariasis, ebola, leprosy, leishmaniasis, and American trypanosomiasis (Chagas). Many different forms of non-invasive approaches such as ultrasound, echocardiography and electrocardiography, bioelectrical impedance, optical detection, simplified and rapid serological tests such as lab-on-chip and micro-/nano-fluidic platforms and medical support systems such as artificial intelligence clinical support systems are discussed. The paper also reviewed the novel clinical diagnosis and management systems using artificial intelligence and bioelectrical impedance techniques for dengue clinical applications. PMID:25806872

  7. Chiropractic management of shoulder pain and dysfunction of myofascial origin using ischemic compression techniques

    PubMed Central

    Hains, Guy

    2002-01-01

    Shoulder pain and dysfunction is a chief complaint commonly presenting to a chiropractor's office. The purpose of this article is to review the most common etiologies of shoulder pain, focusing on those conditions of a myofascial origin. In addition to a review of the literature, the author draws upon his own clinical experience to describe a method to diagnose and manage, patients with shoulder pain of myofascial origin using ischemic compression techniques. This hands-on therapeutic approach conveys several benefits including: positive therapeutic outcomes; a favorable safety profile and; it is minimally strenuous on the doctor and well tolerated by the patient. ImagesFigure 7

  8. The application of biomedical engineering techniques to the diagnosis and management of tropical diseases: a review.

    PubMed

    Ibrahim, Fatimah; Thio, Tzer Hwai Gilbert; Faisal, Tarig; Neuman, Michael

    2015-03-23

    This paper reviews a number of biomedical engineering approaches to help aid in the detection and treatment of tropical diseases such as dengue, malaria, cholera, schistosomiasis, lymphatic filariasis, ebola, leprosy, leishmaniasis, and American trypanosomiasis (Chagas). Many different forms of non-invasive approaches such as ultrasound, echocardiography and electrocardiography, bioelectrical impedance, optical detection, simplified and rapid serological tests such as lab-on-chip and micro-/nano-fluidic platforms and medical support systems such as artificial intelligence clinical support systems are discussed. The paper also reviewed the novel clinical diagnosis and management systems using artificial intelligence and bioelectrical impedance techniques for dengue clinical applications.

  9. The management of femoral bone stock in THA revision: indications and techniques.

    PubMed

    Bianchi, Luca; Galante, Claudio; Zagra, Luigi

    2014-10-02

    Following the increasing number of total hip arthroplasties, the amount of hip revision procedures continue to rise. Careful patient selection and bone loss evaluation is crucial for a correct management of femoral revision procedures. The key point in femoral revision is to obtain a reliable primary stability of the stem, with the least invasive implant as possible, to preserve and if possible to restore the bone stock. In this article we present the indications and the techniques for the femoral revisions most commonly used in Europe, referring to the evidence in the literature and our personal experiences.

  10. Managing the Nuclear Fuel Cycle: Policy Implications of Expanding Global Access to Nuclear Power

    DTIC Science & Technology

    2009-07-01

    uranium to make mixed-oxide ( MOX ) fuel, in which the 239Pu largely substitutes for 235U. Two French reprocessing plants at La Hague can each...Managing the Nuclear Fuel Cycle Congressional Research Service 17 plant.54 About 200 metric tons of MOX fuel is used annually, about 2% of new nuclear...fuel,55 equivalent to about 2,000 metric tons of mined uranium.56 However, the benefits of reprocessing spent fuel to make MOX fuel for today’s

  11. Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

    PubMed

    Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

    2017-02-01

    We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record

  12. A refined electrofishing technique for collecting Silver Carp: Implications for management

    USGS Publications Warehouse

    Bouska, Wesley W.; Glover, David C.; Bouska, Kristen; Garvey, James E.

    2017-01-01

    Detecting nuisance species at low abundance or in newly established areas is critical to developing pest management strategies. Due to their sensitivity to disturbance and erratic jumping behavior, Silver Carp Hypophthalmichthys molitrix can be difficult to collect with traditional sampling methods. We compared catch per unit effort (CPUE) of all species from a Long Term Resource Monitoring (LTRM) electrofishing protocol to an experimental electrofishing technique designed to minimize Silver Carp evasion through tactical boat maneuvering and selective application of power. Differences in CPUE between electrofishing methods were detected for 2 of 41 species collected across 2 years of sampling at 20 sites along the Illinois River. The mean catch rate of Silver Carp using the experimental technique was 2.2 times the mean catch rate of the LTRM electrofishing technique; the increased capture efficiency at low relative abundance emphasizes the utility of this method for early detection. The experimental electrofishing also collected slightly larger Silver Carp (mean: 510.7 mm TL versus 495.2 mm TL), and nearly four times as many Silver Carp independently jumped into the boat during experimental transects. Novel sampling approaches, such as the experimental electrofishing technique used in this study, should be considered to increase probability of detection for aquatic nuisance species.

  13. Effective behaviour change techniques in the prevention and management of childhood obesity.

    PubMed

    Martin, J; Chater, A; Lorencatto, F

    2013-10-01

    Rates of childhood obesity are increasing, and it is essential to identify the active components of interventions aiming to prevent and manage obesity in children. A systematic review of behaviour change interventions was conducted to find evidence of behaviour change techniques (BCTs) that are most effective in changing physical activity and/or eating behaviour for the prevention or management of childhood obesity. An electronic search was conducted for randomised controlled trials published between January 1990 and December 2009. Of 4309 titles and abstracts screened, full texts of 135 articles were assessed, of which 17 published articles were included in this review. Intervention descriptions were coded according to the behaviour-specific CALO-RE taxonomy of BCTs. BCTs were identified and compared across obesity management (n=9) vs prevention (n=8) trials. To assess the effectiveness of individual BCTs, trials were further divided into those that were effective (defined as either a group reduction of at least 0.13 body mass index (BMI) units or a significant difference in BMI between intervention and control groups at follow-up) vs non-effective (reported no significant differences between groups). We reliably identified BCTs utilised in effective and non-effective prevention and management trials. To illustrate the relative effectiveness of each BCT, effectiveness ratios were calculated as the ratio of the number of times each BCT was a component of an intervention in an effective trial divided by the number of times they were a component of all trials. Results indicated six BCTs that may be effective components of future management interventions (provide information on the consequences of behaviour to the individual, environmental restructuring, prompt practice, prompt identification as role model/position advocate, stress management/emotional control training and general communication skills training), and one that may be effective in prevention

  14. Housing assistance and case management: improving access to substance use disorder treatment for homeless veterans.

    PubMed

    Winn, Jaime L; Shealy, Suzanne E; Kropp, Gary J; Felkins-Dohm, Donna; Gonzales-Nolas, Cheryl; Francis, Elie

    2013-05-01

    The problem of waiting list attrition in addiction treatment programs is widespread, and homeless and marginally housed individuals are particularly susceptible. This naturalistic, retrospective study describes an intervention (Transitional Supportive Housing and Case Management) that effectively promoted treatment admission for this high-risk group above and beyond that which could be explained by certain pretreatment factors. The clinical records of 211 military veterans referred to intensive outpatient addiction treatment were reviewed for factors related to treatment program admission, including 3 interventions designed to prevent waiting list attrition. Chi-square tests evaluated univariate predictors of treatment entry, and a hierarchical binary logistic regression evaluated several variables simultaneously. Results showed that fewer than 50% of wait-listed patients achieved treatment admission. Univariate predictors of treatment entry were not having a current partner, having a legal problem, and having had past substance use disorder treatment. The logistic regression showed that patients who received the intervention were 4.5 times more likely to enter the treatment program, and individuals with a current legal problem were 2.5 times more likely to enter treatment. Participation in a weekly support group and/or contact with a psychiatric nurse practitioner did not increase the likelihood of program admission. It may be possible to enhance treatment entry for the homeless and marginally housed by providing case management and housing services. Future research is needed to determine how the individual-level factors predicting treatment entry in this study can be used to tailor other interventions to further address the problem of waiting list attrition.

  15. Postoperative Pain Management in Children, Parental English Proficiency, and Access to Interpretation

    PubMed Central

    Jimenez, Nathalia; Jackson, Douglass L.; Zhou, Chuan; Ayala, Nelly C.; Ebel, Beth E.

    2014-01-01

    BACKGROUND AND OBJECTIVE Patients with limited English proficiency (LEP) are at risk for undertreated pain. The goal of this study was to examine the association between parental language proficiency, interpreted care, and postsurgical pediatric pain management. METHODS This was a retrospective matched cohort study among children <18 years of age. Children of LEP and English-proficient (EP) parents were matched according to age group, surgical procedure, and admission date. Mean number of daily pain assessments and mean daily pain scores were compared between language groups. We also compared the association between pain scores and type of medication given (opioid versus nonopioid). Within the LEP group, similar analyses compared pain assessment and treatment of children whose families received ≥2 professional interpretations per day versus those who received lower rates of interpretation. RESULTS A total of 474 children (237 LEP and 237 EP) were included in the study. Children of LEP parents had fewer pain assessments (mean: 7 [95% confidence interval: 2–13] vs 9 [95% confidence interval: 4–15]; P = .012), and higher levels of pain recorded before receiving opioid analgesics, compared with children of EP parents (P = .003). Within the LEP group, children with ≥2 interpretations per day had lower pain scores after medication administration (P < .05) and were more likely to receive opioids at pain levels similar to those of EP families. CONCLUSIONS Children of LEP parents received fewer pain assessments and were less likely to receive opioid analgesics for similar levels of pain compared with children of EP parents. More frequent use of professional interpreters when assessing pain may aid in reducing the gap in pain management between LEP and EP pediatric patients. PMID:24435597

  16. Reliability and Efficacy of Water Use Estimation Techniques and their Impact on Water Management and Policy

    NASA Astrophysics Data System (ADS)

    Singh, A.; Deeds, N.; Kelley, V.

    2012-12-01

    Estimating how much water is being used by various water users is key to effective management and optimal utilization of groundwater resources. This is especially true for aquifers like the Ogallala that are severely stressed and display depleting trends over the last many years. The High Plains Underground Water Conservation District (HPWD) is the largest and oldest of the Texas water conservation districts, and oversees approximately 1.7 million irrigated acres. Water users within the 16 counties that comprise the HPWD draw from the Ogallala extensively. The HPWD has recently proposed flow-meters as well as various 'alternative methods' for water users to report water usage. Alternative methods include using a) site specific energy conversion factors to convert total amount of energy used (for pumping stations) to water pumped, b) reporting nozzle package (on center pivot irrigation systems) specifications and hours of usage, and c) reporting concentrated animal feeding operations (CAFOs). The focus of this project was to evaluate the reliability and effectiveness for each of these water use estimation techniques for regulatory purposes. Reliability and effectiveness of direct flow-metering devices was also addressed. Findings indicate that due to site-specific variability and hydrogeologic heterogeneity, alternative methods for estimating water use can have significant uncertainties associated with water use estimates. The impact of these uncertainties on overall water usage, conservation, and management was also evaluated. The findings were communicated to the Stakeholder Advisory Group and the Water Conservation District with guidelines and recommendations on how best to implement the various techniques.

  17. Which is the easiest and safest technique for central venous access? A retrospective survey of more than 5,400 cases.

    PubMed

    Pittiruti, M; Malerba, M; Carriero, C; Tazza, L; Gui, D

    2000-01-01

    There is an ongoing debate on the technique for central venous catheterization associated with the lowest complication rate and the highest success rate. In an attempt to better define the easiest and safest venous approach, we have reviewed our 7-year experience with 5479 central venous percutaneous punctures (by Seldinger's technique) for the insertion of short-term (n=2109), medium/long-term (n=2627) catheters, as well as double-lumen, large-bore catheters for hemodialysis and/or hemapheresis (n=743). We have analyzed the incidence of the most frequent in-sertion-related complications by comparing seven different venous approaches: jugular vein, low lateral approach; jugular vein, high lateral approach; jugular vein, low axial approach; subclavian vein, infraclavicular approach; subclavian vein, supraclavicular approach; external jugular vein; femoral vein. The results of our retrospective study suggest that the 'low lateral' approach to the internal jugular vein, as described by Jernigan and modified according to our protocol, appears to be the easiest and safest technique for percutaneous insertion of central venous access, being characterized by the lowest incidence of accidental arte-rial puncture (1.2%) and malposition (0.8%), no pneumothorax, and an extremely low rate of repeated attempts (i.e. more than two punctures before successful cannulation) (3.3%). We advocate the 'low lateral' approach to the internal jugular vein as first-choice technique for venipuncture in both adults and children, for both short-term and long-term central venous percutaneous cannulation.

  18. Software Health Management: A Short Review of Challenges and Existing Techniques

    NASA Technical Reports Server (NTRS)

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

    2009-01-01

    Modern spacecraft (as well as most other complex mechanisms like aircraft, automobiles, and chemical plants) rely more and more on software, to a point where software failures have caused severe accidents and loss of missions. Software failures during a manned mission can cause loss of life, so there are severe requirements to make the software as safe and reliable as possible. Typically, verification and validation (V&V) has the task of making sure that all software errors are found before the software is deployed and that it always conforms to the requirements. Experience, however, shows that this gold standard of error-free software cannot be reached in practice. Even if the software alone is free of glitches, its interoperation with the hardware (e.g., with sensors or actuators) can cause problems. Unexpected operational conditions or changes in the environment may ultimately cause a software system to fail. Is there a way to surmount this problem? In most modern aircraft and many automobiles, hardware such as central electrical, mechanical, and hydraulic components are monitored by IVHM (Integrated Vehicle Health Management) systems. These systems can recognize, isolate, and identify faults and failures, both those that already occurred as well as imminent ones. With the help of diagnostics and prognostics, appropriate mitigation strategies can be selected (replacement or repair, switch to redundant systems, etc.). In this short paper, we discuss some challenges and promising techniques for software health management (SWHM). In particular, we identify unique challenges for preventing software failure in systems which involve both software and hardware components. We then present our classifications of techniques related to SWHM. These classifications are performed based on dimensions of interest to both developers and users of the techniques, and hopefully provide a map for dealing with software faults and failures.

  19. Current management and recommendations for access to antiviral therapy of herpes labialis.

    PubMed

    Cunningham, Anthony; Griffiths, Paul; Leone, Peter; Mindel, Adrian; Patel, Rajul; Stanberry, Lawrence; Whitley, Richard

    2012-01-01

    Herpes labialis is a common skin infective condition, worldwide, which is primarily caused by HSV-1. Recurrent episodes of herpes labialis, also known as cold sores, can be frequent, painful, long-lasting and disfiguring for infected patients. At present, there are two types of antivirals for the treatment of herpes labialis, topical and oral, which are available over the counter or as prescription-only. The aim of antiviral therapy is to block viral replication to enable shortening the duration of symptoms and to accelerate healing of the lesions associated with herpes labialis. This review examines the evidence for the effectiveness of current topical and oral antivirals in the management of recurrent episodes of herpes labialis. In most countries, oral antivirals for herpes labialis are available as prescription-only. However, in early 2010, the oral antiviral famciclovir was reclassified from prescription-only medicine to pharmacist-controlled status in New Zealand. The benefits and risks associated with moving an antiviral therapy for herpes labialis from prescription-only to pharmacist-controlled status are reviewed here, and the implications for patients, general physicians and pharmacists are considered.

  20. Automated secured cost effective key refreshing technique to enhance WiMAX privacy key management

    NASA Astrophysics Data System (ADS)

    Sridevi, B.; Sivaranjani, S.; Rajaram, S.

