Sample records for adaptation planning process

  1. Climate adaptation planning in practice: an evaluation of adaptation plans from three developed nations

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

    Preston, Benjamin L; Westaway, Richard M.; Yuen, Emma J.

    2011-04-01

    Formal planning for climate change adaptation is emerging rapidly at a range of geo-political scales. This first generation of adaptation plans provides useful information regarding how institutions are framing the issue of adaptation and the range of processes that are recognized as being part of an adaptation response. To better understand adaptation planning among developed nations, a set of 57 adaptation plans from Australia, the United Kingdom and the United States was evaluated against a suite of 19 planning processes identified from existing guidance instruments for adaptation planning. Total scores among evaluated plans ranged from 16% of the maximum possiblemore » score to 61%, with an average of 37%. These results suggest adaptation plans are largely under-developed. Critical weaknesses in adaptation planning are related to limited consideration for non-climatic factors as well as neglect for issues of adaptive capacity including entitlements to various forms of capital needed for effective adaptation. Such gaps in planning suggest there are opportunities for institutions to make better use of existing guidance for adaptation planning and the need to consider the broader governance context in which adaptation will occur. In addition, the adaptation options prescribed by adaptation plans reflect a preferential bias toward low-risk capacity-building (72% of identified options) over the delivery of specific actions to reduce vulnerability. To the extent these findings are representative of the state of developed nation adaptation planning, there appear to be significant deficiencies in climate change preparedness, even among those nations often assumed to have the greatest adaptive capacity.« less

  2. SU-E-J-78: Adaptive Planning Workflow in a Pencil Beam Scanning Proton Therapy Center

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

    Blakey, M; Price, S; Robison, B

    Purpose: The susceptibility of proton therapy to changes in patient setup and anatomy necessitates an adaptive planning process. With the right planning tools and clinical workflow, an adaptive plan can be created in a timely manner without adding significant workload to the treatment planning staff. Methods: In our center, a weekly QA CT is performed on most patients to assess setup, anatomy change, and tumor response. The QA CT is fused to the treatment planning CT, the contours are transferred via deformable registration, and the plan dose is recalculated on the QA CT. A physicist assesses the dose distribution, andmore » an adaptive plan is requested based on tumor coverage or OAR dose changes. After the physician confirms or alters the deformed contours, a dosimetrist develops an adaptive plan using our TPS adaptation module. The plan is assessed for robustness and is then reviewed by the physician. Patient QA is performed within three days following the first adapted treatment. Results: Of the patients who received QA CTs, 19% required at least one adaptive plan (18.5% H&N, 18.5% brain, 11.1% breast, 14.8% chestwall, 14.8% lung, 18.5% pelvis and 3.8% abdomen). Of these patients, 14% went on a break, while the remainder was treated with the previous plan during the re-planning process. Adaptive plans were performed based on tumor shrinkage, anatomy change or positioning uncertainties for 37.9%, 44.8%, and 17.3% of the patients, respectively. On average, 3 full days are required between the QA CT and the first adapted plan treatment. Conclusion: Adaptive planning is a crucial component of proton therapy and should be applied to any site when the QA CT shows significant deviation from the plan. With an efficient workflow, an adaptive plan can be applied without delaying patient treatment or burdening the dosimetry and medical physics team.« less

  3. Poster — Thur Eve — 17: In-phantom and Fluence-based Measurements for Quality Assurance of Volumetric-driven Adaptation of Arc Therapy

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

    Schaly, B; Hoover, D; Mitchell, S

    2014-08-15

    During volumetric modulated arc therapy (VMAT) of head and neck cancer, some patients lose weight which may result in anatomical deviations from the initial plan. If these deviations are substantial a new treatment plan can be designed for the remainder of treatment (i.e., adaptive planning). Since the adaptive treatment process is resource intensive, one possible approach to streamlining the quality assurance (QA) process is to use the electronic portal imaging device (EPID) to measure the integrated fluence for the adapted plans instead of the currently-used ArcCHECK device (Sun Nuclear). Although ArcCHECK is recognized as the clinical standard for patient-specific VMATmore » plan QA, it has limited length (20 cm) for most head and neck field apertures and has coarser detector spacing than the EPID (10 mm vs. 0.39 mm). In this work we compared measurement of the integrated fluence using the EPID with corresponding measurements from the ArcCHECK device. In the past year nine patients required an adapted plan. Each of the plans (the original and adapted) is composed of two arcs. Routine clinical QA was performed using the ArcCHECK device, and the same plans were delivered to the EPID (individual arcs) in integrated mode. The dose difference between the initial plan and adapted plan was compared for ArcCHECK and EPID. In most cases, it was found that the EPID is more sensitive in detecting plan differences. Therefore, we conclude that EPID provides a viable alternative for QA of the adapted head and neck plans and should be further explored.« less

  4. Motivations and Barriers for Policymakers to Developing State Adaptation Plans

    NASA Astrophysics Data System (ADS)

    Miller, R.; Sylak-Glassman, E.

    2016-12-01

    Current approaches for developing high-quality adaptation plan require significant resources. In recent years, communities have grown to embrace adaptive plans across multiple forms, including adaptive capacity assessments, resilience strategies, and vulnerability assessments. Across the United States, as of this writing, 14 states have established adaptation plans, with another 8 states having begun the process. Given the high resources requirements and increasing interest in the development of adaptation plans, we aim to examine patterns behind the establishment of resilience plans at the state level. We examine demographic, financial, political, and physical characteristics associated with different states in an effort to explore the reasoning behind investing in the development of adaptation plans. This analysis considers quantitative and qualitative factors, including recent elections for political parties, politicians' climate-related statements and campaign promises, demographics, budgets, and regional climate threats. The analysis aims to identify motivations for state leadership taking action to develop adaptation plans. Results from the analysis seek to identify the primary drivers and barriers associated with state-wide resilience planning. These results could inform the design of scientific communication tools or approaches to aid future adaptation responses to climate change.

  5. Climate-Smart Design for Ecosystem Management: A Test Application for Coral Reefs.

    PubMed

    West, Jordan M; Courtney, Catherine A; Hamilton, Anna T; Parker, Britt A; Julius, Susan H; Hoffman, Jennie; Koltes, Karen H; MacGowan, Petra

    2017-01-01

    The interactive and cumulative impacts of climate change on natural resources such as coral reefs present numerous challenges for conservation planning and management. Climate change adaptation is complex due to climate-stressor interactions across multiple spatial and temporal scales. This leaves decision makers worldwide faced with local, regional, and global-scale threats to ecosystem processes and services, occurring over time frames that require both near-term and long-term planning. Thus there is a need for structured approaches to adaptation planning that integrate existing methods for vulnerability assessment with design and evaluation of effective adaptation responses. The Corals and Climate Adaptation Planning project of the U.S. Coral Reef Task Force seeks to develop guidance for improving coral reef management through tailored application of a climate-smart approach. This approach is based on principles from a recently-published guide which provides a framework for adopting forward-looking goals, based on assessing vulnerabilities to climate change and applying a structured process to design effective adaptation strategies. Work presented in this paper includes: (1) examination of the climate-smart management cycle as it relates to coral reefs; (2) a compilation of adaptation strategies for coral reefs drawn from a comprehensive review of the literature; (3) in-depth demonstration of climate-smart design for place-based crafting of robust adaptation actions; and (4) feedback from stakeholders on the perceived usefulness of the approach. We conclude with a discussion of lessons-learned on integrating climate-smart design into real-world management planning processes and a call from stakeholders for an "adaptation design tool" that is now under development.

  6. Adaptation Strategies to Climate Change and the Role of Planning Instruments - The Example of the Dresden Region (Saxony/Germany)

    NASA Astrophysics Data System (ADS)

    Albrecht, J.; Juta, K.; Nobis, A.

    2009-04-01

    In the past, identifying anthropogenic influences on climate change, scenario analyses and issues of climate change mitigation were predominant approaches in climate change research (IPCC 2007). Currently, for instance in Germany, climate impact research on regional level comes to the forefront of research and policy making. Climate change has become an important topic on the agenda of politicians, administration and planning. In order to counteract the (unavoidable) climate change and its impacts it is necessary to develop adaptation strategies. At present, such strategies and guidelines are formulated on international, supranational and national level. The initial point was the United Nations Framework Convention on Climate Change in 1992 where the contracting states obligated themselves to develop national (and regional) programmes for adaptation. In 2007 the European Commission published its Green Paper called Adaptation to Climate Change in Europe. The paper states that adaptation efforts have to be intensified at different (spatial) levels (local, regional, national, and so forth). Furthermore, coordinating these efforts is of high importance. With the recent agreement on the German Adaptation Strategy to Climate Change (DAS 2008) in December 2008, federal government tries to accomplish this task. The German strategy mainly focuses on two elements: decreasing vulnerability and increasing adaptability. While the above mentioned strategies have presented information and policies concerning climate change and adaptation on international, supranational and national level, such documents dońt yet exist on regional level. However, because of their close link to the local level the regions are of high importance for adaptation strategies. Therefore, the Leibniz-Institute of Ecological and Regional Development developed a transdisciplinary project to formulate and implement the so-called Integrated Regional Climate Adaptation Programme (IRCAP) for the Model Region of Dresden (project REGKLAM). The REGKLAM-project is based on regionalised scenarios of climate change and includes measures of climate change adaptation to change for instance, urban form, infrastructure assets (e.g., reservoirs) and land use. Various institutions from politics, administration, economy, and research as well as civil society are involved in the project (the city of Dresden, several ministries and authorities of Saxony, the Dresden Chamber of Industry and Commerce and the University of Dresden). The IRCAP is planned to be an informal, cross-sectoral instrument of adaptation to climate change. As a regional programme, the IRCAP is addressed to decision-makers of the region of Dresden (defined, for instance, as planning region). Its function is to complement and coordinate existing instruments and measures. These instruments also include instruments of environmental and spatial planning on the regional level. Spatial and environmental planning can rely on a wide range of formal and informal instruments on different spatial, administrative, and sectoral levels, e.g. land use and landscape plans. Our contribution to the EGU conference aims to clear the role and relevance of the existing formal and informal planning instruments in the region of Dresden for the process of developing the IRCAP. Firstly, a survey is conducted for the purpose of identifying all relevant planning instruments. The identification process is based on specific criteria, for example: reference to the region, contents relating to the topic of climate change respectively climate adaptation. Secondly, the presentation argues for a selection of those planning instruments which seem to be most relevant for the process of developing an IRCAP. This selection process is based on specific criteria which include, for instance, complexity of expected effects, reference to regional and sectoral vulnerability, opportunity for future change of the existing planning instruments (e.g., current process of updating), interests of project partners and stakeholders. Thirdly, as a result, an overview of relevant planning instruments in the region of Dresden is shown, including their current status and statements about their relevance for the topic of climate adaptation strategies. Finally it is derived that this procedure provides a basis for the following possibilities: Adapting existing planning instruments, integrate contents of existing planning instruments in the IRCAP process, or develop and define new strategies or measures on the way to an IRCAP.

  7. Beyond Reduction: Climate Change Adaptation Planning for Universities and Colleges

    ERIC Educational Resources Information Center

    Owen, Rochelle; Fisher, Erica; McKenzie, Kyle

    2013-01-01

    Purpose: The purpose of this paper is to outline a unique six-step process for the inclusion of climate change adaption goals and strategies in a University Climate Change Plan. Design/methodology/approach: A mixed-method approach was used to gather data on campus climate change vulnerabilities and adaption strategies. A literature review…

  8. Adaptive management and the Northwest Forest Plan: rhetoric and reality.

    Treesearch

    G.H. Stankey; B.T. Bormann; C. Ryan; B. Shindler; V. Sturtevant; R.N. Clark; C. Philpot

    2003-01-01

    Adaptive management represents a process to use management policies as a source of learning, which in turn can inform subsequent actions. However, despite its appealing and apparently straightforward objectives, examples of successful implementation remain elusive, and a review of efforts to implement an adaptive approach in the Northwest Forest Plan proves the point....

  9. A Meta-Analysis of Urban Climate Change Adaptation ...

    EPA Pesticide Factsheets

    The concentration of people, infrastructure, and ecosystem services in urban areas make them prime sites for climate change adaptation. While advances have been made in developing frameworks for adaptation planning and identifying both real and potential barriers to action, empirical work evaluating urban adaptation planning processes has been relatively piecemeal. Existing assessments of current experience with urban adaptation provide necessarily broad generalizations based on the available peer-reviewed literature. This paper uses a meta-analysis of U.S. cities’ current experience with urban adaptation planning drawing from 54 sources that include peer-reviewed literature, government reports, white papers, and reports published by non-governmental organizations. The analysis specifically evaluates the institutional support structures being developed for urban climate change adaptation. The results demonstrate that adaptation planning is driven by a desire to reduce vulnerability and often catalyzes new collaborations and coordination mechanisms in urban governance. As a result, building capacity for urban climate change adaptation planning requires a focus not only on city governments themselves but also on the complex horizontal and vertical networks that have arisen around such efforts. Existing adaptation planning often lacks attention to equity issues, social vulnerability, and the influence of non-climatic factors on vulnerability. Engaging city govern

  10. Approaches to evaluating climate change impacts on species: A guide to initiating the adaptation planning process

    Treesearch

    Erika L. Rowland; Jennifer E. Davison; Lisa J. Graumlich

    2011-01-01

    Assessing the impact of climate change on species and associated management objectives is a critical initial step for engaging in the adaptation planning process. Multiple approaches are available. While all possess limitations to their application associated with the uncertainties inherent in the data and models that inform their results, conducting and incorporating...

  11. Reflections on the Adaptive Designs Accelerating Promising Trials Into Treatments (ADAPT-IT) Process—Findings from a Qualitative Study

    PubMed Central

    Guetterman, Timothy C.; Fetters, Michael D.; Legocki, Laurie J.; Mawocha, Samkeliso; Barsan, William G.; Lewis, Roger J.; Berry, Donald A.; Meurer, William J.

    2015-01-01

    Context The context for this study was the Adaptive Designs Advancing Promising Treatments Into Trials (ADAPT-IT) project, which aimed to incorporate flexible adaptive designs into pivotal clinical trials and to conduct an assessment of the trial development process. Little research provides guidance to academic institutions in planning adaptive trials. Objectives The purpose of this qualitative study was to explore the perspectives and experiences of stakeholders as they reflected back about the interactive ADAPT-IT adaptive design development process, and to understand their perspectives regarding lessons learned about the design of the trials and trial development. Materials and methods We conducted semi-structured interviews with ten key stakeholders and observations of the process. We employed qualitative thematic text data analysis to reduce the data into themes about the ADAPT-IT project and adaptive clinical trials. Results The qualitative analysis revealed four themes: education of the project participants, how the process evolved with participant feedback, procedures that could enhance the development of other trials, and education of the broader research community. Discussion and conclusions While participants became more likely to consider flexible adaptive designs, additional education is needed to both understand the adaptive methodology and articulate it when planning trials. PMID:26622163

  12. An Accelerated Path to Assisting At-Risk Communities Adapt to Climate Change

    NASA Astrophysics Data System (ADS)

    Socci, A.

    2010-12-01

    Merely throwing money at adaptation is not development. Nor can the focus of adaptation assistance be development alone. Rather, adaptation assistance is arguably best served when it is country- or community-driven, and the overarching process is informed and guided by a set of underlying principles or a philosophy of action that primarily aims at improving the lives and livelihoods of affected communities. In the instance of adaptation assistance, I offer the following three guiding principles: 1. adaptation is at its core, about people; 2. adaptation is not merely an investment opportunity or suite of projects but a process, a lifestyle; and 3. adaptation cannot take place by proxy; nor can it be imposed on others by outside entities. With principles in hand, a suggested first step toward action is to assess what resources, capacity and skills one is capable of bringing to the table and whether these align with community needs. Clearly issues of scale demand a strategic approach in the interest of avoiding overselling and worse, creating false expectations. And because adaptation is a process, consider how best to ensure that adaptation activities remain sustainable by virtue of enhancing community capacity, resiliency and expertise should assistance and/or resources dwindle or come to an end. While not necessarily a first step, community engagement is undoubtedly the most critical element in any assistance process, requiring sorting out and agreeing upon terms of cooperation and respective roles and responsibilities, aspects of which should include discussions on how to assess the efficacy of resource use, how to assess progress, success or outcomes, what constitutes same, and who decides. It is virtually certain that adaptation activities are unlikely to take hold or maintain if they are not community led, community driven or community owned. There is no adaptation by proxy or fiat. It's fair to ask at this point, how might one know what communities and countries need, what and where the opportunities are to assist countries and communities in adapting to climate change, and how might one get started? One of the most effective and efficient ways of identifying community/country needs, assistance opportunities and community/country entry points is to search the online archive of National Adaptation Programmes of Action (NAPAs) that many of the least developed countries have already assembled in conformance with the UNFCCC process. Better still perhaps, consider focusing on community-scale assessments and adaptation action plans that have already been compiled by various communities seeking assistance as national plans are unlikely to capture the nuances and variability of community needs. Unlike NAPAs, such plans are not archived in a central location. Yet clearly, community-scale plans in particular, not only represent an assessment of community needs and plans, presumptively crafted by affected communities, but also represent opportunities to align assistance resources and capacity with community needs, providing the basis for engaging affected communities in an accelerated process. Simply stated, take full advantage of the multitude of assessment and planning efforts that communities have already engaged in on their own behalf.

  13. A Review of National-Level Adaptation Planning with Regards to the Risks Posed by Climate Change on Infectious Diseases in 14 OECD Nations

    PubMed Central

    Panic, Mirna; Ford, James D.

    2013-01-01

    Climate change is likely to have significant implications for human health, particularly through alterations of the incidence, prevalence, and distribution of infectious diseases. In the context of these risks, governments in high income nations have begun developing strategies to reduce potential climate change impacts and increase health system resilience (i.e., adaptation). In this paper, we review and evaluate national-level adaptation planning in relation to infectious disease risks in 14 OECD countries with respect to “best practices” for adaptation identified in peer-reviewed literature. We find a number of limitations to current planning, including negligible consideration of the needs of vulnerable population groups, limited emphasis on local risks, and inadequate attention to implementation logistics, such as available funding and timelines for evaluation. The nature of planning documents varies widely between nations, four of which currently lack adaptation plans. In those countries where planning documents were available, adaptations were mainstreamed into existing public health programs, and prioritized a sectoral, rather than multidisciplinary, approach. The findings are consistent with other scholarship examining adaptation planning indicating an ad hoc and fragmented process, and support the need for enhanced attention to adaptation to infectious disease risks in public health policy at a national level. PMID:24351735

  14. The role of CQI in the strategic planning process.

    PubMed

    Sahney, V K; Warden, G L

    1993-01-01

    This article describes the strategic planning process used to define the health care needs of a region and to prepare Henry Ford Health System (HFHS) to meet the needs of the 21st century. It presents key applications of continuous quality improvement in the development and implementation of the strategic plans for HFHS; explains how HFHS adapted the Deming/Shewhart cycle of continuous improvement for the purpose of improving its planning process; and delineates how the strategic planning, financial planning, and quality planning processes have been integrated.

  15. Improving our legacy: Incorporation of adaptive management into state wildlife action plans

    USGS Publications Warehouse

    Fontaine, J.J.

    2011-01-01

    The loss of biodiversity is a mounting concern, but despite numerous attempts there are few large scale conservation efforts that have proven successful in reversing current declines. Given the challenge of biodiversity conservation, there is a need to develop strategic conservation plans that address species declines even with the inherent uncertainty in managing multiple species in complex environments. In 2002, the State Wildlife Grant program was initiated to fulfill this need, and while not explicitly outlined by Congress follows the fundamental premise of adaptive management, 'Learning by doing'. When action is necessary, but basic biological information and an understanding of appropriate management strategies are lacking, adaptive management enables managers to be proactive in spite of uncertainty. However, regardless of the strengths of adaptive management, the development of an effective adaptive management framework is challenging. In a review of 53 State Wildlife Action Plans, I found a keen awareness by planners that adaptive management was an effective method for addressing biodiversity conservation, but the development and incorporation of explicit adaptive management approaches within each plan remained elusive. Only ???25% of the plans included a framework for how adaptive management would be implemented at the project level within their state. There was, however, considerable support across plans for further development and implementation of adaptive management. By furthering the incorporation of adaptive management principles in conservation plans and explicitly outlining the decision making process, states will be poised to meet the pending challenges to biodiversity conservation. ?? 2010 .

  16. Improving our legacy: incorporation of adaptive management into state wildlife action plans.

    PubMed

    Fontaine, Joseph J

    2011-05-01

    The loss of biodiversity is a mounting concern, but despite numerous attempts there are few large scale conservation efforts that have proven successful in reversing current declines. Given the challenge of biodiversity conservation, there is a need to develop strategic conservation plans that address species declines even with the inherent uncertainty in managing multiple species in complex environments. In 2002, the State Wildlife Grant program was initiated to fulfill this need, and while not explicitly outlined by Congress follows the fundamental premise of adaptive management, 'Learning by doing'. When action is necessary, but basic biological information and an understanding of appropriate management strategies are lacking, adaptive management enables managers to be proactive in spite of uncertainty. However, regardless of the strengths of adaptive management, the development of an effective adaptive management framework is challenging. In a review of 53 State Wildlife Action Plans, I found a keen awareness by planners that adaptive management was an effective method for addressing biodiversity conservation, but the development and incorporation of explicit adaptive management approaches within each plan remained elusive. Only ~25% of the plans included a framework for how adaptive management would be implemented at the project level within their state. There was, however, considerable support across plans for further development and implementation of adaptive management. By furthering the incorporation of adaptive management principles in conservation plans and explicitly outlining the decision making process, states will be poised to meet the pending challenges to biodiversity conservation. Published by Elsevier Ltd.

  17. Using planned adaptation to implement evidence-based programs with new populations.

    PubMed

    Lee, Shawna J; Altschul, Inna; Mowbray, Carol T

    2008-06-01

    The Interactive Systems Framework (ISF) for Dissemination and Implementation (Wandersman et al. 2008) elaborates the functions and structures that move evidence-based programs (EBPs) from research to practice. Inherent in that process is the tension between implementing programs with fidelity and the need to tailor programs to fit the target population. We propose Planned Adaptation as one approach to resolve this tension, with the goal of guiding practitioners in adapting EBPs so that they maintain core components of program theory while taking into account the needs of particular populations. Planned Adaptation is a form of capacity building within the Prevention Support System that provides a framework to guide practitioners in adapting programs while encouraging researchers to provide information relevant to adaptation as a critical aspect of dissemination research, with the goal of promoting wider dissemination and better implementation of EBPs. We illustrate Planned Adaptation using the JOBS Program (Caplan et al. 1989), which was developed for recently laid-off, working- and middle-class workers and subsequently implemented with welfare recipients.

  18. SU-F-J-105: Towards a Novel Treatment Planning Pipeline Delivering Pareto- Optimal Plans While Enabling Inter- and Intrafraction Plan Adaptation

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

    Kontaxis, C; Bol, G; Lagendijk, J

    2016-06-15

    Purpose: To develop a new IMRT treatment planning methodology suitable for the new generation of MR-linear accelerator machines. The pipeline is able to deliver Pareto-optimal plans and can be utilized for conventional treatments as well as for inter- and intrafraction plan adaptation based on real-time MR-data. Methods: A Pareto-optimal plan is generated using the automated multicriterial optimization approach Erasmus-iCycle. The resulting dose distribution is used as input to the second part of the pipeline, an iterative process which generates deliverable segments that target the latest anatomical state and gradually converges to the prescribed dose. This process continues until a certainmore » percentage of the dose has been delivered. Under a conventional treatment, a Segment Weight Optimization (SWO) is then performed to ensure convergence to the prescribed dose. In the case of inter- and intrafraction adaptation, post-processing steps like SWO cannot be employed due to the changing anatomy. This is instead addressed by transferring the missing/excess dose to the input of the subsequent fraction. In this work, the resulting plans were delivered on a Delta4 phantom as a final Quality Assurance test. Results: A conventional static SWO IMRT plan was generated for two prostate cases. The sequencer faithfully reproduced the input dose for all volumes of interest. For the two cases the mean relative dose difference of the PTV between the ideal input and sequenced dose was 0.1% and −0.02% respectively. Both plans were delivered on a Delta4 phantom and passed the clinical Quality Assurance procedures by achieving 100% pass rate at a 3%/3mm gamma analysis. Conclusion: We have developed a new sequencing methodology capable of online plan adaptation. In this work, we extended the pipeline to support Pareto-optimal input and clinically validated that it can accurately achieve these ideal distributions, while its flexible design enables inter- and intrafraction plan adaptation. This research is financially supported by Elekta AB, Stockholm, Sweden.« less

  19. Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women.

    PubMed

    Highfield, Linda; Hartman, Marieke A; Mullen, Patricia Dolan; Rodriguez, Serena A; Fernandez, Maria E; Bartholomew, L Kay

    2015-01-01

    This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI.

  20. Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women

    PubMed Central

    Highfield, Linda; Hartman, Marieke A.; Mullen, Patricia Dolan; Fernandez, Maria E.; Bartholomew, L. Kay

    2015-01-01

    This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI. PMID:26587531

  1. The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project.

    PubMed

    Guetterman, Timothy C; Fetters, Michael D; Mawocha, Samkeliso; Legocki, Laurie J; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

    2017-01-01

    Clinical trials are complicated, expensive, time-consuming, and frequently do not lead to discoveries that improve the health of patients with disease. Adaptive clinical trials have emerged as a methodology to provide more flexibility in design elements to better answer scientific questions regarding whether new treatments are efficacious. Limited observational data exist that describe the complex process of designing adaptive clinical trials. To address these issues, the Adaptive Designs Accelerating Promising Treatments Into Trials project developed six, tailored, flexible, adaptive, phase-III clinical trials for neurological emergencies, and investigators prospectively monitored and observed the processes. The objective of this work is to describe the adaptive design development process, the final design, and the current status of the adaptive trial designs that were developed. To observe and reflect upon the trial development process, we employed a rich, mixed methods evaluation that combined quantitative data from visual analog scale to assess attitudes about adaptive trials, along with in-depth qualitative data about the development process gathered from observations. The Adaptive Designs Accelerating Promising Treatments Into Trials team developed six adaptive clinical trial designs. Across the six designs, 53 attitude surveys were completed at baseline and after the trial planning process completed. Compared to baseline, the participants believed significantly more strongly that the adaptive designs would be accepted by National Institutes of Health review panels and non-researcher clinicians. In addition, after the trial planning process, the participants more strongly believed that the adaptive design would meet the scientific and medical goals of the studies. Introducing the adaptive design at early conceptualization proved critical to successful adoption and implementation of that trial. Involving key stakeholders from several scientific domains early in the process appears to be associated with improved attitudes towards adaptive designs over the life cycle of clinical trial development.

  2. Science-based Forest Management in an Era of Climate Change

    NASA Astrophysics Data System (ADS)

    Swanston, C.; Janowiak, M.; Brandt, L.; Butler, P.; Handler, S.; Shannon, D.

    2014-12-01

    Recognizing the need to provide climate adaptation information, training, and tools to forest managers, the Forest Service joined with partners in 2009 to launch a comprehensive effort called the Climate Change Response Framework (www.forestadaptation.org). The Framework provides a structured approach to help managers integrate climate considerations into forest management plans and then implement adaptation actions on the ground. A planning tool, the Adaptation Workbook, is used in conjunction with vulnerability assessments and a diverse "menu" of adaptation approaches to generate site-specific adaptation actions that meet explicit management objectives. Additionally, a training course, designed around the Adaptation Workbook, leads management organizations through this process of designing on-the-ground adaptation tactics for their management projects. The Framework is now being actively pursued in 20 states in the Northwoods, Central Hardwoods, Central Appalachians, Mid-Atlantic, and New England. The Framework community includes over 100 science and management groups, dozens of whom have worked together to complete six ecoregional vulnerability assessments covering nearly 135 million acres. More than 75 forest and urban forest adaptation strategies and approaches were synthesized from peer-reviewed and gray literature, expert solicitation, and on-the-ground adaptation projects. These are being linked through the Adaptation Workbook process to on-the-ground adaptation tactics being planned and employed in more than 50 adaptation "demonstrations". This presentation will touch on the scientific and professional basis of the vulnerability assessments, and showcase efforts where adaptation actions are currently being implemented in forests.