    2013-01-01

    In all walks of life the way of communication is transformed by the rapid growth of wireless communication and its pervasive use. A wireless network which is fixed and richer in bandwidth is specified as IEEE 802.16, promoted and launched by an industrial forum is termed as Worldwide Interoperability for Microwave Access (WiMAX). This technology enables seamless delivery of wireless broadband service for fixed and/or mobile users. The obscurity is the long delay which occurs during the handoff management in every network. Mobile WiMAX employs an authenticated key management protocol as a part of handoff management in which the Base Station (BS) controls the distribution of keying material to the Mobile Station (MS). The protocol employed is Privacy Key Management Version 2- Extensible Authentication Protocol (PKMV2-EAP) which is responsible for the normal and periodical authorization of MSs, reauthorization as well as key refreshing. Authorization key (AK) and Traffic Encryption key (TEK) plays a vital role in key exchange. When the lifetime of key expires, MS has to request for a new key to BS which in turn leads to repetition of authorization, authentication as well as key exchange. To avoid service interruption during reauthorization , two active keys are transmitted at the same time by BS to MS. The consequences of existing work are hefty amount of bandwidth utilization, time consumption and large storage. It is also endured by Man in the Middle attack and Impersonation due to lack of security in key exchange. This paper designs an automatic mutual refreshing of keys to minimize bandwidth utilization, key storage and time consumption by proposing Previous key and Iteration based Key Refreshing Function (PKIBKRF). By integrating PKIBKRF in key generation, the simulation results indicate that 21.8% of the bandwidth and storage of keys are reduced and PKMV2 mutual authentication time is reduced by 66.67%. The proposed work is simulated with Qualnet model and

  1. Girls' Access to Education in China: Actors, Cultures and the Windmill of Development Management. CREATE Pathways to Access. Research Monograph No. 39

    ERIC Educational Resources Information Center

    Wang, Xiaojun Grace

    2010-01-01

    The world has a mixed record towards achieving EFA [Education for All] and the MDGs [Millennium Development Goals] in relation to the targets on gender equity in basic education. For researchers and practitioners, this raises the question of which factors influence the processes leading to the improvement of access and quality of girls' education…

  2. Electrospray Ionization Mass Spectrometry: A Technique to Access the Information beyond the Molecular Weight of the Analyte

    PubMed Central

    Banerjee, Shibdas; Mazumdar, Shyamalava

    2012-01-01

    The Electrospray Ionization (ESI) is a soft ionization technique extensively used for production of gas phase ions (without fragmentation) of thermally labile large supramolecules. In the present review we have described the development of Electrospray Ionization mass spectrometry (ESI-MS) during the last 25 years in the study of various properties of different types of biological molecules. There have been extensive studies on the mechanism of formation of charged gaseous species by the ESI. Several groups have investigated the origin and implications of the multiple charge states of proteins observed in the ESI-mass spectra of the proteins. The charged analytes produced by ESI can be fragmented by activating them in the gas-phase, and thus tandem mass spectrometry has been developed, which provides very important insights on the structural properties of the molecule. The review will highlight recent developments and emerging directions in this fascinating area of research. PMID:22611397

  3. Evaluating the Effect of Three Water Management Techniques on Tomato Crop

    PubMed Central

    Elnesr, Mohammad Nabil; Alazba, Abdurrahman Ali; Zein El-Abedein, Assem Ibrahim; El-Adl, Mahmoud Maher

    2015-01-01

    The effects of three water management techniques were evaluated on subsurface drip irrigated tomatoes. The three techniques were the intermittent flow (3 pulses), the dual-lateral drip system (two lateral lines per row, at 15 and 25cm below soil surface), and the physical barrier (buried at 30 cm below soil surface). Field experiments were established for two successive seasons. Water movement in soil was monitored using continuously logging capacitance probes up to 60 cm depth. The results showed that the dual lateral technique positively increased the yield up to 50%, water use efficiency up to 54%, while the intermittent application improved some of the quality measures (fruit size, TSS, and Vitamin C), not the quantity of the yield that decreased in one season, and not affected in the other. The physical barrier has no significant effect on any of the important growth measures. The soil water patterns showed that the dual lateral method lead to uniform wetting pattern with depth up to 45 cm, the physical barrier appeared to increase lateral and upward water movement, while the intermittent application kept the wetting pattern at higher moisture level for longer time. The cost analysis showed also that the economic treatments were the dual lateral followed by the intermittent technique, while the physical barrier is not economical. The study recommends researching the effect of the dual lateral method on the root growth and performance. The intermittent application may be recommended to improve tomato quality but not quantity. The physical barrier is not recommended unless in high permeable soils. PMID:26057380

  4. Evaluating the Effect of Three Water Management Techniques on Tomato Crop.

    PubMed

    Elnesr, Mohammad Nabil; Alazba, Abdurrahman Ali; Zein El-Abedein, Assem Ibrahim; El-Adl, Mahmoud Maher

    2015-01-01

    The effects of three water management techniques were evaluated on subsurface drip irrigated tomatoes. The three techniques were the intermittent flow (3 pulses), the dual-lateral drip system (two lateral lines per row, at 15 and 25 cm below soil surface), and the physical barrier (buried at 30 cm below soil surface). Field experiments were established for two successive seasons. Water movement in soil was monitored using continuously logging capacitance probes up to 60 cm depth. The results showed that the dual lateral technique positively increased the yield up to 50%, water use efficiency up to 54%, while the intermittent application improved some of the quality measures (fruit size, TSS, and Vitamin C), not the quantity of the yield that decreased in one season, and not affected in the other. The physical barrier has no significant effect on any of the important growth measures. The soil water patterns showed that the dual lateral method lead to uniform wetting pattern with depth up to 45 cm, the physical barrier appeared to increase lateral and upward water movement, while the intermittent application kept the wetting pattern at higher moisture level for longer time. The cost analysis showed also that the economic treatments were the dual lateral followed by the intermittent technique, while the physical barrier is not economical. The study recommends researching the effect of the dual lateral method on the root growth and performance. The intermittent application may be recommended to improve tomato quality but not quantity. The physical barrier is not recommended unless in high permeable soils.

  5. Double blind randomised controlled trial of two different breathing techniques in the management of asthma

    PubMed Central

    Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic‐Anticevich, S Z; Thien, F C K; Jenkins, C R

    2006-01-01

    Background Previous studies have shown that breathing techniques reduce short acting β2 agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non‐specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. Methods After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Results Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Conclusion Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non‐specific upper body exercises. PMID:16517572

  6. History of vascular access.

    PubMed

    Dudrick, Stanley J

    2006-01-01

    Milestones in the history of the development of vascular access and the subsequent advances in practical clinical applications of the knowledge, techniques, technology, and experience to the beneficial management of a variety of patients are described. The original achievements are presented and briefly discussed primarily, but not exclusively, in relationship to the successful development of parenteral nutrition (PN). Beginning with the discovery of the circulation of blood, landmark events, resulting from astute observations, experimentation, and ingenious technological advances, are summarized or outlined chronologically over the past 4 centuries, with emphasis on the many recent accomplishments of basic and clinical scientists during the past 6 decades. Brief descriptions of several seminal contributions to safe and effective IV access, management, and therapy acknowledge and recognize the historical highlights that have allowed a complex and potentially hazardous therapeutic modality to evolve into a commonly applied useful adjunct to our current inpatient and outpatient armamentarium. A comprehensive list of references documents the highlights of the development of vascular access for the student of history.

  7. Western pond turtle: Biology, sampling techniques, inventory and monitoring, conservation, and management: Northwest Fauna No. 7

    USGS Publications Warehouse

    Bury, R.B.; Welsh, Hartwell H.; Germano, David J.; Ashton, Donald T.

    2012-01-01

    One of only two native, freshwater turtle species in the western United States, western pond turtles are declining in portions of their original range. Declines are mostly due to habitat loss, introduction of non-native species, pollution, and lack of connectivity among populations. USGS zoologist R. Bruce Bury and colleagues from the U.S. Forest Service, California State University, and other agencies compiled and edited a new review and field manual of this charismatic species. Objectives were to determine its current distribution and abundance, summarize and evaluate population features, review techniques to detect population and habitat changes, and improve monitoring for long-term trends. Methods described in the manual should improve consistency, efficiency, and accuracy of survey data, resulting in improved management and conservation efforts.

  8. Project planning and management techniques of the fast-paced TMX-Upgrade construction

    SciTech Connect

    Seberger, C.D.; Chargin, A.K.

    1981-10-26

    The Tandem Mirror Experiment-Upgrade (TMX-Upgrade) construction will be completed in 18 months at a total cost of $14.5 million. This paper describes the project planning and the management techniques used to complete the TMX-Upgrade within its allocated cost and schedule. In the planning stages of a project, before approval of the proposal, we define major project objectives, create a work breakdown structure (WBS), detail a technical description for each level of the WBS, and provide detailed bottoms-up cost estimates and summary schedules. In the operating phase, which continues throughout the project, we establish budget and schedule baselines. The reporting phase includes The Department of Energy (DOE) reviews of project status at monthly, quarterly, and semiannual intervals. These reports include cost, schedule, manpower, major procurement, and technical status information.

  9. Assessment of frequent cutting as a plant-community management technique in power-line corridors

    NASA Astrophysics Data System (ADS)

    Luken, James O.; Hinton, Andrew C.; Baker, Douglas G.

    1991-05-01

    Repeated cutting of vegetation at or near ground level in power-line corridors is a common practice for inhibiting tree growth and regeneration. However, few data exist on long-term community responses. In this study, we sampled 20 northern Kentucky power-line corridors and compared their seedling and sapling communities to the edges and interiors of adjacent undisturbed forests. Mean seedling and sapling density in corridors was roughly twice that of adjacent undisturbed forest interiors, suggesting that repeated cutting is not a viable method of inhibiting tree regeneration. Corridor communities were dominated by Robinia pseudoacacia (black locust) and Fraxinus americana (white ash), but ordinations indicated strong similaritties among communities in corridors and adjacent forests. Many of the tree species found in adjacent forests, with the exception of a few shade-tolerant species, had highest seedling and sapling densities in corridors. Stump or root sprouting by many species appears to regenerate forests quickly after cutting. However, disturbed soil and detritus accumulations caused by management crews and their equipment may also create a large variety of microsites for seedling establishment. Because repeated cutting selects for dominance by species with highest sprout growth rates, it should not be used as the sole management technique. It may instead be used to alter the vigor, stature, and stored reserves of trees so that herbicides or other methods of tree control can be used more efficiently.

  10. Application of capillary fluid management techniques to the design of a phase separating microgravity bioreactor

    NASA Technical Reports Server (NTRS)

    Finger, Barry W.; Neville, Gale E., Jr.; Sager, John C.

    1993-01-01

    Manned space missions require the development of compact, efficient, and reliable life support systems. A number of aqueous biological conversion processes are associated with bioregenerative life support systems. Vessels, or bioreactors, capable of supporting these processes in microgravity must be developed. An annular flow bioreactor has been conceived. It has the potential to incorporate containment, phase separation, gas exchange, and illumination into a single vessel. The bioreactor utilizes capillary fluid management techniques and is configured as a cylindrical tube in which a two-phase liquid-gas flow is maintained. Vanes placed around the inner perimeter enhance capillary forces and cause the liquid phase to attach and flow along the interior surface of the tube. No physical barrier is required to complete phase separation. It is shown analytically that liquid film thickness is limited only by vane geometry and that an annular flow bioreactor capable of managing 284 liters would occupy 0.7 cubic m, less than half the volume of a Spacelab experiment rack.

  11. Bicondylar tibial plateau fractures managed with the Sheffield Hybrid Fixator. Biomechanical study and operative technique.

    PubMed

    Ali, A M; Yang, L; Hashmi, M; Saleh, M

    2001-12-01

    The two main challenges in the management of bicondylar tibial plateau fractures are: Firstly, the compromised skin and soft tissue envelope which invite a high rate of complications following attempted open reduction and dual plating. Secondly, poor bone quality and comminuted fracture patterns, which create difficulty in achieving stable fixation. Although dual plating is considered to be the best mechanical method of stabilizing these complex fractures, there remains concern regarding the high rate of complications associated with extensive soft tissue dissection, required for the insertion of these plates in an already compromised knee. The Sheffield Hybrid fixator (SHF) technique offers a solution to the two main problems of these difficult fractures by minimizing soft tissue dissection, since bone fragments are reduced and fixed percutaneously, and providing superior cancellous bone purchase with beam loading stabilization for comminuted fractures. Our biomechanical testing showed the SHF with four tensioned wires to be as strong as dual plating and able to provide adequate mechanical stability in the fixation of bicondylar tibial plateau fractures. This was confirmed clinically by a prospective review of the use of the SHF at our centre, for managing complex and high-energy tibial plateau fractures with a good final outcome and no cases of deep infection or septic arthritis.

  12. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    SciTech Connect

    Shah, Chirag; Vicini, Frank A.

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  13. Catheter fixation and ligation: a simple technique for ventriculostomy management following endovascular stenting.

    PubMed

    Sweeney, Justin M; Vasan, Rohit; van Loveren, Harry R; Youssef, A Samy; Agazzi, Siviero

    2013-05-01

    The object of this study was to describe a unique method of managing ventriculostomy catheters in patients on antithrombotic therapy following endovascular treatment of ruptured intracranial aneurysms. The authors retrospectively reviewed 3 cases in which a unique method of ventriculostomy management was used to successfully avoid catheter-related hemorrhage while the patient was on dual antiplatelet therapy. In this setting, ventriculostomy catheters are left in place and fixed to the calvarium with titanium straps effectively ligating them. The catheter is divided and the distal end is removed. The proximal end can be directly connected to a distal shunt system during this stage or at a later date if necessary. The method described in this report provided a variety of management options for patients requiring external ventricular drainage for subarachnoid hemorrhage. No patient suffered catheter-related hemorrhage. This preliminary report demonstrates a safe and effective method for discontinuing external ventricular drainage and/or placing a ventriculoperitoneal shunt in the setting of active coagulopathy or antithrombotic therapy. The technique avoids both the risk of hemorrhage related to catheter removal and reinsertion and the thromboembolic risks associated with the reversal of antithrombotic therapy. Some aneurysm centers have avoided the use of stent-assisted coiling in cases of ruptured aneurysms to circumvent ventriculostomy-related complications; however, the method described herein should allow continued use of this important treatment option in ruptured aneurysm cases. Further investigation in a larger cohort with long-term follow-up is necessary to define the associated risks of infection using this method.

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

    USGS Publications Warehouse

    Bergstedt, Roger A.; Twohey, Michael B.

    2005-01-01

    The parasitic sea lamprey (Petromyzon marinus) has been a serious pest since its introduction into the Great Lakes, where it contributed to severe imbalances in the fish communities by selectively removing large predators (Smith 1968; Christie 1974; Schneider et al.1996). Since the 1950s, restoration and maintenance of predator-prey balance has depended on the Great Lakes Fishery Commission (GLFC) sea lamprey management program. Initially, management relied primarily on stream treatments with a selective lampricide to kill larvae, on barriers to migration, and on trapping to remove potential spawners (Smith and Tibbles 1980). By the late 1970s, however, it was clear that the future of sea lamprey management lay in development of a larger array of control strategies, including more alternatives to lampricide applications (Sawyer 1980). Since then the only new alternative to chemical control to reach operational status is the release of sterilized male sea lampreys. Research on the concept began at the USGS, Hammond Bay Biological Station in Millersburg, MI (HBBS) during the 1970s (Hanson and Manion 1980). Development and evaluation continued through the 1980s, leading to the release of sterilized males in Great Lakes tributaries since 1991 (Twohey et al. 2003a). The objectives of this paper are 1) to review the implementation and evaluations of sterile-male-release technique (SMRT) as it is being applied against sea lampreys in the Great Lakes, 2) to review our current understanding of its efficacy, and 3) to identify additional research areas and topics that would increase either the efficacy of SMRT or expand its geographic potential for application.

  15. The Limits of Corporate Social Responsibility: Techniques of Neutralization, Stakeholder Management and Political CSR.

    PubMed

    Fooks, Gary; Gilmore, Anna; Collin, Jeff; Holden, Chris; Lee, Kelley

    2013-01-01

    Since scholarly interest in corporate social responsibility (CSR) has primarily focused on the synergies between social and economic performance, our understanding of how (and the conditions under which) companies use CSR to produce policy outcomes that work against public welfare has remained comparatively under-developed. In particular, little is known about how corporate decision-makers privately reconcile the conflicts between public and private interests, even though this is likely to be relevant to understanding the limitations of CSR as a means of aligning business activity with the broader public interest. This study addresses this issue using internal tobacco industry documents to explore British-American Tobacco's (BAT) thinking on CSR and its effects on the company's CSR Programme. The article presents a three-stage model of CSR development, based on Sykes and Matza's theory of techniques of neutralization, which links together: how BAT managers made sense of the company's declining political authority in the mid-1990s; how they subsequently justified the use of CSR as a tool of stakeholder management aimed at diffusing the political impact of public health advocates by breaking up political constituencies working towards evidence-based tobacco regulation; and how CSR works ideologically to shape stakeholders' perceptions of the relative merits of competing approaches to tobacco control. Our analysis has three implications for research and practice. First, it underlines the importance of approaching corporate managers' public comments on CSR critically and situating them in their economic, political and historical contexts. Second, it illustrates the importance of focusing on the political aims and effects of CSR. Third, by showing how CSR practices are used to stymie evidence-based government regulation, the article underlines the importance of highlighting and developing matrices to assess the negative social impacts of CSR.

  16. The impact of different management techniques on carbon balance of a pine stand after windthrow

    NASA Astrophysics Data System (ADS)

    Ziemblinska, Klaudia; Urbaniak, Marek; Merbold, Lutz; Chojnicki, Bogdan H.; Olejnik, Janusz

    2015-04-01

    Forest ecosystems cover approximately 1/3 of the global land area (and 29.8% in Poland). Since forests are constantly exposed to various types of disturbances - both natural and anthropogenic such as fires, wind, insects outbreaks or clear cuts - it is important to investigate the impact of such damages on the carbon dynamics. This becomes even more important due to the fact that future climate change will most likely result in a higher frequency and intensity of extreme climatic events. Even though wind damages cause large disturbances to forests only few places in the world exist where continuous measurements of carbon exchange (CO2) in windthrown sites are carried out. Besides the opportunity to assess the carbon dynamics following wind disturbance, there is an additional possibility of evaluating differences in post windthrow forest management practices. To fill this knowledge gap we set up two measuring stations in north-western Poland in the 500ha area of pine forest damaged by tornado in July 2012, to assess the impact of such disturbance on CO2 and H2O exchange by use of Eddy Covariance (EC) technique (Tlen I and Tlen II). Both sites are characterized by similar climatic as well as soil conditions and are located 3km from each other. While at the site Tlen I all biomass (coarse and fine woody debris were collected together with stumps) was removed and ploughed thereafter, at Tlen II only trunks and main branches were taken out from the site without ploughing. Total harvested biomass per hectare, as derived from local forest inventory, were almost 18 % higher at Tlen I than Tlen II site (where uprooted stumps were left to decompose). First analysis of the eddy covariance data shows that both sites are significant carbon sources. Emissions of carbon dioxide from the non-ploughed site (Tlen II) are higher than from the ploughed site (Tlen I). Both sites released more than 8.1 t of CO2 per ha during a three month time period (mid July to mid August 2014) after

  17. Reflective Database Access Control

    ERIC Educational Resources Information Center

    Olson, Lars E.