  3. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs.

    PubMed

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Graves, Yan Jiang; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

    2013-12-21

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using our in-house optimization engine.

  4. MO-B-BRB-01: Optimize Treatment Planning Process in Clinical Environment

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

    Feng, W.

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

  5. MO-B-BRB-00: Optimizing the Treatment Planning Process

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

    NONE

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

  6. MO-B-BRB-03: Systems Engineering Tools for Treatment Planning Process Optimization in Radiation Medicine

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

    Kapur, A.

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

  7. Untangling Risk in Water Supply Systems: What Factors Drive Long-term Adaptation?

    NASA Astrophysics Data System (ADS)

    Zeff, H. B.; Lin, L.; Band, L. E.; Reed, P. M.; Characklis, G. W.

    2016-12-01

    Deeply uncertain factors like climate change, the hydrologic impacts of urbanization, forest evolution, and long-term demand forecasts make water supply planning a `wicked' problem. The traditional technique of assessing risk based on historical observations can be inadequate in the face of environmental non-stationarity. However, competing models and limited observational data make it difficult for decision makers and experts to agree on how much uncertainty should be built into analyses of risk, particularly at the timescales relevant to long-term investments in water infrastructure. Further, the physical connectivity of these deeply uncertain processes create inter-related systems, amplifying the challenges of a `worst case scenario'. The development of adaptive systems and planning processes provide solutions that have been shown to meet technical, environmental, and social objectives at lower costs. Instead of developing plans with fixed targets for the timing of actions, adaptive plans develop risk metrics and thresholds that are able to integrate new information to determine when conditions reach a `tipping point' which necessitates action. It is an open question as to how new information can be best integrated into the decision-making process (i.e. how much weight do we give new observations relative to the historical record), but a better understanding of the way the relevant systems are expected to evolve and change over time could inform these decisions. In this study, we use linked, dynamic models of temperature and precipitation changes, forest evolution, urbanization, hydrology, and water demand to develop scenarios for an adaptive water management framework that uses risk-based metrics to make short- and long-term decisions. The impact of individual environmental processes on the adaptive capability of this management framework is evaluated through problem formulations that successively increase the complexity of the uncertainty scenarios. Although this work is focused on a group of water utilities in the Research Triangle of North Carolina, results provide insights into the conditions under which environmental changes could outpace our adaptive skill. In turn, risk measures can be designed to identify these conditions and better inform adaptive planning methods.

  8. MO-B-BRB-02: Maintain the Quality of Treatment Planning for Time-Constraint Cases

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

    Chang, J.

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

  9. Guideline adaptation and implementation planning: a prospective observational study

    PubMed Central

    2013-01-01

    Background Adaptation of high-quality practice guidelines for local use has been advanced as an efficient means to improve acceptability and applicability of evidence-informed care. In a pan-Canadian study, we examined how cancer care groups adapted pre-existing guidelines to their unique context and began implementation planning. Methods Using a mixed-methods, case-study design, five cases were purposefully sampled from self-identified groups and followed as they used a structured method and resources for guideline adaptation. Cases received the ADAPTE Collaboration toolkit, facilitation, methodological and logistical support, resources and assistance as required. Documentary and primary data collection methods captured individual case experience, including monthly summaries of meeting and field notes, email/telephone correspondence, and project records. Site visits, process audits, interviews, and a final evaluation forum with all cases contributed to a comprehensive account of participant experience. Results Study cases took 12 to >24 months to complete guideline adaptation. Although participants appreciated the structure, most found the ADAPTE method complex and lacking practical aspects. They needed assistance establishing individual guideline mandate and infrastructure, articulating health questions, executing search strategies, appraising evidence, and achieving consensus. Facilitation was described as a multi-faceted process, a team effort, and an essential ingredient for guideline adaptation. While front-line care providers implicitly identified implementation issues during adaptation, they identified a need to add an explicit implementation planning component. Conclusions Guideline adaptation is a positive initial step toward evidence-informed care, but adaptation (vs. ‘de novo’ development) did not meet expectations for reducing time or resource commitments. Undertaking adaptation is as much about the process (engagement and capacity building) as it is about the product (adapted guideline). To adequately address local concerns, cases found it necessary to also search and appraise primary studies, resulting in hybrid (adaptation plus de novo) guideline development strategies that required advanced methodological skills. Adaptation was found to be an action element in the knowledge translation continuum that required integration of an implementation perspective. Accordingly, the adaptation methodology and resources were reformulated and substantially augmented to provide practical assistance to groups not supported by a dedicated guideline panel and to provide more implementation planning support. The resulting framework is called CAN-IMPLEMENT. PMID:23656884

  10. Developing Capacity for Cities to Adapt to a Changing Climate-a Case Study in Boulder, Colorado

    NASA Astrophysics Data System (ADS)

    Sands, R.; Groves, D. G.; Nason, M.; Pandya, R.

    2016-12-01

    The City of Boulder in Colorado has undertaken many progressive climate-related initiatives, from signing the Kyoto protocol to passing a Climate Action Tax. But as the city prepared to launch its Climate Commitment document and lead a community process, it realized that one critical group that had not been fully engaged in the process was its own staff. It became clear that for organizational change to occur and for the city to meet its goals, city staff needed to develop a deeper understanding of the importance of the climate goals while also learning better how to use these goals to guide their long-term planning. In early 2016, the city launched a year-long "Climate Leaders" initiative which comprised of a series of workshops that brought together over 70 staff members with climate scientists and experts in climate adaptation planning. The first two workshops, billed as Climate 101 and 201, reviewed the best available scientific information about climate threats and potential impacts, and worked with participants to understand how climate changes could affect diverse city functions. These interactive workshops also explored ways to help city staff feel comfortable preparing for a significantly different climate and discussed ways to communicate this information to the public. From there the group split into two tracks. A "mitigation" track focused on the ways in which Boulder could meet its aggressive emissions reduction targets. The "adaptation" track developed integrated scenarios for citywide planning to highlight Boulder's vulnerability to climate change and guide adaptation planning. Bringing these two conversations together is helping city staff to explore critical linkages between mitigation and adaptation, develop common messages to build community support for climate action, and inform comprehensive climate resiliency planning. We will describe how Boulder successfully partnered with scientists and planning experts to program a year of interactive workshops to bring diverse city staff into the climate action process. We will share outcomes from the development of the integrated climate scenarios vulnerability assessment and adaptation planning. Lastly we will share key lessons learned that will be valuable to other cities and jurisdictions engaging in similar climate action.

  11. Strategic survey framework for the Northwest Forest Plan survey and manage program.

    Treesearch

    Randy Molina; Dan McKenzie; Robin Lesher; Jan Ford; Jim Alegria; Richard Cutler

    2003-01-01

    This document outlines an iterative process for assessing the information needs for all Northwest Forest Plan (NWFP) survey and manage species, designing and implementing strategic surveys (including field surveys and other information-gathering processes), and analyzing that information for use in the NWFP annual species review and adaptive-management processes. The...

  12. The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project

    PubMed Central

    Guetterman, Timothy C; Fetters, Michael D; Mawocha, Samkeliso; Legocki, Laurie J; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

    2017-01-01

    Objectives: Clinical trials are complicated, expensive, time-consuming, and frequently do not lead to discoveries that improve the health of patients with disease. Adaptive clinical trials have emerged as a methodology to provide more flexibility in design elements to better answer scientific questions regarding whether new treatments are efficacious. Limited observational data exist that describe the complex process of designing adaptive clinical trials. To address these issues, the Adaptive Designs Accelerating Promising Treatments Into Trials project developed six, tailored, flexible, adaptive, phase-III clinical trials for neurological emergencies, and investigators prospectively monitored and observed the processes. The objective of this work is to describe the adaptive design development process, the final design, and the current status of the adaptive trial designs that were developed. Methods: To observe and reflect upon the trial development process, we employed a rich, mixed methods evaluation that combined quantitative data from visual analog scale to assess attitudes about adaptive trials, along with in-depth qualitative data about the development process gathered from observations. Results: The Adaptive Designs Accelerating Promising Treatments Into Trials team developed six adaptive clinical trial designs. Across the six designs, 53 attitude surveys were completed at baseline and after the trial planning process completed. Compared to baseline, the participants believed significantly more strongly that the adaptive designs would be accepted by National Institutes of Health review panels and non-researcher clinicians. In addition, after the trial planning process, the participants more strongly believed that the adaptive design would meet the scientific and medical goals of the studies. Conclusion: Introducing the adaptive design at early conceptualization proved critical to successful adoption and implementation of that trial. Involving key stakeholders from several scientific domains early in the process appears to be associated with improved attitudes towards adaptive designs over the life cycle of clinical trial development. PMID:29085638

  13. Convergence Properties of a Class of Probabilistic Adaptive Schemes Called Sequential Reproductive Plans. Psychology and Education Series, Technical Report No. 210.

    ERIC Educational Resources Information Center

    Martin, Nancy

    Presented is a technical report concerning the use of a mathematical model describing certain aspects of the duplication and selection processes in natural genetic adaptation. This reproductive plan/model occurs in artificial genetics (the use of ideas from genetics to develop general problem solving techniques for computers). The reproductive…

  14. Climate Risk Informed Decision Analysis: A Hypothetical Application to the Waas Region

    NASA Astrophysics Data System (ADS)

    Gilroy, Kristin; Mens, Marjolein; Haasnoot, Marjolijn; Jeuken, Ad

    2016-04-01

    More frequent and intense hydrologic events under climate change are expected to enhance water security and flood risk management challenges worldwide. Traditional planning approaches must be adapted to address climate change and develop solutions with an appropriate level of robustness and flexibility. The Climate Risk Informed Decision Analysis (CRIDA) method is a novel planning approach embodying a suite of complementary methods, including decision scaling and adaptation pathways. Decision scaling offers a bottom-up approach to assess risk and tailors the complexity of the analysis to the problem at hand and the available capacity. Through adaptation pathway,s an array of future strategies towards climate robustness are developed, ranging in flexibility and immediacy of investments. Flexible pathways include transfer points to other strategies to ensure that the system can be adapted if future conditions vary from those expected. CRIDA combines these two approaches in a stakeholder driven process which guides decision makers through the planning and decision process, taking into account how the confidence in the available science, the consequences in the system, and the capacity of institutions should influence strategy selection. In this presentation, we will explain the CRIDA method and compare it to existing planning processes, such as the US Army Corps of Engineers Principles and Guidelines as well as Integrated Water Resources Management Planning. Then, we will apply the approach to a hypothetical case study for the Waas Region, a large downstream river basin facing rapid development threatened by increased flood risks. Through the case study, we will demonstrate how a stakeholder driven process can be used to evaluate system robustness to climate change; develop adaptation pathways for multiple objectives and criteria; and illustrate how varying levels of confidence, consequences, and capacity would play a role in the decision making process, specifically in regards to the level of robustness and flexibility in the selected strategy. This work will equip practitioners and decision makers with an example of a structured process for decision making under climate uncertainty that can be scaled as needed to the problem at hand. This presentation builds further on another submitted abstract "Climate Risk Informed Decision Analysis (CRIDA): A novel practical guidance for Climate Resilient Investments and Planning" by Jeuken et al.

  15. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs

    NASA Astrophysics Data System (ADS)

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Jiang Graves, Yan; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

    2013-12-01

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using our in-house optimization engine. This work was originally presented at the 54th AAPM annual meeting in Charlotte, NC, July 29-August 2, 2012.

  16. Online adaptation and over-trial learning in macaque visuomotor control.

    PubMed

    Braun, Daniel A; Aertsen, Ad; Paz, Rony; Vaadia, Eilon; Rotter, Stefan; Mehring, Carsten

    2011-01-01

    When faced with unpredictable environments, the human motor system has been shown to develop optimized adaptation strategies that allow for online adaptation during the control process. Such online adaptation is to be contrasted to slower over-trial learning that corresponds to a trial-by-trial update of the movement plan. Here we investigate the interplay of both processes, i.e., online adaptation and over-trial learning, in a visuomotor experiment performed by macaques. We show that simple non-adaptive control schemes fail to perform in this task, but that a previously suggested adaptive optimal feedback control model can explain the observed behavior. We also show that over-trial learning as seen in learning and aftereffect curves can be explained by learning in a radial basis function network. Our results suggest that both the process of over-trial learning and the process of online adaptation are crucial to understand visuomotor learning.

  17. Online Adaptation and Over-Trial Learning in Macaque Visuomotor Control

    PubMed Central

    Braun, Daniel A.; Aertsen, Ad; Paz, Rony; Vaadia, Eilon; Rotter, Stefan; Mehring, Carsten

    2011-01-01

    When faced with unpredictable environments, the human motor system has been shown to develop optimized adaptation strategies that allow for online adaptation during the control process. Such online adaptation is to be contrasted to slower over-trial learning that corresponds to a trial-by-trial update of the movement plan. Here we investigate the interplay of both processes, i.e., online adaptation and over-trial learning, in a visuomotor experiment performed by macaques. We show that simple non-adaptive control schemes fail to perform in this task, but that a previously suggested adaptive optimal feedback control model can explain the observed behavior. We also show that over-trial learning as seen in learning and aftereffect curves can be explained by learning in a radial basis function network. Our results suggest that both the process of over-trial learning and the process of online adaptation are crucial to understand visuomotor learning. PMID:21720526

  18. Adaptation Design Tool for Climate-Smart Management of Coral Reefs and Other Natural Resources.

    PubMed

    West, Jordan M; Courtney, Catherine A; Hamilton, Anna T; Parker, Britt A; Gibbs, David A; Bradley, Patricia; Julius, Susan H

    2018-06-22

    Scientists and managers of natural resources have recognized an urgent need for improved methods and tools to enable effective adaptation of management measures in the face of climate change. This paper presents an Adaptation Design Tool that uses a structured approach to break down an otherwise overwhelming and complex process into tractable steps. The tool contains worksheets that guide users through a series of design considerations for adapting their planned management actions to be more climate-smart given changing environmental stressors. Also provided with other worksheets is a framework for brainstorming new adaptation options in response to climate threats not yet addressed in the current plan. Developed and tested in collaboration with practitioners in Hawai'i and Puerto Rico using coral reefs as a pilot ecosystem, the tool and associated reference materials consist of worksheets, instructions and lessons-learned from real-world examples. On the basis of stakeholder feedback from expert consultations during tool development, we present insights and recommendations regarding how to maximize tool efficiency, gain the greatest value from the thought process, and deal with issues of scale and uncertainty. We conclude by reflecting on how the tool advances the theory and practice of assessment and decision-making science, informs higher level strategic planning, and serves as a platform for a systematic, transparent and inclusive process to tackle the practical implications of climate change for management of natural resources.

  19. Adopting best practices: "Agility" moves from software development to healthcare project management.

    PubMed

    Kitzmiller, Rebecca; Hunt, Eleanor; Sproat, Sara Breckenridge

    2006-01-01

    It is time for a change in mindset in how nurses operationalize system implementations and manage projects. Computers and systems have evolved over time from unwieldy mysterious machines of the past to ubiquitous computer use in every aspect of daily lives and work sites. Yet, disconcertingly, the process used to implement these systems has not evolved. Technology implementation does not need to be a struggle. It is time to adapt traditional plan-driven implementation methods to incorporate agile techniques. Agility is a concept borrowed from software development and is presented here because it encourages flexibility, adaptation, and continuous learning as part of the implementation process. Agility values communication and harnesses change to an advantage, which facilitates the natural evolution of an adaptable implementation process. Specific examples of agility in an implementation are described, and plan-driven implementation stages are adapted to incorporate relevant agile techniques. This comparison demonstrates how an agile approach enhances traditional implementation techniques to meet the demands of today's complex healthcare environments.

  20. 33 CFR 385.11 - Implementation process for projects.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... figure 1 in Appendix A of this part. Typical steps in this process involve: (a) Project Management Plan. The Project Management Plan describes the activities, tasks, and responsibilities that will be used to... effectiveness of the project and to provide information that will be used for the adaptive management program. ...

  1. The Adapted Dance Process: Planning, Partnering, and Performing

    ERIC Educational Resources Information Center

    Block, Betty A.; Johnson, Peggy V.

    2011-01-01

    This article contains specific planning, partnering, and performing techniques for fully integrating dancers with special needs into a dance pedagogy program. Each aspect is discussed within the context of the domains of learning. Fundamental partnering strategies are related to each domain as part of the integration process. The authors recommend…

  2. 33 CFR 385.11 - Implementation process for projects.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... figure 1 in Appendix A of this part. Typical steps in this process involve: (a) Project Management Plan. The Project Management Plan describes the activities, tasks, and responsibilities that will be used to... effectiveness of the project and to provide information that will be used for the adaptive management program. ...

  3. 33 CFR 385.11 - Implementation process for projects.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... figure 1 in appendix A of this part. Typical steps in this process involve: (a) Project Management Plan. The Project Management Plan describes the activities, tasks, and responsibilities that will be used to... effectiveness of the project and to provide information that will be used for the adaptive management program. ...

  4. 33 CFR 385.11 - Implementation process for projects.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... figure 1 in Appendix A of this part. Typical steps in this process involve: (a) Project Management Plan. The Project Management Plan describes the activities, tasks, and responsibilities that will be used to... effectiveness of the project and to provide information that will be used for the adaptive management program. ...

  5. 33 CFR 385.11 - Implementation process for projects.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... figure 1 in Appendix A of this part. Typical steps in this process involve: (a) Project Management Plan. The Project Management Plan describes the activities, tasks, and responsibilities that will be used to... effectiveness of the project and to provide information that will be used for the adaptive management program. ...

  6. Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress

    NASA Astrophysics Data System (ADS)

    Anhalt-Depies, Christine M.; Knoot, Tricia Gorby; Rissman, Adena R.; Sharp, Anthony K.; Martin, Karl J.

    2016-05-01

    There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

  7. Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress.

    PubMed

    Anhalt-Depies, Christine M; Knoot, Tricia Gorby; Rissman, Adena R; Sharp, Anthony K; Martin, Karl J

    2016-05-01

    There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

  8. Feasibility of Adaptive MR-guided Stereotactic Body Radiotherapy (SBRT) of Lung Tumors

    PubMed Central

    Simpson, Garrett N; Llorente, Ricardo; Samuels, Michael A; Dogan, Nesrin

    2018-01-01

    Online adaptive radiotherapy (ART) with frequent imaging has the potential to improve dosimetric accuracy by accounting for anatomical and functional changes during the course of radiotherapy. Presented are three interesting cases that provide an assessment of online adaptive magnetic resonance-guided radiotherapy (MRgRT) for lung stereotactic body radiotherapy (SBRT). The study includes three lung SBRT cases, treated on an MRgRT system where MR images were acquired for planning and prior to each treatment fraction. Prescription dose ranged from 48 to 50 Gy in four to five fractions, normalized to where 95% of the planning target volume (PTV) was covered by 100% of the prescription dose. The process begins with the gross tumor volume (GTV), PTV, spinal cord, lungs, heart, and esophagus being delineated on the planning MRI. The treatment plan was then generated using a step-and-shoot intensity modulated radiotherapy (IMRT) technique, which utilized a Monte Carlo dose calculation. Next, the target and organs at risk (OAR) contours from the planning MRI were deformably propagated to the daily setup MRIs. These deformed contours were reviewed and modified by the physician. To determine the efficacy of ART, two different strategies were explored: 1) Calculating the plan created for the planning MR on each fraction setup MR dataset (Non-Adapt) and 2) creating a new optimized IMRT plan on the fraction setup MR dataset (FxAdapt). The treatment plans from both strategies were compared using the clinical dose-volume constraints. PTV coverage constraints were not met for 33% Non-Adapt fractions; all FxAdapt fractions met this constraint. Eighty-eight percent of all OAR constraints studied were better on FxAdapt plans, while 12% of OAR constraints were superior on Non-Adapt fractions. The OAR that garnered the largest benefit would be the uninvolved lung, with superior sparing in 92% of the FxAdapt studied. Similar, but less pronounced, benefits from adaptive planning were experienced for the spinal cord, chest wall, and esophagus. Online adaptive MR-guided lung SBRT can provide better target conformality and homogeneity and OAR sparing compared with non-adaptive SBRT in selected cases. Conversely, if the PTV isn’t adjacent to multiple OARs, then the benefit from ART may be limited. Further studies, which incorporate a larger cohort of patients with uniform prescriptions, are needed to thoroughly evaluate the benefits of daily online ART during MRgRT. PMID:29872603

  9. Developing Coastal Adaptation to Climate Change in the New York City Infrastructure-Shed: Process, Approach, Tools, and Strategies

    NASA Technical Reports Server (NTRS)

    Rosenzweig, Cynthia; Solecki, William D.; Blake, Reginald; Bowman, Malcolm; Faris, Craig; Gornitz, Vivien; Horton, Radley; Jacob, Klaus; LeBlanc, Alice; Leichenko, Robin; hide

    2010-01-01

    While current rates of sea level rise and associated coastal flooding in the New York City region appear to be manageable by stakeholders responsible for communications, energy, transportation, and water infrastructure, projections for sea level rise and associated flooding in the future, especially those associated with rapid icemelt of the Greenland and West Antarctic Icesheets, may be beyond the range of current capacity because an extreme event might cause flooding and inundation beyond the planning and preparedness regimes. This paper describes the comprehensive process, approach, and tools developed by the New York City Panel on Climate Change (NPCC) in conjunction with the region s stakeholders who manage its critical infrastructure, much of which lies near the coast. It presents the adaptation approach and the sea-level rise and storm projections related to coastal risks developed through the stakeholder process. Climate change adaptation planning in New York City is characterized by a multi-jurisdictional stakeholder-scientist process, state-of-the-art scientific projections and mapping, and development of adaptation strategies based on a risk-management approach.

  10. Including "Everyone" in Outdoor Play.

    ERIC Educational Resources Information Center

    Flynn, Lynda L.; Kieff, Judith

    2002-01-01

    Presents guidelines for outdoor play that are important when young children have special needs. Details a decision-making process for planning adaptations and practical strategies for making adaptations and interventions to enhance outdoor play for children with special needs. Lists adaptations for a child who is blind, is deaf, has physical…

  11. Population and reproductive health in National Adaptation Programmes of Action (NAPAs) for climate change in Africa.

    PubMed

    Mutunga, Clive; Hardee, Karen

    2010-12-01

    This paper reviews 44 National Adaptation Programmes of Action (NAPAs) to assess the NAPA process and identify the range of interventions included in countries' priority adaptation actions and highlight how population issues and reproductive health/family planning (RH/FP) are addressed as part of the adaptation agenda. A majority of the 44 NAPAs identify rapid population growth as a key component of vulnerability to climate change impacts. However, few chose to prioritise NAPA funds for family planning/reproductive health programmes. The paper emphasizes the need to translate the recognition of population pressure as a factor related to countries' ability to adapt to climate change into relevant project activities. Such projects should include access to RH/FP, in addition to other strategies such as girls' education and women's empowerment that lead to lower fertility. Attention to population and integrated strategies should be central and aligned to longer-term national adaptation plans and strategies.

  12. Integrated Modeling and Participatory Scenario Planning for Climate Adaptation: the Maui Groundwater Project

    NASA Astrophysics Data System (ADS)

    Keener, V. W.; Finucane, M.; Brewington, L.

    2014-12-01

    For the last century, the island of Maui, Hawaii, has been the center of environmental, agricultural, and legal conflict with respect to surface and groundwater allocation. Planning for adequate future freshwater resources requires flexible and adaptive policies that emphasize partnerships and knowledge transfer between scientists and non-scientists. In 2012 the Hawai'i state legislature passed the Climate Change Adaptation Priority Guidelines (Act 286) law requiring county and state policy makers to include island-wide climate change scenarios in their planning processes. This research details the ongoing work by researchers in the NOAA funded Pacific RISA to support the development of Hawaii's first island-wide water use plan under the new climate adaptation directive. This integrated project combines several models with participatory future scenario planning. The dynamically downscaled triply nested Hawaii Regional Climate Model (HRCM) was modified from the WRF community model and calibrated to simulate the many microclimates on the Hawaiian archipelago. For the island of Maui, the HRCM was validated using 20 years of hindcast data, and daily projections were created at a 1 km scale to capture the steep topography and diverse rainfall regimes. Downscaled climate data are input into a USGS hydrological model to quantify groundwater recharge. This model was previously used for groundwater management, and is being expanded utilizing future climate projections, current land use maps and future scenario maps informed by stakeholder input. Participatory scenario planning began in 2012 to bring together a diverse group of over 50 decision-makers in government, conservation, and agriculture to 1) determine the type of information they would find helpful in planning for climate change, and 2) develop a set of scenarios that represent alternative climate/management futures. This is an iterative process, resulting in flexible and transparent narratives at multiple scales. The resulting climate, land use, and groundwater recharge maps give stakeholders a common set of future scenarios that they understand through the participatory scenario process, and identify the vulnerabilities, trade-offs, and adaptive priorities for different groundwater management and land uses in an uncertain future.

  13. Collaborative Adaptation Planning for Water Security: Preliminary Lessons, Challenges, and the Way Forward for Maipo Basin Adaptation Plan, Chile

    NASA Astrophysics Data System (ADS)

    Vicuna, S.; Scott, C. A.; Bonelli, S.; Bustos, E.; Meza, F. J.

    2014-12-01

    The Maipo basin holds 40% of Chile's total population and almost half of the country's Gross Domestic Product. The basin is located in the semiarid central region of the country and, aside from the typical pressures of growth in developing country basins, the Maipo river faces climate change impacts associated with a reduction in total runoff and changes in its seasonality. Surface water is the main water source for human settlements and economic activities including agriculture. In 2012 we started a research project to create a climate variability and climate change adaptation plan for the basin. The pillars of the plan are co-produced by researchers and a Scenario Building Team (SBT) with membership of relevant water and land use stakeholders (including from civil society, public and private sectors) in the basin. Following similar experiences in other regions in the world that have faced the challenges of dealing with long term planning under uncertainty, the project has divided the task of developing the plan into a series of interconnected elements. A critical first component is to work on the desired vision(s) of the basin for the future. In this regards, the "water security" concept has been chosen as a framework that accommodates all objectives of the SBT members. Understanding and quantifying the uncertainties that could affect the future water security of the basin is another critical aspect of the plan. Near and long term climate scenarios are one dimension of these uncertainties that are combined with base development uncertainties such as urban growth scenarios. A third component constructs the models/tools that allows the assessment of impacts on water security that could arise under these scenarios. The final critical component relates to the development of the adaptation measures that could avoid the negative impacts and/or capture the potential opportunities. After two years in the development of the adaptation plan a series of results has been achieved in all critical components that are presented here. The success in the process now poses a series of new challenges, most importantly: how to implement and monitor the evolution of the adaptation process.

  14. Scientifically defensible fish conservation and recovery plans: Addressing diffuse threats and developing rigorous adaptive management plans

    USGS Publications Warehouse

    Maas-Hebner, Kathleen G.; Schreck, Carl B.; Hughes, Robert M.; Yeakley, Alan; Molina, Nancy

    2016-01-01

    We discuss the importance of addressing diffuse threats to long-term species and habitat viability in fish conservation and recovery planning. In the Pacific Northwest, USA, salmonid management plans have typically focused on degraded freshwater habitat, dams, fish passage, harvest rates, and hatchery releases. However, such plans inadequately address threats related to human population and economic growth, intra- and interspecific competition, and changes in climate, ocean, and estuarine conditions. Based on reviews conducted on eight conservation and/or recovery plans, we found that though threats resulting from such changes are difficult to model and/or predict, they are especially important for wide-ranging diadromous species. Adaptive management is also a critical but often inadequately constructed component of those plans. Adaptive management should be designed to respond to evolving knowledge about the fish and their supporting ecosystems; if done properly, it should help improve conservation efforts by decreasing uncertainty regarding known and diffuse threats. We conclude with a general call for environmental managers and planners to reinvigorate the adaptive management process in future management plans, including more explicitly identifying critical uncertainties, implementing monitoring programs to reduce those uncertainties, and explicitly stating what management actions will occur when pre-identified trigger points are reached.

  15. From vision to action: roadmapping as a strategic method and tool to implement climate change adaptation - the example of the roadmap 'water sensitive urban design 2020'.

    PubMed

    Hasse, J U; Weingaertner, D E

    2016-01-01

    As the central product of the BMBF-KLIMZUG-funded Joint Network and Research Project (JNRP) 'dynaklim - Dynamic adaptation of regional planning and development processes to the effects of climate change in the Emscher-Lippe region (North Rhine Westphalia, Germany)', the Roadmap 2020 'Regional Climate Adaptation' has been developed by the various regional stakeholders and institutions containing specific regional scenarios, strategies and adaptation measures applicable throughout the region. This paper presents the method, elements and main results of this regional roadmap process by using the example of the thematic sub-roadmap 'Water Sensitive Urban Design 2020'. With a focus on the process support tool 'KlimaFLEX', one of the main adaptation measures of the WSUD 2020 roadmap, typical challenges for integrated climate change adaptation like scattered knowledge, knowledge gaps and divided responsibilities but also potential solutions and promising chances for urban development and urban water management are discussed. With the roadmap and the related tool, the relevant stakeholders of the Emscher-Lippe region have jointly developed important prerequisites to integrate their knowledge, to clarify vulnerabilities, adaptation goals, responsibilities and interests, and to foresightedly coordinate measures, resources, priorities and schedules for an efficient joint urban planning, well-grounded decision-making in times of continued uncertainties and step-by-step implementation of adaptation measures from now on.

  16. The Binding of Learning to Action in Motor Adaptation

    PubMed Central

    Gonzalez Castro, Luis Nicolas; Monsen, Craig Bryant; Smith, Maurice A.

    2011-01-01

    In motor tasks, errors between planned and actual movements generally result in adaptive changes which reduce the occurrence of similar errors in the future. It has commonly been assumed that the motor adaptation arising from an error occurring on a particular movement is specifically associated with the motion that was planned. Here we show that this is not the case. Instead, we demonstrate the binding of the adaptation arising from an error on a particular trial to the motion experienced on that same trial. The formation of this association means that future movements planned to resemble the motion experienced on a given trial benefit maximally from the adaptation arising from it. This reflects the idea that actual rather than planned motions are assigned ‘credit’ for motor errors because, in a computational sense, the maximal adaptive response would be associated with the condition credited with the error. We studied this process by examining the patterns of generalization associated with motor adaptation to novel dynamic environments during reaching arm movements in humans. We found that these patterns consistently matched those predicted by adaptation associated with the actual rather than the planned motion, with maximal generalization observed where actual motions were clustered. We followed up these findings by showing that a novel training procedure designed to leverage this newfound understanding of the binding of learning to action, can improve adaptation rates by greater than 50%. Our results provide a mechanistic framework for understanding the effects of partial assistance and error augmentation during neurologic rehabilitation, and they suggest ways to optimize their use. PMID:21731476

  17. Iowa Climate Change Adaptation and Resilience Report

    EPA Pesticide Factsheets

    The findings of a pilot project to work with stakeholders and governments in Iowa to identify barriers to and incentives for considering regional effects of climate change in hazard mitigation planning and other community planning processes.

  18. Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia

    PubMed Central

    Saint, Victoria; Floranita, Rustini; Koemara Sakti, Gita Maya; Pambudi, Imran; Hermawan, Lukas; Villar, Eugenio; Magar, Veronica

    2018-01-01

    ABSTRACT The World Health Organization’s Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals’ commitment to ‘leave no one behind’. In 2014–2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This ‘methods forum’ article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a ‘leave no one behind’ approach. As follow-up during 2015–2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs’ commitment to leave no one behind, in particular in relation to influencing programming and monitoring and evaluation. PMID:29569529

  19. Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia.

    PubMed

    Koller, Theadora Swift; Saint, Victoria; Floranita, Rustini; Koemara Sakti, Gita Maya; Pambudi, Imran; Hermawan, Lukas; Briot, Benedicte; Frenz, Patricia; Solar, Orielle; Campos, Pilar; Villar, Eugenio; Magar, Veronica

    The World Health Organization's Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals' commitment to 'leave no one behind'. In 2014-2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This 'methods forum' article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a 'leave no one behind' approach. As follow-up during 2015-2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs' commitment to leave no one behind, in particular in relation to influencing programming and monitoring and evaluation.

  20. A ten-step process to develop case management plans.

    PubMed

    Tahan, Hussein A

    2002-01-01

    The use of case management plans has contained cost and improved quality of care successfully. However, the process of developing these plans remains a great challenge for healthcare executives, in this article, the author presents the answer to this challenge by discussing a 10-step formal process that administrators of patient care services and case managers can adapt to their institutions. It also can be used by interdisciplinary team members as a practical guide to develop a specific case management plan. This process is applicable to any care setting (acute, ambulatory, long term, and home care), diagnosis, or procedure. It is particularly important for those organizations that currently do not have a deliberate and systematic process to develop case management plans and are struggling with how to improve the efficiency and productivity of interdisciplinary teams charged with developing case management plans.

  1. Some problems of human adaptation and ecology under the aspect of general pathology

    NASA Technical Reports Server (NTRS)

    Kaznacheyev, V. P.

    1980-01-01

    The main problems of human adaptation at the level of the body and the population in connection with the features of current morbidity of the population and certain demographic processes are analyzed. The concepts of health and adaptation of the individual and human populations are determined. The importance of the anthropo-ecological approach to the investigation of the adaptation process of human populations is demonstrated. Certain features of the etiopathogenesis of diseases are considered in connection with the population-ecological regularities of human adaptation. The importance of research on general pathology aspects of adaptation and the ecology of man for planning, and organization of public health protection is discussed.

  2. Conservation Action Planning: Lessons learned from the St. Marys River watershed biodiversity conservation planning process

    USGS Publications Warehouse

    Patterson, Tamatha A.; Grundel, Ralph

    2014-01-01

    Conservation Action Planning (CAP) is an adaptive management planning process refined by The Nature Conservancy (TNC) and embraced worldwide as the Open Standards for the Practice of Conservation. The CAP process facilitates open, multi-institutional collaboration on a common conservation agenda through organized actions and quantified results. While specifically designed for conservation efforts, the framework is adaptable and flexible to multiple scales and can be used for any collaborative planning effort. The CAP framework addresses inception; design and development of goals, measures, and strategies; and plan implementation and evaluation. The specific components of the CAP include defining the project scope and conservation targets; assessing the ecological viability; ascertaining threats and surrounding situation; identifying opportunities and designing strategies for action; and implementing actions and monitoring results. In 2007, TNC and a multidisciplinary graduate student team from the University of Michigan's School of Natural Resources and Environment initiated a CAP for the St. Marys River, the connecting channel between Lake Superior and Lake Huron, and its local watershed. The students not only gained experience in conservation planning, but also learned lessons that notably benefited the CAP process and were valuable for any successful collaborative effort—a dedicated core team improved product quality, accelerated the timeline, and provided necessary support for ongoing efforts; an academic approach in preparation for engagement in the planning process brought applicable scientific research to the forefront, enhanced workshop facilitation, and improved stakeholder participation; and early and continuous interactions with regional stakeholders improved cooperation and built a supportive network for collaboration.

  3. A Review of Qualitative Data Gathering Methods and Their Applications To Support Organizational Strategic Planning Processes. Study Number Six.

    ERIC Educational Resources Information Center

    Wright, Phillip C.; Geroy, Gary D.

    Exploring existing methodologies to determine whether they can be adapted or adopted to support strategic goal setting, this paper focuses on information gathering techniques as they relate to the human resource development professional's input into strategic planning processes. The information gathering techniques are all qualitative methods and…

  4. Team table: a framework and tool for continuous factory planning

    NASA Astrophysics Data System (ADS)

    Sihn, Wilfried; Bischoff, Juergen; von Briel, Ralf; Josten, Marcus

    2000-10-01

    Growing market turbulences and shorter product life cycles require a continuous adaptation of factory structures resulting in a continuous factory planning process. Therefore a new framework is developed which focuses on configuration and data management process integration. This enable an online system performance evaluation based on continuous availability of current data. The use of this framework is especially helpful and will guarantee high cost and time savings, when used in the early stages of the planning, called the concept or rough planning phase. The new framework is supported by a planning round table as a tool for team-based configuration processes integrating the knowledge of all persons involved in planning processes. A case study conducted at a German company shows the advantages which can be achieved by implementing the new framework and methods.

  5. Challenges and Opportunities for Mainstreaming Climate Change Adaptation into WaSH Development Planning in Ghana

    PubMed Central

    2017-01-01

    Climate change threatens water, sanitation and hygiene (WaSH) facilities and services, as these are intimately linked to the water cycle and are vulnerable to changes in the quantity and quality of available water resources. Floods and droughts, which pollute and reduce water delivery respectively, have now become a perennial issue to deal with in the northern regions of Ghana. This study aimed to assess the degree to which climate change adaptation measures are mainstreamed into the water, sanitation and hygiene (WaSH) development planning process in Ghana. Stakeholders from government and non-government agencies were interviewed to gain perspectives on the threat of climate change, the inclusion of climate change in WaSH planning and the barriers preventing mainstreaming. Despite awareness of climate change, adaptation measures have not been considered, and the immediate WaSH needs remain the priority. Overall, stakeholders felt the adaptive capacity of the Municipality was low and that mainstreaming has not yet occurred. Despite the lack of progress, there are great opportunities for mainstreaming climate change adaptation into planning through increasing awareness and capacity, legislative and institutional changes and the development of participatory systems to provide early warning systems and disaster risk analyses that will inform future planning. PMID:28698518

  6. Challenges and Opportunities for Mainstreaming Climate Change Adaptation into WaSH Development Planning in Ghana.

    PubMed

    Alhassan, Salley; Hadwen, Wade L

    2017-07-10

    Climate change threatens water, sanitation and hygiene (WaSH) facilities and services, as these are intimately linked to the water cycle and are vulnerable to changes in the quantity and quality of available water resources. Floods and droughts, which pollute and reduce water delivery respectively, have now become a perennial issue to deal with in the northern regions of Ghana. This study aimed to assess the degree to which climate change adaptation measures are mainstreamed into the water, sanitation and hygiene (WaSH) development planning process in Ghana. Stakeholders from government and non-government agencies were interviewed to gain perspectives on the threat of climate change, the inclusion of climate change in WaSH planning and the barriers preventing mainstreaming. Despite awareness of climate change, adaptation measures have not been considered, and the immediate WaSH needs remain the priority. Overall, stakeholders felt the adaptive capacity of the Municipality was low and that mainstreaming has not yet occurred. Despite the lack of progress, there are great opportunities for mainstreaming climate change adaptation into planning through increasing awareness and capacity, legislative and institutional changes and the development of participatory systems to provide early warning systems and disaster risk analyses that will inform future planning.

  7. Adaptive Planning: Understanding Organizational Workload to Capability/ Capacity through Modeling and Simulation

    NASA Technical Reports Server (NTRS)

    Hase, Chris

    2010-01-01

    In August 2003, the Secretary of Defense (SECDEF) established the Adaptive Planning (AP) initiative [1] with an objective of reducing the time necessary to develop and revise Combatant Commander (COCOM) contingency plans and increase SECDEF plan visibility. In addition to reducing the traditional plan development timeline from twenty-four months to less than twelve months (with a goal of six months)[2], AP increased plan visibility to Department of Defense (DoD) leadership through In-Progress Reviews (IPRs). The IPR process, as well as the increased number of campaign and contingency plans COCOMs had to develop, increased the workload while the number of planners remained fixed. Several efforts from collaborative planning tools to streamlined processes were initiated to compensate for the increased workload enabling COCOMS to better meet shorter planning timelines. This paper examines the Joint Strategic Capabilities Plan (JSCP) directed contingency planning and staffing requirements assigned to a combatant commander staff through the lens of modeling and simulation. The dynamics of developing a COCOM plan are captured with an ExtendSim [3] simulation. The resulting analysis provides a quantifiable means by which to measure a combatant commander staffs workload associated with development and staffing JSCP [4] directed contingency plans with COCOM capability/capacity. Modeling and simulation bring significant opportunities in measuring the sensitivity of key variables in the assessment of workload to capability/capacity analysis. Gaining an understanding of the relationship between plan complexity, number of plans, planning processes, and number of planners with time required for plan development provides valuable information to DoD leadership. Through modeling and simulation AP leadership can gain greater insight in making key decisions on knowing where to best allocate scarce resources in an effort to meet DoD planning objectives.

  8. SU-E-J-52: Dosimetric Benefit of Adaptive Re-Planning in Lung Cancer Stereotactic Body Radiotherapy (SBRT)

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

    Jia, J; Tian, Z; Gu, X

    Purpose: To investigate the dosimetric benefit of adaptive re-planning for lung stereotactic body radiotherapy(SBRT). Methods: Five lung cancer patients with SBRT treatment were retrospectively investigated. Our in-house supercomputing online re-planning environment (SCORE) was used to realize the re-planning process. First a deformable image registration was carried out to transfer contours from treatment planning CT to each treatment CBCT. Then an automatic re-planning using original plan DVH guided fluence-map optimization is performed to get a new plan for the up-to-date patient geometry. We compared the re-optimized plan to the original plan projected on the up-to-date patient geometry in critical dosimetric parameters,more » such as PTV coverage, spinal cord maximum and volumetric constraint dose, esophagus maximum and volumetric constraint dose. Results: The average volume of PTV covered by prescription dose for all patients was improved by 7.56% after the adaptive re-planning. The volume of the spinal cord receiving 14.5Gy and 23Gy (V14.5, V23) decreased by 1.48% and 0.68%, respectively. For the esophagus, the volume receiving 19.5Gy (V19.5) reduced by 1.37%. Meanwhile, the maximum dose dropped off by 2.87% for spinal cord and 4.80% for esophagus. Conclusion: Our experimental results demonstrate that adaptive re-planning for lung SBRT has the potential to minimize the dosimetric effect of inter-fraction deformation and thus improve target coverage while reducing the risk of toxicity to nearby normal tissues.« less

  9. Sustaining a Mature Risk Management Process: Ensuring the International Space Station for a Vibrant Future

    NASA Technical Reports Server (NTRS)

    Raftery, Michael; Carter-Journet, Katrina

    2013-01-01

    The International Space Station (ISS) risk management methodology is an example of a mature and sustainable process. Risk management is a systematic approach used to proactively identify, analyze, plan, track, control, communicate, and document risks to help management make risk-informed decisions that increase the likelihood of achieving program objectives. The ISS has been operating in space for over 14 years and permanently crewed for over 12 years. It is the longest surviving habitable vehicle in low Earth orbit history. Without a mature and proven risk management plan, it would be increasingly difficult to achieve mission success throughout the life of the ISS Program. A successful risk management process must be able to adapt to a dynamic program. As ISS program-level decision processes have evolved, so too has the ISS risk management process continued to innovate, improve, and adapt. Constant adaptation of risk management tools and an ever-improving process is essential to the continued success of the ISS Program. Above all, sustained support from program management is vital to risk management continued effectiveness. Risk management is valued and stressed as an important process by the ISS Program.

  10. Building a Community Framework for Adaptation to Sea Level Rise and Inundation

    NASA Astrophysics Data System (ADS)

    Culver, M. E.; Schubel, J.; Davidson, M. A.; Haines, J.

    2010-12-01

    Sea level rise and inundation pose a substantial risk to many coastal communities, and the risk is projected to increase because of continued development, changes in the frequency and intensity of inundation events, and acceleration in the rate of sea-level rise. Calls for action at all levels acknowledge that a viable response must engage federal, state and local expertise, perspectives, and resources in a coordinated and collaborative effort. Representatives from a variety of these agencies and organizations have developed a shared framework to help coastal communities structure and facilitate community-wide adaptation processes and to help agencies determine where investments should be made to enable states and local governments to assess impacts and initiate adaptation strategies over the next decade. For sea level rise planning and implementation, the requirements for high-quality data and information are vast and the availability is limited. Participants stressed the importance of data interoperability to ensure that users are able to apply data from a variety of sources and to improve availability and confidence in the data. Participants were able to prioritize the following six categories of data needed to support future sea level rise planning and implementation: - Data to understand land forms and where and how water will flow - Monitoring data and environmental drivers - Consistent sea level rise scenarios and projections across agencies to support local planning - Data to characterize vulnerabilities and impacts of sea level rise - Community characteristics - Legal frameworks and administrative structure. To develop a meaningful and effective sea level rise adaptation plan, state and local planners must understand how the availability, scale, and uncertainty of these types of data will impact new guidelines or adaptation measures. The tools necessary to carry-out the adaptation planning process need to be understood in terms of data requirements, assumptions of the method, and the reliability and utility of the outputs. This type of information will assist the community in choosing among the available options. Communities have experience with storm and hazardous events, and the response typically is to return to pre-event conditions. With sea level rise, there will need to be a shift in perception and response from storm events, and the people must collectively arrive at a new vision for their community in light of a changing environment. Understanding the possible scenarios and the uncertainty or probability of those scenarios is a critical component in the adaptation process. Although there is a broad constituency that does not know the issue well, many communities are savvy about the impacts of sea level rise. Armed with the available information and resources and an understanding of the uncertainties, many communities are ready to take action. Successful adaptation planning will require that all sectors — local, state, federal, academic, nongovernmental, and the private sector — work together throughout the process to provide local communities with resources, scientific and political support.

  11. TU-AB-303-12: Towards Inter and Intra Fraction Plan Adaptation for the MR-Linac

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

    Kontaxis, C; Bol, G; Lagendijk, J

    Purpose: To develop a new sequencer for IMRT that during treatment can account for anatomy changes provided by online and real-time MRI. This sequencer employs a novel inter and intra fraction scheme that converges to the prescribed dose without a final segment weight optimization (SWO) and enables immediate optimization and delivery of radiation adapted to the deformed anatomy. Methods: The sequencer is initially supplied with a voxel-based dose prescription and during the optimization iteratively generates segments that provide this prescribed dose. Every iteration selects the best segment for the current anatomy state, calculates the dose it will deliver, warps itmore » back to the reference prescription grid and subtracts it from the remaining prescribed dose. This process continues until a certain percentage of dose or a number of segments has been delivered. The anatomy changes that occur during treatment require that convergence is achieved without a final SWO. This is resolved by adding the difference between the prescribed and delivered dose up to this fraction to the prescription of the subsequent fraction. This process is repeated for all fractions of the treatment. Results: Two breast cases were selected to stress test the pipeline by producing artificial inter and intra fraction anatomy deformations using a combination of incrementally applied rigid transformations. The dose convergence of the adaptive scheme over the entire treatment, relative to the prescribed dose, was on average 8.6% higher than the static plans delivered to the respective deformed anatomies and only 1.6% less than the static segment weighted plans on the static anatomy. Conclusion: This new adaptive sequencing strategy enables dose convergence without the need of SWO while adapting the plan to intermediate anatomies, which is a prerequisite for online plan adaptation. We are now testing our pipeline on prostate cases using clinical anatomy deformation data from our department. This work is financially supported by Elekta AB, Stockholm, Sweden.« less

  12. Using evaluation to adapt health information outreach to the complex environments of community-based organizations.

    PubMed

    Olney, Cynthia A

    2005-10-01

    After arguing that most community-based organizations (CBOs) function as complex adaptive systems, this white paper describes the evaluation goals, questions, indicators, and methods most important at different stages of community-based health information outreach. This paper presents the basic characteristics of complex adaptive systems and argues that the typical CBO can be considered this type of system. It then presents evaluation as a tool for helping outreach teams adapt their outreach efforts to the CBO environment and thus maximize success. Finally, it describes the goals, questions, indicators, and methods most important or helpful at each stage of evaluation (community assessment, needs assessment and planning, process evaluation, and outcomes assessment). Literature from complex adaptive systems as applied to health care, business, and evaluation settings is presented. Evaluation models and applications, particularly those based on participatory approaches, are presented as methods for maximizing the effectiveness of evaluation in dynamic CBO environments. If one accepts that CBOs function as complex adaptive systems-characterized by dynamic relationships among many agents, influences, and forces-then effective evaluation at the stages of community assessment, needs assessment and planning, process evaluation, and outcomes assessment is critical to outreach success.

  13. Eye movements show similar adaptations in temporal coordination to movement planning conditions in both people with and without cerebral palsy.

    PubMed

    Payne, Alexander R; Plimmer, Beryl; McDaid, Andrew; Davies, T Claire

    2017-05-01

    The effects of cerebral palsy on movement planning for simple reaching tasks are not well understood. Movement planning is complex and entails many processes which could be affected. This study specifically sought to evaluate integrating task information, decoupling movements, and adjusting to altered mapping. For a reaching task, the asynchrony between the eye onset and the hand onset was measured across different movement planning conditions for participants with and without cerebral palsy. Previous research shows people without cerebral palsy vary this temporal coordination for different planning conditions. Our measurements show similar adaptations in temporal coordination for groups with and without cerebral palsy, to three of the four variations in planning condition tested. However, movement durations were still longer for the participants with cerebral palsy. Hence for simple goal-directed reaching, movement execution problems appear to limit activity more than movement planning deficits.

  14. Adapting a strategic management model to hospital operating strategies. A model development and justification.

    PubMed

    Swinehart, K; Zimmerer, T W; Oswald, S

    1995-01-01

    Industrial organizations have employed the process of strategic management in their attempts to cope effectively with global competitive pressures, while attempting to build and maintain competitive advantage. With health-care organizations presently trying to cope with an increasingly turbulent environment created by the uncertainty as to pending legislation and anticipated reform, the need for such organizational strategic planning is apparent. Presents and discusses a methodology for adapting a business-oriented model of strategic planning to health care.

  15. Lateral Coherence and Mixing in the Coastal Ocean: Adaptive Sampling using Gliders

    DTIC Science & Technology

    2011-09-30

    Coherence and Mixing in the Coastal Ocean: Adaptive Sampling using Gliders R. Kipp Shearman Jonathan D. Nash James N. Moum John A. Barth College of...These structures evolve yet are often persistent on O (3 day) timescales, so are ideally suited to be adaptively sampled by autonomous gliders that...processes driving lateral dispersion, we plan to deploy 4 AUV gliders to perform intensive, adaptive surveys. Newly-enhanced to measure turbulent mixing

  16. The role of strategies in motor learning

    PubMed Central

    Taylor, Jordan A.; Ivry, Richard B.

    2015-01-01

    There has been renewed interest in the role of strategies in sensorimotor learning. The combination of new behavioral methods and computational methods has begun to unravel the interaction between processes related to strategic control and processes related to motor adaptation. These processes may operate on very different error signals. Strategy learning is sensitive to goal-based performance error. In contrast, adaptation is sensitive to prediction errors between the desired and actual consequences of a planned movement. The former guides what the desired movement should be, whereas the latter guides how to implement the desired movement. Whereas traditional approaches have favored serial models in which an initial strategy-based phase gives way to more automatized forms of control, it now seems that strategic and adaptive processes operate with considerable independence throughout learning, although the relative weight given the two processes will shift with changes in performance. As such, skill acquisition involves the synergistic engagement of strategic and adaptive processes. PMID:22329960

  17. Participatory Scenario Planning for Climate Change Adaptation: the Maui Groundwater Project

    NASA Astrophysics Data System (ADS)

    Keener, V. W.; Brewington, L.; Finucane, M.

    2015-12-01

    For the last century, the island of Maui in Hawai'i has been the center of environmental, agricultural, and legal conflict with respect to both surface and groundwater allocation. Planning for sustainable future freshwater supply in Hawai'i requires adaptive policies and decision-making that emphasizes private and public partnerships and knowledge transfer between scientists and non-scientists. We have downscaled dynamical climate models to 1 km resolution in Maui and coupled them with a USGS Water Budget model and a participatory scenario building process to quantify future changes in island-scale climate and groundwater recharge under different land uses. Although these projections are uncertain, the integrated nature of the Pacific RISA research program has allowed us to take a multi-pronged approach to facilitate the uptake of climate information into policy and management. This presentation details the ongoing work to support the development of Hawai'i's first island-wide water use plan under the new climate adaptation directive. Participatory scenario planning began in 2012 to bring together a diverse group of ~100 decision-makers in state and local government, watershed restoration, agriculture, and conservation to 1) determine the type of information (climate variables, land use and development, agricultural practices) they would find helpful in planning for climate change, and 2) develop a set of nested scenarios that represent alternative climate and management futures. This integration of knowledge is an iterative process, resulting in flexible and transparent narratives of complex futures comprised of information at multiple scales. We will present an overview of the downscaling, scenario building, hydrological modeling processes, and stakeholder response.

  18. Public Health Climate Change Adaptation Planning Using Stakeholder Feedback.

    PubMed

    Eidson, Millicent; Clancy, Kathleen A; Birkhead, Guthrie S

    2016-01-01

    Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities. To develop a state health department climate and health adaptation plan as informed by stakeholder feedback. With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities. New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders. In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P < .0001) LHDs (22.9%) were incorporating or considering incorporating climate and health into planning compared to state health leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development. Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health Strategic Map in 2013. The CDC Building Resilience Against Climate Effects (BRACE) framework and funding provides a collaborative model for state climate and health adaptation planning.

  19. Operational considerations for implementing regional sediment management plans in the northern Gulf of Mexico

    USGS Publications Warehouse

    Underwood, Steven G.; Khalil, Syed M.; Byrnes, Mark R.; Steyer, Gregory D.; Raynie, Richard C

    2015-01-01

    Development of a comprehensive and stakeholder-driven Regional Sediment Management plan can provide the basis for long-term sustainable resource use and protection. This paper highlights three operational components that can positively influence sediment management at a regional scale, including (1) integration of an operational sediment budget, (2) development of a monitoring and adaptive management plan, and (3) development of a regional sediment availability and allocation program. These components seek to incorporate science and adaptive management through implementation of an organized and well-documented decision making process. They represent a coordinated framework that could serve as a guide for unifying financial investments in regional sediment management plans. Collectively, they establish an integrated process for addressing uncertainties about future system change in light of shrinking federal and state budgets, competing demands for sediment resources within riverine and marine waters, and policy considerations related to sediment/water use (e.g., navigation and commerce versus environmental management).

  20. NASA End-to-End Data System /NEEDS/ information adaptive system - Performing image processing onboard the spacecraft

    NASA Technical Reports Server (NTRS)

    Kelly, W. L.; Howle, W. M.; Meredith, B. D.

    1980-01-01

    The Information Adaptive System (IAS) is an element of the NASA End-to-End Data System (NEEDS) Phase II and is focused toward onbaord image processing. Since the IAS is a data preprocessing system which is closely coupled to the sensor system, it serves as a first step in providing a 'Smart' imaging sensor. Some of the functions planned for the IAS include sensor response nonuniformity correction, geometric correction, data set selection, data formatting, packetization, and adaptive system control. The inclusion of these sensor data preprocessing functions onboard the spacecraft will significantly improve the extraction of information from the sensor data in a timely and cost effective manner and provide the opportunity to design sensor systems which can be reconfigured in near real time for optimum performance. The purpose of this paper is to present the preliminary design of the IAS and the plans for its development.