    2009-01-01

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

  18. Assisting Australian indigenous resource management and sustainable utilization of species through the use of GIS and environmental modeling techniques.

    PubMed

    Gorman, Julian; Pearson, Diane; Whitehead, Peter

    2008-01-01

    Information on distribution and relative abundance of species is integral to sustainable management, especially if they are to be harvested for subsistence or commerce. In northern Australia, natural landscapes are vast, centers of population few, access is difficult, and Aboriginal resource centers and communities have limited funds and infrastructure. Consequently defining distribution and relative abundance by comprehensive ground survey is difficult and expensive. This highlights the need for simple, cheap, automated methodologies to predict the distribution of species in use, or having potential for use, in commercial enterprise. The technique applied here uses a Geographic Information System (GIS) to make predictions of probability of occurrence using an inductive modeling technique based on Bayes' theorem. The study area is in the Maningrida region, central Arnhem Land, in the Northern Territory, Australia. The species examined, Cycas arnhemica and Brachychiton diversifolius, are currently being 'wild harvested' in commercial trials, involving sale of decorative plants and use as carving wood, respectively. This study involved limited and relatively simple ground surveys requiring approximately 7 days of effort for each species. The overall model performance was evaluated using Cohen's kappa statistics. The predictive ability of the model for C. arnhemica was classified as moderate and for B. diversifolius as fair. The difference in model performance can be attributed to the pattern of distribution of these species. C. arnhemica tends to occur in a clumped distribution due to relatively short distance dispersal of its large seeds and vegetative growth from long-lived rhizomes, while B. diversifolius seeds are smaller and more widely dispersed across the landscape. The output from analysis predicts trends in species distribution that are consistent with independent on-site sampling for each species and therefore should prove useful in gauging the extent of

  19. Facing the Challenges of Accessing, Managing, and Integrating Large Observational Datasets in Ecology: Enabling and Enriching the Use of NEON's Observational Data

    NASA Astrophysics Data System (ADS)

    Thibault, K. M.

    2013-12-01

    As the construction of NEON and its transition to operations progresses, more and more data will become available to the scientific community, both from NEON directly and from the concomitant growth of existing data repositories. Many of these datasets include ecological observations of a diversity of taxa in both aquatic and terrestrial environments. Although observational data have been collected and used throughout the history of organismal biology, the field has not yet fully developed a culture of data management, documentation, standardization, sharing and discoverability to facilitate the integration and synthesis of datasets. Moreover, the tools required to accomplish these goals, namely database design, implementation, and management, and automation and parallelization of analytical tasks through computational techniques, have not historically been included in biology curricula, at either the undergraduate or graduate levels. To ensure the success of data-generating projects like NEON in advancing organismal ecology and to increase transparency and reproducibility of scientific analyses, an acceleration of the cultural shift to open science practices, the development and adoption of data standards, such as the DarwinCore standard for taxonomic data, and increased training in computational approaches for biologists need to be realized. Here I highlight several initiatives that are intended to increase access to and discoverability of publicly available datasets and equip biologists and other scientists with the skills that are need to manage, integrate, and analyze data from multiple large-scale projects. The EcoData Retriever (ecodataretriever.org) is a tool that downloads publicly available datasets, re-formats the data into an efficient relational database structure, and then automatically imports the data tables onto a user's local drive into the database tool of the user's choice. The automation of these tasks results in nearly instantaneous execution

  20. Contribution of community health workers to improving access to timely and appropriate case management of childhood fever in Mozambique

    PubMed Central

    Guenther, Tanya; Sadruddin, Salim; Finnegan, Karen; Wetzler, Erica; Ibo, Fatima; Rapaz, Paulo; Koepsell, Jeanne; Khan, Ibad ul Haque; Amouzou, Agbessi

    2017-01-01

    Background Large scale evaluations in several settings have demonstrated that lay community health workers can be trained to provide quality case management of childhood illnesses. In 2010, Mozambique introduced the integrated community case management (iCCM) strategy to reach children in remote areas with care provided through Agentes Polivalentes Elementares (APEs). We assessed the contribution of the program to improved care–seeking and appropriate treatment of childhood febrile illness in Nampula Province. Methods We used a post–test quasi–experimental design with three intervention and one comparison districts to compare access and appropriateness of care for sick children in Nampula province. We carried out a household survey in the study districts to measure levels of care–seeking and treatment of childhood fever after approximately two years of full implementation of the iCCM program in the intervention districts. We also assessed consistency of care with standard case management protocols comparing children receiving care from (APEs) to those receiving care from first–level health facilities. Results A total of 773 children 6–59 months with fever in the last two weeks were included in the study. In iCCM served areas, APEs were the predominant source of care and treatment; 87.1% (95% confidence interval CI 80.8–93.4) of children 6–59 months with fever who sought care were taken first to an APE and APEs accounted for 86.2% (95% CI 79.7–92.7) of all first–line antimalarial treatments. Public health facilities were the leading source of care in comparison areas, providing care to 86.1% (95% CI 79.0–93.3) of children with fever taken for care outside the home. Timeliness of treatment was significantly better in intervention areas, where 63.9% (95% CI 54.4–73.3) of children received treatment within 24 hours of symptom onset compared to 37.5% (95% CI 31.1–43.9) in comparison areas. Children taken first to an APE were more likely to

  1. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  2. [Online enrichment ability of restricted-access column coupled with high performance liquid chromatography by column switching technique for benazepril hydrochloride].

    PubMed

    Zhang, Xiaohui; Wang, Rong; Xie, Hua; Yin, Qiang; Li, Xiaoyun; Jia, Zhengping; Wu, Xiaoyu; Zhang, Juanhong; Li, Wenbin

    2013-05-01

    The online enrichment ability of the restricted-access media (RAM) column coupled with high performance liquid chromatography by column switching technique for benazepril hydrochloride in plasma was studied. The RAM-HPLC system consisted of an RAM column as enrichment column and a C18 column as analytical column coupled via the column switching technique. The effects of the injection volume on the peak area and the systematic pressure were studied. When the injection volume was less than 100 microL, the peak area increased with the increase of the injection volume. However, when the injection volume was more than 80 microL, the pressure of whole system increased obviously. In order to protect the whole system, 80 microL was chosen as the maximum injection volume. The peak areas of ordinary injection and the large volume injection showed a good linear relationship. The enrichment ability of RAM-HPLC system was satisfactory. The system was successfully used for the separation and detection of the trace benazepril hydrochloride in rat plasma after its administration. The sensitivity of HPLC can be improved by RAM pre-enrichment. It is a simple and economic measurement method.

  3. Prediction of microbial accessibility of carbon-14-phenanthrene in soil in the presence of pyrene or benzo[a]pyrene using an aqueous cyclodextrin extraction technique.

    PubMed

    Papadopoulos, Apostolos; Reid, Brian J; Semple, Kirk T

    2007-01-01

    Traditionally, solvent extractions are routinely used in the assessment of contaminated land. However, vigorous solvent extractions only give total concentrations rather than that relating to the bioaccessible fraction. Recently, less harsh, aqueous-based extraction methods have been shown to be a better estimate of the microbial degradation of polycyclic aromatic hydrocarbons (PAHs). The aqueous-based hydroxypropyl-beta-cyclodextrin (HPCD) extraction technique was tested using 14C-PAHs in soils and compared against indigenous microbial mineralization (a measure of bioaccessibility) of 14C-phenanthrene in the presence of pyrene or benzo[a]pyrene (B[a]P) over a range of concentrations (0, 5, 10, or 50 mg kg(-1)) and aged for 0, 25, 50, and 100 d in four soils. At each time point, the total loss, extractability, and mineralization of 14C-phenanthrene was measured in each of the soils. The presence of the other PAHs had little effect on the behavior of 14C-phenanthrene in any of the soils. Comparisons between the amounts of 14C-phenanthrene extracted using HPCD and mineralized were made and showed that there was a correlation (1:1). This study demonstrates that HPCD extraction is able to predict the microbial accessibility fraction of 14C-phenanthrene in the presence of other PAHs in a range of soils, further supporting the applicability of this technique.

  4. Pain management in video assisted thoracic surgery: evaluation of localised partial rib resection. A new technique.

    PubMed

    Richardson, J; Sabanathan, S

    1995-10-01

    We undertook a re-evaluation of acute and chronic pain generation following Video Assisted Thoracic Surgery (VATS) with regard to chest wall trauma produced by the instruments and their ports. From intercostal space (ICS) measurements made on 40 patients, it was confirmed that both the camera and the staple gun port diameters are too large for insertion without trauma. An instrument was produced (the "Sari" Punch, Bolton Surgical Services, Sheffield, England) which cleanly excises an elipse of the superior aspect of a rib, prior to the introduction of the ports. At the same time, the recommended orbit of the instruments about the surgical focus was abandoned in favour of an alignment along one ICS so that only one nerve was potentially traumatised. These modifications were then combined with balanced, pre-emptive and continuous paravertebral analgesia and the efficacy of this approach was evaluated in nine patients undergoing VATS. Operation of the rib punch was easy in all patients and was carried out without clinical or radiological trauma to the rib. Insertion of the ports was easy and access was good to all intrathoracic structures. Postoperative analgesia was good and the mean hospital stay was 2.7 days (range 2-4). Follow-up two months later confirmed a satisfactory surgical procedure and no patients complained of chest wall pain or numbness. We conclude that pain generation with VATS must be seriously considered if the technique is to become truly successful. Balanced, pre-emptive, paravertebral analgesia will protect the central nervous system while the removal of an elipse of rib and alignment of the instruments along one ICS will reduce the likelihood of peripheral nerve trauma.

  5. Mobile multiple access study

    NASA Technical Reports Server (NTRS)

    1977-01-01

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

  6. Assessment of alternative management techniques of tank bottom petroleum sludge in Oman.

    PubMed

    Al-Futaisi, Ahmed; Jamrah, Ahmad; Yaghi, Basma; Taha, Ramzi

    2007-03-22

    This paper investigated several options for environmentally acceptable management techniques of tank bottom oily sludge. In particular, we tested the applicability of managing the sludge by three options: (1) as a fuel supplement; (2) in solidification; (3) as a road material. Environmental testing included determination of heavy metals concentration; toxic organics concentration and radiological properties. The assessment of tank bottom sludge as a fuel supplement included various properties such as proximate analysis, ultimate analysis and energy content. Solidified sludge mixtures and road application sludge mixtures were subjected to leaching using the toxicity characteristic leaching procedure (TCLP). Tank bottom sludge was characterized as having higher concentrations of lead, zinc, and mercury, but lower concentrations of nickel, copper and chromium in comparison with values reported in the literature. Natural occurring radioactive minerals (NORM) activity values obtained on different sludge samples were very low or negligible compared to a NORM standard value of 100Bq/g. The fuel assessment results indicate that the heating values, the carbon content and the ash content of the sludge samples are comparable with bituminous coal, sewage sludge, meat and bone meal and petroleum coke/coal mixture, but lower than those in car tyres and petroleum coke. The nitrogen content is lower than those fuels mentioned above, while the sulfur content seems comparable with bituminous coal, petroleum coke and a petroleum coke/coal mixture. The apparent lack of leachability of metals from solidification and road material sludge applications suggests that toxic metals and organics introduced to these applications are not readily attacked by weak acid solutions and would not be expected to migrate or dissolved into the water. Thus, in-terms of trace metals and organics, the suggested sludge applications would not be considered hazardous as defined by the TCLP leaching procedure.

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

    PubMed

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

    2012-01-01

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

  8. Techniques in Endovascular Aneurysm Repair

    PubMed Central

    Phade, Sachin V.; Garcia-Toca, Manuel; Kibbe, Melina R.

    2011-01-01

    Endovascular repair of infrarenal abdominal aortic aneurysms (EVARs) has revolutionized the treatment of aortic aneurysms, with over half of elective abdominal aortic aneurysm repairs performed endoluminally each year. Since the first endografts were placed two decades ago, many changes have been made in graft design, operative technique, and management of complications. This paper summarizes modern endovascular grafts, considerations in preoperative planning, and EVAR techniques. Specific areas that are addressed include endograft selection, arterial access, sheath delivery, aortic branch management, graft deployment, intravascular ultrasonography, pressure sensors, management of endoleaks and compressed limbs, and exit strategies. PMID:22121487

  9. Health Realization/Innate Health: can a quiet mind and a positive feeling state be accessible over the lifespan without stress-relief techniques?

    PubMed

    Sedgeman, Judith A

    2005-12-01

    Health Realization/Innate Health (HR/IH) questions long-held assumptions about chronic stress, and challenges current definitions of both stress and resiliency. HR/IH sets forth principles that explain why the experience of psychological stress is not an effect of causal factors beyond people's control, but is an artifact of the energetic potential of the mind. HR/IH describes the "cognitive factor" in stress not as the content of people's thinking in response to stressors, but rather as a quality of the way people hold and use their thinking, referred to as state of mind. HR/IH hypothesizes that understanding principles that explain the nature and origin of thinking and experience offers a means to access innate protective processes that are healing and antibiosenescent reliably and consistently, without techniques. HR/IH suggests that the primary effort of mental health care could be to initiate life-long prevention of the state of chronic stress. In addition, HR/IH suggests that addressing mental well-being would have a broad impact on the incidence and course of the many physical illnesses that are known to be stress-related. The brief therapeutic interactions of HR/IH draw upon people's innate wisdom and recognition of the healthy perspective available to everyone. Anecdotal results suggest that people who gain insight into the principles that explain the nature of thought and experience and who realize how to re-access a natural, positive state of mind can and do experience sustained day-to-day peace of mind, wisdom and well-being, regardless of circumstances. HR/IH deserves rigorous scientific evaluation.

  10. Assessment of Limited Chest X-ray Technique in Postcardiac Surgery Management

    PubMed Central

    Salehi, Mehrdad; Saberi, Kianoush; Rahmanian, Mehrzad; Bakhshandeh, Ali Reza; Sharifi, Shahnaz

    2017-01-01

    Objectives: The objective of this study is to investigate the safety of elimination of chest radiography in the postcardiac surgery Intensive Care Unit (ICU). Methods and Design: We compared patients in two different groups of routine CXR (RCXR) and limited CXR (LCXR) and their diagnostic and therapeutic outcome in a University hospital-based single center from 2014 to 2016. 3 CXR in the RCXR group and 1 CXR in the limited group was performed, in addition to on-demand criteria. Measurement and Main Results: A total of 978 samples were acceptable for analysis which 55.21% of RCXR and 59.50% of LCXR were male patients. In total, 523 abnormalities in RCXR group and 154 occasions in LCXR group resulted in 26.73% diagnostic efficacy for RCXRs and 28.57% for LCXR. From 1956 CXR that was taken in RCXR group, 72 occasions required intervention (3.68%) and 84 cases out of 539 (15.58%) LCXR needed an action to therapy. This means a 14.40% in RCXRs’ abnormalities and 56.00% of LCXRs’ abnormalities were accompanied with some interventions. Conclusions: Abolishing routine CXR in the ICUs would not be harmful for the patients, and it can be managed based on their clinical status and other safer imaging techniques. PMID:28074793

  11. Student Well-Being Interventions: The Effects of Stress Management Techniques and Gratitude Journaling in the Management Education Classroom

    ERIC Educational Resources Information Center

    Flinchbaugh, Carol L.; Moore, E. Whitney G.; Chang, Young K.; May, Douglas R.

    2012-01-01

    Student well-being in the management classroom is of concern to both educators and managers. Well-being is conceptualized here as students' reduction in stress, enhanced experienced meaning and engagement in the classroom, and, ultimately, heightened satisfaction with life. The authors investigated whether purposeful semester-long classroom…

  12. Conservative surgical and microsurgical techniques for the management of dental implants that impinge on the inferior alveolar nerve.

    PubMed

    Gennaro, Paolo; Chisci, Glauco; Gabriele, Guido; Iannetti, Giorgio

    2014-07-01

    Loss of sensation in the lip after insertion of an implant is annoying. The aim of this paper was to describe two techniques for management of osseointegrated dental implants that impinge on the mandibular nerve, the purpose of which is to improve sensation without unscrewing the dental implant.