  1. Enabling Incremental Query Re-Optimization.

    PubMed

    Liu, Mengmeng; Ives, Zachary G; Loo, Boon Thau

    2016-01-01

    As declarative query processing techniques expand to the Web, data streams, network routers, and cloud platforms, there is an increasing need to re-plan execution in the presence of unanticipated performance changes. New runtime information may affect which query plan we prefer to run. Adaptive techniques require innovation both in terms of the algorithms used to estimate costs , and in terms of the search algorithm that finds the best plan. We investigate how to build a cost-based optimizer that recomputes the optimal plan incrementally given new cost information, much as a stream engine constantly updates its outputs given new data. Our implementation especially shows benefits for stream processing workloads. It lays the foundations upon which a variety of novel adaptive optimization algorithms can be built. We start by leveraging the recently proposed approach of formulating query plan enumeration as a set of recursive datalog queries ; we develop a variety of novel optimization approaches to ensure effective pruning in both static and incremental cases. We further show that the lessons learned in the declarative implementation can be equally applied to more traditional optimizer implementations.

  2. Enabling Incremental Query Re-Optimization

    PubMed Central

    Liu, Mengmeng; Ives, Zachary G.; Loo, Boon Thau

    2017-01-01

    As declarative query processing techniques expand to the Web, data streams, network routers, and cloud platforms, there is an increasing need to re-plan execution in the presence of unanticipated performance changes. New runtime information may affect which query plan we prefer to run. Adaptive techniques require innovation both in terms of the algorithms used to estimate costs, and in terms of the search algorithm that finds the best plan. We investigate how to build a cost-based optimizer that recomputes the optimal plan incrementally given new cost information, much as a stream engine constantly updates its outputs given new data. Our implementation especially shows benefits for stream processing workloads. It lays the foundations upon which a variety of novel adaptive optimization algorithms can be built. We start by leveraging the recently proposed approach of formulating query plan enumeration as a set of recursive datalog queries; we develop a variety of novel optimization approaches to ensure effective pruning in both static and incremental cases. We further show that the lessons learned in the declarative implementation can be equally applied to more traditional optimizer implementations. PMID:28659658

  3. Health care planning and education via gaming-simulation: a two-stage experiment.

    PubMed

    Gagnon, J H; Greenblat, C S

    1977-01-01

    A two-stage process of gaming-simulation design was conducted: the first stage of design concerned national planning for hemophilia care; the second stage of design was for gaming-simulation concerning the problems of hemophilia patients and health care providers. The planning design was intended to be adaptable to large-scale planning for a variety of health care problems. The educational game was designed using data developed in designing the planning game. A broad range of policy-makers participated in the planning game.

  4. Synthesizing genetic divergence and climate modeling to inform conservation planning for ponderosa pine

    Treesearch

    Kevin M. Potter; Douglas J. Shinneman; Robert E. Means; Valerie D. Hipkins; Mary Frances Mahalovich

    2017-01-01

    Geological, climatological and ecological processes partially or entirely isolate evolutionary lineages within tree species. These lineages may develop adaptations to different local environmental conditions, and may eventually evolve into distinct forms or species. Isolation also can reduce adaptive genetic variation within populations of a species, potentially...

  5. Local adaptation of the National Physical Activity Plan: creation of the Active Living Plan for a Healthier San Antonio.

    PubMed

    Esparza, Laura A; Velasquez, Katherine S; Zaharoff, Annette M

    2014-03-01

    Physical inactivity and related health consequences are serious public health threats. Effective strategies to facilitate and support active-living opportunities must be implemented at national, state, and local levels. San Antonio, Texas, health department officials launched the Active Living Council of San Antonio (ALCSA) to engage the community in developing a 3- to 5-year plan to promote active living. A steering committee set preliminary ALCSA aims and established a multisector membership structure modeled after the US National Physical Activity Plan (NPAP). ALCSA adopted governance standards, increased knowledge of physical activity and health, and engaged in an 18-month collaborative master plan writing process. ALCSA selected overarching strategies and evidence-based strategies for each societal sector and adapted strategies to the local context, including tactics, measures of success, and timelines. Community and expert engagement led to a localized plan reflecting national recommendations, the Active Living Plan for a Healthier San Antonio. Multisector collaborations among governmental agencies and community organizations, which were successfully developed in this case to produce the first-ever local adaptation of the NPAP, require clearly defined expectations. Lessons learned in ALCSA's organizational and plan development can serve as a model for future community-driven efforts to increase active living.

  6. Adaptive constructive processes and the future of memory.

    PubMed

    Schacter, Daniel L

    2012-11-01

    Memory serves critical functions in everyday life but is also prone to error. This article examines adaptive constructive processes, which play a functional role in memory and cognition but can also produce distortions, errors, and illusions. The article describes several types of memory errors that are produced by adaptive constructive processes and focuses in particular on the process of imagining or simulating events that might occur in one's personal future. Simulating future events relies on many of the same cognitive and neural processes as remembering past events, which may help to explain why imagination and memory can be easily confused. The article considers both pitfalls and adaptive aspects of future event simulation in the context of research on planning, prediction, problem solving, mind-wandering, prospective and retrospective memory, coping and positivity bias, and the interconnected set of brain regions known as the default network. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  7. Does Wildfire Open a Policy Window? Local Government and Community Adaptation After Fire in the United States.

    PubMed

    Mockrin, Miranda H; Fishler, Hillary K; Stewart, Susan I

    2018-05-15

    Becoming a fire adapted community that can coexist with wildfire is envisioned as a continuous, iterative process of adaptation, but it is unclear how communities may pursue adaptation. Experience with wildfire and other natural hazards suggests that disasters may open a "window of opportunity" leading to local government policy changes. We examined how destructive wildfire affected progress toward becoming fire adapted in eight locations in the United States. We found that community-level adaptation following destructive fires is most common where destructive wildfire is novel and there is already government capacity and investment in wildfire regulation and land use planning. External funding, staff capacity, and the presence of issue champions combined to bring about change after wildfire. Locations with long histories of destructive wildfire, extensive previous investment in formal wildfire regulation and mitigation, or little government and community capacity to manage wildfire saw fewer changes. Across diverse settings, communities consistently used the most common tools and actions for wildfire mitigation and planning. Nearly all sites reported changes in wildfire suppression, emergency response, and hazard planning documents. Expansion in voluntary education and outreach programs to increase defensible space was also common, occurring in half of our sites, but land use planning and regulations remained largely unchanged. Adaptation at the community and local governmental level therefore may not axiomatically follow from each wildfire incident, nor easily incorporate formal approaches to minimizing land use and development in hazardous environments, but in many sites wildfire was a focusing event that inspired reflection and adaptation.

  8. Designing and Adapting Tasks in Lesson Planning: A Critical Process of Lesson Study

    ERIC Educational Resources Information Center

    Fujii, Toshiakira

    2016-01-01

    There is no doubt that a lesson plan is a necessary product of Lesson Study. However, the collaborative work among teachers that goes into creating that lesson plan is largely under-appreciated by non-Japanese adopters of Lesson Study, possibly because the effort involved is invisible to outsiders, with our attention going to its most visible…

  9. Assisting a College's Service Area in the Transition to the New Technology Society through Strategic Planning and Management.

    ERIC Educational Resources Information Center

    Groff, Warren H.

    North Central Technical College's (NCTC's) strategic planning and human resource development model is described in this paper in terms of its role in assisting the college's service area in adapting to new technologies. First, background information is presented on NCTC's planning process with respect to the strategic goal areas of: (1)…

  10. 33 CFR 385.9 - Implementation principles.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Responsibilities § 385.9 Implementation principles. The Corps of Engineers and the South Florida Water Management...) Endorsement of the Plan as a restoration framework is not intended as a constraint on innovation during implementation through the adaptive management process. Continuous improvement of the Plan shall be sought to...

  11. Adaptation workbook: Chapter 3

    Treesearch

    Maria Janowiak; Patricia Butler; Chris Swanston; Linda Parker; Matt St. Pierre; Leslie Brandt

    2012-01-01

    Climate change imposes many challenges on the long-term management of ecosystems and is becoming an increasingly important consideration in land management planning and decisionmaking at a variety of spatial scales. The process outlined in this chapter helps managers incorporate climate change considerations into management planning and activities, while complementing...

  12. Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.

    PubMed

    Hawkins, Maria A; Brooks, Corrinne; Hansen, Vibeke N; Aitken, Alexandra; Tait, Diana M

    2010-06-01

    To investigate the potential for reduction in normal tissue irradiation by creating a patient specific planning target volume (PTV) using cone beam computed tomography (CBCT) imaging acquired in the first week of radiotherapy for patients receiving radical radiotherapy. Patients receiving radical RT for carcinoma of the esophagus were investigated. The PTV is defined as CTV(tumor, nodes) plus esophagus outlined 3 to 5 cm cranio-caudally and a 1.5-cm circumferential margin is added (clinical plan). Prefraction CBCT are acquired on Days 1 to 4, then weekly. No correction for setup error made. The images are imported into the planning system. The tumor and esophagus for the length of the PTV are contoured on each CBCT and 5 mm margin is added. A composite volume (PTV1) is created using Week 1 composite CBCT volumes. The same process is repeated using CBCT Week 2 to 6 (PTV2). A new plan is created using PTV1 (adaptive plan). The coverage of the 95% isodose of PTV1 is evaluated on PTV2. Dose-volume histograms (DVH) for lungs, heart, and cord for two plans are compared. A total of 139 CBCT for 14 cases were analyzed. For the adaptive plan the coverage of the 95% prescription isodose for PTV1 = 95.6% +/- 4% and the PTV2 = 96.8% +/- 4.1% (t test, 0.19). Lungs V20 (15.6 Gy vs. 10.2 Gy) and heart mean dose (26.9 Gy vs. 20.7 Gy) were significantly smaller for the adaptive plan. A reduced planning volume can be constructed within the first week of treatment using CBCT. A single plan modification can be performed within the second week of treatment with considerable reduction in organ at risk dose. Copyright 2010 Elsevier Inc. All rights reserved.

  13. Decision-support tools for Extreme Weather and Climate Events in the Northeast United States

    NASA Astrophysics Data System (ADS)

    Kumar, S.; Lowery, M.; Whelchel, A.

    2013-12-01

    Decision-support tools were assessed for the 2013 National Climate Assessment technical input document, "Climate Change in the Northeast, A Sourcebook". The assessment included tools designed to generate and deliver actionable information to assist states and highly populated urban and other communities in assessment of climate change vulnerability and risk, quantification of effects, and identification of adaptive strategies in the context of adaptation planning across inter-annual, seasonal and multi-decadal time scales. State-level adaptation planning in the Northeast has generally relied on qualitative vulnerability assessments by expert panels and stakeholders, although some states have undertaken initiatives to develop statewide databases to support vulnerability assessments by urban and local governments, and state agencies. The devastation caused by Superstorm Sandy in October 2012 has raised awareness of the potential for extreme weather events to unprecedented levels and created urgency for action, especially in coastal urban and suburban communities that experienced pronounced impacts - especially in New Jersey, New York and Connecticut. Planning approaches vary, but any adaptation and resiliency planning process must include the following: - Knowledge of the probable change in a climate variable (e.g., precipitation, temperature, sea-level rise) over time or that the climate variable will attain a certain threshold deemed to be significant; - Knowledge of intensity and frequency of climate hazards (past, current or future events or conditions with potential to cause harm) and their relationship with climate variables; - Assessment of climate vulnerabilities (sensitive resources, infrastructure or populations exposed to climate-related hazards); - Assessment of relative risks to vulnerable resources; - Identification and prioritization of adaptive strategies to address risks. Many organizations are developing decision-support tools to assist in the urban planning process by addressing some of these needs. In this paper we highlight the decision tools available today, discuss their application in selected case studies, and present a gap analysis with opportunities for innovation and future work.

  14. 21 CFR 123.10 - Training.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HACCP principles to fish and fishery product processing at least equivalent to that received under... standardized curriculum. (a) Developing a HACCP plan, which could include adapting a model or generic-type HACCP plan, that is appropriate for a specific processor, in order to meet the requirements of § 123.6(b...

  15. A conceptual model for the development process of confirmatory adaptive clinical trials within an emergency research network.

    PubMed

    Mawocha, Samkeliso C; Fetters, Michael D; Legocki, Laurie J; Guetterman, Timothy C; Frederiksen, Shirley; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

    2017-06-01

    Adaptive clinical trials use accumulating data from enrolled subjects to alter trial conduct in pre-specified ways based on quantitative decision rules. In this research, we sought to characterize the perspectives of key stakeholders during the development process of confirmatory-phase adaptive clinical trials within an emergency clinical trials network and to build a model to guide future development of adaptive clinical trials. We used an ethnographic, qualitative approach to evaluate key stakeholders' views about the adaptive clinical trial development process. Stakeholders participated in a series of multidisciplinary meetings during the development of five adaptive clinical trials and completed a Strengths-Weaknesses-Opportunities-Threats questionnaire. In the analysis, we elucidated overarching themes across the stakeholders' responses to develop a conceptual model. Four major overarching themes emerged during the analysis of stakeholders' responses to questioning: the perceived statistical complexity of adaptive clinical trials and the roles of collaboration, communication, and time during the development process. Frequent and open communication and collaboration were viewed by stakeholders as critical during the development process, as were the careful management of time and logistical issues related to the complexity of planning adaptive clinical trials. The Adaptive Design Development Model illustrates how statistical complexity, time, communication, and collaboration are moderating factors in the adaptive design development process. The intensity and iterative nature of this process underscores the need for funding mechanisms for the development of novel trial proposals in academic settings.

  16. Strategies for flood hazard adaptation in drought affected regions of Afghanistan

    NASA Astrophysics Data System (ADS)

    Schleupner, Christine

    2010-05-01

    The development and management of water resources in Afghanistan are critically important for the economic development of the country. But Afghanistan presents a number of specific challenges in terms of water resource management and climate change impact assessment. Political instability and war has caused widespread devastation, insecurity, displacement, poverty and severe environmental degradation. Recent droughts have led to the collapse of many livelihoods, and poor national security restricts structured fieldwork. The recent restructuring and rebuilding of the state can be seen as opportunity to integrate climate change mitigation and adaptation measures into national, regional, and local planning. Governmental organizations are responsible to integrate climate change related issues and pro-active planning processes in water management and environmental considerations into relevant legislations, ministry and sector strategies. Integrated water resource management has been practically nonexistent during the last decades and consideration of climate change impacts are widely ignored in regional planning processes. However, flooding, landslides, drought, and extreme heat and freezing weather are already threatening the population. Climate models suggest that Afghanistan will be confronted by an increase of these events. Desertification and land degradation but also floods due to untimely rainfall are expected to broaden. Studies show that the impact of increasingly frequent flash floods may be amplified due to more rapid spring snow melt as a result of higher temperatures, combined with the downstream effects of land degradation, loss of vegetative cover and land mismanagement. It is further exacerbated by drought, which has the effect of hardening soils and reducing their permeability. In 2007 heavy floods already destroyed fields and harvests, killed livestock, damaged buildings, and claimed many lives. The intensified climatic conditions in Afghanistan will continue to impact upon society by creating stresses for specific vulnerable groups. This study discusses and compares existing policies, legislations and strategies considering flood adaptation planning in Afghanistan. It reviews available Flood Hazard Maps and reflects on regional adaptation options. Present and future vulnerability to flooding is assessed through a GIS-based model by using scenario techniques. A strategy is developed how to implement measures into regional and integrated water resource management planning. In general, not a single but the selection of multiple measures will be successful in pro-active planning for climate change adaptation. In this regard a continuous consultation with stakeholders needs to take place to address their demands. Thus the results of this study cannot give solutions but might build the basis for recommended active planning processes.

  17. Coordinating Decentralized Learning and Conflict Resolution across Agent Boundaries

    ERIC Educational Resources Information Center

    Cheng, Shanjun

    2012-01-01

    It is crucial for embedded systems to adapt to the dynamics of open environments. This adaptation process becomes especially challenging in the context of multiagent systems because of scalability, partial information accessibility and complex interaction of agents. It is a challenge for agents to learn good policies, when they need to plan and…

  18. Cross-Cultural Adaptation of Developmental Criteria for Young Children: A Preliminary Psychometric Study

    ERIC Educational Resources Information Center

    Yunus, Faridah

    2014-01-01

    Authentic assessment approach applies naturalistic observation method to gather and analyse data about children's development that are socio-culturally appropriate to plan for individual teaching and learning needs. This article discusses the process of adapting an authentic developmental instrument for children of 3-6 years old. The instrument…

  19. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness.

    PubMed

    Norris, Fran H; Stevens, Susan P; Pfefferbaum, Betty; Wyche, Karen F; Pfefferbaum, Rose L

    2008-03-01

    Communities have the potential to function effectively and adapt successfully in the aftermath of disasters. Drawing upon literatures in several disciplines, we present a theory of resilience that encompasses contemporary understandings of stress, adaptation, wellness, and resource dynamics. Community resilience is a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity. Community adaptation is manifest in population wellness, defined as high and non-disparate levels of mental and behavioral health, functioning, and quality of life. Community resilience emerges from four primary sets of adaptive capacities--Economic Development, Social Capital, Information and Communication, and Community Competence--that together provide a strategy for disaster readiness. To build collective resilience, communities must reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, and plan for not having a plan, which requires flexibility, decision-making skills, and trusted sources of information that function in the face of unknowns.

  20. SU-E-J-127: Implementation of An Online Replanning Tool for VMAT Using Flattening Filter-Free Beams

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

    Ates, O; Ahunbay, E; Li, X

    2015-06-15

    Purpose: This is to report the implementation of an online replanning tool based on segment aperture morphing (SAM) for VMAT with flattening filter free (FFF) beams. Methods: Previously reported SAM algorithm modified to accommodate VMAT with FFF beams was implemented in a tool that was interfaced with a treatment planning system (Monaco, Elekta). The tool allows (1) to output the beam parameters of the original VMAT plan from Monaco, and (2) to input the apertures generated from the SAM algorithm into Monaco for the dose calculation on daily CT/CBCT/MRI in the following steps:(1) Quickly generating target contour based on themore » image of the day, using an auto-segmentation tool (ADMIRE, Elekta) with manual editing if necessary; (2) Morphing apertures based on the SAM in the original VMAT plan to account for the interfractional change of the target from the planning to the daily images; (3) Calculating dose distribution for new apertures with the same numbers of MU as in the original plan; (4) Transferring the new plan into a record & verify system (MOSAIQ, Elekta); (5) Performing a pre-delivery QA based on software; (6) Delivering the adaptive plan for the fraction.This workflow was implemented on a 16-CPU (2.6 GHz dual-core) hardware with GPU and was tested for sample cases of prostate, pancreas and lung tumors. Results: The online replanning process can be completed within 10 minutes. The adaptive plans generally have improved the plan quality when compared to the IGRT repositioning plans. The adaptive plans with FFF beams have better normal tissue sparing as compared with those of FF beams. Conclusion: The online replanning tool based on SAM can quickly generate adaptive VMAT plans using FFF beams with improved plan quality than those from the IGRT repositioning plans based on daily CT/CBCT/MRI and can be used clinically. This research was supported by Elekta Inc. (Crawley, UK)« less

  1. 11. Strategic planning.

    PubMed

    2014-05-01

    There are several types of planning processes and plans, including strategic, operational, tactical, and contingency. For this document, operational planning includes tactical planning. This chapter examines the strategic planning process and includes an introduction into disaster response plans. "A strategic plan is an outline of steps designed with the goals of the entire organisation as a whole in mind, rather than with the goals of specific divisions or departments". Strategic planning includes all measures taken to provide a broad picture of what must be achieved and in which order, including how to organise a system capable of achieving the overall goals. Strategic planning often is done pre-event, based on previous experience and expertise. The strategic planning for disasters converts needs into a strategic plan of action. Strategic plans detail the goals that must be achieved. The process of converting needs into plans has been deconstructed into its components and includes consideration of: (1) disaster response plans; (2) interventions underway or planned; (3) available resources; (4) current status vs. pre-event status; (5) history and experience of the planners; and (6) access to the affected population. These factors are tempered by the local: (a) geography; (b) climate; (c) culture; (d) safety; and (e) practicality. The planning process consumes resources (costs). All plans must be adapted to the actual conditions--things never happen exactly as planned.

  2. SU-F-J-57: Effectiveness of Daily CT-Based Three-Dimensional Image Guided and Adaptive Proton Therapy

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

    Moriya, S; National Cancer Center, Kashiwa, Chiba; Tachibana, H

    Purpose: Daily CT-based three-dimensional image-guided and adaptive (CTIGRT-ART) proton therapy system was designed and developed. We also evaluated the effectiveness of the CTIGRT-ART. Methods: Retrospective analysis was performed in three lung cancer patients: Proton treatment planning was performed using CT image datasets acquired by Toshiba Aquilion ONE. Planning target volume and surrounding organs were contoured by a well-trained radiation oncologist. Dose distribution was optimized using 180-deg. and 270-deg. two fields in passive scattering proton therapy. Well commissioned Simplified Monte Carlo algorithm was used as dose calculation engine. Daily consecutive CT image datasets was acquired by an in-room CT (Toshiba Aquilionmore » LB). In our in-house program, two image registrations for bone and tumor were performed to shift the isocenter using treatment CT image dataset. Subsequently, dose recalculation was performed after the shift of the isocenter. When the dose distribution after the tumor registration exhibits change of dosimetric parameter of CTV D90% compared to the initial plan, an additional process of was performed that the range shifter thickness was optimized. Dose distribution with CTV D90% for the bone registration, the tumor registration only and adaptive plan with the tumor registration was compared to the initial plan. Results: In the bone registration, tumor dose coverage was decreased by 16% on average (Maximum: 56%). The tumor registration shows better coverage than the bone registration, however the coverage was also decreased by 9% (Maximum: 22%) The adaptive plan shows similar dose coverage of the tumor (Average: 2%, Maximum: 7%). Conclusion: There is a high possibility that only image registration for bone and tumor may reduce tumor coverage. Thus, our proposed methodology of image guidance and adaptive planning using the range adaptation after tumor registration would be effective for proton therapy. This research is partially supported by Japan Agency for Medical Research and Development (AMED).« less

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

    Nugent, Philip J; Omitaomu, Olufemi A; Parish, Esther S

    The urban climate is changing rapidly. Therefore, climate change and its projected impacts on environmental conditions must be considered in assessing and comparing urban planning alternatives. In this paper, we present an integrated framework for urban climate adaptation tool (Urban-CAT) that will help cities to plan for, rather than react to, possible risks. Urban-CAT will be developed as a scenario planning tool that is locally relevant to existing urban decision-making processes.

  4. Strategic Planning for Sustainable Forests: The Plan Drives the Budgets Which Drive Results

    Treesearch

    Paul Brouha; Elisabeth Grinspoon

    2006-01-01

    The USDA Forest Service is among the pioneers incorporating the Montreal Process criteria and indicators into its programs. Among its initial efforts is the adaptation of a criteria and indicators framework for its national strategic plan, which is the primary instrument for setting the course to achieve the Forest Service mission of sustaining the nation’s forests and...

  5. Towards an equitable allocation of the cost of a global change adaptation plan at the river basin scale: going beyond the perfect cooperation assumption

    NASA Astrophysics Data System (ADS)

    Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velázquez, Manuel

    2015-04-01

    Adaptation to global change is a key issue in the planning of water resource systems in a changing world. Adaptation has to be efficient, but also equitable in the share of the costs of joint adaptation at the river basin scale. Least-cost hydro-economic optimization models have been helpful at defining efficient adaptation strategies. However, they often rely on the assumption of a "perfect cooperation" among the stakeholders, required for reaching the optimal solution. Nowadays, most adaptation decisions have to be agreed among the different actors in charge of their implementation, thus challenging the validity of a perfect command-and-control solution. As a first attempt to over-pass this limitation, our work presents a method to allocate the cost of an efficient adaptation programme of measures among the different stakeholders at the river basin scale. Principles of equity are used to define cost allocation scenarios from different perspectives, combining elements from cooperative game theory and axioms from social justice to bring some "food for thought" in the decision making process of adaptation. To illustrate the type of interactions between stakeholders in a river basin, the method has been applied in a French case study, the Orb river basin. Located on the northern rim of the Mediterranean Sea, this river basin is experiencing changes in demand patterns, and its water resources will be impacted by climate change, calling for the design of an adaptation plan. A least-cost river basin optimization model (LCRBOM) has been developed under GAMS to select the combination of demand- and supply-side adaptation measures that allows meeting quantitative water management targets at the river basin scale in a global change context. The optimal adaptation plan encompasses measures in both agricultural and urban sectors, up-stream and down-stream of the basin, disregarding the individual interests of the stakeholders. In order to ensure equity in the cost allocation of the adaptation plan, different allocation scenarios are considered. The LCRBOM allows defining a solution space based on economic rationality concepts from cooperative game theory (the core of the game), and then, to define equitable allocation of the cost of the programme of measures (the Shapley value and the nucleolus). Moreover, alternative allocation scenarios have been considered based on axiomatic principles of social justice, such as "utilitarian", "prior rights" or "strict equality", applied in the case study area. The comparison of the cost allocation scenarios brings insight to inform the decision making process at the river basin scale and potentially reap the efficiency gains from cooperation in the design of adaptation plan. The study has been partially supported by the IMPADAPT project /CGL2013-48424-C2-1-R) from the Spanish ministry MINECO (Ministerio de Economía y Competitividad) and European FEDER funds. Corentin Girard is supported by a grant from the University Lecturer Training Program (FPU12/03803) of the Ministry of Education, Culture and Sports of Spain.

  6. Learning and adaptation in waterfowl conservation: By chance or by design?

    USGS Publications Warehouse

    Johnson, Fred A.; Case, David J.; Humburg, Dale H.

    2016-01-01

    The most recent revision of the North American Waterfowl Management Plan seeks to increase the adaptive capacity of the management enterprise to cope with accelerating changes in climate, land-use patterns, agency priorities, and the waterfowl and wetlands constituency. Institutional and cultural changes of the magnitude envisioned are necessarily slow, messy processes, involving many actors who at a minimum must agree on the need for change. Waterfowl conservation now finds itself in the transition zone between business as usual and some new mode of operation. There are at least 2 different perspectives of this transition: one focuses on process, accountability, and planning for change; another focuses on solutions generated from an organic process of creativity, information sharing, and risk-taking. Both of these views have something to contribute, but some in the wildlife management enterprise may tend to focus more on the first view. We suggest that ideas from panarchy theory, especially those related to the behaviors of complex adaptive systems, can help waterfowl managers better understand and foster the institutional changes they seek.

  7. Lessons from a Space Analog on Adaptation for Long-Duration Exploration Missions.

    PubMed

    Anglin, Katlin M; Kring, Jason P

    2016-04-01

    Exploration missions to asteroids and Mars will bring new challenges associated with communication delays and more autonomy for crews. Mission safety and success will rely on how well the entire system, from technology to the human elements, is adaptable and resilient to disruptive, novel, or potentially catastrophic events. The recent NASA Extreme Environment Missions Operations (NEEMO) 20 mission highlighted this need and produced valuable "lessons learned" that will inform future research on team adaptation and resilience. A team of NASA, industry, and academic members used an iterative process to design a tripod shaped structure, called the CORAL Tower, for two astronauts to assemble underwater with minimal tools. The team also developed assembly procedures, administered training to the crew, and provided support during the mission. During the design, training, and assembly of the Tower, the team learned first-hand how adaptation in extreme environments depends on incremental testing, thorough procedures and contingency plans that predict possible failure scenarios, and effective team adaptation and resiliency for the crew and support personnel. Findings from NEEMO 20 provide direction on the design and testing process for future space systems and crews to maximize adaptation. This experience also underscored the need for more research on team adaptation, particularly how input and process factors affect adaption outcomes, the team adaptation iterative process, and new ways to measure the adaptation process.

  8. Using Global Climate Data to Inform Long-Term Water Planning Decisions

    NASA Astrophysics Data System (ADS)

    Groves, D. G.; Lempert, R.

    2008-12-01

    Water managers throughout the world are working to consider climate change in their long-term water planning processes. The best available information regarding plausible future hydrologic conditions are largely derived from global circulation models and from paleoclimate data. To date there lacks a single approach for (1) utilizing these data in water management planning tools for analysis and (2) evaluating the myriad of possible adaptation options. This talk will describe several approaches being used at RAND to incorporate global projections of climate change into local, regional, and state-wide long-term water planning. It will draw on current work with the California Department of Water Resources and other local Western water agencies, and a recently completed project with the Inland Empire Utilities Agency. Work to date suggests that climate information can be assimilated into local water planning tools to help identify robust climate adaptation water management strategies.

  9. Mission Data System Java Edition Version 7

    NASA Technical Reports Server (NTRS)

    Reinholtz, William K.; Wagner, David A.

    2013-01-01

    The Mission Data System framework defines closed-loop control system abstractions from State Analysis including interfaces for state variables, goals, estimators, and controllers that can be adapted to implement a goal-oriented control system. The framework further provides an execution environment that includes a goal scheduler, execution engine, and fault monitor that support the expression of goal network activity plans. Using these frameworks, adapters can build a goal-oriented control system where activity coordination is verified before execution begins (plan time), and continually during execution. Plan failures including violations of safety constraints expressed in the plan can be handled through automatic re-planning. This version optimizes a number of key interfaces and features to minimize dependencies, performance overhead, and improve reliability. Fault diagnosis and real-time projection capabilities are incorporated. This version enhances earlier versions primarily through optimizations and quality improvements that raise the technology readiness level. Goals explicitly constrain system states over explicit time intervals to eliminate ambiguity about intent, as compared to command-oriented control that only implies persistent intent until another command is sent. A goal network scheduling and verification process ensures that all goals in the plan are achievable before starting execution. Goal failures at runtime can be detected (including predicted failures) and handled by adapted response logic. Responses can include plan repairs (try an alternate tactic to achieve the same goal), goal shedding, ignoring the fault, cancelling the plan, or safing the system.

  10. Integrating top-down and bottom-up approaches to design a cost-effective and equitable programme of measures for adaptation of a river basin to global change

    NASA Astrophysics Data System (ADS)

    Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velazquez, Manuel

    2016-04-01

    Adaptation to the multiple facets of global change challenges the conventional means of sustainably planning and managing water resources at the river basin scale. Numerous demand or supply management options are available, from which adaptation measures need to be selected in a context of high uncertainty of future conditions. Given the interdependency of water users, agreements need to be found at the local level to implement the most effective adaptation measures. Therefore, this work develops an approach combining economics and water resources engineering to select a cost-effective programme of adaptation measures in the context of climate change uncertainty, and to define an equitable allocation of the cost of the adaptation plan between the stakeholders involved. A framework is developed to integrate inputs from the two main approaches commonly used to plan for adaptation. The first, referred to as "top-down", consists of a modelling chain going from global greenhouse gases emission scenarios to local hydrological models used to assess the impact of climate change on water resources. Conversely, the second approach, called "bottom-up", starts from assessing vulnerability at the local level to then identify adaptation measures used to face an uncertain future. The methodological framework presented in this contribution relies on a combination of these two approaches to support the selection of adaptation measures at the local level. Outcomes from these two approaches are integrated to select a cost-effective combination of adaptation measures through a least-cost optimization model developed at the river basin scale. The performances of a programme of measures are assessed under different climate projections to identify cost-effective and least-regret adaptation measures. The issue of allocating the cost of the adaptation plan is considered through two complementary perspectives. The outcome of a negotiation process between the stakeholders is modelled through the implementation of cooperative game theory to define cost allocation scenarios. These results are compared with cost allocation rules based on social justice principles to provide contrasted insights into a negotiation process. The interdisciplinary framework developed in this research combines economics and water resources engineering methods, establishing a promising means of bridging the gap between bottom-up and top-down approaches and supporting the creation of cost-effective and equitable adaptation plans at the local level. The approach has been applied to the Orb river basin in Southern France. Acknowledgements The study has been partially supported by the IMPADAPT project /CGL2013-48424-C2-1-R) from the Spanish ministry MINECO (Ministerio de Economía y Competitividad) and European FEDER funds. Corentin Girard is supported by a grant from the University Lecturer Training Program (FPU12/03803) of the Ministry of Education, Culture and Sports of Spain.

  11. Using the collaborative intervention planning framework to adapt a health-care manager intervention to a new population and provider group to improve the health of people with serious mental illness.

    PubMed

    Cabassa, Leopoldo J; Gomes, Arminda P; Meyreles, Quisqueya; Capitelli, Lucia; Younge, Richard; Dragatsi, Dianna; Alvarez, Juana; Manrique, Yamira; Lewis-Fernández, Roberto

    2014-11-30

    Health-care manager interventions improve the physical health of people with serious mental illness (SMI) and could be widely implemented in public mental health clinics. Local adaptations and customization may be needed to increase the reach of these interventions in the public mental health system and across different racial and ethnic communities. In this study, we describe how we used the collaborative intervention planning framework to customize an existing health-care manager intervention to a new patient population (Hispanics with SMI) and provider group (social workers) to increase its fit with our local community. The study was conducted in partnership with a public mental health clinic that serves predominantly Hispanic clients. A community advisory board (CAB) composed of researchers and potential implementers (e.g., social workers, primary care physicians) used the collaborative intervention planning framework, an approach that combines community-based participatory research principles and intervention mapping (IM) procedures, to inform intervention adaptations. The adaptation process included four steps: fostering collaborations between CAB members; understanding the needs of the local population through a mixed-methods needs assessment, literature reviews, and group discussions; reviewing intervention objectives to identify targets for adaptation; and developing the adapted intervention. The application of this approach enabled the CAB to identify a series of cultural and provider level-adaptations without compromising the core elements of the original health-care manager intervention. Reducing health disparities in people with SMI requires community engagement, particularly when preparing existing interventions to be used with new communities, provider groups, and practice settings. Our study illustrates one approach that can be used to involve community stakeholders in the intervention adaptation process from the very beginning to enhance the transportability of a health-care manager intervention in order to improve the health of people with SMI.

  12. Methodological issues with adaptation of clinical trial design.

    PubMed

    Hung, H M James; Wang, Sue-Jane; O'Neill, Robert T

    2006-01-01

    Adaptation of clinical trial design generates many issues that have not been resolved for practical applications, though statistical methodology has advanced greatly. This paper focuses on some methodological issues. In one type of adaptation such as sample size re-estimation, only the postulated value of a parameter for planning the trial size may be altered. In another type, the originally intended hypothesis for testing may be modified using the internal data accumulated at an interim time of the trial, such as changing the primary endpoint and dropping a treatment arm. For sample size re-estimation, we make a contrast between an adaptive test weighting the two-stage test statistics with the statistical information given by the original design and the original sample mean test with a properly corrected critical value. We point out the difficulty in planning a confirmatory trial based on the crude information generated by exploratory trials. In regards to selecting a primary endpoint, we argue that the selection process that allows switching from one endpoint to the other with the internal data of the trial is not very likely to gain a power advantage over the simple process of selecting one from the two endpoints by testing them with an equal split of alpha (Bonferroni adjustment). For dropping a treatment arm, distributing the remaining sample size of the discontinued arm to other treatment arms can substantially improve the statistical power of identifying a superior treatment arm in the design. A common difficult methodological issue is that of how to select an adaptation rule in the trial planning stage. Pre-specification of the adaptation rule is important for the practicality consideration. Changing the originally intended hypothesis for testing with the internal data generates great concerns to clinical trial researchers.

  13. Evaluation of National Adaptation Planning: A Case Study in Indonesia

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

    Kawanishi, Masato; Ridwan, Nadia Amelia

    2016-01-01

    The present study aims to evaluate national adaptation planning, using the National Action Plan for Climate Change Adaptation (RAN-API) in Indonesia as a case. In doing so, the current study applies the methodology used in Preston et al. (2011), where a set of 57 adaptation plans from three developed countries was evaluated against 19 planning processes. The same criteria and scoring system were applied to the current study to evaluate RAN-API, both as identified in its document and as viewed by the stakeholders. A desktop review and questionnaires were undertaken to this end. It was found that discrepancies exist betweenmore » the status of RAN-API as documented and the stakeholders views of some criteria, suggesting that information or knowledge gaps may still exist despite the efforts made for stakeholder engagement. In some of the other criteria, the stakeholders views match the status as identified in the document. Most notably, they both agree that the weakness of RAN-API is related to limited consideration for non-climatic factors. While the development of RAN-API is a critical step taken in the country, the current study finds that there remains room for further improvement. The criteria or indicators to be used to assess the progress of RAN-API as a whole may need to be further elaborated.« less

  14. A case study for online plan adaptation using helical tomotherapy

    PubMed Central

    Neilson, Christopher E.; Yartsev, Slav

    2012-01-01

    Helical tomotherapy's ability to provide daily megavoltage (MV) computed tomography (CT) images for patient set-up verification allows for the creation of adapted plans. As plans become more complex by introducing sharper dose gradients in an effort to spare healthy tissue, inter-fraction changes of organ position with respect to plan become a limiting factor in the correct dose delivery to the target. Tomotherapy's planned adaptive option provides the possibility to evaluate the dose distribution for each fraction and subsequently adapt the original plan to the current anatomy. In this study, 30 adapted plans were created using new contours based on the daily MVCT studies of a bladder cancer patient with considerable anatomical variations. Dose to the rectum and two planning target volumes (PTVs) were compared between the original plan, the dose that was actually delivered to the patient, and the theoretical dose from the 30 adapted plans. The adaptation simulation displayed a lower dose to 35% and 50% of the rectum compared to no adaptation at all, while maintaining an equivalent dose to the PTVs. Although online adaptation is currently too time-consuming, it has the potential to improve the effectiveness of radiotherapy. PMID:22557799

  15. Planning for Sea Level Rise: An AGU Talk in the Form of a Co-Production Experiment Exploring Recent Science

    NASA Astrophysics Data System (ADS)

    Behar, D. H.; Kopp, R. E.; DeConto, R.; Weaver, C. P.; White, K. D.; May, K.; Bindschadler, R.

    2017-12-01

    Global sea level rise (SLR) may present the most urgent climate change adaptation challenge facing coastal communities today. The direction is clear, impacts are manifesting now, and the pace of rise is likely to accelerate. As a result, many coastal communities have begun planning their adaptation response and some are quite far along in the process. At the same time, evolving science provides new observations, models, and understanding of land-ocean dynamics that can increase clarity while also in many ways increase uncertainty about the scope, timing, and regional nature of SLR. The planning, design, and construction of water infrastructure has a relatively long timeline (up to 30 years), and thus the evolution of scientific knowledge presents challenges for communities already planning for SLR based on previous information. When does science become actionable for decision-makers? Are there characteristics or thresholds that could cause communities decide to move from one set of scenarios to another, or change approaches altogether? This talk focuses on two important studies different in kind but dominating the conversation about SLR adaptation planning today. First, DeConto and Pollard (2016) have suggested significantly higher upper end projections for Antarctic ice sheet melt, which increase both global and regional SLR above most previously assumed upper limits. Second, probabilistic projections using model output and expert elicitation as presented in Kopp et al (2014) are increasingly appearing in federal reports and planning-related documents. These two papers are pushing the boundaries of the science-to-planning interface, while the application of this work as actionable science is far from settled. This talk will present the outcome of recent conversations among our diverse author team. The authors are engaged in SLR planning related contexts from many angles and perspectives and include the aforementioned Kopp and DeConto as well as representatives of the City of San Francisco, Army Corps of Engineers, Environmental Protection Agency, and engineering consultant community. Attendees of this session will hear a presentation demonstrating co-production in process, including topics about which the authors have and have not agreed upon to date, with some attention to next steps in the process.

  16. Policy Coherence and Interplay between Climate Change Adaptation Policies and the Forestry Sector in Nepal.

    PubMed

    Ranabhat, Sunita; Ghate, Rucha; Bhatta, Laxmi Dutt; Agrawal, Nand Kishor; Tankha, Sunil

    2018-06-01

    Least Developed Countries are likely to be hit the hardest by climate change and need focused efforts towards adaptation. Nepal recognizes that it needs to integrate climate change adaptation into various policies, but limited understanding of how to make these policies coherent is among the factors that hinder effective adaptation action. This can lead to wasted resources and lost opportunities. This paper applies concepts from policy coherence for development frameworks and policy content analysis to examine coherence in Nepal's climate and forest policies-and discusses the factors hindering effective implementation. The policies are analyzed at the horizontal/external level at three layers-motivation, measures, and planned implementation process. The paper finds that policies are more consistent on motivation level and adaptation measures, but are less coherent on implementation. The National Adaptation Programme of Action (NAPA) is more explicit in identifying institutions, organizations, roles and responsibilities, resource allocation (financial), and a monitoring and evaluation plan for climate change adaptation while other policies such as Climate Change Policy 2011, National Biodiversity Strategy and Action Plan 2014-2020, Forest Policy 2015, and Forest Sector Strategy 2016 have critical gaps in this area. This paper conclude that formulation of a policy, articulating targets, and mobilizing financial resources are in themselves not sufficient to effectively address climate change adaptation. Policy-based legislation is required, together with development of a supportive collaborative multi-stakeholder approach at different levels of governance, backed up by effective, collaborative monitoring and enforcement.

  17. Policy Coherence and Interplay between Climate Change Adaptation Policies and the Forestry Sector in Nepal

    NASA Astrophysics Data System (ADS)

    Ranabhat, Sunita; Ghate, Rucha; Bhatta, Laxmi Dutt; Agrawal, Nand Kishor; Tankha, Sunil

    2018-06-01

    Least Developed Countries are likely to be hit the hardest by climate change and need focused efforts towards adaptation. Nepal recognizes that it needs to integrate climate change adaptation into various policies, but limited understanding of how to make these policies coherent is among the factors that hinder effective adaptation action. This can lead to wasted resources and lost opportunities. This paper applies concepts from policy coherence for development frameworks and policy content analysis to examine coherence in Nepal's climate and forest policies—and discusses the factors hindering effective implementation. The policies are analyzed at the horizontal/external level at three layers—motivation, measures, and planned implementation process. The paper finds that policies are more consistent on motivation level and adaptation measures, but are less coherent on implementation. The National Adaptation Programme of Action (NAPA) is more explicit in identifying institutions, organizations, roles and responsibilities, resource allocation (financial), and a monitoring and evaluation plan for climate change adaptation while other policies such as Climate Change Policy 2011, National Biodiversity Strategy and Action Plan 2014-2020, Forest Policy 2015, and Forest Sector Strategy 2016 have critical gaps in this area. This paper conclude that formulation of a policy, articulating targets, and mobilizing financial resources are in themselves not sufficient to effectively address climate change adaptation. Policy-based legislation is required, together with development of a supportive collaborative multi-stakeholder approach at different levels of governance, backed up by effective, collaborative monitoring and enforcement.

  18. 76 FR 12945 - Instructions for Implementing Climate Change Adaptation Planning in Accordance With Executive...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-09

    ... COUNCIL ON ENVIRONMENTAL QUALITY Instructions for Implementing Climate Change Adaptation Planning... Availability of Climate Change Adaptation Planning Implementing Instructions. SUMMARY: The Chair of the Council... for Implementing Climate Change Adaptation Planning are now available at: http://www.whitehouse.gov...

  19. Intestinal mucosal atrophy and adaptation

    PubMed Central

    Shaw, Darcy; Gohil, Kartik; Basson, Marc D

    2012-01-01

    Mucosal adaptation is an essential process in gut homeostasis. The intestinal mucosa adapts to a range of pathological conditions including starvation, short-gut syndrome, obesity, and bariatric surgery. Broadly, these adaptive functions can be grouped into proliferation and differentiation. These are influenced by diverse interactions with hormonal, immune, dietary, nervous, and mechanical stimuli. It seems likely that clinical outcomes can be improved by manipulating the physiology of adaptation. This review will summarize current understanding of the basic science surrounding adaptation, delineate the wide range of potential targets for therapeutic intervention, and discuss how these might be incorporated into an overall treatment plan. Deeper insight into the physiologic basis of adaptation will identify further targets for intervention to improve clinical outcomes. PMID:23197881

  20. Culturally Adaptive Walking Intervention for Korean-Chinese Female Migrant Workers.

    PubMed

    Cho, Sunghye; Lee, Hyeonkyeong; Kim, Jung Hee; Lee, Meenhye; Lee, Young-Me

    2017-05-01

    Although the literature has commonly cited that development of culturally adaptive interventions is key to improving the health outcomes of culturally and linguistically diverse populations, there have been limited culturally adaptive walking interventions specific to Korean-Chinese (KC) migrants. The objective of this study is to describe the process in development of culturally adaptive walking interventions for KC female migrant workers, using the intervention mapping (IM) method. The culturally adaptive walking intervention was developed using the IM method, which is a stepwise theory and evidence-based approach for planning interventions. The IM method process has six steps, including needs assessment, formulation of change objectives, selection of theory-based methods and practical strategies, development of an intervention program, development of an adoption and implementation plan, and development of an evaluation design. The determinants of walking behavior, including knowledge, self-efficacy, social support, and acculturation, were identified through an extensive literature review, community leader interviews, and a survey of female KC migrant workers. Appropriate intervention methods and strategies were identified based on relevant theories. Acculturation was a determinant of exercise behavior, and various methods to improve cultural adaptation were identified in the context of the lifestyles and working environments of the target population. The IM method provided a foundation for creating a health intervention for KC female migrant workers. This method could easily be useful for health care providers working with other groups.

  1. On the role of model-based monitoring for adaptive planning under uncertainty

    NASA Astrophysics Data System (ADS)

    Raso, Luciano; Kwakkel, Jan; Timmermans, Jos; Haasnoot, Mariolijn

    2016-04-01

    Adaptive plans, designed to anticipate and respond to an unfolding uncertain future, have found a fertile application domain in the planning of deltas that are exposed to rapid socioeconomic development and climate change. Adaptive planning, under the moniker of adaptive delta management, is used in the Dutch Delta Program for developing a nation-wide plan to prepare for uncertain climate change and socio-economic developments. Scientifically, adaptive delta management relies heavily on Dynamic Adaptive Policy Pathways. Currently, in the Netherlands the focus is shifting towards implementing the adaptive delta plan. This shift is especially relevant because the efficacy of adaptive plans hinges on monitoring on-going developments and ensuring that actions are indeed taken if and when necessary. In the design of an effective monitoring system for an adaptive plan, three challenges have to be confronted: • Shadow of the past: The development of adaptive plans and the design of their monitoring system relies heavily on current knowledge of the system, and current beliefs about plausible future developments. A static monitoring system is therefore exposed to the exact same uncertainties one tries to address through adaptive planning. • Inhibition of learning: Recent applications of adaptive planning tend to overlook the importance of learning and new information, and fail to account for this explicitly in the design of adaptive plans. • Challenge of surprise: Adaptive policies are designed in light of the current foreseen uncertainties. However, developments that are not considered during the design phase as being plausible could still substantially affect the performance of adaptive policies. The shadow of the past, the inhibition of learning, and the challenge of surprise taken together suggest that there is a need for redesigning the concepts of monitoring and evaluation to support the implementation of adaptive plans. Innovations from control theory, triggered by the challenge of uncertainty in operational control, may offer solutions from which monitoring for adaptive planning can benefit. Specifically: (i) in control, observations are incorporated into the model through data assimilation, updating the present state, boundary conditions, and parameters based on new observations, diminishing the shadow of the past; (ii) adaptive control is a way to modify the characteristics of the internal model, incorporating new knowledge on the system, countervailing the inhibition of learning; and (iii) in closed-loop control, a continuous system update equips the controller with "inherent robustness", i.e. to capacity to adapts to new conditions even when these were not initially considered. We aim to explore how inherent robustness addresses the challenge of surprise. Innovations in model-based control might help to improve and adapt the models used to support adaptive delta management to new information (reducing uncertainty). Moreover, this would offer a starting point for using these models not only in the design of adaptive plans, but also as part of the monitoring. The proposed research requires multidisciplinary cooperation between control theory, the policy sciences, and integrated assessment modeling.

  2. Patient Activities Planning and Progress Noting a Humanistic Integrated-Team Approach.

    ERIC Educational Resources Information Center

    Muilenburg, Ted

    This document outlines a system for planning recreation therapy, documenting progress, and relating the entire process to a team approach which includes patient assessment and involvement. The recreation program is seen as therapeutic, closely related to the total medical treatment program. The model is designed so that it can be adapted to almost…

  3. Adaptation Planning for Water Resources Management in the Context of Scientific Uncertainty

    NASA Astrophysics Data System (ADS)

    Lowrey, J.; Kenney, D.

    2008-12-01

    Several municipalities are beginning to create policies and plans in order to adapt to potential impacts from climate change. A 2007 report from the Heinz Center for Science, Economics, and the Environment, 'A Survey of Climate Change Adaptation Planning,' surveyed fourteen cities or counties across the U.S. and Canada that have created or are working towards creating climate change adaptation plans. Informal interactions with water managers in the Intermountain West indicate an eagerness to learn from those who have already begun adapting to potential climate change. Many of those without plans do not feel comfortable making potentially expensive long-term policy decisions based on impacts derived from uncertain climate change projections. This research identifies how decision makers currently consider climate change in adaptation planning despite imperfect information about climate change impacts, particularly in the water sector. Insights are offered into how best to provide information on climate change projections to regional decision makers so that they can begin adaptation planning for a changing climate. This research analyzes how a subset of the fourteen municipalities justified adaptive planning in the face of scientific uncertainty, paying particular attention to water resource adaptation, using the adaptation approaches studied in the 2007 Heinz Center Report. Interviews will be conducted with decision makers to learn how policies will be implemented and evaluated, and to explore resulting changes in policy or planning. Adaptation strategies are not assessed, but are used to identify how the decision makers plan to evaluate their own adaptation policies. In addition to looking at information use in adaptation plans, we compare how the plans orient themselves (adapting to projected impacts vs. increasing resiliency to current climate variability), how they address barriers and opportunities for adaptation, and whether they follow some key steps for successful adaptation as outlined in the literature. This part of the study will identify any consensus among the municipalities already adapting, and see of the decision makers tend to agree with the points of views expressed in the literature. The conclusions here will not only help decision makers trying to adapt, but it will help researchers orient future research to the informational needs of the decision makers. The work is intended to provide useful information for the Western Water Assessment, a NOAA-funded research boundary organization, which provides climate information to water resource managers in the Intermountain West, including the Colorado River Basin.

  4. Adapted Intervention Mapping: A Strategic Planning Process for Increasing Physical Activity and Healthy Eating Opportunities in Schools via Environment and Policy Change

    ERIC Educational Resources Information Center

    Belansky, Elaine S.; Cutforth, Nick; Chavez, Robert; Crane, Lori A.; Waters, Emily; Marshall, Julie A.

    2013-01-01

    Background: School environment and policy changes have increased healthy eating and physical activity; however, there has been modest success in translating research ?ndings to practice. The School Environment Project tested whether an adapted version of Intervention Mapping (AIM) resulted in school change. Methods: Using a pair randomized design,…

  5. 12th Annual Science and Engineering Technology Conference/DoD TECH Exposition

    DTIC Science & Technology

    2011-06-23

    compound when planning horizons grow: long design - test - build-field-adapt lead-times exacerbate uncertain futures problems, overload designs , and...ERS Environment ERS: Tools and Technologies to Facilitate Adaptability & Trustability 4. Tying design , physical and computational testing 6...science, engineering concepts, processes, and design tools to: • Continuously coordinate design , testing , and production with warfighter review to

  6. ADAPTIPS: Adapting Curricula for Students Who Are Deaf-Blind and Who Function in the Sensorimotor Developmental Stage.

    ERIC Educational Resources Information Center

    Goodrich, Judy A.; Kinney, Patricia G.

    Intended to assist teachers as they assess, plan for, and teach deaf blind students, this manual describes a process for adapting curricula for students who function within the 0-24 month developmental period, also known as the sensorimotor period. The manual's first section provides an overview of project activities including the literature…

  7. NEEDS - Information Adaptive System

    NASA Technical Reports Server (NTRS)

    Kelly, W. L.; Benz, H. F.; Meredith, B. D.

    1980-01-01

    The Information Adaptive System (IAS) is an element of the NASA End-to-End Data System (NEEDS) Phase II and is focused toward onboard image processing. The IAS is a data preprocessing system which is closely coupled to the sensor system. Some of the functions planned for the IAS include sensor response nonuniformity correction, geometric correction, data set selection, data formatting, packetization, and adaptive system control. The inclusion of these sensor data preprocessing functions onboard the spacecraft will significantly improve the extraction of information from the sensor data in a timely and cost effective manner, and provide the opportunity to design sensor systems which can be reconfigured in near real-time for optimum performance. The purpose of this paper is to present the preliminary design of the IAS and the plans for its development.

  8. The Development of Innovative Climates in Educational Organizations.

    ERIC Educational Resources Information Center

    Miles, Matthew B.

    The actualization of educational improvements in school systems necessitates an innovative climate. A schematic diagram shows seven functions as constituting the planning and inventing process for educational improvement. Of these seven functions, four are developmental and adaptation processes, and three provide for the routinization of building…

  9. A strategic planning methodology for aircraft redesign

    NASA Astrophysics Data System (ADS)

    Romli, Fairuz Izzuddin

    Due to a progressive market shift to a customer-driven environment, the influence of engineering changes on the product's market success is becoming more prominent. This situation affects many long lead-time product industries including aircraft manufacturing. Derivative development has been the key strategy for many aircraft manufacturers to survive the competitive market and this trend is expected to continue in the future. Within this environment of design adaptation and variation, the main market advantages are often gained by the fastest aircraft manufacturers to develop and produce their range of market offerings without any costly mistakes. This realization creates an emphasis on the efficiency of the redesign process, particularly on the handling of engineering changes. However, most activities involved in the redesign process are supported either inefficiently or not at all by the current design methods and tools, primarily because they have been mostly developed to improve original product development. In view of this, the main goal of this research is to propose an aircraft redesign methodology that will act as a decision-making aid for aircraft designers in the change implementation planning of derivative developments. The proposed method, known as Strategic Planning of Engineering Changes (SPEC), combines the key elements of the product redesign planning and change management processes. Its application is aimed at reducing the redesign risks of derivative aircraft development, improving the detection of possible change effects propagation, increasing the efficiency of the change implementation planning and also reducing the costs and the time delays due to the redesign process. To address these challenges, four research areas have been identified: baseline assessment, change propagation prediction, change impact analysis and change implementation planning. Based on the established requirements for the redesign planning process, several methods and tools that are identified within these research areas have been abstracted and adapted into the proposed SPEC method to meet the research goals. The proposed SPEC method is shown to be promising in improving the overall efficiency of the derivative aircraft planning process through two notional aircraft system redesign case studies that are presented in this study.

  10. Intelligent control and adaptive systems; Proceedings of the Meeting, Philadelphia, PA, Nov. 7, 8, 1989

    NASA Technical Reports Server (NTRS)

    Rodriguez, Guillermo (Editor)

    1990-01-01

    Various papers on intelligent control and adaptive systems are presented. Individual topics addressed include: control architecture for a Mars walking vehicle, representation for error detection and recovery in robot task plans, real-time operating system for robots, execution monitoring of a mobile robot system, statistical mechanics models for motion and force planning, global kinematics for manipulator planning and control, exploration of unknown mechanical assemblies through manipulation, low-level representations for robot vision, harmonic functions for robot path construction, simulation of dual behavior of an autonomous system. Also discussed are: control framework for hand-arm coordination, neural network approach to multivehicle navigation, electronic neural networks for global optimization, neural network for L1 norm linear regression, planning for assembly with robot hands, neural networks in dynamical systems, control design with iterative learning, improved fuzzy process control of spacecraft autonomous rendezvous using a genetic algorithm.