  13. Using palaeoecological techniques to inform contemporary hydrological management of a peatland

    NASA Astrophysics Data System (ADS)

    Blundell, Antony; Holden, Joseph

    2014-05-01

    Realization of the economic and environmental value of upland peatlands has led both public and private organizations to implement 'restoration' schemes. The word 'restore' implies that we seek to reverse adverse effects that have occurred and return the ecosystem to a pre-disturbance state. Restoration schemes in UK upland peatlands focus on the objectives of raising the water table through blocking drainage channels and gullies and re-vegetating bare areas of peat that are prone to erosion. The target is often the reinstatement of Sphagnum as a significant part of the peatland flora as this will produce an accumulating peat system. Restoration of a peatland implies that we have knowledge of its previous ecological history from which we can attain a restoration blueprint but restoration schemes often take little, if any, account of the ecological history of the site. This study is an example of how palaeoecological techniques have been employed at a UK upland catchment with findings to support the peatland restoration schemes. The study combined an extensive stratigraphic survey of the catchment and a detailed core-based analysis. Macrofossil, testate amoebae, humification and charcoal analysis were employed to determine the historical representation of Sphagnum at the site, the changes in water-table level, the degree of decomposition and also burning history. Stratigraphic survey and core results show that Sphagnum has played a significant role in parts but not all of the catchment, persisting in the main core until late 19th century. They also demonstrate that the loss of Sphagnum and subsequent abundance of Calluna vulgaris is coincident with evidence of wildfire. Continued absence of Sphagnum and abundance of Calluna vulgaris is coincident with further, less intense, burning likely due to grouse moor management. The 3000 year old record from the main core demonstrates the importance of historical climate change in changing water-table levels, vegetation, and

  14. Advanced InSAR techniques for the management and characterization of geothermal resources

    NASA Astrophysics Data System (ADS)

    Bellotti, F.; Falorni, G.; Morgan, J.; Rucci, A.; Ferretti, A.

    2012-04-01

    InSAR is a remote sensing tool that has applications in both geothermal exploitation and in the management of producing fields. The technique has developed rapidly in recent years and the most evolved algorithms, now capable of providing precise ground movement measurements with unprecedented spatial density over large areas, allow the monitoring of the effects of fluid injection and extraction on surface deformation and the detection of active faults. Multi-interferogram approaches have been used at several geothermal sites in different stages of development. SqueeSAR™, which represents the latest breakthrough in InSAR technology, provides a significant increase in the spatial density of measurement points by exploiting signal returns from both point-like and distributed scatterers. Furthermore, recent satellite radar sensors have a higher spatial resolution (down to 1 m), as well as a higher temporal frequency of image acquisitions (down to a few days). The coupling of the new algorithm with this new generation of satellites provides a valuable tool for monitoring the different phases of geothermal production and in support of the decision making process. Some examples from the US are presented here: the first case study involves the use of InSAR within a suite of tools for exploration of the San Emidio geothermal field in Nevada. This project aimed to develop geophysical techniques to identify and map large aperture fractures for the placement of new production/exploration wells. The second and third examples examine two zones in California: the Salton Sea area, where multi-interferogram InSAR provided an overview of surface deformation at a producing geothermal reservoir. Surface deformation in this area was complex, and the added detail provided insight into the interplay of tectonics and production activities. Additional InSAR studies have also been carried out at the Geysers field in order to evaluate the behavior of an Enhanced Geothermal System (EGS) in

  15. New Tools, New Times: Strategic Planning. A Seminar Focusing on Proactive Management Techniques (Chapel Hill, North Carolina, June 17-19, 1991).

    ERIC Educational Resources Information Center

    Morrison, James L.; Ashley, William C.

    This handbook was designed to accompany a three-day workshop for senior administrators in higher education on proactive management techniques in higher education. Proactive management allows for anticipating change and managing uncertainty in place of crisis management or reactive actions. The workshop covered: (1) strategic thinking; (2)…

  16. Role of Recipient-site Preparation Techniques and Post-operative Wound Dressing in the Surgical Management of Vitiligo

    PubMed Central

    Al-Hadidi, Nour; Griffith, James L; Al-Jamal, Mohammed S; Hamzavi, Iltefat

    2015-01-01

    Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below. PMID:26157306

  17. Comparison of different final impression techniques for management of resorbed mandibular ridge: a case report.

    PubMed

    Yadav, Bhupender; Jayna, Manisha; Yadav, Harish; Suri, Shrey; Phogat, Shefali; Madan, Reshu

    2014-01-01

    The history of complete denture impression procedures has been influenced largely by the development of impression materials from which new techniques and ideas arose. The purpose of this study was to compare the retention of complete dentures made by using different impression techniques like conventional, admixed, all green, and functional techniques. The results showed that there was significant difference in retention between the six techniques where functional technique showed the highest mean value of retention followed by elastomeric, all green, and admixed, while cocktail and green stick compound showed the lowest mean value. However, on clinical examination, the retention produced by the six techniques was satisfactory.

  18. Quality management systems for fruit fly (Diptera: Tephritidae) sterile insect technique

    SciTech Connect

    Caceres, C.; Robinson, A.; Shelly, T.; Hendrichs, J.

    2007-03-15

    The papers presented in this issue are focused on developing and validating procedures to improve the overall quality of sterile fruit flies for use in area-wide integrated pest management (AW-IPM) programs with a sterile insect technique (SIT) component. The group was coordinated and partially funded by the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, International Atomic Energy Agency, Vienna, Austria, under a five-year Coordinated Research Project (CRP) on 'Quality Assurance in Mass-Reared and Released Fruit Flies for Use in SIT Programmes'. Participants in the CRP from 16 countries came from both basic and applied fields of expertise to ensure that appropriate and relevant procedures were developed. A variety of studies was undertaken to develop protocols to assess strain compatibility and to improve colonization procedures and strain management. Specific studies addressed issues related to insect nutrition, irradiation protocols, field dispersal and survival, field cage behavior assessments, and enhancement of mating competitiveness. The main objective was to increase the efficiency of operational fruit fly programs using sterile insects and to reduce their cost. Many of the protocols developed or improved during the CRP will be incorporated into the international quality control manual for sterile tephritid fruit flies, standardizing key components of the production, sterilization, shipment, handling, and release of sterile insects. (author) [Spanish] Los articulos presentados en este numero se enfocan en el desarrollo y la validacion de procedimientos para mejorar la calidad total de moscas de las frutas esteriles para su uso en programas de manejo integrado de plagas en donde la tecnica del insecto esteril (TIE) es uno de los componentes clave. El grupo fue coordinado y parcialmente financiado por la Division Conjunta de Tecnicas Nucleares para la Alimentacion y la Agricultura de la FAO/OIEA, Viena, Austria, por un periodo de

  19. Management of Helicobacter pylori infection in Latin America: A Delphi technique-based consensus

    PubMed Central

    Rollan, Antonio; Arab, Juan Pablo; Camargo, M Constanza; Candia, Roberto; Harris, Paul; Ferreccio, Catterina; Rabkin, Charles S; Gana, Juan Cristóbal; Cortés, Pablo; Herrero, Rolando; Durán, Luisa; García, Apolinaria; Toledo, Claudio; Espino, Alberto; Lustig, Nicole; Sarfatis, Alberto; Figueroa, Catalina; Torres, Javier; Riquelme, Arnoldo

    2014-01-01

    AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature. METHODS: Relevant questions were distributed among the experts, who generated draft statements for consideration by the entire panel. A modified three-round Delphi technique method was used to reach consensus. Critical input was also obtained from representatives of the concerned medical community. The quality of the evidence and level of recommendation supporting each statement was graded according to United States Preventive Services Task Force criteria. RESULTS: A group of ten experts was established. The survey included 15 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 50% in the first round, 73.3% in the second round and 100% in the third round. Main consensus recommendations included: (1) when available, urea breath and stool antigen test (HpSA) should be used for non-invasive diagnosis; (2) detect and eradicate Helicobacter pylori (H. pylori) in all gastroscopy patients to decrease risk of peptic ulcer disease, prevent o retard progression in patients with preneoplastic lesions, and to prevent recurrence in patients treated for gastric cancer; (3) further investigate implementation issues and health outcomes of H. pylori eradication for primary prevention of gastric cancer in high-risk populations; (4) prescribe standard 14-d triple therapy or sequential therapy for first-line treatment; (5) routinely assess eradication success post-treatment in clinical settings; and (6) select second- and third-line therapies according to antibiotic susceptibility testing. CONCLUSION: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes. PMID:25152601

  20. Combined spinal epidural (CSE) analgesia: technique, management, and outcome of 300 mothers.

    PubMed

    Collis, R E; Baxandall, M L; Srikantharajah, I D; Edge, G; Kadim, M Y; Morgan, B M

    1994-04-01

    Epidural analgesia in labour is commonly associated with some degree of lower limb weakness often severe enough to be described as paralysis by the mother. We aimed to produce rapid reliable analgesia with no motor block throughout labour. We report a pilot survey of 300 consecutive women requesting regional analgesia in labour who received a combined spinal epidural blockade (CSE). The initial dose was given into the subarachnoid space and analgesia maintained via an epidural catheter. A subarachnoid injection of 2.5 mg bupivacaine and 25 mug fentanyl was successfully given in 268 women (89.3%). Completely pain-free contractions within 3 min of this injection occurred in 195 women (65%) and in all 300 within 20 min and there was no associated motor block in 291 (97%). 141 women chose to stand, walk or sit in a rocking chair at some time during labour. Only 38 women (12.6%) were immobile during the first stage of labour. Analgesia was maintained via the epidural catheter with bolus doses of 10-15 ml of 0.1% bupivacaine and 0.0002% fentanyl. The mean bupivacaine requirement was 9.5 mg/h throughout the entire duration of analgesia. The incidence of post lumbar puncture headache was 2.3%. Transient hypotension occurred in 24 women (8%) and was treated with 6 mg intravenous boluses of ephedrine. Complete satisfaction with analgesia and mobility was reported 12-24 h post partum by 95% of mothers. The use of this analgesic technique caused no alteration in obstetric management or post partum care of the women.

  1. Managing costs and managing care.

    PubMed

    Rivers, P A; Tsai, K L

    2001-01-01

    With a defined population served, contracted provider panels and the nature of care delivery integration, managed care has provided a solution, though not a panacea, to provide equitable services, standardized and prevention oriented cares to its enrolled members. Combined with the earmarked capitation reimbursement system and a series of cost containment and utilization review techniques, managed care has also demonstrated potently its capacity in cost-saving and quality promotion. Presents steps and measures related to managed care that federal government has taken to manage care and contain cost. It is crucial to identify and promulgate best practices continually, while managing utilization of resources for improving health care, containing cost, and equalizing medical care access to a greater proportion of the population. Concludes that it may take time for a universal adoption of managed care. However, Americans may actually benefit more from having a standard level of health care that managed care could achieve and provide.

  2. Channel Access in Erlang

    SciTech Connect

    Nicklaus, Dennis J.

    2013-10-13

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

  3. Treatment modalities for surgical management of anterior palatal fistula: Comparison of various techniques, their outcomes, and the factors governing treatment plan: A retrospective study

    PubMed Central

    Bonanthaya, Krishnamurthy; Shetty, Pritham; Sharma, Abhimanyu; Ahlawat, Jyoti; Passi, Deepak; Singh, Mahinder

    2016-01-01

    Aim: Aim of this retrospective study was to access the various surgical treatment options available for repair of Anterior palatal fistula depending upon their size and presenting age, and also to anticipate the treatment outcome. Materials and Methods: The series include study report of forty patients with secondary anterior palatal fistula post cleft palate repair, reported in a single unit during a duration of 3 years. All the cases were managed surgically under general anesthesia. The patients were classified depending upon the location of anterior palatal fistula (APF), the quality of tissue and age of patients to chalk out a justified treatment option outlay. Results: Forty cases were split for surgical correction into various options depending on their size, site, and quality of the tissue. Most of the cases were operated with a Bardach's Redo for fistula closure (n = 16) (40%) and crevicular flap technique (n = 13) (32.5%). Our overall success (satisfactory results) was 77.5% as observed in 31 out of 40 cases with individual success rates for Bardach's and crevicular being 75% and 77%, respectively. There was reduction in size of fistula in three cases (7.5%) and a remnant pinpoint hole in four cases (10%) among all the operated cases. Conclusion: Management of post palatoplasty fistulas of the hard palate presents a challenging situation for a clinician following the surgical correction of cleft palate. Current paper describes the diagnosis and clinical management of forty cases reporting with unilateral APF following cleft palate surgery, over 3 years. Authors have attempted to propose different treatment modalities for surgical management of unilateral APF. It was concluded in the primary review that the size of fistula was irrelevant in determining the clinical outcome. Instead, the quality and condition of the adjacent tissue appear to be the major governing factors for selecting treatment modality as well as the surgical consequences. PMID:28356685

  4. Advanced Autonomous Formation Control and Trajectory Management Techniques for Multiple Micro UAV Applications (Controle d’une formation autonome evoluee, et gestion des trajectoires. Techniques d’applications pour micro UAV multiples)

    DTIC Science & Technology

    2008-06-01

    Formation Control and Trajectory Management Techniques for Multiple Micro UAV Applications ( Contrôle d’une formation autonome évoluée, et gestion des...EN-SCI-195 Advanced Autonomous Formation Control and Trajectory Management Techniques for Multiple Micro UAV Applications ( Contrôle d’une formation...autonome évoluée, et gestion des trajectoires. Techniques d’applications pour micro UAV multiples) The material in this publication was

  5. An Investigation of Network Enterprise Risk Management Techniques to Support Military Net-Centric Operations

    DTIC Science & Technology

    2009-09-01

    Entreprise Risk Management .........................................116 B. RECOMMENDATIONS OF AREAS FOR FURTHER RESEARCH ..117 APPENDIX A...enterprise, can come from external or internal sources and can be directed at multiple objectives such as finance , people, processes, and operational...of managing risk is essentially the same for safety, finances , or operations. How it is applied depends in large part on the application.. Figure

  6. Management of the droopy tip: a comparison of three alar cartilage-modifying techniques.

    PubMed

    Foda, Hossam M T

    2003-10-01

    The droopy tip is a common nasal deformity in which the tip is inferiorly rotated. Five hundred consecutive rhinoplasty cases were studied to assess the incidence and causes of the droopy tip deformity and to evaluate the role of three alar cartilage-modifying techniques--lateral crural steal, lateral crural overlay, and tongue in groove--in correcting such a deformity. The external rhinoplasty approach was used in all cases. Only one of the three alar cartilage-modifying techniques was used in each case, and the degree of tip rotation and projection was measured both preoperatively and postoperatively. The incidence of droopy tip was 72 percent, and the use of an alar cartilage-modifying technique was required in 85 percent of these cases to achieve the desired degree of rotation. The main causes of droopy tip included inferiorly oriented alar cartilages (85 percent), overdeveloped scrolls of upper lateral cartilages (73 percent), high anterior septal angle (65 percent), and thick skin of the nasal lobule (56 percent). The lateral crural steal technique increased nasal tip rotation and projection, the lateral crural overlay technique increased tip rotation and decreased tip projection, and the tongue-in-groove technique increased tip rotation without significantly changing the amount of projection. The lateral crural overlay technique resulted in the highest degrees of rotation, followed by the lateral crural steal and finally the tongue-in-groove technique. According to these results, the lateral crural steal technique is best indicated in cases with droopy underprojected nasal tip, the lateral crural overlay technique in cases of droopy overprojected nasal tip, and the tongue-in-groove technique in cases where the droopy nasal tip is associated with an adequate amount of projection.

  7. A case-based reasoning tool for breast cancer knowledge management with data mining concepts and techniques

    NASA Astrophysics Data System (ADS)

    Demigha, Souâd.

    2016-03-01

    The paper presents a Case-Based Reasoning Tool for Breast Cancer Knowledge Management to improve breast cancer screening. To develop this tool, we combine both concepts and techniques of Case-Based Reasoning (CBR) and Data Mining (DM). Physicians and radiologists ground their diagnosis on their expertise (past experience) based on clinical cases. Case-Based Reasoning is the process of solving new problems based on the solutions of similar past problems and structured as cases. CBR is suitable for medical use. On the other hand, existing traditional hospital information systems (HIS), Radiological Information Systems (RIS) and Picture Archiving Information Systems (PACS) don't allow managing efficiently medical information because of its complexity and heterogeneity. Data Mining is the process of mining information from a data set and transform it into an understandable structure for further use. Combining CBR to Data Mining techniques will facilitate diagnosis and decision-making of medical experts.

  8. Technique for air bubble management during endothelial keratoplasty in eyes after penetrating glaucoma surgery.

    PubMed

    Banitt, Michael; Arrieta-Quintero, Esdras; Parel, Jean-Marie; Fantes, Francisco

    2011-02-01

    Our purpose was to develop a technique for maintaining air within the anterior chamber during endothelial keratoplasty in eyes that have previously undergone trabeculectomy or a glaucoma drainage implant. Whole human globes and rabbits underwent penetrating glaucoma surgery to develop the technique. Without the aid of any additional device or manipulation, continuing to inject air into the anterior chamber as it escapes through the sclerostomy or tube eventually fills the subconjunctival space and allows for back pressure. This allows for a full anterior chamber air fill and brief elevation of intraocular pressure. We employed this overfilling technique on 3 patients with previous incisional glaucoma surgery to perform successful Descemet stripping endothelial keratoplasty without complication. We recommend using the overfilling technique when performing Descemet stripping endothelial keratoplasty surgery in eyes with previous penetrating glaucoma surgery because it is a simple technique without the need for pre- or postoperative manipulation.

  9. 78 FR 55114 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-09

    ... Occupational Safety and Health Administration Access to Employee Exposure and Medical Records; Extension of the... Exposure and Medical Records Standard (29 CFR 1910.1020). DATES: Comments must be submitted (postmarked... to employee exposure monitoring data and medical records. This regulation does not require...