  11. Improving processes through evolutionary optimization.

    PubMed

    Clancy, Thomas R

    2011-09-01

    As systems evolve over time, their natural tendency is to become increasingly more complex. Studies on complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 18th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, I discuss methods to optimize complex healthcare processes through learning, adaptation, and evolutionary planning.

  12. Interaction of attentional and motor control processes in handwriting.

    PubMed

    Brown, T L; Donnenwirth, E E

    1990-01-01

    The interaction between attentional capacity, motor control processes, and strategic adaptations to changing task demands was investigated in handwriting, a continuous (rather than discrete) skilled performance. Twenty-four subjects completed 12 two-minute handwriting samples under instructions stressing speeded handwriting, normal handwriting, or highly legible handwriting. For half of the writing samples, a concurrent auditory monitoring task was imposed. Subjects copied either familiar (English) or unfamiliar (Latin) passages. Writing speed, legibility ratings, errors in writing and in the secondary auditory task, and a derived measure of the average number of characters held in short-term memory during each sample ("planning unit size") were the dependent variables. The results indicated that the ability to adapt to instructions stressing speed or legibility was substantially constrained by the concurrent listening task and by text familiarity. Interactions between instructions, task concurrence, and text familiarity in the legibility ratings, combined with further analyses of planning unit size, indicated that information throughput from temporary storage mechanisms to motor processes mediated the loss of flexibility effect. Overall, the results suggest that strategic adaptations of a skilled performance to changing task circumstances are sensitive to concurrent attentional demands and that departures from "normal" or "modal" performance require attention.

  13. Evaluation of adaptive treatment planning for patients with non-small cell lung cancer

    NASA Astrophysics Data System (ADS)

    Zhong, Hualiang; Siddiqui, Salim M.; Movsas, Benjamin; Chetty, Indrin J.

    2017-06-01

    The purpose of this study was to develop metrics to evaluate uncertainties in deformable dose accumulation for patients with non-small cell lung cancer (NSCLC). Initial treatment plans (primary) and cone-beam CT (CBCT) images were retrospectively processed for seven NSCLC patients, who showed significant tumor regression during the course of treatment. Each plan was developed with IMRT for 2 Gy  ×  33 fractions. A B-spline-based DIR algorithm was used to register weekly CBCT images to a reference image acquired at fraction 21 and the resultant displacement vector fields (DVFs) were then modified using a finite element method (FEM). The doses were calculated on each of these CBCT images and mapped to the reference image using a tri-linear dose interpolation method, based on the B-spline and FEM-generated DVFs. Contours propagated from the planning image were adjusted to the residual tumor and OARs on the reference image to develop a secondary plan. For iso-prescription adaptive plans (relative to initial plans), mean lung dose (MLD) was reduced, on average from 17.3 Gy (initial plan) to 15.2, 14.5 and 14.8 Gy for the plans adapted using the rigid, B-Spline and FEM-based registrations. Similarly, for iso-toxic adaptive plans (considering MLD relative to initial plans) using the rigid, B-Spline and FEM-based registrations, the average doses were 69.9  ±  6.8, 65.7  ±  5.1 and 67.2  ±  5.6 Gy in the initial volume (PTV1), and 81.5  ±  25.8, 77.7  ±  21.6, and 78.9  ±  22.5 Gy in the residual volume (PTV21), respectively. Tumor volume reduction was correlated with dose escalation (for isotoxic plans, correlation coefficient  =  0.92), and with MLD reduction (for iso-fractional plans, correlation coefficient  =  0.85). For the case of the iso-toxic dose escalation, plans adapted with the B-Spline and FEM DVFs differed from the primary plan adapted with rigid registration by 2.8  ±  1.0 Gy and 1.8  ±  0.9 Gy in PTV1, and the mean difference between doses accumulated using the B-spline and FEM DVF’s was 1.1  ±  0.6 Gy. As a dose mapping-induced energy change, energy defect in the tumor volume was 20.8  ±  13.4% and 4.5  ±  2.4% for the B-spline and FEM-based dose accumulations, respectively. The energy defect of the B-Spline-based dose accumulation is significant in the tumor volume and highly correlated to the difference between the B-Spline and FEM-accumulated doses with their correlation coefficient equal to 0.79. Adaptive planning helps escalate target dose and spare normal tissue for patients with NSCLC, but deformable dose accumulation may have a significant loss of energy in regressed tumor volumes when using image intensity-based DIR algorithms. The metric of energy defect is a useful tool for evaluation of adaptive planning accuracy for lung cancer patients.

  14. Technique adaptation, strategic replanning, and team learning during implementation of MR-guided brachytherapy for cervical cancer.

    PubMed

    Skliarenko, Julia; Carlone, Marco; Tanderup, Kari; Han, Kathy; Beiki-Ardakani, Akbar; Borg, Jette; Chan, Kitty; Croke, Jennifer; Rink, Alexandra; Simeonov, Anna; Ujaimi, Reem; Xie, Jason; Fyles, Anthony; Milosevic, Michael

    MR-guided brachytherapy (MRgBT) with interstitial needles is associated with improved outcomes in cervical cancer patients. However, there are implementation barriers, including magnetic resonance (MR) access, practitioner familiarity/comfort, and efficiency. This study explores a graded MRgBT implementation strategy that included the adaptive use of needles, strategic use of MR imaging/planning, and team learning. Twenty patients with cervical cancer were treated with high-dose-rate MRgBT (28 Gy in four fractions, two insertions, daily MR imaging/planning). A tandem/ring applicator alone was used for the first insertion in most patients. Needles were added for the second insertion based on evaluation of the initial dosimetry. An interdisciplinary expert team reviewed and discussed the MR images and treatment plans. Dosimetry-trigger technique adaptation with the addition of needles for the second insertion improved target coverage in all patients with suboptimal dosimetry initially without compromising organ-at-risk (OAR) sparing. Target and OAR planning objectives were achieved in most patients. There were small or no systematic differences in tumor or OAR dosimetry between imaging/planning once per insertion vs. daily and only small random variations. Peer review and discussion of images, contours, and plans promoted learning and process development. Technique adaptation based on the initial dosimetry is an efficient approach to implementing MRgBT while gaining comfort with the use of needles. MR imaging and planning once per insertion is safe in most patients as long as applicator shifts, and large anatomical changes are excluded. Team learning is essential to building individual and programmatic competencies. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  15. Adaptive management: a paradigm for remediation of public facilities

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

    Janecky, David R; Whicker, Jeffrey J; Doerr, Ted B

    2009-01-01

    Public facility restoration planning traditionally focused on response to natural disasters and hazardous materials accidental releases. These plans now need to integrate response to terrorist actions. Therefore, plans must address a wide range of potential vulnerabilities. Similar types of broad remediation planning are needed for restoration of waste and hazardous material handling areas and facilities. There are strong similarities in damage results and remediation activities between unintentional and terrorist actions; however, the uncertainties associated with terrorist actions result in a re-evaluation of approaches to planning. Restoration of public facilities following a release of a hazardous material is inherently far moremore » complex than in confined industrial settings and has many unique technical, economic, social, and political challenges. Therefore, they arguably involve a superset of drivers, concerns and public agencies compared to other restoration efforts. This superset of conditions increases complexity of interactions, reduces our knowledge of the initial conditions, and even condenses the timeline for restoration response. Therefore, evaluations of alternative restoration management approaches developed for responding to terrorist actions provide useful knowledge for large, complex waste management projects. Whereas present planning documents have substantial linearity in their organization, the 'adaptive management' paradigm provides a constructive parallel operations paradigm for restoration of facilities that anticipates and plans for uncertainty, multiple/simUltaneous public agency actions, and stakeholder participation. Adaptive management grew out of the need to manage and restore natural resources in highly complex and changing environments with limited knowledge about causal relationships and responses to restoration actions. Similarities between natural resource management and restoration of a facility and surrounding area(s) after a disruptive event suggest numerous advantages over preset linearly-structured plans by incorporating the flexibility and overlap of processes inherent in effective facility restoration. We discuss three restoration case studies (e.g., the Hart Senate Office Building anthrax restoration, Rocky Flats actinide remediation, and hurricane destruction restoration), that implement aspects of adaptive management but not a formal approach. We propose that more formal adoption of adaptive management principles could be a basis for more flexible standards to improve site-specific remediation plans under conditions of high uncertainty.« less

  16. Adaptive/nonadaptive proton radiation planning and outcomes in a phase II trial for locally advanced non-small cell lung cancer.

    PubMed

    Koay, Eugene J; Lege, David; Mohan, Radhe; Komaki, Ritsuko; Cox, James D; Chang, Joe Y

    2012-12-01

    To analyze dosimetric variables and outcomes after adaptive replanning of radiation therapy during concurrent high-dose protons and chemotherapy for locally advanced non-small cell lung cancer (NSCLC). Nine of 44 patients with stage III NSCLC in a prospective phase II trial of concurrent paclitaxel/carboplatin with proton radiation [74 Gy(RBE) in 37 fractions] had modifications to their original treatment plans after re-evaluation revealed changes that would compromise coverage of the target volume or violate dose constraints; plans for the other 35 patients were not changed. We compared patients with adaptive plans with those with nonadaptive plans in terms of dosimetry and outcomes. At a median follow-up of 21.2 months (median overall survival, 29.6 months), no differences were found in local, regional, or distant failure or overall survival between groups. Adaptive planning was used more often for large tumors that shrank to a greater extent (median, 107.1 cm(3) adaptive and 86.4 cm(3) nonadaptive; median changes in volume, 25.3% adaptive and 1.2% nonadaptive; P<.01). The median number of fractions delivered using adaptive planning was 13 (range, 4-22). Adaptive planning generally improved sparing of the esophagus (median absolute decrease in V(70), 1.8%; range, 0%-22.9%) and spinal cord (median absolute change in maximum dose, 3.7 Gy; range, 0-13.8 Gy). Without adaptive replanning, target coverage would have been compromised in 2 cases (57% and 82% coverage without adaptation vs 100% for both with adaptation); neither patient experienced local failure. Radiation-related grade 3 toxicity rates were similar between groups. Adaptive planning can reduce normal tissue doses and prevent target misses, particularly for patients with large tumors that shrink substantially during therapy. Adaptive plans seem to have acceptable toxicity and achieve similar local, regional, and distant control and overall survival, even in patients with larger tumors, vs nonadaptive plans. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Adaptive designs in clinical trials.

    PubMed

    Bowalekar, Suresh

    2011-01-01

    In addition to the expensive and lengthy process of developing a new medicine, the attrition rate in clinical research was on the rise, resulting in stagnation in the development of new compounds. As a consequence to this, the US Food and Drug Administration released a critical path initiative document in 2004, highlighting the need for developing innovative trial designs. One of the innovations suggested the use of adaptive designs for clinical trials. Thus, post critical path initiative, there is a growing interest in using adaptive designs for the development of pharmaceutical products. Adaptive designs are expected to have great potential to reduce the number of patients and duration of trial and to have relatively less exposure to new drug. Adaptive designs are not new in the sense that the task of interim analysis (IA)/review of the accumulated data used in adaptive designs existed in the past too. However, such reviews/analyses of accumulated data were not necessarily planned at the stage of planning clinical trial and the methods used were not necessarily compliant with clinical trial process. The Bayesian approach commonly used in adaptive designs was developed by Thomas Bayes in the 18th century, about hundred years prior to the development of modern statistical methods by the father of modern statistics, Sir Ronald A. Fisher, but the complexity involved in Bayesian approach prevented its use in real life practice. The advances in the field of computer and information technology over the last three to four decades has changed the scenario and the Bayesian techniques are being used in adaptive designs in addition to other sequential methods used in IA. This paper attempts to describe the various adaptive designs in clinical trial and views of stakeholders about feasibility of using them, without going into mathematical complexities.

  18. The role of U.S. states in facilitating effective water governance under stress and change

    NASA Astrophysics Data System (ADS)

    Kirchhoff, Christine J.; Dilling, Lisa

    2016-04-01

    Worldwide water governance failures undermine effective water management under uncertainty and change. Overcoming these failures requires employing more adaptive, resilient water management approaches; yet, while scholars have advance theory of what adaptive, resilient approaches should be, there is little empirical evidence to support those normative propositions. To fill this gap, we reviewed the literature to derive theorized characteristics of adaptive, resilient water governance including knowledge generation and use, participation, clear rules for water use, and incorporating nonstationarity. Then, using interviews and documentary analysis focused on five U.S. states' allocation and planning approaches, we examined empirically if embodying these characteristics made states more (or less) adaptive and resilient in practice. We found that adaptive, resilient water governance requires not just possessing these characteristics but combining and building on them. That is, adaptive, resilient water governance requires well-funded, transparent knowledge systems combined with broad, multilevel participatory processes that support learning, strong institutional arrangements that establish authorities and rules and that allow flexibility as conditions change, and resources for integrated planning and allocation. We also found that difficulty incorporating climate change or altering existing water governance paradigms and inadequate funding of water programs undermine adaptive, resilient governance.

  19. Expected treatment dose construction and adaptive inverse planning optimization: Implementation for offline head and neck cancer adaptive radiotherapy

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

    Yan Di; Liang Jian

    Purpose: To construct expected treatment dose for adaptive inverse planning optimization, and evaluate it on head and neck (h and n) cancer adaptive treatment modification. Methods: Adaptive inverse planning engine was developed and integrated in our in-house adaptive treatment control system. The adaptive inverse planning engine includes an expected treatment dose constructed using the daily cone beam (CB) CT images in its objective and constrains. Feasibility of the adaptive inverse planning optimization was evaluated retrospectively using daily CBCT images obtained from the image guided IMRT treatment of 19 h and n cancer patients. Adaptive treatment modification strategies with respect tomore » the time and the number of adaptive inverse planning optimization during the treatment course were evaluated using the cumulative treatment dose in organs of interest constructed using all daily CBCT images. Results: Expected treatment dose was constructed to include both the delivered dose, to date, and the estimated dose for the remaining treatment during the adaptive treatment course. It was used in treatment evaluation, as well as in constructing the objective and constraints for adaptive inverse planning optimization. The optimization engine is feasible to perform planning optimization based on preassigned treatment modification schedule. Compared to the conventional IMRT, the adaptive treatment for h and n cancer illustrated clear dose-volume improvement for all critical normal organs. The dose-volume reductions of right and left parotid glands, spine cord, brain stem and mandible were (17 {+-} 6)%, (14 {+-} 6)%, (11 {+-} 6)%, (12 {+-} 8)%, and (5 {+-} 3)% respectively with the single adaptive modification performed after the second treatment week; (24 {+-} 6)%, (22 {+-} 8)%, (21 {+-} 5)%, (19 {+-} 8)%, and (10 {+-} 6)% with three weekly modifications; and (28 {+-} 5)%, (25 {+-} 9)%, (26 {+-} 5)%, (24 {+-} 8)%, and (15 {+-} 9)% with five weekly modifications. Conclusions: Adaptive treatment modification can be implemented including the expected treatment dose in the adaptive inverse planning optimization. The retrospective evaluation results demonstrate that utilizing the weekly adaptive inverse planning optimization, the dose distribution of h and n cancer treatment can be largely improved.« less

  20. A roadmap to effective urban climate change adaptation

    NASA Astrophysics Data System (ADS)

    Setiadi, R.

    2018-03-01

    This paper outlines a roadmap to effective urban climate change adaptation built from our practical understanding of the evidence and effects of climate change and the preparation of climate change adaptation strategies and plans. This roadmap aims to drive research in achieving fruitful knowledge and solution-based achievable recommendations in adapting to climate change in urban areas with effective and systematic manner. This paper underscores the importance of the interplay between local government initiatives and a national government for effective adaptation to climate change and takes into account the policy process and politics. This paper argues that effective urban climate change adaptation has a contribution to build urban resilience and helps the achievement of national government goals and targets in climate change adaptation.

  1. Health diplomacy the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: Evaluating findings from Project Accept (HPTN 043)

    PubMed Central

    2012-01-01

    Background Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of ‘global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. Methods We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Results Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of ‘youth-friendly’ services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand: and adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). Conclusions Adaptation selection, development and approval during multi-site global health research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a global health diplomacy perspective. PMID:22716131

  2. Career Preparation: A Longitudinal, Process-Oriented Examination

    ERIC Educational Resources Information Center

    Stringer, Kate; Jennifer Kerpelman; Vladimir Skorikov

    2011-01-01

    Preparing for an adult career through careful planning, choosing a career, and gaining confidence to achieve career goals is a primary task during adolescence and early adulthood. The current study bridged identity process literature and career construction theory (Savickas, 2005) by examining the commitment component of career adaptability,…

  3. Knowledge exchange for climate adaptation planning in western North America

    NASA Astrophysics Data System (ADS)

    Garfin, Gregg; Orr, Barron

    2015-04-01

    In western North America, the combination of sustained drought, rapid ecosystem changes, and land use changes associated with urban population growth has motivated concern among ecosystem managers about the implications of future climate changes for the landscapes which they manage. Through literature review, surveys, and workshop discussions, we assess the process of moving from concern, to planning, to action, with an emphasis on questions, such as: What are the roles of boundary organizations in facilitating knowledge exchange? Which practices lead to effective interactions between scientists, decision-makers, and knowledge brokers? While there is no "one size fits all" science communication method, the co-production of science and policy by research scientists, science translators, and decision-makers, as co-equals, is a resource intensive, but effective practice for moving adaptation planning forward. Constructive approaches make use of alliances with early adopters and opinion leaders, and make strong communication links between predictions, impacts and solutions. Resource managers need information on the basics of regional climate variability and global climate change, region-specific projections of climate changes and impacts, frank discussion of uncertainties, and opportunities for candid exploration of these topics with peers and subject experts. Research scientists play critical roles in adaptation planning discussions, because they assist resource managers in clarifying the cascade of interactions leading to potential impacts and, importantly, because decision-makers want to hear the information straight from the scientists conducting the research, which bolsters credibility. We find that uncertainty, formerly a topic to avoided, forms the foundation for constructive progress in adaptation planning. Candid exploration of the array of uncertainties, including those due to modeling, institutional, policy and economic factors, with practitioners, science translators, and subject experts, stimulates constructive thinking on adaptation strategies. Discussion support to explore multiple future scenarios and research nuances advances the discussion beyond "uncertainty paralysis."

  4. Knowledge-light adaptation approaches in case-based reasoning for radiotherapy treatment planning.

    PubMed

    Petrovic, Sanja; Khussainova, Gulmira; Jagannathan, Rupa

    2016-03-01

    Radiotherapy treatment planning aims at delivering a sufficient radiation dose to cancerous tumour cells while sparing healthy organs in the tumour-surrounding area. It is a time-consuming trial-and-error process that requires the expertise of a group of medical experts including oncologists and medical physicists and can take from 2 to 3h to a few days. Our objective is to improve the performance of our previously built case-based reasoning (CBR) system for brain tumour radiotherapy treatment planning. In this system, a treatment plan for a new patient is retrieved from a case base containing patient cases treated in the past and their treatment plans. However, this system does not perform any adaptation, which is needed to account for any difference between the new and retrieved cases. Generally, the adaptation phase is considered to be intrinsically knowledge-intensive and domain-dependent. Therefore, an adaptation often requires a large amount of domain-specific knowledge, which can be difficult to acquire and often is not readily available. In this study, we investigate approaches to adaptation that do not require much domain knowledge, referred to as knowledge-light adaptation. We developed two adaptation approaches: adaptation based on machine-learning tools and adaptation-guided retrieval. They were used to adapt the beam number and beam angles suggested in the retrieved case. Two machine-learning tools, neural networks and naive Bayes classifier, were used in the adaptation to learn how the difference in attribute values between the retrieved and new cases affects the output of these two cases. The adaptation-guided retrieval takes into consideration not only the similarity between the new and retrieved cases, but also how to adapt the retrieved case. The research was carried out in collaboration with medical physicists at the Nottingham University Hospitals NHS Trust, City Hospital Campus, UK. All experiments were performed using real-world brain cancer patient cases treated with three-dimensional (3D)-conformal radiotherapy. Neural networks-based adaptation improved the success rate of the CBR system with no adaptation by 12%. However, naive Bayes classifier did not improve the current retrieval results as it did not consider the interplay among attributes. The adaptation-guided retrieval of the case for beam number improved the success rate of the CBR system by 29%. However, it did not demonstrate good performance for the beam angle adaptation. Its success rate was 29% versus 39% when no adaptation was performed. The obtained empirical results demonstrate that the proposed adaptation methods improve the performance of the existing CBR system in recommending the number of beams to use. However, we also conclude that to be effective, the proposed adaptation of beam angles requires a large number of relevant cases in the case base. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Towards Contextualized Learning Services

    NASA Astrophysics Data System (ADS)

    Specht, Marcus

    Personalization of feedback and instruction has often been considered as a key feature in learning support. The adaptations of the instructional process to the individual and its different aspects have been investigated from different research perspectives as learner modelling, intelligent tutoring systems, adaptive hypermedia, adaptive instruction and others. Already in the 1950s first commercial systems for adaptive instruction for trainings of keyboard skills have been developed utilizing adaptive configuration of feedback based on user performance and interaction footprints (Pask 1964). Around adaptive instruction there is a variety of research issues bringing together interdisciplinary research from computer science, engineering, psychology, psychotherapy, cybernetics, system dynamics, instructional design, and empirical research on technology enhanced learning. When classifying best practices of adaptive instruction different parameters of the instructional process have been identified which are adapted to the learner, as: sequence and size of task difficulty, time of feedback, pace of learning speed, reinforcement plan and others these are often referred to the adaptation target. Furthermore Aptitude Treatment Interaction studies explored the effect of adapting instructional parameters to different characteristics of the learner (Tennyson and Christensen 1988) as task performance, personality characteristics, or cognitive abilities, this is information is referred to as adaptation mean.

  6. Advancing mission in the marketplace. Integrated strategic planning and budgeting helps a system remain accountable.

    PubMed

    Smessaert, A H

    1992-10-01

    In the late 1980s Holy Cross Health System (HCHS), South Bend, IN, began to implement a revised strategic planning and budgeting process to effectively link the system's mission with its day-to-day operations. Leaders wanted a process that would help system employees internalize and act on the four major elements articulated in the HCHS mission statement: fidelity, excellence, empowerment, and stewardship. Representatives from mission, strategic planning, and finance from the corporate office and subsidiaries examined planning and budgeting methods. From the beginning, HCHS leaders decided that the process should be implemented gradually, with each step focusing on refining methodology and improving mission integration. As the process evolved. HCHS developed a sequence in which planning preceded budgeting. The system also developed a variety of educational and collaborative initiatives to help system employees adapt to the organization's change of direction. One critical aspect of HCHS's ongoing education is an ethical reflection process that helps participants balance ethical considerations by viewing an issue from three perspectives: social vision, multiple responsibility, and self-interest.

  7. Designing urban rules from emergent patterns: co-evolving paths of informal and formal urban systems - the case of Portugal

    NASA Astrophysics Data System (ADS)

    Silva, Paulo

    2018-05-01

    In many societies, informality has been a relevant part of the construction of the urban fabric. This is valid along a city’s history and in recent urbanization processes. In the past, informality was in the origin of many of urban planning. Very soon urban planning adopted, as one of their main missions malfunctions in cities. Therefore, the need of formalization became one of the main reasons on the emergence, the control of informal processes. As an answer to informal individual solutions, urban planning responded with standardized rules and the urge of creating spaces fitting into pre-established rules instead of rules fitting into spaces. Urban planning as a discipline has gradually changed its path. The contrast between urbanization promoted under formal urban planning and informal urbanization is only one sign of the mismatch between urban planning actions and informal urbanization dynamics. Considering this tension between formal and informal dynamics, in some cases, planning rules and planning processes continue ignoring informal dynamics; in other cases, planning rules are designed to integrate informality “without losing its face” through “planning games” [1]; and a third and less explored way in which planning systems interact with informality and from that interaction learn how to improve (we consider it a process of enrichment) planning rules while they promote an upgrade of informal interventions [2]. This latter win-win situation in which both informal and formal systems benefit from their interaction is still rare: most of the time either only one side benefits or none benefit from the interaction. Nevertheless, there are signs that from this interaction co-dependent adaptation might occur with positive outcomes for the urban system – in which co-evolutionary dynamics can be traced. We propose to look at the way building rules have been designed in Europe in a context considered successful in the sense of dealing of informality – the one of Portugal. The country experienced a wave of informality associated with illegal urbanization since the 1960’s in the main urban areas. The process of interaction between informal and formal urban systems proved to be a success in statistic terms. Slum clearance reduced the existence of informal occupations to almost zero. Informal settlements involving land tenure have been dealt with in the last two decades with considerable positive impact in the urban fabric. Based on this, with this paper we will evaluate how informal and formal systems are impacting each other and changing along the time the shape of building and of planning rules. For this we will look at the planning tools created to formalize informal settlements in the Lisbon Metropolitan Area from the last forty years to see how urban and building rules were adapted to respond to the specific needs of informal settlements; how this adaptation moved from temporary and exceptional to permanent rules; finally, how were these new rules able to “contaminate” the general planning and building codes. We aim that these findings would help us to contribute to a “healthier” relation between formal and informal urban systems, not ignoring each other, not controlling each other but instead learning with each other. By achieving this, planning systems become more responsive; on the other hand, informal occupations can be upgraded without being destroyed with the contribution of the planning systems.

  8. Design and evaluation of a software prototype for participatory planning of environmental adaptations.

    PubMed

    Eriksson, J; Ek, A; Johansson, G

    2000-03-01

    A software prototype to support the planning process for adapting home and work environments for people with physical disabilities was designed and later evaluated. The prototype exploits low-cost three-dimensional (3-D) graphics products in the home computer market. The essential features of the prototype are: interactive rendering with optional hardware acceleration, interactive walk-throughs, direct manipulation tools for moving objects and measuring distances, and import of 3-D-objects from a library. A usability study was conducted, consisting of two test sessions (three weeks apart) and a final interview. The prototype was then tested and evaluated by representatives of future users: five occupational therapist students, and four persons with physical disability, with no previous experience of the prototype. Emphasis in the usability study was placed on the prototype's efficiency and learnability. We found that it is possible to realise a planning tool for environmental adaptations, both regarding usability and technical efficiency. The usability evaluation confirms our findings from previous case studies, regarding the relevance and positive attitude towards this kind of planning tool. Although the prototype was found to be satisfactorily efficient for the basic tasks, the paper presents several suggestions for improvement of future prototype versions.

  9. Delivering organisational adaptation through legislative mechanisms: Evidence from the Adaptation Reporting Power (Climate Change Act 2008).