  10. A review of post-modern management techniques as currently applied to Turkish forestry.

    PubMed

    Dölarslan, Emre Sahin

    2009-01-01

    This paper reviews the effects of six post-modern management concepts as applied to Turkish forestry. Up to now, Turkish forestry has been constrained, both in terms of its operations and internal organization, by a highly bureaucratic system. The application of new thinking in forestry management, however, has recently resulted in new organizational and production concepts that promise to address problems specific to this Turkish industry and bring about positive changes. This paper will elucidate these specific issues and demonstrate how post-modern management thinking is influencing the administration and operational capacity of Turkish forestry within its current structure.

  11. Selected techniques for monitoring water movement through unsaturated alluvium during managed aquifer recharge

    USGS Publications Warehouse

    Nawikas, Joseph M.; O'Leary, David R.; Izbicki, John A.; Burgess, Matthew K.

    2016-10-21

    Managed aquifer recharge is used to augment natural recharge to aquifers. It can be used to replenish aquifers depleted by pumping or to store water during wetter years for withdrawal during drier years. Infiltration from ponds is a commonly used, inexpensive approach for managed aquifer recharge.At some managed aquifer-recharge sites, the time when infiltrated water arrives at the water table is not always clearly shown by water-level data. As part of site characterization and operation, it can be desirable to track downward movement of infiltrated water through the unsaturated zone to identify when it arrives at the water table.

  12. Endonasal management of pediatric congenital transsphenoidal encephaloceles: nuances of a modified reconstruction technique. Technical note and report of 3 cases.

    PubMed

    Zeinalizadeh, Mehdi; Sadrehosseini, Seyed Mousa; Habibi, Zohreh; Nejat, Farideh; Silva, Harley Brito da; Singh, Harminder

    2017-03-01

    OBJECTIVE Congenital transsphenoidal encephaloceles are rare malformations, and their surgical treatment remains challenging. This paper reports 3 cases of transsphenoidal encephalocele in 8- to 24-month-old infants, who presented mainly with airway obstruction, respiratory distress, and failure to thrive. METHODS The authors discuss the surgical management of these lesions via a minimally invasive endoscopic endonasal approach, as compared with the traditional transcranial and transpalatal approaches. A unique endonasal management algorithm for these lesions is outlined. The lesions were repaired with no resection of the encephalocele sac, and the cranial base defects were reconstructed with titanium mesh plates and vascular nasoseptal flaps. RESULTS Reduction of the encephalocele and reconstruction of the skull base was successfully accomplished in all 3 cases, with favorable results. CONCLUSIONS The described endonasal management algorithm for congenital transsphenoidal encephaloceles is a safe, viable alternative to traditional transcranial and transpalatal approaches, and avoids much of the morbidity associated with these open techniques.

  13. Genetic Diversity Strategy for the Management and Use of Rubber Genetic Resources: More than 1,000 Wild and Cultivated Accessions in a 100-Genotype Core Collection

    PubMed Central

    Cerqueira-Silva, Carlos Bernardo Moreno; Silva, Carla Cristina; Mantello, Camila Campos; Conson, Andre Ricardo Oliveira; Vianna, João Paulo Gomes; Zucchi, Maria Imaculada; Scaloppi Junior, Erivaldo José; Fialho, Josefino de Freitas; de Moraes, Mario Luis Teixeira; Gonçalves, Paulo de Souza; de Souza, Anete Pereira

    2015-01-01

    The rubber tree [Hevea brasiliensis (Willd. ex Adr. de Juss.) Muell. Arg.] is the only plant species worldwide that is cultivated for the commercial production of natural rubber. This study describes the genetic diversity of the Hevea spp. complex that is available in the main ex situ collections of South America, including Amazonian populations that have never been previously described. Genetic data were analyzed to determine the genetic structure of the wild populations, quantify the allelic diversity and suggest the composition of a core collection to capture the maximum genetic diversity within a minimal sample size. A total of 1,117 accessions were genotyped with 13 microsatellite markers. We identified a total of 408 alleles, 319 of which were shared between groups and 89 that were private in different groups of accessions. In a population structure and principal component analysis, the level of clustering reflected a primary division into the following two subgroups: cluster 1, which consisted of varieties from the advanced breeding germplasm that originated from the Wickham and Mato Grosso accessions; and cluster 2, which consisted of the wild germplasm from the Acre, Amazonas, Pará and Rondônia populations and Hevea spp. The analyses revealed a high frequency of gene flow between the groups, with the genetic differentiation coefficient (GST) estimated to be 0.018. Additionally, no distinct separation among the H. brasiliensis accessions and the other species from Amazonas was observed. A core collection of 99 accessions was identified that captured the maximum genetic diversity. Rubber tree breeders can effectively utilize this core collection for cultivar improvement. Furthermore, such a core collection could provide resources for forming an association panel to evaluate traits with agronomic and commercial importance. Our study generated a molecular database that should facilitate the management of the Hevea germplasm and its use for subsequent genetic

  14. Genetic Diversity Strategy for the Management and Use of Rubber Genetic Resources: More than 1,000 Wild and Cultivated Accessions in a 100-Genotype Core Collection.

    PubMed

    de Souza, Livia Moura; Le Guen, Vincent; Cerqueira-Silva, Carlos Bernardo Moreno; Silva, Carla Cristina; Mantello, Camila Campos; Conson, Andre Ricardo Oliveira; Vianna, João Paulo Gomes; Zucchi, Maria Imaculada; Scaloppi Junior, Erivaldo José; Fialho, Josefino de Freitas; de Moraes, Mario Luis Teixeira; Gonçalves, Paulo de Souza; Souza, Anete Pereira de

    2015-01-01

    The rubber tree [Hevea brasiliensis (Willd. ex Adr. de Juss.) Muell. Arg.] is the only plant species worldwide that is cultivated for the commercial production of natural rubber. This study describes the genetic diversity of the Hevea spp. complex that is available in the main ex situ collections of South America, including Amazonian populations that have never been previously described. Genetic data were analyzed to determine the genetic structure of the wild populations, quantify the allelic diversity and suggest the composition of a core collection to capture the maximum genetic diversity within a minimal sample size. A total of 1,117 accessions were genotyped with 13 microsatellite markers. We identified a total of 408 alleles, 319 of which were shared between groups and 89 that were private in different groups of accessions. In a population structure and principal component analysis, the level of clustering reflected a primary division into the following two subgroups: cluster 1, which consisted of varieties from the advanced breeding germplasm that originated from the Wickham and Mato Grosso accessions; and cluster 2, which consisted of the wild germplasm from the Acre, Amazonas, Pará and Rondônia populations and Hevea spp. The analyses revealed a high frequency of gene flow between the groups, with the genetic differentiation coefficient (GST) estimated to be 0.018. Additionally, no distinct separation among the H. brasiliensis accessions and the other species from Amazonas was observed. A core collection of 99 accessions was identified that captured the maximum genetic diversity. Rubber tree breeders can effectively utilize this core collection for cultivar improvement. Furthermore, such a core collection could provide resources for forming an association panel to evaluate traits with agronomic and commercial importance. Our study generated a molecular database that should facilitate the management of the Hevea germplasm and its use for subsequent genetic

  15. Attitudes Toward Patient Management Problems as a Self-Assessment Technique in Dermatology

    ERIC Educational Resources Information Center

    Ramsay, David L.; And Others

    1977-01-01

    Patient management problems were found to be favorable methods of self-assessment by an overwhelming majority of practicing dermatologists and those in training, regardless of the type of practice or the number of years in practice. (LBH)

  16. Neuro-stimulation Techniques for the Management of Anxiety Disorders: An Update

    PubMed Central

    Kar, Sujita Kumar; Sarkar, Siddharth

    2016-01-01

    Neuro-stimulation techniques have gradually evolved over the decades and have emerged potential therapeutic modalities for the treatment of psychiatric disorders, especially treatment refractory cases. The neuro-stimulation techniques involves modalities like electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS) and others. This review discusses the role of neuro-stimulation techniques in the treatment of anxiety disorders. The various modalities of neuro-stimulation techniques are briefly discussed. The evidence base relating to use of these techniques in the treatment of anxiety disorders is discussed further. The review then highlights the challenges in conducting research in relation to the use of neuro-stimulation techniques with reference to patients with anxiety disorders. The review provides the future directions of research and aimed at expanding the evidence base of treatment of anxiety disorders and providing neuro-stimulation techniques as promising effective and acceptable alternative in select cases. PMID:27776384

  17. Different techniques for management of common bile duct stones: a single centre experience.

    PubMed

    El Wakil, Mohamed Reda M; Abdelkader, Nadia A; Salem, Hossam El-Deen M; Halima Abo, Ahmed Samir

    2014-12-01

    Local experience on the combined technique of endoscopic sphincterotomy followed by endo: scopic balloon dilation is scarce. This study clarified whether this crombined technique will offer any advantages, with respect to therapeutic outcome and complications rate, as compared with endoscopic sphincterotomy (ES) and endoscopic balloon dilatation (EBD) alone for the extraction of large and/or multiple common bile duct stones. For a total of 76 patients, extraction of large and/or multiple common bile duct (CBD) stones during endoscopic retrograde cholangiopancreatography was performed. According to the used technique, they were categorized into 3 groups; Endoscopic sphincterotomy, endoscopic balloon dilatation or combined technique. The success rate of complete stone removal and the incidence of procedure-related complications were compared among the three groups. Success rate after one session was recorded to be comparable among the three groups. Relative Risk Ratio assessment of success rate after single session among the three groups showed no statistically significant difference. Regarding bleeding, only 3 (10%) cases were recorded in the ES group with no cases in the, other 2 groups. No significant difference was noted among the three groups regarding other complication. The combined technique of ES followed by EBD is an effective and safe technique enables extraction of multiple and/or relatively large stones. It could be a reasonable alternative option when standard techniques are inadequate to remove bile duct stones.

  18. Esthetic management of the upper labial frenum: a novel frenectomy technique.

    PubMed

    Bagga, Sukhchain; Bhat, K Mahalinga; Bhat, G Subraya; Thomas, Betsy S

    2006-01-01

    An abnormal upper labial frenum is capable of retracting the gingival margin, creating a diastema, limiting lip movement, and in cases of a high smile line, affecting esthetics also. When an abnormal frenum is present, frenectomy is advised. This technique has been modified in many ways. But in most of the techniques the zone of attached gingiva and esthetics are not considered. This case report highlights a new technique of frenectomy that results in good esthetics, excellent color match, gain in attached gingiva, and healing by primary intention at the site of the thick, extensive abnormal frenum.

  19. Endovascular Management of Visceral Artery Pseudoaneurysms: Transcatheter Coil Embolization Using the Isolation Technique

    SciTech Connect

    Ikeda, Osamu Nakasone, Yutaka; Tamura, Yoshitaka; Yamashita, Yasuyuki

    2010-12-15

    PurposeTo describe our experiences with treatment of visceral artery pseudoaneurysms (VAPA) by transcatheter coil embolization using an isolation technique and to propose indications for treating VAPA with this method.Materials and MethodsWe treated 37 patients with VAPA endovascularly: There were 15 pancreaticoduodenal arcade, 10 hepatic, 5 renal, 3 splenic, and 1 each left gastric, gastroepiploic, adrenal, and superior mesenteric artery pseudoaneurysms. Preprocedure computed tomography (CT) and/or angiographic studies confirmed the presence of VAPA in all 37 patients. Using the isolation technique, we embolized vessels at sites distal and proximal to the pseudoaneurysm.ResultsTranscatheter coil embolization with the isolation technique was technically successful in 33 (89%) of 37 patients, and angiogram confirmed the complete disappearance of the VAPA in 32 patients. No major complications occurred during the procedures. In a patient with a pancreaticoduodenal arcade artery pseudoaneurysm, we were unable to control hemorrhage. In 30 of 32 patients who recovered after transcatheter coil embolization using the isolation technique, follow-up CT scan showed no flow in VAPA; they survived without rebleeding. Two of the 32 patients (6%) with confirmed complete disappearance of VAPA on angiogram and CT scan obtained the day after the procedure manifested rebleeding during follow-up.ConclusionTranscatheter coil embolization using the isolation technique is an effective alternative treatment in patients with VAPA. In combination with coil embolization, the isolation technique is particularly useful in patients whose pseudoaneurysms present surgical difficulties.

  20. MO-FG-BRD-00: Real-Time Imaging and Tracking Techniques for Intrafractional Motion Management

    SciTech Connect

    2015-06-15

    Intrafraction target motion is a prominent complicating factor in the accurate targeting of radiation within the body. Methods compensating for target motion during treatment, such as gating and dynamic tumor tracking, depend on the delineation of target location as a function of time during delivery. A variety of techniques for target localization have been explored and are under active development; these include beam-level imaging of radio-opaque fiducials, fiducial-less tracking of anatomical landmarks, tracking of electromagnetic transponders, optical imaging of correlated surrogates, and volumetric imaging within treatment delivery. The Joint Imaging and Therapy Symposium will provide an overview of the techniques for real-time imaging and tracking, with special focus on emerging modes of implementation across different modalities. In particular, the symposium will explore developments in 1) Beam-level kilovoltage X-ray imaging techniques, 2) EPID-based megavoltage X-ray tracking, 3) Dynamic tracking using electromagnetic transponders, and 4) MRI-based soft-tissue tracking during radiation delivery. Learning Objectives: Understand the fundamentals of real-time imaging and tracking techniques Learn about emerging techniques in the field of real-time tracking Distinguish between the advantages and disadvantages of different tracking modalities Understand the role of real-time tracking techniques within the clinical delivery work-flow.

  1. Gynecomastia Management: An Evolution and Refinement in Technique at UT Southwestern Medical Center

    PubMed Central

    Bailey, Steven H.; Guenther, Dax; Constantine, Fadi

    2016-01-01

    Summary: Gynecomastia is a benign proliferation of male breast glandular tissue. Gynecomastia can affect men at any stage of life. Traditional treatment options involved excisional surgeries with periareolar or T-shaped scars, which can leave more visible scars on the chest. The technique presented represents a technique used by the senior author, which relies on ultrasonic liposuction and pull-through technique to remove breast tissue. A retrospective chart review was performed, including all patients who were treated, from 2000 to 2013 by the senior author, for gynecomastia. A deidentified database was created to record patient characteristics, including age, height, weight, ptosis, stage of gynecomastia, and gynecomastia classification. Surgical approaches, complications, and revisions were also recorded. Our experience includes 75 patients with all grades of gynecomastia from 2000 to 2013. These cases span the evolution of our technique to include direct pull-through excision with ultrasound-assisted liposuction. The distribution of the grades I, II, III, and IV ptosis was 30.6%, 36 %, 22.6%, and 10.6% respectively. There were no complications in this series. Only one patient with grade III ptosis required revision surgery. This technique provides a safe and aesthetically pleasing way to treat gynecomastia with a low need for revision. PMID:27482482

  2. Advanced Endovascular Approaches in the Management of Challenging Proximal Aortic Neck Anatomy: Traditional Endografts and the Snorkel Technique

    PubMed Central

    Quatromoni, Jon G.; Orlova, Ksenia; Foley, Paul J.

    2015-01-01

    Advances in endovascular technology, and access to this technology, have significantly changed the field of vascular surgery. Nowhere is this more apparent than in the treatment of abdominal aortic aneurysms (AAAs), in which endovascular aneurysm repair (EVAR) has replaced the traditional open surgical approach in patients with suitable anatomy. However, approximately one-third of patients presenting with AAAs are deemed ineligible for standard EVAR because of anatomic constraints, the majority of which involve the proximal aneurysmal neck. To overcome these challenges, a bevy of endovascular approaches have been developed to either enhance stent graft fixation at the proximal neck or extend the proximal landing zone to allow adequate apposition to the aortic wall and thus aneurysm exclusion. This article is composed of two sections that together address new endovascular approaches for treating aortic aneurysms with difficult proximal neck anatomy. The first section will explore advancements in the traditional EVAR approach for hostile neck anatomy that maximize the use of the native proximal landing zone; the second section will discuss a technique that was developed to extend the native proximal landing zone and maintain perfusion to vital aortic branches using common, off-the-shelf components: the snorkel technique. While the techniques presented differ in terms of approach, the available clinical data, albeit limited, support the notion that they may both have roles in the treatment algorithm for patients with challenging proximal neck anatomy. PMID:26327748

  3. Exploring the Degree of Support by PMOs for New Project Management Techniques and Methods

    ERIC Educational Resources Information Center

    Lopez, Kathleen P.

    2012-01-01

    An organization tends to seek out the best set of practices in order to achieve project success. Many organizations are implementing a Project Management Office (PMO) to serve as a central post for organizing and disseminating best practices. The PMO responsibilities in part is to examine all practices, old and new, to best determine which…

  4. Improving IT Portfolio Management Decision Confidence Using Multi-Criteria Decision Making and Hypervariate Display Techniques

    ERIC Educational Resources Information Center

    Landmesser, John Andrew

    2014-01-01

    Information technology (IT) investment decision makers are required to process large volumes of complex data. An existing body of knowledge relevant to IT portfolio management (PfM), decision analysis, visual comprehension of large volumes of information, and IT investment decision making suggest Multi-Criteria Decision Making (MCDM) and…

  5. Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques

    ERIC Educational Resources Information Center

    Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

    2006-01-01

    This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

  6. SMART: School Management Appraisal Rating Technique. A Compensation and Performance Appraisal Plan for School Administrators. Revised.

    ERIC Educational Resources Information Center

    Heddinger, Fred M.; Oravitz, Joseph V.

    A 1982 revision of a 1972 publication, this handbook aims to provide a process that school boards can use to evaluate management performance and set administrator salary and compensation schedules. Following a brief introduction, the first two sections note the problem of public criticism of school administrator salaries and review several…

  7. Improving Student Understanding of Operations Management Techniques through a Rolling Reinforcement Strategy.

    ERIC Educational Resources Information Center

    Mukherjee, Arup

    2002-01-01

    Operations management problems were taught to 41 students with same-day reinforcement and to 67 with rolling reinforcement (a day after teaching). Rolling reinforcement resulted in 71.4% mean score compared to 55.4%. Use of two reinforcements had a positive but not significant impact. More reinforcement helped significantly more students achieve…

  8. Physiotherapy in the management of disorders of the temporomandibular joint--perceived effectiveness and access to services: a national United Kingdom survey.

    PubMed

    Rashid, Arif; Matthews, Nigel Shaun; Cowgill, Helen

    2013-01-01

    Up to a quarter of the general population has experienced temporomandibular joint disorder (TMD) at some point in time. Physiotherapy has been used in the management of TMD for many years, but evidence supporting its clinical effectiveness is limited. We investigated the perceived effectiveness of physiotherapy for patients with TMD among consultants in oral and maxillofacial surgery (OMFS) and the accessibility of these services in the United Kingdom (UK). Information was gathered from a postal or electronic questionnaire sent to the 356 OMFS consultants listed on the British Association of Oral and Maxillofacial Surgeons' website. A total of 208 responded (58%) and 72% considered physiotherapy to be effective. Amongst these respondents, jaw exercises (79%), ultrasound (52%), manual therapy (48%), acupuncture (41%) and laser therapy (15%) were considered to be effective. Twenty-eight percent of respondents did not consider physiotherapy to be effective. Reasons for this included lack of knowledge or expertise of the physiotherapist (41%) and lack of awareness of the benefits of physiotherapy (28%). In relation to access to physiotherapy services, 10% of respondents had a designated physiotherapist for patients with TMD, 89% could refer directly to physiotherapy and 7% worked in an environment that provided training for physiotherapists. Patients were prescribed jaw exercises by 69% of respondents. Despite limited evidence to support its effectiveness, approximately three-quarters of OMFS consultants in the UK regard physiotherapy to be beneficial in the management of TMD.

  9. Job stress management protocol using a merge between cognitive-behavioral techniques and ergonomic tools.

    PubMed

    Viola, Elaine; Vidal, Mario Cesar

    2012-01-01

    This paper presents a protocol for work distress assessment. Work distress is defined as a merge between nonergonomic related aspects, in tasks or environment, and adversely conditions perceived for a worker, in a certain work situation. This frame requires an approach that can treat individuals and organizational factors in the same way, at the same time. For this, we elaborate a psycho-ergonomics method, associating concepts and practices from cognitive-behavioral techniques and work ergonomic analysis, which we named CEWAT - Cognitive-Behavioral Work Analysis Technique. This paper presents CEWAT's foundations and structure, in steps. An application to a complex and dangerous system illustrates its benefits in the ergonomics action.

  10. Arteriovenous Access

    PubMed Central

    MacRae, Jennifer M.; Dipchand, Christine; Oliver, Matthew; Moist, Louise; Yilmaz, Serdar; Lok, Charmaine; Leung, Kelvin; Clark, Edward; Hiremath, Swapnil; Kappel, Joanne; Kiaii, Mercedeh; Luscombe, Rick; Miller, Lisa M.

    2016-01-01

    Complications of vascular access lead to morbidity and may reduce quality of life. In this module, we review both infectious and noninfectious arteriovenous access complications including neuropathy, aneurysm, and high-output access. For the challenging patients who have developed many complications and are now nearing their last vascular access, we highlight some potentially novel approaches. PMID:28270919

  11. Effects of soil management techniques on soil water erosion in apricot orchards.

    PubMed

    Keesstra, Saskia; Pereira, Paulo; Novara, Agata; Brevik, Eric C; Azorin-Molina, Cesar; Parras-Alcántara, Luis; Jordán, Antonio; Cerdà, Artemi

    2016-05-01

    Soil erosion is extreme in Mediterranean orchards due to management impact, high rainfall intensities, steep slopes and erodible parent material. Vall d'Albaida is a traditional fruit production area which, due to the Mediterranean climate and marly soils, produces sweet fruits. However, these highly productive soils are left bare under the prevailing land management and marly soils are vulnerable to soil water erosion when left bare. In this paper we study the impact of different agricultural land management strategies on soil properties (bulk density, soil organic matter, soil moisture), soil water erosion and runoff, by means of simulated rainfall experiments and soil analyses. Three representative land managements (tillage/herbicide/covered with vegetation) were selected, where 20 paired plots (60 plots) were established to determine soil losses and runoff. The simulated rainfall was carried out at 55mmh(-1) in the summer of 2013 (<8% soil moisture) for one hour on 0.25m(2) circular plots. The results showed that vegetation cover, soil moisture and organic matter were significantly higher in covered plots than in tilled and herbicide treated plots. However, runoff coefficient, total runoff, sediment yield and soil erosion were significantly higher in herbicide treated plots compared to the others. Runoff sediment concentration was significantly higher in tilled plots. The lowest values were identified in covered plots. Overall, tillage, but especially herbicide treatment, decreased vegetation cover, soil moisture, soil organic matter, and increased bulk density, runoff coefficient, total runoff, sediment yield and soil erosion. Soil erosion was extremely high in herbicide plots with 0.91Mgha(-1)h(-1) of soil lost; in the tilled fields erosion rates were lower with 0.51Mgha(-1)h(-1). Covered soil showed an erosion rate of 0.02Mgha(-1)h(-1). These results showed that agricultural management influenced water and sediment dynamics and that tillage and herbicide

  12. The effect of stress management training on stress and depression in women with depression disorders: Using cognitive-behavioral techniques

    PubMed Central

    Abbasian, Farahzad; Najimi, Arash; Meftagh, Sayyed Davood; Ghasemi, Gholamreza; Afshar, Hamid

    2014-01-01

    Background: The present study aimed to investigate the effect of stress management training through cognitive-behavioral techniques on stress, social adaptability and depression in women with depression disorders. Materials and Methods: In this study, 40 patients diagnosed with depression who had referred to psychiatry and consultation clinics of Isfahan were randomly selected and assigned to intervention and control groups (20 patients in each group). The intervention group received eight 90-min sessions of stress training through cognitive–behavioral techniques. Data collection tools included Cooper's stress questionnaire, Bell's social adaptability questionnaire and Hamilton's depression scale questionnaire. The participants completed the questionnaires before the intervention and 1 month after the same. Data analysis was performed using covariance analysis. Results: Based on the results, considering variables of stress, social adaptability and depression, the equal variance hypothesis was confirmed. The relationship between pre- and post-test scores on stress, social adaptability and depression was statistically significant (P < 0.001). The modified mean difference was F = 12.45, P < 0.001 on stress; F = 6.88, P < 0.01 on social adaptability; and F = 5.36, P < 0.02 on depression, all of which were significant. Conclusion: Stress management training through cognitive behavioral techniques can play a main role in depression reduction and development of social adaptability through modifying inappropriate social information-processing patterns. PMID:25077163

  13. A Study of the Outcome of Primary Excision and Closure Technique in the Management of Lip Leukoderma in 30 Patients

    PubMed Central

    Shilpa, Kanathur; Sacchidanand, S.; Savitha, Somaiah; Ranjitha, Ramamurthy; Lakshmi, DV; Divya, Gorur

    2016-01-01

    Context: Lips being one of the graceful cosmetic units of the face, any disfigurement, including depigmentation, can be embarrassing, psychologically distressing, and socially stigmatizing. Even with the evolution of various surgical modalities, none of the techniques ensure 100% pigmentation with a good cosmetic appearance. With this background, this study was undertaken to study the efficacy of the technique—primary excision and closure in treatment of lip leukoderma (LL). Aims: To study the efficacy, cosmetic outcome, and recurrence following primary excision and closure technique in the management of LL. Settings and Design: A prospective single-center open-label uncontrolled study. Materials and Methods: Thirty patients with LL involving inner margin of the lower lip and those who fulfilled inclusion and exclusion criteria were included in the study. After obtaining consent and physician fitness, patients were posted for primary excision and closure of the vitiliginous area of the lip. Patients were followed up at the immediate postoperative period and 6 months later. Patient satisfaction scale was done by asking the patient to grade the response between one and ten. Statistical Analysis Used: Mean and percentiles. Results: Out of 30 patients, 29 patients achieved complete clearance that was cosmetically acceptable. Only one patient showed recurrence at the end of 6 months. Average patient satisfaction scale showed an average of 9.66. Conclusions: Primary excision and closure technique is one of the safe, inexpensive modality in the management of LL involving the inner margin of the lip with immediate result. PMID:27081245

  14. Planning, Managing, and Financing in the 1980s. Achieving Excellence, Diversity, and Access in the Context of Stable Resources and Demands for Increased Productivity. Proceedings of the 1977 NCHEMS National Assembly (Denver, Colorado, November 6-8, 1977).

    ERIC Educational Resources Information Center

    Western Interstate Commission for Higher Education, Boulder, CO. National Center for Higher Education Management Systems.

    The 1977 National Assembly of the National Center for Higher Education Management Systems addressed specific aspects of excellence, diversity, and access to postsecondary education and suggested ways to preserve these values in planning, managing, and financing in the 1980's. The following conference papers are presented: "Placing Value…

  15. Techniques and long-term outcomes of cotton-clipping and cotton-augmentation strategies for management of cerebral aneurysms.

    PubMed

    Safavi-Abbasi, Sam; Moron, Felix; Sun, Hai; Oppenlander, Mark E; Kalani, M Yashar S; Mulholland, Celene B; Zabramski, Joseph M; Nakaji, Peter; Spetzler, Robert F

    2016-09-01

    OBJECTIVE To address the challenges of microsurgically treating broad-based, frail, and otherwise complex aneurysms that are not amenable to direct clipping, alternative techniques have been developed. One such technique is to use cotton to augment clipping ("cotton-clipping" technique), which is also used to manage intraoperative aneurysm neck rupture, and another is to reinforce unclippable segments or remnants of aneurysm necks with cotton ("cotton-augmentation" technique). This study reviews the natural history of patients with aneurysms treated with cotton-clipping and cotton-augmentation techniques. METHODS The authors queried a database consisting of all patients with aneurysms treated at Barrow Neurological Institute in Phoenix, Arizona, between January 1, 2004, and December 31, 2014, to identify cases in which cotton-clipping or cotton-augmentation strategies had been used. Management was categorized as the cotton-clipping technique if cotton was used within the blades of the aneurysm clip and as the cotton-clipping technique if cotton was used to reinforce aneurysms or portions of the aneurysm that were unclippable due to the presence of perforators, atherosclerosis, or residual aneurysms. Data were reviewed to assess patient outcomes and annual rates of aneurysm recurrence or hemorrhage after the initial procedures were performed. RESULTS The authors identified 60 aneurysms treated with these techniques in 57 patients (18 patients with ruptured aneurysms and 39 patients with unruptured aneurysms) whose mean age was 53.1 years (median 55 years; range 24-72 years). Twenty-three aneurysms (11 cases of subarachnoid hemorrhage) were treated using cotton-clipping and 37 with cotton-augmentation techniques (7 cases of subarachnoid hemorrhage). In total, 18 patients presented with subarachnoid hemorrhage. The mean Glasgow Outcome Scale (GOS) score at the time of discharge was 4.4. At a mean follow-up of 60.9 ± 35.6 months (median 70 months; range 10-126 months

  16. Use of Formative Classroom Assessment Techniques in a Project Management Course

    ERIC Educational Resources Information Center

    Purcell, Bernice M.

    2014-01-01

    Formative assessment is considered to be an evaluation technique that informs the instructor of the level of student learning, giving evidence when it may be necessary for the instructor to make a change in delivery based upon the results. Several theories of formative assessment exist, all which propound the importance of feedback to the student.…

  17. Recognizing and Managing Complexity: Teaching Advanced Programming Concepts and Techniques Using the Zebra Puzzle

    ERIC Educational Resources Information Center

    Crabtree, John; Zhang, Xihui

    2015-01-01

    Teaching advanced programming can be a challenge, especially when the students are pursuing different majors with diverse analytical and problem-solving capabilities. The purpose of this paper is to explore the efficacy of using a particular problem as a vehicle for imparting a broad set of programming concepts and problem-solving techniques. We…

  18. Inadequate vertical bone dimension managed by indirect sinus grafting technique and simultaneous implant placement

    PubMed Central

    Nandal, Shikha; Ghalaut, Pankaj; Nandal, Deepika

    2016-01-01

    Implant placement into the posterior maxilla often creates a challenge due to inadequate bone height because of close sinus proximity. This article presents a case report of indirect sinus lift technique involving hydraulic pressure to elevate the floor of the maxillary sinus. PMID:28356698

  19. Vis-A-Plan /visualize a plan/ management technique provides performance-time scale

    NASA Technical Reports Server (NTRS)

    Ranck, N. H.

    1967-01-01

    Vis-A-Plan is a bar-charting technique for representing and evaluating project activities on a performance-time basis. This rectilinear method presents the logic diagram of a project as a series of horizontal time bars. It may be used supplementary to PERT or independently.

  20. The pouch and tunnel technique for management of multiple gingival recession defects

    PubMed Central

    Dani, Sneha; Dhage, Aditi; Gundannavar, Gayatri

    2014-01-01

    The desire for improved esthetics has increased tremendously over the years. Periodontal plastic surgery deals with regenerative procedures designed to restore form, function and enhance esthetics. The aim of this study was to evaluate the effectiveness of subepithelial connective tissue graft using pouch and tunnel technique as root coverage procedure. Three patients corresponding to a total of 8 sites participated in the study. Maxillary teeth with miller's class I gingival recession were included in the study. All the sites were treated using subepithelial connective tissue graft using pouch and tunneling technique. Patients were followed up for a period of 6 months and 1 year. All the treated teeth showed 100% root coverage at the end of 6 months and 1 year. Gingival recession is a common occurrence and its prevalence increases with age. It can lead to clinical problems, diminished cosmetic appeal and hence esthetic concern. There are various techniques for root coverage. Subepithelial connective tissue graft has shown the best predictability (95%) of root coverage in Millers class I & II cases. This technique preserves the intermediate papilla, accelerates the initial wound healing & also applies less traction. Due to minimal trauma at the recipient site, this procedure may be advantageous in treatment of recession as compared to other treatment modalities. PMID:25624637

  1. Organizational Behavior Change: The Effectiveness of Behavior Modification Techniques with and without Participatory Management.

    ERIC Educational Resources Information Center

    Sweeney, Mary M.; Goldstein, Marc B.

    This study examines a naturally occurring experiment in a large urban hospital faced with budget cuts, in which departments were ordered to reduce employees' overtime without jeopardizing service quality. The study focuses on two departments that chose to use behavior modification techniques. In one department (Radiology) the intervention combined…

  2. Leadership Enhancement through Mind Management by Meditation--A Scientific Yogic Technique

    ERIC Educational Resources Information Center

    Selvi, B. Tamil; Thangarajathi, S.

    2010-01-01

    Good education is the product of good administration and the administration is not simply a managerial occupation. It demands new dimensions of knowledge, techniques and skills. Today administrators are confronting a variety of problems in their respective organizations. The complex environments of the educational institutions require leaders and…

  3. Management: A bibliography for NASA managers

    NASA Technical Reports Server (NTRS)

    1985-01-01

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

  4. Toward high efficiency ultra-thin CIGSe based solar cells using light management techniques

    NASA Astrophysics Data System (ADS)

    Naghavi, Negar; Jehl, Zacharie; Donsanti, Frederique; Guillemoles, Jean-François; Gérard, Isabelle; Bouttemy, Muriel; Etcheberry, Arnaud; Pelouard, Jean-Luc; Collin, Stéphane; Colin, Clément; Péré-Laperne, Nicolas; Dahan, Nir; Greffet, Jean-Jacques; Morel, Boris; Djebbour, Zakaria; Darga, Arouna; Mencaraglia, Denis; Voorwinden, Georg; Dimmler, Bernhard; Powalla, Micheal; Lincot, Daniel

    2012-02-01

    This study addresses the potential of different approaches to improve the generated current density in ultrathin Cu(In,Ga)Se2 (CIGSe) based solar cells down to 0.1 μm. Advanced photon management, involving both absorption enhancement and reflection reduction in the absorber, is studied. In this contribution, the three main approaches used are: - The reduction of the CIGSe thickness by chemical etching which combines thickness reduction and smoothing effect on the absorber. - Optical management by front contact engineering and by the replacement of the back contact by the "lift-off" of CIGSe layer from the Mo layer and the deposition of a new reflective back contact. - Application of plasmonic structures to CIGSe solar cells enabling light confinement at the subwavelength scale.

  5. Tools and Techniques for Evaluating the Effects of Maintenance Resource Management (MRM) in Air Safety

    NASA Technical Reports Server (NTRS)

    Taylor, James C.