    PubMed

    Jude, S R; Drew, G H; Pollard, S J T; Rocks, S A; Jenkinson, K; Lamb, R

    2017-01-01

    There is increasing recognition that organisations, particularly in key infrastructure sectors, are potentially vulnerable to climate change and extreme weather events, and require organisational responses to ensure they are resilient and adaptive. However, detailed evidence of how adaptation is facilitated, implemented and reported, particularly through legislative mechanisms is lacking. The United Kingdom Climate Change Act (2008), introduced the Adaptation Reporting Power, enabling the Government to direct so-called reporting authorities to report their climate change risks and adaptation plans. We describe the authors' unique role and experience supporting the Department for Environment, Food and Rural Affairs (Defra) during the Adaptation Reporting Power's first round. An evaluation framework, used to review the adaptation reports, is presented alongside evidence on how the process provides new insights into adaptation activities and triggered organisational change in 78% of reporting authorities, including the embedding of climate risk and adaptation issues. The role of legislative mechanisms and risk-based approaches in driving and delivering adaptation is discussed alongside future research needs, including the development of organisational maturity models to determine resilient and well adapting organisations. The Adaptation Reporting Power process provides a basis for similar initiatives in other countries, although a clear engagement strategy to ensure buy-in to the process and research on its long-term legacy, including the potential merits of voluntary approaches, is required. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  10. TU-H-CAMPUS-JeP3-02: Automated Dose Accumulation and Dose Accuracy Assessment for Online Or Offline Adaptive Replanning

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

    Chen, G; Ahunbay, E; Li, X

    Purpose: With introduction of high-quality treatment imaging during radiation therapy (RT) delivery, e.g., MR-Linac, adaptive replanning of either online or offline becomes appealing. Dose accumulation of delivered fractions, a prerequisite for the adaptive replanning, can be cumbersome and inaccurate. The purpose of this work is to develop an automated process to accumulate daily doses and to assess the dose accumulation accuracy voxel-by-voxel for adaptive replanning. Methods: The process includes the following main steps: 1) reconstructing daily dose for each delivered fraction with a treatment planning system (Monaco, Elekta) based on the daily images using machine delivery log file and consideringmore » patient repositioning if applicable, 2) overlaying the daily dose to the planning image based on deformable image registering (DIR) (ADMIRE, Elekta), 3) assessing voxel dose deformation accuracy based on deformation field using predetermined criteria, and 4) outputting accumulated dose and dose-accuracy volume histograms and parameters. Daily CTs acquired using a CT-on-rails during routine CT-guided RT for sample patients with head and neck and prostate cancers were used to test the process. Results: Daily and accumulated doses (dose-volume histograms, etc) along with their accuracies (dose-accuracy volume histogram) can be robustly generated using the proposed process. The test data for a head and neck cancer case shows that the gross tumor volume decreased by 20% towards the end of treatment course, and the parotid gland mean dose increased by 10%. Such information would trigger adaptive replanning for the subsequent fractions. The voxel-based accuracy in the accumulated dose showed that errors in accumulated dose near rigid structures were small. Conclusion: A procedure as well as necessary tools to automatically accumulate daily dose and assess dose accumulation accuracy is developed and is useful for adaptive replanning. Partially supported by Elekta, Inc.« less

  11. Dosimetric advantages of a clinical daily adaptive plan selection strategy compared with a non-adaptive strategy in cervical cancer radiation therapy.

    PubMed

    van de Schoot, Agustinus J A J; de Boer, Peter; Visser, Jorrit; Stalpers, Lukas J A; Rasch, Coen R N; Bel, Arjan

    2017-05-01

    Radiation therapy (RT) using a daily plan selection adaptive strategy can be applied to account for interfraction organ motion while limiting organ at risk dose. The aim of this study was to quantify the dosimetric consequences of daily plan selection compared with non-adaptive RT in cervical cancer. Ten consecutive patients who received pelvic irradiation, planning CTs (full and empty bladder), weekly post-fraction CTs and pre-fraction CBCTs were included. Non-adaptive plans were generated based on the PTV defined using the full bladder planning CT. For the adaptive strategy, multiple PTVs were created based on both planning CTs by ITVs of the primary CTVs (i.e., GTV, cervix, corpus-uterus and upper part of the vagina) and corresponding library plans were generated. Daily CBCTs were rigidly aligned to the full bladder planning CT for plan selection. For daily plan recalculation, selected CTs based on initial similarity were deformably registered to CBCTs. Differences in daily target coverage (D 98%  > 95%) and in V 0.5Gy , V 1.5Gy , V 2Gy , D 50% and D 2% for rectum, bladder and bowel were assessed. Non-adaptive RT showed inadequate primary CTV coverage in 17% of the daily fractions. Plan selection compensated for anatomical changes and improved primary CTV coverage significantly (p < 0.01) to 98%. Compared with non-adaptive RT, plan selection decreased the fraction dose to rectum and bowel indicated by significant (p < 0.01) improvements for daily V 0.5Gy , V 1.5Gy , V 2Gy , D 50% and D 2% . However, daily plan selection significantly increased the bladder V 1.5Gy , V 2Gy , D 50% and D 2% . In cervical cancer RT, a non-adaptive strategy led to inadequate target coverage for individual patients. Daily plan selection corrected for day-to-day anatomical variations and resulted in adequate target coverage in all fractions. The dose to bowel and rectum was decreased significantly when applying adaptive RT.

  12. Addressing Climate Change Adaptation in Regional Transportation Plans in California: A Guide and Online Visualization Tool for Planners to Incorporate Risks of Climate Change Impacts in Policy and Decision-Making

    NASA Astrophysics Data System (ADS)

    Tao, W.; Tucker, K.; DeFlorio, J.

    2012-12-01

    The reality of a changing climate means that transportation and planning agencies need to understand the potential effects of changes in storm activity, sea levels, temperature, and precipitation patterns; and develop strategies to ensure the continuing robustness and resilience of transportation infrastructure and services. This is a relatively new challenge for California's regional planning agencies - adding yet one more consideration to an already complex and multifaceted planning process. In that light, the California Department of Transportation (Caltrans) is developing a strategy framework using a module-based process that planning agencies can undertake to incorporating the risks of climate change impacts into their decision-making and long-range transportation plans. The module-based approach was developed using a best practices survey of existing work nationally, along with a set of structured interviews with metropolitan planning organizations (MPOs) and regional transportation planning agencies (RTPAs) within California. Findings led to the development of a process, as well as a package of foundational geospatial layers (i.e. the Statewide Transportation Asset Geodatabase - STAG), primarily comprising state and Federal transportation assets. These assets are intersected with a set of geospatial layers for the climate stressors of relevance in the state which are placed in the same reference layers as the STAG; thus providing a full set of GIS layers that can be a starting point for MPOs/RTPAs that want to follow the step-by-step module-based approach in its entirety. The fast-paced changes in science and climate change knowledge requires a flexible platform to display continuously evolving information. To this end, the development of the modules are accompanied by a set of geospatial analysis disseminated using an online web portal. In this way, the information can be relayed to MPO/RTPAs in a easy-to-use fashion that can help them follow the modules for the strategy framework. The strategy framework for MPOs and RTPAs is used to: 1) Assess the relative risks to their transportation system infrastructure and services of different climate stressors (sea level rise, temperature changes, snow melt, precipita¬tion changes, flooding, extreme weather events); 2) Conduct an asset inventory and vulnerability assessment of existing infrastructure; 3) Prioritize segments and facilities for adaptation action; 4) Identify appropriate and cost-effective adaptation strategies; and 5) Incorporate climate impact considerations into future long-range transportation planning and investment decisions. This framework complements the broader planning and investment processes that MPOs and RTPAs already manage. It recognizes the varying capacities and resources among MPOs and RTPAs and provide methods that can be used by organizations seeking to conduct in-depth analysis or a more sketch-level assessment.

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

    Koay, Eugene J.; Lege, David; Mohan, Radhe

    Purpose: To analyze dosimetric variables and outcomes after adaptive replanning of radiation therapy during concurrent high-dose protons and chemotherapy for locally advanced non-small cell lung cancer (NSCLC). Methods and Materials: Nine of 44 patients with stage III NSCLC in a prospective phase II trial of concurrent paclitaxel/carboplatin with proton radiation [74 Gy(RBE) in 37 fractions] had modifications to their original treatment plans after re-evaluation revealed changes that would compromise coverage of the target volume or violate dose constraints; plans for the other 35 patients were not changed. We compared patients with adaptive plans with those with nonadaptive plans in termsmore » of dosimetry and outcomes. Results: At a median follow-up of 21.2 months (median overall survival, 29.6 months), no differences were found in local, regional, or distant failure or overall survival between groups. Adaptive planning was used more often for large tumors that shrank to a greater extent (median, 107.1 cm{sup 3} adaptive and 86.4 cm{sup 3} nonadaptive; median changes in volume, 25.3% adaptive and 1.2% nonadaptive; P<.01). The median number of fractions delivered using adaptive planning was 13 (range, 4-22). Adaptive planning generally improved sparing of the esophagus (median absolute decrease in V{sub 70}, 1.8%; range, 0%-22.9%) and spinal cord (median absolute change in maximum dose, 3.7 Gy; range, 0-13.8 Gy). Without adaptive replanning, target coverage would have been compromised in 2 cases (57% and 82% coverage without adaptation vs 100% for both with adaptation); neither patient experienced local failure. Radiation-related grade 3 toxicity rates were similar between groups. Conclusions: Adaptive planning can reduce normal tissue doses and prevent target misses, particularly for patients with large tumors that shrink substantially during therapy. Adaptive plans seem to have acceptable toxicity and achieve similar local, regional, and distant control and overall survival, even in patients with larger tumors, vs nonadaptive plans.« less

  14. Computational path planner for product assembly in complex environments

    NASA Astrophysics Data System (ADS)

    Shang, Wei; Liu, Jianhua; Ning, Ruxin; Liu, Mi

    2013-03-01

    Assembly path planning is a crucial problem in assembly related design and manufacturing processes. Sampling based motion planning algorithms are used for computational assembly path planning. However, the performance of such algorithms may degrade much in environments with complex product structure, narrow passages or other challenging scenarios. A computational path planner for automatic assembly path planning in complex 3D environments is presented. The global planning process is divided into three phases based on the environment and specific algorithms are proposed and utilized in each phase to solve the challenging issues. A novel ray test based stochastic collision detection method is proposed to evaluate the intersection between two polyhedral objects. This method avoids fake collisions in conventional methods and degrades the geometric constraint when a part has to be removed with surface contact with other parts. A refined history based rapidly-exploring random tree (RRT) algorithm which bias the growth of the tree based on its planning history is proposed and employed in the planning phase where the path is simple but the space is highly constrained. A novel adaptive RRT algorithm is developed for the path planning problem with challenging scenarios and uncertain environment. With extending values assigned on each tree node and extending schemes applied, the tree can adapts its growth to explore complex environments more efficiently. Experiments on the key algorithms are carried out and comparisons are made between the conventional path planning algorithms and the presented ones. The comparing results show that based on the proposed algorithms, the path planner can compute assembly path in challenging complex environments more efficiently and with higher success. This research provides the references to the study of computational assembly path planning under complex environments.

  15. Coupling Adaptation Tipping Points and Engineering Options: New Insights for Resilient Water Infrastructure Replacement Planning

    NASA Astrophysics Data System (ADS)

    Smet, K.; de Neufville, R.; van der Vlist, M.

    2017-12-01

    This work presents an innovative approach for replacement planning for aging water infrastructure given uncertain future conditions. We draw upon two existing methodologies to develop an integrated long-term replacement planning framework. We first expand the concept of Adaptation Tipping Points to generate long-term planning timelines that incorporate drivers of investment related to both internal structural processes as well as changes in external operating conditions. Then, we use Engineering Options to explore different actions taken at key moments in this timeline. Contrasting to the traditionally more static approach to infrastructure design, designing the next generation of infrastructure so it can be changed incrementally is a promising method to safeguard current investments given future uncertainty. This up-front inclusion of structural options in the system actively facilitates future adaptation, transforming uncertainty management in infrastructure planning from reactive to more proactive. A two-part model underpins this approach. A simulation model generates diverse future conditions, allowing development of timelines of intervention moments in the structure's life. This feeds into an economic model, evaluating the lifetime performance of different replacement strategies, making explicit the value of different designs and their flexibility. A proof of concept study demonstrates this approach for a pumping station. The strategic planning timelines for this structure demonstrate that moments when capital interventions become necessary due to reduced functionality from structural degradation or changed operating conditions are widely spread over the structure's life. The disparate timing of these necessary interventions supports an incremental, adaptive mindset when considering end-of-life and replacement decisions. The analysis then explores different replacement decisions, varying the size and specific options included in the proposed new structure. Results show that incremental adaptive designs and incorporating options can improve economic performance, as compared to traditional, "build it once & build it big" designs. The benefit from incorporating flexibility varies with structural functionality, future conditions and the specific options examined.

  16. Adapting to the Effects of Climate Change on Inuit Health

    PubMed Central

    Ford, James D.; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-01-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks—one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context. PMID:24754615

  17. Adapting to the effects of climate change on Inuit health.

    PubMed

    Ford, James D; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-06-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks-one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context.

  18. The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.

    PubMed

    Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A

    2012-02-10

    To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.

  19. Risk tradeoffs in adaptive ecosystem management: the case of the U.S. Forest Service

    Treesearch

    Marc J. Stern; Caysie A. Martin; S. Andrew Predmore; Wayde C. Morse

    2014-01-01

    Natural resource planning processes on public lands in the United States are driven in large part by the requirements of the National Environmental Policy Act (NEPA), which dictates general processes for analyzing and disclosing the likely impacts of proposed actions. The outcomes of these processes are the result of multiple factors, many related to the manifold...

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

    USGS Publications Warehouse

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

    2009-01-01

    The purpose of this technical guide is to present an operational definition of adaptive management, identify the conditions in which adaptive management should be considered, and describe the process of using adaptive management for managing natural resources. The guide is not an exhaustive discussion of adaptive management, nor does it include detailed specifications for individual projects. However, it should aid U.S. Department of the Interior (DOI) managers and practitioners in determining when and how to apply adaptive management. Adaptive management is framed within the context of structured decision making, with an emphasis on uncertainty about resource responses to management actions and the value of reducing that uncertainty to improve management. Though learning plays a key role in adaptive management, it is seen here as a means to an end, namely good management, and not an end in itself. The operational definition used in the guide is adopted from the National Research Council, which characterizes adaptive management as an iterative learning process producing improved understanding and improved management over time: Adaptive management [is a decision process that] promotes flexible decision making that can be adjusted in the face of uncertainties as outcomes from management actions and other events become better understood. Careful monitoring of these outcomes both advances scientific understanding and helps adjust policies or operations as part of an iterative learning process. Adaptive management also recognizes the importance of natural variability in contributing to ecological resilience and productivity. It is not a ‘trial and error’ process, but rather emphasizes learning while doing. Adaptive management does not represent an end in itself, but rather a means to more effective decisions and enhanced benefits. Its true measure is in how well it helps meet environmental, social, and economic goals, increases scientific knowledge, and reduces tensions among stakeholders. Adaptive management as defined here involves ongoing, real-time learning and knowledge creation, both in a substantive sense and in terms of the adaptive process itself. It is described in what follows in a series of 9 steps, as summarized in section 4.1, involving stakeholder involvement, management objectives, management alternatives, predictive models, monitoring plans, decision making, monitoring responses to management, assessment, and adjustment to management actions. An adaptive approach actively engages stakeholders in all phases of a project over its timeframe, facilitating mutual learning and reinforcing the commitment to learning-based management. Adaptive management in DOI is implemented within a legal context that includes statutory authorities such as the National Environmental Policy Act (NEPA), the Endangered Species Act, and the Federal Advisory Committee Act. For many important problems now facing the resource management community, adaptive management holds great promise in reducing the uncertainties that limit the effective management of natural resource systems. For many conservation and management problems, utilizing management itself in an experimental context may be the only feasible way to gain the system understanding needed to improve management. Though it is commonly thought that an adaptive approach can produce results quickly at low cost, the opposite is more likely to be true. An initial investment of time and effort will increase the likelihood of better decision making and resource stewardship in the future, but patience, flexibility, and support are needed over the life of an adaptive management project. For these reasons it is important to carefully consider the potential use of an adaptive approach, and to engage in careful planning and evaluation when adaptive management is used.

  1. ELECTRONIC DATA PROCESSING--I, A SUGGESTED 2-YEAR POST HIGH SCHOOL CURRICULUM FOR COMPUTER PROGRAMERS AND BUSINESS APPLICATIONS ANALYSTS.

    ERIC Educational Resources Information Center

    RONEY, MAURICE W.; AND OTHERS

    DESIGNED FOR USE IN PLANNING PREPARATORY PROGRAMS, THIS CURRICULUM CAN ALSO BE USEFUL IN PLANNING EXTENSION COURSES FOR EMPLOYED PERSONS. MATERIALS WERE ADAPTED FROM A GUIDE PREPARED BY ORANGE COAST COLLEGE, CALIFORNIA, UNDER A CONTRACTUAL ARRANGEMENT WITH THE U.S. OFFICE OF EDUCATION, AND REVIEWED BY A COMMITTEE COMPOSED OF SPECIALISTS IN DATA…

  2. A 'Healthy Islands' framework for climate change in the Pacific.

    PubMed

    McIver, Lachlan; Bowen, Kathryn; Hanna, Elizabeth; Iddings, Steven

    2017-06-01

    Small Pacific Island countries (PICs) are among the most vulnerable countries in the world to the anticipated detrimental health effects of climate change. The assessment of health vulnerabilities and planning adaptation strategies to minimize the impacts of climate change on health tests traditional health governance structures and depends on strong linkages and partnerships between actors involved in these vital processes. This article reviews the actors, processes and contexts of the climate change and health vulnerability assessment and adaptation planning project carried out by the World Health Organization and health sector partners in three island countries in the Micronesian region of the Pacific throughout 2010 and 2011: Federated States of Micronesia, Marshall Islands and Palau. Despite their shared history and cultural characteristics, the findings and implications of this article are considered to have substantial relevance and potential application to other PICs. The modified 'Healthy Islands' framework for climate change and health adaptation presented in this article draws upon real-world experience and governance theory from both the health and climate change literature and, for the first time, places health systems adaptation within the vision for 'Healthy Islands' in the Pacific region. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Climate Adaptation is About More Than Climate: Value-Driven Science Delivery

    NASA Astrophysics Data System (ADS)

    Swanston, C.

    2015-12-01

    Efforts to deliver relevant scientific information and tools to diverse stakeholders have dramatically increased in recent years with the intention of promoting climate change adaptation. Much work has been done to understand the barriers to action, but these largely overlook the need to frame the discussion in terms of stakeholder values and co-create innovative solutions that meet their individual needs. A partnership-based effort in the upper Midwest and Northeast called the Climate Change Response Framework (CCRF; www.forestadaptation.org) ensures relevance, breadth, and credibility of its products through stakeholder inclusion at all levels. The fundamental role of the CCRF is to help people meet their land stewardship goals while minimizing climate risk. This represents a subtle but important shift in focus to people and their values, as opposed to climate change and its effects. The CCRF uses a climate planning tool, the Adaptation Workbook (www.adaptationworkbook.org), along with ecosystem vulnerability assessments and a diverse "menu" of adaptation approaches to generate site-specific adaptation actions that meet explicit conservation objectives. These tools are integrated into an Adaptation Planning and Practices workshop that leads organizations through this structured process of designing adaptation tactics for their projects and plans. All of these tools were developed with stakeholders, or in response to their direct and continuing feedback. The CCRF has involved thousands of people and over 100 organizations, published six ecoregional vulnerability assessments with more than 130 authors, and generated more than 125 intentional adaptation demonstrations in real-world land management projects on federal, state, tribal, county, conservancy, and private lands. The CCRF contributes strongly to the USDA Regional Climate Hubs, working on the applied end of the continuum of climate services occupied by providers such as the CSCs, LCCs, RISAs, and RCCs.

  4. The municipalities of the Northwest region of the Czech Republic adapt to climate change: overview of barriers and challenges

    NASA Astrophysics Data System (ADS)

    Emmer, Adam; Krkoška Lorencová, Eliška; Vačkář, David

    2017-04-01

    The municipalities of the Czech Republic have been facing negative impacts of changing climate in the past decades - especially floods (1997, 2002, 2010, 2013), droughts and heat waves (2013, 2015), claiming lives, material damages and economic losses up to several % of GDP. Reflecting these events, climate change adaptation should represent major issue in strategical planning on all administrative levels, which is actually not fully met nowadays. Sectoral National Adaptation Strategy (NAS) was approved by the Government of the Czech Republic in autumn 2015 and the implementation action plan is currently being approved. Adaptation strategies on lower administrative level (adaptation strategies of individual municipalities) are, however, still quite rare. In this contribution, we analyse barriers and challenges for: (i) the development of climate change adaptation strategies on administrative level of individual municipalities in the Northwest region, Czech Republic; and (ii) implementation of adaptation measures into the decision-making processes. Based on participatory seminars with key stakeholders organised in pilot municipalities, it was shown that municipalities are (at least partly) able to cope with existing risks such as floods, but are not well-prepared for expected regionally "new" risks such as long lasting heat waves, insufficient water retention and flash floods. Linking the goals of adaptation strategy with urban planning seems to be challenging task but also potentially powerfull tool to implement specific adaptation measures. It emerged, that complicated ownership relations often cause obstacles for implementation of adaptation measures, highlighting the potential of stimulation and motivation tools from the side of the municipality. On the other hand, it was also shown that despite experiencing its negative impacts, climate change is often neglected or percepted as a marginal issue by some municipalities and developing adaptation strategy is considered needless, referring to another burning issues such as socioeconomic situation. The role of information campaigns and education of stakeholders as well as public regarding climate change and possible future climate change impacts is, therefore, considered highly important task.

  5. SU-F-BRB-07: A Plan Comparison Tool to Ensure Robustness and Deliverability in Online-Adaptive Radiotherapy

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

    Hill, P; Labby, Z; Bayliss, R A

    Purpose: To develop a plan comparison tool that will ensure robustness and deliverability through analysis of baseline and online-adaptive radiotherapy plans using similarity metrics. Methods: The ViewRay MRIdian treatment planning system allows export of a plan file that contains plan and delivery information. A software tool was developed to read and compare two plans, providing information and metrics to assess their similarity. In addition to performing direct comparisons (e.g. demographics, ROI volumes, number of segments, total beam-on time), the tool computes and presents histograms of derived metrics (e.g. step-and-shoot segment field sizes, segment average leaf gaps). Such metrics were investigatedmore » for their ability to predict that an online-adapted plan reasonably similar to a baseline plan where deliverability has already been established. Results: In the realm of online-adaptive planning, comparing ROI volumes offers a sanity check to verify observations found during contouring. Beyond ROI analysis, it has been found that simply editing contours and re-optimizing to adapt treatment can produce a delivery that is substantially different than the baseline plan (e.g. number of segments increased by 31%), with no changes in optimization parameters and only minor changes in anatomy. Currently the tool can quickly identify large omissions or deviations from baseline expectations. As our online-adaptive patient population increases, we will continue to develop and refine quantitative acceptance criteria for adapted plans and relate them historical delivery QA measurements. Conclusion: The plan comparison tool is in clinical use and reports a wide range of comparison metrics, illustrating key differences between two plans. This independent check is accomplished in seconds and can be performed in parallel to other tasks in the online-adaptive workflow. Current use prevents large planning or delivery errors from occurring, and ongoing refinements will lead to increased assurance of plan quality.« less

  6. Online adaptation and verification of VMAT

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

    Crijns, Wouter, E-mail: wouter.crijns@uzleuven.be; Defraene, Gilles; Depuydt, Tom

    2015-07-15

    Purpose: This work presents a method for fast volumetric modulated arc therapy (VMAT) adaptation in response to interfraction anatomical variations. Additionally, plan parameters extracted from the adapted plans are used to verify the quality of these plans. The methods were tested as a prostate class solution and compared to replanning and to their current clinical practice. Methods: The proposed VMAT adaptation is an extension of their previous intensity modulated radiotherapy (IMRT) adaptation. It follows a direct (forward) planning approach: the multileaf collimator (MLC) apertures are corrected in the beam’s eye view (BEV) and the monitor units (MUs) are corrected usingmore » point dose calculations. All MLC and MU corrections are driven by the positions of four fiducial points only, without need for a full contour set. Quality assurance (QA) of the adapted plans is performed using plan parameters that can be calculated online and that have a relation to the delivered dose or the plan quality. Five potential parameters are studied for this purpose: the number of MU, the equivalent field size (EqFS), the modulation complexity score (MCS), and the components of the MCS: the aperture area variability (AAV) and the leaf sequence variability (LSV). The full adaptation and its separate steps were evaluated in simulation experiments involving a prostate phantom subjected to various interfraction transformations. The efficacy of the current VMAT adaptation was scored by target mean dose (CTV{sub mean}), conformity (CI{sub 95%}), tumor control probability (TCP), and normal tissue complication probability (NTCP). The impact of the adaptation on the plan parameters (QA) was assessed by comparison with prediction intervals (PI) derived from a statistical model of the typical variation of these parameters in a population of VMAT prostate plans (n = 63). These prediction intervals are the adaptation equivalent of the tolerance tables for couch shifts in the current clinical practice. Results: The proposed adaptation of a two-arc VMAT plan resulted in the intended CTV{sub mean} (Δ ≤ 3%) and TCP (ΔTCP ≤ 0.001). Moreover, the method assures the intended CI{sub 95%} (Δ ≤ 11%) resulting in lowered rectal NTCP for all cases. Compared to replanning, their adaptation is faster (13 s vs 10 min) and more intuitive. Compared to the current clinical practice, it has a better protection of the healthy tissue. Compared to IMRT, VMAT is more robust to anatomical variations, but it is also less sensitive to the different correction steps. The observed variations of the plan parameters in their database included a linear dependence on the date of treatment planning and on the target radius. The MCS is not retained as QA metric due to a contrasting behavior of its components (LSV and AAV). If three out of four plan parameters (MU, EqFS, AAV, and LSV) need to lie inside a 50% prediction interval (3/4—50%PI), all adapted plans will be accepted. In contrast, all replanned plans do not meet this loose criterion, mainly because they have no connection to the initially optimized and verified plan. Conclusions: A direct (forward) VMAT adaptation performs equally well as (inverse) replanning but is faster and can be extended to real-time adaptation. The prediction intervals for the machine parameters are equivalent to the tolerance tables for couch shifts in the current clinical practice. A 3/4—50%PI QA criterion accepts all the adapted plans but rejects all the replanned plans.« less

  7. Evaluation of a software module for adaptive treatment planning and re-irradiation.

    PubMed

    Richter, Anne; Weick, Stefan; Krieger, Thomas; Exner, Florian; Kellner, Sonja; Polat, Bülent; Flentje, Michael

    2017-12-28

    The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy. The Module was also used for patients scheduled for re-irradiation to estimate the dose in the pretreated region and calculate the accumulated dose to critical organs at risk. During one year, 370 patients were scheduled for plan adaptation or re-irradiation. All patient cases were classified according to their treated body region. For a sub-group of 20 patients treated with RT for lung cancer, the dosimetric effect of plan adaptation during the main treatment course was evaluated in detail. Changes in tumor volume, frequency of re-planning and the time interval between treatment start and plan adaptation were assessed. The Dynamic Planning Tool was used in 20% of treated patients per year for both approaches nearly equally (42% plan adaptation and 58% re-irradiation). Most cases were assessed for the thoracic body region (51%) followed by pelvis (21%) and head and neck cases (10%). The sub-group evaluation showed that unintended plan adaptation was performed in 38% of the scheduled cases. A median time span between first day of treatment and necessity of adaptation of 17 days (range 4-35 days) was observed. PTV changed by 12 ± 12% on average (maximum change 42%). PTV decreased in 18 of 20 cases due to tumor shrinkage and increased in 2 of 20 cases. Re-planning resulted in a reduction of the mean lung dose of the ipsilateral side in 15 of 20 cases. The experience of one year showed high acceptance of the Dynamic Planning Module in our department for both physicians and medical physicists. The re-planning can potentially reduce the accumulated dose to the organs at risk and ensure a better target volume coverage. In the re-irradiation situation, the Dynamic Planning Tool was used to consider the pretreatment dose, to adapt the actual treatment schema more specifically and to review the accumulated dose.