    2002-01-01

    This research project was designed as part of a larger effort to help Human Factors (HF) implementers, and others in the aviation maintenance community, understand, evaluate, and validate the impact of Maintenance Resource Management (MRM) training programs, and other MRM interventions; on participant attitudes, opinions, behaviors, and ultimately on enhanced safety performance. It includes research and development of evaluation methodology as well as examination of psychological constructs and correlates of maintainer performance. In particular, during 2001, three issues were addressed. First a prototype process for measuring performance was developed and used. Second an automated calculator was developed to aid the HF implementer user in analyzing and evaluating local survey data. These results include being automatically compared with the experience from all MRM programs studied since 1991. Third the core survey (the Maintenance Resource Management Technical Operations Questionnaire, or 'MRM/TOQ') was further developed and tested to include topics of added relevance to the industry.

  6. A novel tracer technique for the assessment of fine sediment dynamics in urban water management systems.

    PubMed

    Spencer, K L; Droppo, I G; He, C; Grapentine, L; Exall, K

    2011-04-01

    Urban storm water run off can reduce the quality of receiving waters due to high sediment load and associated sediment-bound contaminants. Consequently, urban water management systems, such as detention ponds, that both modify water quantity through storage and improve water quality through sediment retention are frequently-used best management practices. To manage such systems effectively and to improve their efficiency, there is a need to understand the dynamics (transport and settling) of sediment, and in particular the fine sediment fraction (<63 μm) and its associated contaminants within urban storm water management systems. This can be difficult to achieve, as modelling the transport behaviour of fine-grained and cohesive sediment is problematic and field-based measurements can be costly, time-consuming and unrepresentative. The aim of this study was to test the application of a novel cohesive sediment tracer and to determine fine sediment transport dynamics within a storm water detention pond. The cohesive sediment tracer used was a holmium labelled montmorillonite clay which flocculated and had similar size and settling velocity to the natural pond sediment it was intended to mimic. The tracer demonstrated that fine sediment was deposited across the entire pond, with the presence of reed beds and water depth being important factors for maximising sediment retention. The results of the sediment tracer experiment were in good agreement with those of a mathematical sediment transport model. Here, the deposited sediment tracer was sampled by collecting and analysing surface pond sediments for holmium. However, analysis and sampling of the three dimensional suspended tracer 'cloud' may provide more accurate information regarding internal pond sediment dynamics.

  7. Post-traumatic stress disorder managed successfully with hypnosis and the rewind technique: two cases in obstetric patients.

    PubMed

    Slater, P M

    2015-08-01

    Two obstetric patients presenting with post-traumatic stress disorder in the antenatal period are discussed. The first patient had previously had an unexpected stillborn delivered by emergency caesarean section under general anaesthesia. She developed post-traumatic stress disorder and presented for repeat caesarean section in her subsequent pregnancy, suffering flashbacks and severe anxiety. Following antenatal preparation with hypnosis and a psychological method called the rewind technique, she had a repeat caesarean section under spinal anaesthesia, successfully managing her anxiety. The second patient suffered post-traumatic stress disorder symptoms after developing puerperal psychosis during the birth of her first child. Before the birth of her second child, she was taught self-hypnosis, which she used during labour in which she had an uneventful water birth. These cases illustrate the potential value of hypnosis and alternative psychological approaches in managing women with severe antenatal anxiety.

  8. The use of modelling and reuse techniques in the development of water management systems in basins with limited water resources.

    PubMed

    Gabbrielli, E

    2004-01-01

    Drawing on experiences in New South Wales from 1950 to 1980 in modeling and re-use techniques in the development of desalination technology and its application in fresh water production for potable use, the paper describes how Australia realized its responsibilities in developing participative and sustainable approaches to land use and water resources management. An analysis of the lessons from the operation of the Bayswater zero-discharge power station significantly contributed to the debate on sustainable approaches, highlighting that no management policy of a water basin can be implemented without a model based on reliable data from all sectors (including the environment), and no management model can be implemented without the participation of all stakeholders. These ideals were reflected in the conception and establishment of the Murray-Darling Basin Commission. The Commission succeeded in bringing together all major stakeholders in this huge basin, though it took more than 15 years to do so. While widely recognized as one of the most advanced and successful experiences in integrated management of a drainage basin, it has still not achieved the reversal of many unsustainable agricultural practices, giving a clear indication of the difficulties and time required for producing sustainable solutions.

  9. Acceptance of direct physician access to a computer-based patient record in a managed care setting.

    PubMed

    Dewey, J B; Manning, P; Brandt, S

    1993-01-01

    Kaiser Permanente Mid-Atlantic States has developed a fully integrated outpatient information system which currently runs on an IBM ES9000 on a VM platform written in MUMPS. The applications include Lab, Radiology, Transcription, Appointments. Pharmacy, Encounter tracking, Hospitalizations, Referrals, Phone Advice, Pap tracking, Problem list, Immunization tracking, and Patient demographics. They are department specific and require input and output from a dumb terminal. We have developed a physician's work station to access this information using PC compatible computers running Microsoft Windows and a custom Microsoft Visual Basic 2.0 environment which draws from these 14 applications giving the physician a comprehensive view of all electronic medical records. Through rapid prototyping, voluntary participation, formal training and gradual implementation we have created an enthusiastic response. 95% of our physician PC users access the system each month. The use ranges from 0.2 to 3.0 screens of data viewed per patient visit. This response continues to drive the process toward still greater user acceptance and further practice enhancement.

  10. Environmental assessment for the Area 5 radioactive waste management site access improvement at the Nevada Test Site

    SciTech Connect

    1997-11-01

    The United States Department of Energy has prepared an Environmental Assessment which analyzes the potential environmental effects of improving access to its AREA 5 RWMS at the NTS. The EA evaluates the potential impacts of constructing an extension of the Cane Springs Road between Mercury Highway and the 5-01 Road. Three alternative actions are also evaluated: (1) construction of a new road along the existing alignment of the Powerline Road between Mercury Highway and the 5-01 Road, (2) upgrading the existing 5-01 Road, and (3) taking no action. The purpose and need for improving access to the RWMS are addressed in Section 1.0 of the EA. A detailed description of the proposed action and alternatives is in Section 2.0. Section 3.0 describes the affected environment and Section 4.0 the environmental effects of the proposed action and alternatives. Health and transportation effects, accident scenarios, cumulative effects, and other relevant information are found in Sections 5.0 through 12.0 of the EA. DOE determined that the alternative action of upgrading the existing 5-01 Road would best meet the needs of the agency.

  11. New and Common Perioperative Pain Management Techniques in Total Knee Arthroplasty.

    PubMed

    Elmallah, Randa K; Cherian, Jeffrey J; Pierce, Todd P; Jauregui, Julio J; Harwin, Steven F; Mont, Michael A

    2016-02-01

    Optimal pain control in patients undergoing total knee arthroplasty (TKA) is imperative for good rehabilitation and functional outcomes. However, despite technological advancements, surgeons continue to struggle with adequate pain management in their patients. Current modalities in use, such as patient-controlled analgesia, opioids, and epidural anesthetics, provide good pain relief but can be associated with side effects and serious complications. As a result, newer pain control modalities have been used to try to reduce the use of opioids while providing adequate pain relief. Currently, there are no clear guidelines or evidence for an optimum postoperative TKA analgesic regimen. Our aim was to evaluate the recent literature and provide a summary of the newer perioperative analgesic modalities. Evidence suggests that analgesics, such as newer oral medications, peripheral nerve blocks, and periarticular injections, may improve pain management, rehabilitation, and patient satisfaction, as well as reduce opioid consumption. The literature has also highlighted that a multimodal approach to pain management may provide the best results. However, determining which modalities provide superior pain control is still being extensively studied, and further research is needed.

  12. An improved interim therapeutic restoration technique for management of anterior early childhood caries: report of two cases.

    PubMed

    Nelson, Travis

    2013-01-01

    Early childhood caries presents unique treatment challenges that often require advanced behavior management techniques, such as general anesthesia or procedural sedation. In some cases, use of these pharmacologic adjuncts is undesirable or not possible. The interim therapeutic restoration is a treatment method that, while sometimes employed in such cases, can often produce unsatisfactory results in primary anterior teeth. This is often due to insufficient bulk of material and lack of retention. The purpose of this report was to describe a simple alternative technique (resin modified glass ionomer strip crowns) that may be employed to deliver esthetic anterior restorations to marginally cooperative children in the dental clinic setting and to report on two cases in which it was successfully used. \\\\\\Department of Pediatric Dentistry, University of Washington, Seattle, Wash., USA. tmnelson@uw.edu

  13. Part I: Integrated water quality management: river basin approach. Geochemical techniques on contaminated sediments--river basin view.

    PubMed

    Förstner, Ulrich

    2003-01-01

    The big flood in the upper Elbe River catchment area has revealed a wide spectrum of problems with contaminated sediments. So far, an effective strategy for managing contaminated sediments on a river basin scale is still missing and it seems that not much has been learned from the lessons received during the last decade. In the following overview, special emphasis is given to the utilization of geochemically-based techniques for sediment remediation, which can be applied in different parts of a river basin. The examples presented here are mostly from the Elbe River catchment area. In general, new technical problem solutions need a set of practical process knowledge that uses a wide range of simulation techniques, as well as models in different spatial and temporal scales. The evaluation of recent flood events clearly demonstrates the importance of chemical expertise in the decision-making process for the sustainable development in river basins.

  14. Management of a coronally advanced lingual flap in regenerative osseous surgery: a case series introducing a novel technique.

    PubMed

    Ronda, Marco; Stacchi, Claudio

    2011-01-01

    One of the crucial factors in the success of guided bone regeneration procedures is the correct management of the soft tissues. This allows for stable primary wound closure without tension, which can result in premature exposure of the augmentation area, jeopardizing the final outcome. The use of vertical and periosteal incisions to passivate buccal and lingual flaps in the posterior mandible is often limited by anatomical factors. This paper reports on a series of 69 consecutive cases introducing a novel surgical technique to release and advance the lingual flap coronally in a safe and predictable manner.

  15. INNOVATIVE TECHNIQUES AND TECHNOLOGY APPLICATION IN MANAGEMENT OF REMOTE HANDLED AND LARGE SIZED MIXED WASTE FORMS

    SciTech Connect

    BLACKFORD LT

    2008-02-04

    CH2M HILL Hanford Group, Inc. (CH2M HILL) plays a critical role in Hanford Site cleanup for the U. S. Department of Energy, Office of River Protection (ORP). CH2M HILL is responsible for the management of 177 tanks containing 53 million gallons of highly radioactive wastes generated from weapons production activities from 1943 through 1990. In that time, 149 single-shell tanks, ranging in capacity from 50,000 gallons to 500,000 gallons, and 28 double-shell tanks with a capacity of 1 million gallons each, were constructed and filled with toxic liquid wastes and sludges. The cleanup mission includes removing these radioactive waste solids from the single-shell tanks to double-shell tanks for staging as feed to the Waste Treatment Plant (WTP) on the Hanford Site for vitrification of the wastes and disposal on the Hanford Site and Yucca Mountain repository. Concentrated efforts in retrieving residual solid and sludges from the single-shell tanks began in 2003; the first tank retrieved was C-106 in the 200 East Area of the site. The process for retrieval requires installation of modified sluicing systems, vacuum systems, and pumping systems into existing tank risers. Inherent with this process is the removal of existing pumps, thermo-couples, and agitating and monitoring equipment from the tank to be retrieved. Historically, these types of equipment have been extremely difficult to manage from the aspect of radiological dose, size, and weight of the equipment, as well as their attendant operating and support systems such as electrical distribution and control panels, filter systems, and mobile retrieval systems. Significant effort and expense were required to manage this new waste stream and resulted in several events over time that were both determined to be unsafe for workers and potentially unsound for protection of the environment. Over the last four years, processes and systems have been developed that reduce worker exposures to these hazards, eliminate violations

  16. Novel techniques for the thermal management of space-based, high-power microwave tubes

    NASA Astrophysics Data System (ADS)

    Rose, M. F.; Hyder, Anthony K.; Askew, R. F.; Chow, L.; Gilmour, A. S., Jr.; Faghri, A.

    1991-10-01

    This work is based in part on a study by the authors to determine the applicability of several concepts to the cooling of high-power linear microwave tubes operating in space under a variety of conditions. The authors focus on: direct radiation to space, beam exit to space, thermal storage, secondary coolant loops/heat pipes, and the use of supercritical hydrogen as a coolant with subsequent ejection to space. Each of these techniques is evaluated within the framework of a neutral particle beam weapons system or other limited duty cycle device which might lay dormant for long periods of time, come to life, and function reliably for a specified time. System impact for each technique is estimated in terms of impact on weight, volume, spacecraft interaction, and ease of implementation.

  17. Surgical management of Gorlin syndrome: a 4-decade experience using local excision technique.

    PubMed

    Griner, Devan; Sutphin, Daniel; Sargent, Larry A

    2015-04-01

    Basal cell nevus syndrome (aka Gorlin syndrome, Gorlin-Goltz syndrome, nevoid basal cell carcinoma syndrome, and fifth phacomatosis) is a rare but well-described autosomal dominant condition with variable penetrance. We present a female patient who has been successfully treated using local surgical excision and diligent skin surveillance for more than 4 decades, demonstrating that simple local incision is an efficacious and reasonable surgical alternative that may circumvent the specialization and expense of Mohs technique.

  18. Applications notice. [application of space techniques to earth resources, environment management, and space processing

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The discipline programs of the Space and Terrestrial (S&T) Applications Program are described and examples of research areas of current interest are given. Application of space techniques to improve conditions on earth are summarized. Discipline programs discussed include: resource observations; environmental observations; communications; materials processing in space; and applications systems/information systems. Format information on submission of unsolicited proposals for research related to the S&T Applications Program are given.

  19. Acquisition Reform: Contractors Can Use Technologies and Management Techniques to Reduce Costs

    DTIC Science & Technology

    1993-07-01

    industry downsizing , the Department of Defense (DOD) is planning to expand the potential of the defense industrial base by encouraging contraetors to...identified in the financial and technical literature as having used innovative technologies and techniques.2 We identified those that had achieved cost...DOD is looking at alternative means to motivate defense companies to achieve significant cost reductions, which will include a review of procurement

  20. Factors Influencing Access to Integrated Soil Fertility Management Information and Knowledge and Its Uptake among Smallholder Farmers in Zimbabwe

    ERIC Educational Resources Information Center

    Gwandu, T.; Mtambanengwe, F.; Mapfumo, P.; Mashavave, T. C.; Chikowo, R.; Nezomba, H.

    2014-01-01

    Purpose: The study evaluated how farmer acquisition, sharing and use patterns of information and knowledge interact with different socioeconomic factors to influence integrated soil fertility management (ISFM) technology uptake. Design/methodology/approach: The study was conducted as part of an evaluation of field-based farmer learning approaches…

  1. Decision Making Regarding Access to Training and Development in Medium-Sized Enterprises: An Exploratory Study Using the Critical Incident Technique

    ERIC Educational Resources Information Center

    Coetzer, Alan; Redmond, Janice; Sharafizad, Jalleh

    2012-01-01

    Purpose: The purpose of this paper is to develop an understanding of factors that impinge on managerial decision-making processes regarding employee access to structured training and development (T&D) opportunities that are at least partially funded by the firm. Design/methodology/approach: Semi-structured interviews incorporating the Critical…

  2. Endodontic Management of a Mandibular First Molar with Radix Entomolaris and Conservative Post-endodontic Restoration with CAD/CAM Onlay: A Novel Clinical Technique

    PubMed Central

    De Ataide, Ida De Noronha; Fernandes, Marina; Lambor, Rajan; Alreja, Dalip

    2016-01-01

    This case report describes a novel technique of restoring endodontically treated teeth. Hidden caries causing irreversible pulpitis in a mandibular molar with Radix Entomolaris (RE) was evident. The intact occlusal surface anatomy was duplicated before preparing an access cavity to replicate the original occlusal surface in the post endodontic restoration using (Computer-Aided Design and Computer-Aided Manufacturing) CAD/CAM technique. This report highlights uniquely designed onlay utilizing the benefits of contemporary materials and advanced technology. PMID:28050515

  3. SeaDataNet - Pan-European infrastructure for marine and ocean data management: Unified access to distributed data sets (www.seadatanet.org)

    NASA Astrophysics Data System (ADS)

    Schaap, Dick M. A.; Maudire, Gilbert

    2010-05-01

    SeaDataNet is a leading infrastructure in Europe for marine & ocean data management. It is actively operating and further developing a Pan-European infrastructure for managing, indexing and providing access to ocean and marine data sets and data products, acquired via research cruises and other observational activities, in situ and remote sensing. The basis of SeaDataNet is interconnecting 40 National Oceanographic Data Centres and Marine Data Centers from 35 countries around European seas into a distributed network of data resources with common standards for metadata, vocabularies, data transport formats, quality control methods and flags, and access. Thereby most of the NODC's operate and/or are developing national networks to other institutes in their countries to ensure national coverage and long-term stewardship of available data sets. The majority of data managed by SeaDataNet partners concerns physical oceanography, marine chemistry, hydrography, and a substantial volume of marine biology and geology and geophysics. These are partly owned by the partner institutes themselves and for a major part also owned by other organizations from their countries. The SeaDataNet infrastructure is implemented with support of the EU via the EU FP6 SeaDataNet project to provide the Pan-European data management system adapted both to the fragmented observation system and the users need for an integrated access to data, meta-data, products and services. The SeaDataNet project has a duration of 5 years and started in 2006, but builds upon earlier data management infrastructure projects, undertaken over a period of 20 years by an expanding network of oceanographic data centres from the countries around all European seas. Its predecessor project Sea-Search had a strict focus on metadata. SeaDataNet maintains significant interest in the further development of the metadata infrastructure, extending its services with the provision of easy data access and generic data products

  4. Principles and techniques in the design of ADMS+. [advanced data-base management system

    NASA Technical Reports Server (NTRS)

    Roussopoulos, Nick; Kang, Hyunchul

    1986-01-01

    'ADMS+/-' is an advanced data base management system whose architecture integrates the ADSM+ mainframe data base system with a large number of work station data base systems, designated ADMS-; no communications exist between these work stations. The use of this system radically decreases the response time of locally processed queries, since the work station runs in a single-user mode, and no dynamic security checking is required for the downloaded portion of the data base. The deferred update strategy used reduces overhead due to update synchronization in message traffic.

  5. An Investigation of Techniques for Detecting Data Anomalies in Earned Value Management Data

    DTIC Science & Technology

    2011-12-01

    federally funded research and development center. Any opinions, findings and conclusions or recommendations expressed in this material are those of... Research Focus 4 1.6 Collaborators and Data Source for this Research 4 1.7 What is Earned Value Management? 4 2 Methodology 7 2.1 High-Level Approach...Results – NCC, CBB 32 4.2 Challenges Encountered During This Research 32 4.3 Implications of This Research 33 4.4 Recommendations 34 CMU/SEI-2011-TR

  6. Application of Modern Tools and Techniques for Mine Safety & Disaster Management

    NASA Astrophysics Data System (ADS)

    Kumar, Dheeraj

    2016-04-01

    The implementation of novel systems and adoption of improvised equipment in mines help mining companies in two important ways: enhanced mine productivity and improved worker safety. There is a substantial need for adoption of state-of-the-art automation technologies in the mines to ensure the safety and to protect health of mine workers. With the advent of new autonomous equipment used in the mine, the inefficiencies are reduced by limiting human inconsistencies and error. The desired increase in productivity at a mine can sometimes be achieved by changing only a few simple variables. Significant developments have been made in the areas of surface and underground communication, robotics, smart sensors, tracking systems, mine gas monitoring systems and ground movements etc. Advancement in information technology in the form of internet, GIS, remote sensing, satellite communication, etc. have proved to be important tools for hazard reduction and disaster management. This paper is mainly focused on issues pertaining to mine safety and disaster management and some of the recent innovations in the mine automations that could be deployed in mines for safe mining operations and for avoiding any unforeseen mine disaster.

  7. The etch-bleach-seal technique for managing stained enamel defects in young permanent incisors.

    PubMed

    Wright, J Timothy

    2002-01-01

    Hypomineralized enamel defects frequently are manifest as a mottled-white appearance and can be associated with variable degrees of discrete yellow-brown intrinsic staining. Numerous treatment approaches have been proposed, ranging from bleaching to enamel reduction to restorative techniques. Bleaching of hypomineralized enamel lesions, using 1 to 2 applications (10 to 15 minutes each) of 5% sodium hypochlorite, has been applied clinically. Treatment using this approach has proven successful in removing yellow-brown discolorations from lesions in young permanent teeth. Young permanent incisors with yellow-brown intrinsic discolorations can often be treated by a simple and conservative bleaching protocol using sodium hypochlorite.

  8. Video Data Management System Archives and Provides Online Access to NOAA Deep-Sea Corals Digital Video and Image Data

    DTIC Science & Technology

    2008-09-01

    System (OAS) and NCDDC’s MERMAid catalogs, CoRIS and OER Digital Atlas databases. II. VIDEO AND IMAGE DATA MANAGEMENT The primary media currently...protocol. • A crosswalk and converter in the MERMAid system (NCDDC online catalog) enables sharing common metadata in both FGDC and MARC21 metadata...records provide the descriptive information for both NOAALINC and MERMAid metadata discovery tools (Figure 4). Figure 4. FGDC-MARCXML-MARC21 Metadata

  9. Water impact studies. [impact of remote sensing techniques on management storage, flow, and delivery of California water

    NASA Technical Reports Server (NTRS)

    Colwell, R. N.

    1973-01-01

    An investigation has begun into the potential impact of using modern remote sensing techniques as an aid in managing, even on a day-to-day basis, the storage, flow, and delivery of water made available through the California Water Project. It is obvious that the amount of this impact depends upon the extent to which remote sensing is proven to be useful in improving predictions of both the amount of water that will be available and the amount that will be needed. It is also proposed to investigate the potential impact of remote sensing techniques as an aid in monitoring, and perhaps even in directing, changes in land use and life style being brought about through the increased availability of water in central and southern California as a result of the California Water Project. The impact of remote sensing can be of appreciable significance only if: (1) the induced changes are very substantial ones; (2) remote sensing is found, in this context, to be very useful and potentially very cost effective; and (3) resource managers adopt this new technology. Analyses will be conducted of the changing economic bases and the new land use demands resulting from increased water availability in central and southern California.

  10. Development of minimally invasive techniques for management of medically-complicated obesity

    PubMed Central

    Rashti, Farzin; Gupta, Ekta; Ebrahimi, Suzan; Shope, Timothy R; Koch, Timothy R; Gostout, Christopher J

    2014-01-01

    The field of bariatric surgery has been rapidly growing and evolving over the past several decades. During the period that obesity has become a worldwide epidemic, new interventions have been developed to combat this complex disorder. The development of new laparoscopic and minimally invasive treatments for medically-complicated obesity has made it essential that gastrointestinal physicians obtain a thorough understanding of past developments and possible future directions in bariatrics. New laparoscopic advancements provide patients and practitioners with a variety of options that have an improved safety profile and better efficacy without open, invasive surgery. The mechanisms of weight loss after bariatric surgery are complex and may in part be related to altered release of regulatory peptide hormones from the gut. Endoscopic techniques designed to mimic the effects of bariatric surgery and endolumenal interventions performed entirely through the gastrointestinal tract offer potential advantages. Several of these new techniques have demonstrated promising, preliminary results. We outline herein historical and current trends in the development of bariatric surgery and its transition to safer and more minimally invasive procedures designed to induce weight loss. PMID:25309074

  11. A comprehensive guide to perioperative management and operative technique for robotic cystectomy with intracorporeal urinary diversion.

    PubMed

    Tan, Wei Shen; Lamb, Benjamin W; Sridhar, Ashwin; Briggs, Timothy P; Kelly, John D

    2017-02-27

    Robotic-assisted radical cystectomy (RARC) represents an evolution of open radical cystectomy (ORC) with the aim of reducing patient morbidity and improving return to normal function, whilst maintaining oncological equivalence. RARC is gaining popularity, especially in high-volume centres, although there remains a lack of level 1 evidence to demonstrate any superiority of RARC over ORC. All previously reported studies that randomised ORC and RARC have utilised a technique for RARC requiring a conversion to open surgery for urinary diversion. Conversion to open surgery invariably masks the benefits of a truly minimally invasive approach. Moreover, such studies tend to report a small sample size, likely reflecting early surgical experience that may contribute to the lack of observed benefit. Nonetheless, it is established that short-term oncological outcomes following RARC are comparable to those after ORC. It is likely that the benefits of RARC are only observed in cases wherein intracorporeal urinary diversion (iRARC) is performed by a surgical team with high volume experience, which will minimise morbidity and maximise early return to normal function. In this review, we will discuss a holistic approach to iRARC, including patient selection, perioperative optimisation, the surgical technique for iRARC with urinary diversion reconstruction, the use of enhanced recovery protocol, oncological outcomes and perioperative complications.

  12. Coherent and consistent decision making for mixed hazardous waste management: The application of quantitative assessment techniques

    SciTech Connect

    Smith, G.M.; Little, R.H.; Torres, C.

    1994-12-31

    This paper focuses on predictive modelling capacity for post-disposal safety assessments of land-based disposal facilities, illustrated by presentation of the development and application of a comprehensive, yet practicable, assessment framework. The issues addressed include: (1) land-based disposal practice, (2) the conceptual and mathematical representation of processes leading to release, migration and accumulation of contaminants, (3) the identification and evaluation of relevant assessment end-points, including human health, health of non-human biota and eco-systems, and property and resource effects, (4) the gap between data requirements and data availability, and (5) the application of results in decision making, given the uncertainties in assessment results and the difficulty of comparing qualitatively different impacts arising in different temporal and spatial scales. The paper illustrates the issues with examples based on disposal of metals and radionuclides to shallow facilities. The types of disposal facility considered include features consistent with facilities for radioactive wastes as well as other types of design more typical of hazardous wastes. The intention is to raise the question of whether radioactive and other hazardous wastes are being consistently managed, and to show that assessment methods are being developed which can provide quantitative information on the levels of environmental impact as well as a consistent approach for different types of waste, such methods can then be applied to mixed hazardous wastes contained radionuclides as well as other contaminants. The remaining question is whether the will exists to employ them. The discussion and worked illustrations are based on a methodology developed and being extended within the current European Atomic Energy Community`s cost-sharing research program on radioactive waste management and disposal, with co-funding support from Empresa Nacional de Residuous Radiactivos SA, Spain.

  13. The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

    PubMed

    Zamani-Hank, Yasamean

    2016-08-01

    The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $667 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-of-pocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA. (Population Health Management 2016;19:272-278).

  14. Management of surgical splenorenal shunt-related hepatic myelopathy with endovascular interventional techniques.

    PubMed

    Wang, Mao-Qiang; Liu, Feng-Yong; Duan, Feng

    2012-12-21

    We present a case with hepatic myelopathy (HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques. A 39-year-old man presented with progressive spastic paraparesis of his lower limbs 14 mo after a splenorenal shunt. A portal venogram identified a widened patent splenorenal shunt. We used an occlusion balloon catheter initially to occlude the shunt. Further monitoring of the patient revealed a decrease in his serum ammonia level and an improvement in leg strength. We then used an Amplatzer vascular plug (AVP) to enable closure of the shunt. During the follow up period of 7 mo, the patient experienced significant clinical improvement and normalization of blood ammonia, without any complications. Occlusion of a surgically created splenorenal shunt with AVP represents an alternative therapy to surgery or coil embolization that can help to relieve shunt-induced HM symptoms.

  15. Symposium on the management of inguinal hernias: 4. The Shouldice technique: a canon in hernia repair

    PubMed Central

    Bendavid, Robert

    1997-01-01

    Controversy exists on the merits of the various approaches to inguinal repair. Evolution of the classic open repair has culminated in the Shouldice repair. Challenges from newcomers, namely, tension-free repair and laparoscopy, are being examined. These two techniques have a number of disadvantages: the presence of foreign bodies (prostheses) and their implication in cases of infection; the cost of prosthetic material, which is no longer negligible (particularly with expanded polytetrafluoroethylene); and problems of safety in that the laparoscopic approach is no longer a dependable asset except in the hands of a highly specialized and dextrous operator. Still, complications occur with laparoscopic repair that should not be associated with a surgical procedure that is considered benign, safe and cost-effective. Surgeons must recognize the pertinent facts and decide according to their conscience which method of repair to use. PMID:9194781

  16. Accessibility, usability, and usefulness of a Web-based clinical decision support tool to enhance provider-patient communication around Self-management TO Prevent (STOP) Stroke.

    PubMed

    Anderson, Jane A; Godwin, Kyler M; Saleem, Jason J; Russell, Scott; Robinson, Joshua J; Kimmel, Barbara

    2014-12-01

    This article reports redesign strategies identified to create a Web-based user-interface for the Self-management TO Prevent (STOP) Stroke Tool. Members of a Stroke Quality Improvement Network (N = 12) viewed a visualization video of a proposed prototype and provided feedback on implementation barriers/facilitators. Stroke-care providers (N = 10) tested the Web-based prototype in think-aloud sessions of simulated clinic visits. Participants' dialogues were coded into themes. Access to comprehensive information and the automated features/systematized processes were the primary accessibility and usability facilitator themes. The need for training, time to complete the tool, and computer-centric care were identified as possible usability barriers. Patient accountability, reminders for best practice, goal-focused care, and communication/counseling themes indicate that the STOP Stroke Tool supports the paradigm of patient-centered care. The STOP Stroke Tool was found to prompt clinicians on secondary stroke-prevention clinical-practice guidelines, facilitate comprehensive documentation of evidence-based care, and support clinicians in providing patient-centered care through the shared decision-making process that occurred while using the action-planning/goal-setting feature of the tool.

  17. Laparoscopic surgical technique to facilitate management of high anorectal malformations – report of seven cases

    PubMed Central

    Murawski, Maciej; Łosin, Marcin; Królak, Marek; Czauderna, Piotr

    2011-01-01

    Anorectal malformations (ARMs) occur in approximately 1 per 5000 live births. The most commonly used procedure for repair of high ARMs is posterior sagittal anorectoplasty (PSARP). This operation is performed entirely through a perineal approach. The first report of laparoscopically assisted anorectal pull-through (LAARP) for repair of ARMs was presented by Georgeson in 2000. The aim is presenting early experience with laparoscopically assisted anorectal pull-through technique in boys with high anorectal malformations. In the last 5 years 7 boys (9 months to 2 years old) with high ARMs were operated on using the LAARP technique. Laparoscopically the rectal pouch was exposed down to the urethral fistula, which was clipped and divided. Externally, the centre of the muscle complex was identified using an electrical stimulator. In the first 4 patients after a midline incision of 2 cm at the planned anoplasty site, a tunnel to the pelvis was created bluntly and dilated with Hegar probes under laparoscopic control. In the last 3 boys a minimal PSARP was done creating a channel into the pelvis. The separated rectum was pulled down and sutured to the perineum. Laparoscopic mobilization of the rectal pouch and fistula division was possible in all cases. There were no intraoperative complications except one ureteral injury. Patients were discharged home on post-operative day 5 to 7. The early results prove that LAARP, an alternative option to PSARP for treatment of imperforate anus, offers many advantages, including excellent visualization of the pelvic anatomical structures, accurate placement of the bowel into the muscle complex and a minimally invasive abdominal and perineal incision. It allows for shorter hospital stay and faster recovery. However, to compare the functional results against the standard procedure (PSARP), longer follow-up of all patients is necessary. PMID:23255974

  18. I, S, T, and J Grading Techniques for Es, Ns, Fs, and Ps: Insights from the MBTI on Managing the Grading Process

    ERIC Educational Resources Information Center

    Fornaciari, Charles J.; Lund Dean, Kathy

    2013-01-01

    Most instructors at least occasionally experience grading student work as a frustrating, time-consuming task. The Myers-Briggs Type Indicator (MBTI) instrument can be a powerful self-awareness tool for management educators seeking to enhance their grading techniques. Evidence suggests that many management professors prefer Extraversion (E),…

  19. Reducing costs of managing and accessing navigation and ancillary data by relying on the extensive capabilities of NASA's spice system

    NASA Technical Reports Server (NTRS)

    Semenov, Boris V.; Acton, Charles H., Jr.; Bachman, Nathaniel J.; Elson, Lee S.; Wright, Edward D.

    2005-01-01

    The SPICE system of navigation and ancillary data possesses a number of traits that make its use in modern space missions of all types highly cost efficient. The core of the system is a software library providing API interfaces for storing and retrieving such data as trajectories, orientations, time conversions, and instrument geometry parameters. Applications used at any stage of a mission life cycle can call SPICE APIs to access this data and compute geometric quantities required for observation planning, engineering assessment and science data analysis. SPICE is implemented in three different languages, supported on 20+ computer environments, and distributed with complete source code and documentation. It includes capabilities that are extensively tested by everyday use in many active projects and are applicable to all types of space missions - flyby, orbiters, observatories, landers and rovers. While a customer's initial SPICE adaptation for the first mission or experiment requires a modest effort, this initial effort pays off because adaptation for subsequent missions/experiments is just a small fraction of the initial investment, with the majority of tools based on SPICE requiring no or very minor changes.

  20. Usability Evaluation of an Online, Tailored Self-Management Intervention for Chronic Obstructive Pulmonary Disease Patients Incorporating Behavior Change Techniques

    PubMed Central

    Moser, Albine; van der Weijden, Trudy; Nagykaldi, Zsolt; de Vries, Hein; Tange, Huibert

    2013-01-01

    Background An eHealth intervention using computer tailored technology including several behavior change techniques was developed to support the self-management of chronic obstructive pulmonary disease patients. Objective The goal of this study was to evaluate and improve the usability of the eHealth intervention. Methods We conducted a usability evaluation with 8 chronic obstructive pulmonary disease patients, with a mixed methods design. We improved the usability through iterative cycles of evaluation and adaptation. Participants were asked to think aloud during the evaluation sessions. Participants then completed a semi-structured interview. The sessions were observed and recorded. Descriptive statistics and content analysis were used to uncover usability issues. Results Areas for improvement were layout, navigation, and content. Most issues could be solved within 3 iterations of improvement. Overall, participants found the program easy to use. The length of the program urged us to further analyze the appreciation of behavior change techniques. Some were perceived as helpful and easy to use, while others evoked frustration. Conclusions The usability study identified several issues for improvement, confirming the need for usability evaluation during the development of eHealth interventions. The uncovered strengths and limitations of behavior change techniques may lead to optimization of eHealth interventions, but further insight is needed. PMID:23612363