  8. Health sector operational planning and budgeting processes in Kenya—“never the twain shall meet”

    PubMed Central

    Molyneux, Sassy; Goodman, Catherine

    2015-01-01

    Summary Operational planning is considered an important tool for translating government policies and strategic objectives into day‐to‐day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top‐down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local‐level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. PMID:25783862

  9. Technical note: DIRART--A software suite for deformable image registration and adaptive radiotherapy research.

    PubMed

    Yang, Deshan; Brame, Scott; El Naqa, Issam; Aditya, Apte; Wu, Yu; Goddu, S Murty; Mutic, Sasa; Deasy, Joseph O; Low, Daniel A

    2011-01-01

    Recent years have witnessed tremendous progress in image guide radiotherapy technology and a growing interest in the possibilities for adapting treatment planning and delivery over the course of treatment. One obstacle faced by the research community has been the lack of a comprehensive open-source software toolkit dedicated for adaptive radiotherapy (ART). To address this need, the authors have developed a software suite called the Deformable Image Registration and Adaptive Radiotherapy Toolkit (DIRART). DIRART is an open-source toolkit developed in MATLAB. It is designed in an object-oriented style with focus on user-friendliness, features, and flexibility. It contains four classes of DIR algorithms, including the newer inverse consistency algorithms to provide consistent displacement vector field in both directions. It also contains common ART functions, an integrated graphical user interface, a variety of visualization and image-processing features, dose metric analysis functions, and interface routines. These interface routines make DIRART a powerful complement to the Computational Environment for Radiotherapy Research (CERR) and popular image-processing toolkits such as ITK. DIRART provides a set of image processing/registration algorithms and postprocessing functions to facilitate the development and testing of DIR algorithms. It also offers a good amount of options for DIR results visualization, evaluation, and validation. By exchanging data with treatment planning systems via DICOM-RT files and CERR, and by bringing image registration algorithms closer to radiotherapy applications, DIRART is potentially a convenient and flexible platform that may facilitate ART and DIR research. 0 2011 Ameri-

  10. SU-F-J-66: Anatomy Deformation Based Comparison Between One-Step and Two-Step Optimization for Online ART

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

    Feng, Z; Yu, G; Qin, S

    Purpose: This study investigated that how the quality of adapted plan was affected by inter-fractional anatomy deformation by using one-step and two-step optimization for on line adaptive radiotherapy (ART) procedure. Methods: 10 lung carcinoma patients were chosen randomly to produce IMRT plan by one-step and two-step algorithms respectively, and the prescribed dose was set as 60 Gy on the planning target volume (PTV) for all patients. To simulate inter-fractional target deformation, four specific cases were created by systematic anatomy variation; including target superior shift 0.5 cm, 0.3cm contraction, 0.3 cm expansion and 45-degree rotation. Based on these four anatomy deformation,more » adapted plan, regenerated plan and non-adapted plan were created to evaluate quality of adaptation. Adapted plans were generated automatically by using one-step and two-step algorithms respectively to optimize original plans, and regenerated plans were manually created by experience physicists. Non-adapted plans were produced by recalculating the dose distribution based on corresponding original plans. The deviations among these three plans were statistically analyzed by paired T-test. Results: In PTV superior shift case, adapted plans had significantly better PTV coverage by using two-step algorithm compared with one-step one, and meanwhile there was a significant difference of V95 by comparison with adapted and non-adapted plans (p=0.0025). In target contraction deformation, with almost same PTV coverage, the total lung received lower dose using one-step algorithm than two-step algorithm (p=0.0143,0.0126 for V20, Dmean respectively). In other two deformation cases, there were no significant differences observed by both two optimized algorithms. Conclusion: In geometry deformation such as target contraction, with comparable PTV coverage, one-step algorithm gave better OAR sparing than two-step algorithm. Reversely, the adaptation by using two-step algorithm had higher efficiency and accuracy as target occurred position displacement. We want to thank Dr. Lei Xing and Dr. Yong Yang in the Stanford University School of Medicine for this work. This work was jointly supported by NSFC (61471226), Natural Science Foundation for Distinguished Young Scholars of Shandong Province (JQ201516), and China Postdoctoral Science Foundation (2015T80739, 2014M551949).« less

  11. Adaptive management of urban watersheds

    NASA Astrophysics Data System (ADS)

    Garmestani, A.; Shuster, W.; Green, O. O.

    2013-12-01

    Consent decree settlements for violations of the Clean Water Act (1972) increasingly include provisions for redress of combined sewer overflow activity through hybrid approaches that incorporate the best of both gray (e.g., storage tunnels) and green infrastructure (e.g., rain gardens). Adaptive management is an environmental management strategy that uses an iterative process of decision-making to improve environmental management via system monitoring. A central tenet of adaptive management is that management involves a learning process that can help regulated communities achieve environmental quality objectives. We are using an adaptive management approach to guide a green infrastructure retrofit of a neighborhood in the Slavic Village Development Corporation area (Cleveland, Ohio). We are in the process of gathering hydrologic and ecosystem services data and will use this data as a basis for collaboration with area citizens on a plan to use green infrastructure to contain stormflows. Monitoring data provides researchers with feedback on the impact of green infrastructure implementation and suggest where improvements can be made.

  12. The tug-of-war: fidelity versus adaptation throughout the health promotion program life cycle.

    PubMed

    Bopp, Melissa; Saunders, Ruth P; Lattimore, Diana

    2013-06-01

    Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a "program life cycle" framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

  13. Hybrid adaptive radiotherapy with on-line MRI in cervix cancer IMRT.

    PubMed

    Oh, Seungjong; Stewart, James; Moseley, Joanne; Kelly, Valerie; Lim, Karen; Xie, Jason; Fyles, Anthony; Brock, Kristy K; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael; Jaffray, David; Cho, Young-Bin

    2014-02-01

    Substantial organ motion and tumor shrinkage occur during radiotherapy for cervix cancer. IMRT planning studies have shown that the quality of radiation delivery is influenced by these anatomical changes, therefore the adaptation of treatment plans may be warranted. Image guidance with off-line replanning, i.e. hybrid-adaptation, is recognized as one of the most practical adaptation strategies. In this study, we investigated the effects of soft tissue image guidance using on-line MR while varying the frequency of off-line replanning on the adaptation of cervix IMRT. 33 cervical cancer patients underwent planning and weekly pelvic MRI scans during radiotherapy. 5 patients of 33 were identified in a previous retrospective adaptive planning study, in which the coverage of gross tumor volume/clinical target volume (GTV/CTV) was not acceptable given single off-line IMRT replan using a 3mm PTV margin with bone matching. These 5 patients and a randomly selected 10 patients from the remaining 28 patients, a total of 15 patients of 33, were considered in this study. Two matching methods for image guidance (bone to bone and soft tissue to dose matrix) and three frequencies of off-line replanning (none, single, and weekly) were simulated and compared with respect to target coverage (cervix, GTV, lower uterus, parametrium, upper vagina, tumor related CTV and elective lymph node CTV) and OAR sparing (bladder, bowel, rectum, and sigmoid). Cost (total process time) and benefit (target coverage) were analyzed for comparison. Hybrid adaptation (image guidance with off-line replanning) significantly enhanced target coverage for both 5 difficult and 10 standard cases. Concerning image guidance, bone matching was short of delivering enough doses for 5 difficult cases even with a weekly off-line replan. Soft tissue image guidance proved successful for all cases except one when single or more frequent replans were utilized in the difficult cases. Cost and benefit analysis preferred (soft tissue) image guidance over (frequent) off-line replanning. On-line MRI based image guidance (with combination of dose distribution) is a crucial element for a successful hybrid adaptive radiotherapy. Frequent off-line replanning adjuvantly enhances adaptation quality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Mujeres Fuertes y Corazones Saludables: adaptation of the StrongWomen -healthy hearts program for rural Latinas using an intervention mapping approach.

    PubMed

    Perry, Cynthia K; McCalmont, Jean C; Ward, Judy P; Menelas, Hannah-Dulya K; Jackson, Christie; De Witz, Jazmyne R; Solanki, Emma; Seguin, Rebecca A

    2017-12-28

    To describe our use of intervention mapping as a systematic method to adapt an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas. An intervention mapping process involving six steps guided the adaptation of an evidence based physical activity and nutrition program, using a community-based participatory research approach. We partnered with a community advisory board of rural Latinas throughout the adaptation process. A needs assessment and logic models were used to ascertain which program was the best fit for adaptation. Once identified, we collaborated with one of the developers of the original program (StrongWomen - Healthy Hearts) during the adaptation process. First, essential theoretical methods and program elements were identified, and additional elements were added or adapted. Next, we reviewed and made changes to reflect the community and cultural context of the practical applications, intervention strategies, program curriculum, materials, and participant information. Finally, we planned for the implementation and evaluation of the adapted program, Mujeres Fuertes y Corazones Saludables, within the context of the rural community. A pilot study will be conducted with overweight, sedentary, middle-aged, Spanish-speaking Latinas. Outcome measures will assess change in weight, physical fitness, physical activity, and nutrition behavior. The intervention mapping process was feasible and provided a systematic approach to balance fit and fidelity in the adaptation of an evidence-based program. Collaboration with community members ensured that the components of the curriculum that were adapted were culturally appropriate and relevant within the local community context.

  15. Heat and Health in a Changing Climate: Building a Decision Support Tool for California Public Health Officials

    NASA Astrophysics Data System (ADS)

    Steinberg, N.

    2017-12-01

    There is considerable interest in overlaying climate projections with social vulnerability maps as a mechanism for targeting community adaptation efforts. Yet the identification of relevant factors for adaptation- and resilience-based decisions remain a challenge. Our findings show that successful adaptation interventions are more likely when factors are grouped and spatially represented. By designing a decision-support tool that is focused on informing long-term planning to mitigate the public health impacts of extreme heat, communities can more easily integrate climate, land use, and population characteristics into local planning processes. The ability to compare risks and potential health impacts across census tracts may also position local practitioners to leverage scarce resources. This presentation will discuss the information gaps identified by planners and public health practitioners throughout California and illustrate the spatial variations of key health risk factors.

  16. Effect of MLC leaf width on treatment adaptation and accuracy for concurrent irradiation of prostate and pelvic lymph nodes

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

    Shang Qingyang; Qi Peng; Ferjani, Samah

    2013-06-15

    Purpose: The aim of the study was to evaluate the impact of multileaf collimator (MLC) leaf width on treatment adaptation and delivery accuracy for concurrent treatment of the prostate and pelvic lymph nodes with intensity modulated radiation therapy (IMRT). Methods: Seventy-five kilovoltage cone beam CTs (KV-CBCT) from six patients were included for this retrospective study. For each patient, three different IMRT plans were created based on a planning CT using three different MLC leaf widths of 2.5, 5, and 10 mm, respectively. For each CBCT, the prostate displacement was determined by a dual image registration. Adaptive plans were created bymore » shifting selected MLC leaf pairs to compensate for daily prostate movements. To evaluate the impact of MLC leaf width on the adaptive plan for each daily CBCT, three MLC shifted plans were created using three different leaf widths of MLCs (a total of 225 adaptive treatment plans). Selective dosimetric endpoints for the tumor volumes and organs at risk (OARs) were evaluated for these adaptive plans. Using the planning CT from a selected patient, MLC shifted plans for three hypothetical longitudinal shifts of 2, 4, and 8 mm were delivered on the three linear accelerators to test the deliverability of the shifted plans and to compare the dose accuracy of the shifted plans with the original IMRT plans. Results: Adaptive plans from 2.5 and 5 mm MLCs had inadequate dose coverage to the prostate (D99 < 97%, or D{sub mean} < 99% of the planned dose) in 6%-8% of the fractions, while adaptive plans from 10 mm MLC led to inadequate dose coverage to the prostate in 25.3% of the fractions. The average V{sub 56Gy} of the prostate over the six patients was improved by 6.4% (1.6%-32.7%) and 5.8% (1.5%-35.7%) with adaptive plans from 2.5 and 5 mm MLCs, respectively, when compared with adaptive plans from 10 mm MLC. Pelvic lymph nodes were well covered for all MLC adaptive plans, as small differences were observed for D99, D{sub mean}, and V{sub 50.4Gy}. Similar OAR sparing could be achieved for the bladder and rectum with all three MLCs for treatment adaptation. The MLC shifted plans can be accurately delivered on all three linear accelerators with accuracy similar to their original IMRT plans, where gamma (3%/3 mm) passing rates were 99.6%, 93.0%, and 92.1% for 2.5, 5, and 10 mm MLCs, respectively. The percentages of pixels with dose differences between the measurement and calculation being less than 3% of the maximum dose were 85.9%, 82.5%, and 70.5% for the original IMRT plans from the three MLCs, respectively. Conclusions: Dosimetric advantages associated with smaller MLC leaves were observed in terms of the coverage to the prostate, when the treatment was adapted to account for daily prostate movement for concurrent irradiation of the prostate and pelvic lymph nodes. The benefit of switching the MLC from 10 to 5 mm was significant (p Much-Less-Than 0.01); however, switching the MLC from 5 to 2.5 mm would not gain significant (p= 0.15) improvement. IMRT plans with smaller MLC leaf widths achieved more accurate dose delivery.« less

  17. MO-E-BRC-00: Online Adaptive Radiotherapy - Considerations for Practical Clinical Implementation

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

    NONE

    Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled themore » implementation of ART in the clinic in the past couple of years. The introduction of these tools into routine clinical use requires many considerations and progressive knowledge to understand how processes that have historically taken hours/days to complete can now be done in less than 30 minutes. This session will discuss considerations to perform real time contouring, planning and patient specific QA, as well as a practical workflow and the required resources. Learning Objectives: To understand the difficulties, challenges and available technologies for online adaptive RT. To understand how to implement online adaptive therapy in a clinical environment and to understand the workflow and resources required. To understand the limitations and sources of uncertainty in the online adaptive process I have research funding from ViewRay Inc. and Philips Medical Systems.; R. Kashani, I have research funding from ViewRay Inc. and Philips Medical Systems.; X. Li, Research supported by Elekta Inc.« less

  18. MO-E-BRC-02: MRI-Guided Online Adaptive Radiotherapy: The UCLA Approach to Quality Management

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

    Lamb, J.

    Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled themore » implementation of ART in the clinic in the past couple of years. The introduction of these tools into routine clinical use requires many considerations and progressive knowledge to understand how processes that have historically taken hours/days to complete can now be done in less than 30 minutes. This session will discuss considerations to perform real time contouring, planning and patient specific QA, as well as a practical workflow and the required resources. Learning Objectives: To understand the difficulties, challenges and available technologies for online adaptive RT. To understand how to implement online adaptive therapy in a clinical environment and to understand the workflow and resources required. To understand the limitations and sources of uncertainty in the online adaptive process I have research funding from ViewRay Inc. and Philips Medical Systems.; R. Kashani, I have research funding from ViewRay Inc. and Philips Medical Systems.; X. Li, Research supported by Elekta Inc.« less

  19. MO-E-BRC-01: Online Adaptive MR-Guided RT: Workflow and Clinical Implementation

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

    Kashani, R.

    Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled themore » implementation of ART in the clinic in the past couple of years. The introduction of these tools into routine clinical use requires many considerations and progressive knowledge to understand how processes that have historically taken hours/days to complete can now be done in less than 30 minutes. This session will discuss considerations to perform real time contouring, planning and patient specific QA, as well as a practical workflow and the required resources. Learning Objectives: To understand the difficulties, challenges and available technologies for online adaptive RT. To understand how to implement online adaptive therapy in a clinical environment and to understand the workflow and resources required. To understand the limitations and sources of uncertainty in the online adaptive process I have research funding from ViewRay Inc. and Philips Medical Systems.; R. Kashani, I have research funding from ViewRay Inc. and Philips Medical Systems.; X. Li, Research supported by Elekta Inc.« less

  20. GPU-based ultra-fast dose calculation using a finite size pencil beam model.

    PubMed

    Gu, Xuejun; Choi, Dongju; Men, Chunhua; Pan, Hubert; Majumdar, Amitava; Jiang, Steve B

    2009-10-21

    Online adaptive radiation therapy (ART) is an attractive concept that promises the ability to deliver an optimal treatment in response to the inter-fraction variability in patient anatomy. However, it has yet to be realized due to technical limitations. Fast dose deposit coefficient calculation is a critical component of the online planning process that is required for plan optimization of intensity-modulated radiation therapy (IMRT). Computer graphics processing units (GPUs) are well suited to provide the requisite fast performance for the data-parallel nature of dose calculation. In this work, we develop a dose calculation engine based on a finite-size pencil beam (FSPB) algorithm and a GPU parallel computing framework. The developed framework can accommodate any FSPB model. We test our implementation in the case of a water phantom and the case of a prostate cancer patient with varying beamlet and voxel sizes. All testing scenarios achieved speedup ranging from 200 to 400 times when using a NVIDIA Tesla C1060 card in comparison with a 2.27 GHz Intel Xeon CPU. The computational time for calculating dose deposition coefficients for a nine-field prostate IMRT plan with this new framework is less than 1 s. This indicates that the GPU-based FSPB algorithm is well suited for online re-planning for adaptive radiotherapy.

  1. An information adaptive system study report and development plan

    NASA Technical Reports Server (NTRS)

    Ataras, W. S.; Eng, K.; Morone, J. J.; Beaudet, P. R.; Chin, R.

    1980-01-01

    The purpose of the information adaptive system (IAS) study was to determine how some selected Earth resource applications may be processed onboard a spacecraft and to provide a detailed preliminary IAS design for these applications. Detailed investigations of a number of applications were conducted with regard to IAS and three were selected for further analysis. Areas of future research and development include algorithmic specifications, system design specifications, and IAS recommended time lines.

  2. Climate Hazard Assessment for Stakeholder Adaptation Planning in New York City

    NASA Technical Reports Server (NTRS)

    Horton, Radley M.; Gornitz, Vivien; Bader, Daniel A.; Ruane, Alex C.; Goldberg, Richard; Rosenzweig, Cynthia

    2011-01-01

    This paper describes a time-sensitive approach to climate change projections, developed as part of New York City's climate change adaptation process, that has provided decision support to stakeholders from 40 agencies, regional planning associations, and private companies. The approach optimizes production of projections given constraints faced by decision makers as they incorporate climate change into long-term planning and policy. New York City stakeholders, who are well-versed in risk management, helped pre-select the climate variables most likely to impact urban infrastructure, and requested a projection range rather than a single 'most likely' outcome. The climate projections approach is transferable to other regions and consistent with broader efforts to provide climate services, including impact, vulnerability, and adaptation information. The approach uses 16 Global Climate Models (GCMs) and three emissions scenarios to calculate monthly change factors based on 30-year average future time slices relative to a 30- year model baseline. Projecting these model mean changes onto observed station data for New York City yields dramatic changes in the frequency of extreme events such as coastal flooding and dangerous heat events. Based on these methods, the current 1-in-10 year coastal flood is projected to occur more than once every 3 years by the end of the century, and heat events are projected to approximately triple in frequency. These frequency changes are of sufficient magnitude to merit consideration in long-term adaptation planning, even though the precise changes in extreme event frequency are highly uncertain

  3. Adaptive social impact management for conservation and environmental management.

    PubMed

    Kaplan-Hallam, Maery; Bennett, Nathan J

    2018-04-01

    Concerns about the social consequences of conservation have spurred increased attention the monitoring and evaluation of the social impacts of conservation projects. This has resulted in a growing body of research that demonstrates how conservation can produce both positive and negative social, economic, cultural, health, and governance consequences for local communities. Yet, the results of social monitoring efforts are seldom applied to adaptively manage conservation projects. Greater attention is needed to incorporating the results of social impact assessments in long-term conservation management to minimize negative social consequences and maximize social benefits. We bring together insights from social impact assessment, adaptive management, social learning, knowledge coproduction, cross-scale governance, and environmental planning to propose a definition and framework for adaptive social impact management (ASIM). We define ASIM as the cyclical process of monitoring and adaptively managing social impacts over the life-span of an initiative through the 4 stages of profiling, learning, planning, and implementing. We outline 14 steps associated with the 4 stages of the ASIM cycle and provide guidance and potential methods for social-indicator development, predictive assessments of social impacts, monitoring and evaluation, communication of results, and identification and prioritization of management responses. Successful ASIM will be aided by engaging with best practices - including local engagement and collaboration in the process, transparent communication of results to stakeholders, collective deliberation on and choice of interventions, documentation of shared learning at the site level, and the scaling up of insights to inform higher-level conservation policies-to increase accountability, trust, and perceived legitimacy among stakeholders. The ASIM process is broadly applicable to conservation, environmental management, and development initiatives at various scales and in different contexts. © 2017 Society for Conservation Biology.

  4. Health sector operational planning and budgeting processes in Kenya-"never the twain shall meet".

    PubMed

    Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine

    2016-07-01

    Operational planning is considered an important tool for translating government policies and strategic objectives into day-to-day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top-down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local-level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

  5. U.S. Global Climate Change Impacts Report, Adaptation

    NASA Astrophysics Data System (ADS)

    Pulwarty, R.

    2009-12-01

    Adaptation measures improve our ability to cope with or avoid harmful climate impacts and take advantage of beneficial ones, now and as climate varies and changes. Adaptation and mitigation are necessary elements of an effective response to climate change. Adaptation options also have the potential to moderate harmful impacts of current and future climate variability and change. The Global Climate Change Impacts Report identifies examples of adaptation-related actions currently being pursued in various sectors and regions to address climate change, as well as other environmental problems that could be exacerbated by climate change such as urban air pollution and heat waves. Some adaptation options that are currently being pursued in various regions and sectors to deal with climate change and/or other environmental issues are identified in this report. A range of adaptation responses can be employed to reduce risks through redesign or relocation of infrastructure, sustainability of ecosystem services, increased redundancy of critical social services, and operational improvements. Adapting to climate change is an evolutionary process and requires both analytic and deliberative decision support. Many of the climate change impacts described in the report have economic consequences. A significant part of these consequences flow through public and private insurance markets, which essentially aggregate and distribute society's risk. However, in most cases, there is currently insufficient robust information to evaluate the practicality, efficiency, effectiveness, costs, or benefits of adaptation measures, highlighting a need for research. Adaptation planning efforts such as that being conducted in New York City and the Colorado River will be described. Climate will be continually changing, moving at a relatively rapid rate, outside the range to which society has adapted in the past. The precise amounts and timing of these changes will not be known with certainty. The disaster research and emergency management communities have shown over that early warnings of impending hazards need to be complemented by information on the risks actually posed by the hazards (including those resulting from low levels of preparedness), existing strategies on the ground, and likely pathways to mitigate the loss and damage in the particular context in which they arise. Effective adaptations require information for long-term infrastructural planning and as critically deliberative mechanisms to structure learning and redesign in the face of emergent problems. Adaptation tends to be reactive, unevenly distributed, and focused on coping rather than preventing problems. Reduction in vulnerability will require anticipatory deliberative processes focused on incorporating adaptation into long-term municipal and public service planning, including energy, water, and health services, in the face of changing climate-related risks combined with ongoing changes in population, land use and development patterns.

  6. Software Testbed for Developing and Evaluating Integrated Autonomous Subsystems

    NASA Technical Reports Server (NTRS)

    Ong, James; Remolina, Emilio; Prompt, Axel; Robinson, Peter; Sweet, Adam; Nishikawa, David

    2015-01-01

    To implement fault tolerant autonomy in future space systems, it will be necessary to integrate planning, adaptive control, and state estimation subsystems. However, integrating these subsystems is difficult, time-consuming, and error-prone. This paper describes Intelliface/ADAPT, a software testbed that helps researchers develop and test alternative strategies for integrating planning, execution, and diagnosis subsystems more quickly and easily. The testbed's architecture, graphical data displays, and implementations of the integrated subsystems support easy plug and play of alternate components to support research and development in fault-tolerant control of autonomous vehicles and operations support systems. Intelliface/ADAPT controls NASA's Advanced Diagnostics and Prognostics Testbed (ADAPT), which comprises batteries, electrical loads (fans, pumps, and lights), relays, circuit breakers, invertors, and sensors. During plan execution, an experimentor can inject faults into the ADAPT testbed by tripping circuit breakers, changing fan speed settings, and closing valves to restrict fluid flow. The diagnostic subsystem, based on NASA's Hybrid Diagnosis Engine (HyDE), detects and isolates these faults to determine the new state of the plant, ADAPT. Intelliface/ADAPT then updates its model of the ADAPT system's resources and determines whether the current plan can be executed using the reduced resources. If not, the planning subsystem generates a new plan that reschedules tasks, reconfigures ADAPT, and reassigns the use of ADAPT resources as needed to work around the fault. The resource model, planning domain model, and planning goals are expressed using NASA's Action Notation Modeling Language (ANML). Parts of the ANML model are generated automatically, and other parts are constructed by hand using the Planning Model Integrated Development Environment, a visual Eclipse-based IDE that accelerates ANML model development. Because native ANML planners are currently under development and not yet sufficiently capable, the ANML model is translated into the New Domain Definition Language (NDDL) and sent to NASA's EUROPA planning system for plan generation. The adaptive controller executes the new plan, using augmented, hierarchical finite state machines to select and sequence actions based on the state of the ADAPT system. Real-time sensor data, commands, and plans are displayed in information-dense arrays of timelines and graphs that zoom and scroll in unison. A dynamic schematic display uses color to show the real-time fault state and utilization of the system components and resources. An execution manager coordinates the activities of the other subsystems. The subsystems are integrated using the Internet Communications Engine (ICE). an object-oriented toolkit for building distributed applications.

  7. Social-Ecological Resilience and Sustainable Commons Management Paradigms in State Comprehensive Water Planning Legislation: Are We Adapting or Maintaining the Status Quo?

    NASA Astrophysics Data System (ADS)

    Dyckman, C.

    2016-12-01

    Water shortage has been increasing throughout the country, as record drought grips the western states and several southeastern states have sued adjoining states over shared water resources. State water planning can avert or lessen conflicts by balancing sectoral needs and legal priority within their own states. The state comprehensive water planning laws dictate the state water plan's process, coverage, and content, and the extent to which they codify the allocation status quo. The plans can contain the latest resource management paradigms that respond to climate change uncertainty; namely, sustainable commons management (SCM) and social-ecological resilience (SER). Building on the work of Pahl-Wostl (2009), Ostrom and Cox (2010), Agrawal (2003), and Walker and Salt (2012), who have advocated for and empirically researched the presence of sustainable SCM and SER processes in water management, I surveyed all 50 states to determine which states had comprehensive water planning legislation. Of those 26, I evaluated their legislative content using an augmented coercive versus cooperative analysis metric (May, 1993; Berke and French, 1994) that includes codifiable SCM and SER measures. I found that the majority of the states' legislation did not contain the SER and SCM measures; they also lack integral comprehensive water planning measures (i.e., conjoined surface and groundwater planning, instream flow protection, critical area planning, and water conservation practices) (Dyckman, forthcoming). There is a statistically significant and inverse relationship between the indices within the metric, affirming that the greater the legislation's coerciveness, the lower its adaptive capacity and its water planning comprehensiveness (Ostrom, 2010; Pendall, 2001). Planners in states with more SER and SCM measures in their state water planning statutes are more likely to have autonomy and ability to respond to localized water needs, with more comprehensive water planning tools.

  8. Situating Green Infrastructure in Context: Adaptive Socio-Hydrology for Sustainable Cities - poster

    EPA Science Inventory

    The benefits of green infrastructure (GI) in controlling urban hydrologic processes have largely focused on practical matters like stormwater management, which drives the planning stage. Green Infrastructure design and implementation usually takes into account physical site chara...

  9. Let's Not Be Shy about Marketing.

    ERIC Educational Resources Information Center

    Trachtenberg, Stephen Joel

    1984-01-01

    Attitudes about college marketing have hindered its progress. It is an informative process with strong feedback, including such elements as information gathering, travel, development of a marketing or public relations plan, organizational communication, institutional adaptation to the current market, and administrator input. (MSE)

  10. Communicating for Climate Change Adaptation: Lessons from a Case Study with Nature-Based Tour Operators

    NASA Astrophysics Data System (ADS)

    Timm, K.; Sparrow, E. B.; Pettit, E. C.; Trainor, S. F.; Taylor, K.

    2014-12-01

    Increasing temperatures are projected to have a positive effect on the length of Alaska's tourism season, but the natural attractions that tourism relies on, such as glaciers, wildlife, fish, or other natural resources, may change. In order to continue to derive benefits from these resources, nature-based tour operators may have to adapt to these changes, and communication is an essential, but poorly understood, component of the climate change adaptation process. The goal of this study was to determine how to provide useful climate change information to nature-based tour operators by answering the following questions: 1. What environmental changes do nature-based tour operators perceive? 2. How are nature-based tour operators responding to climate and environmental change? 3. What climate change information do nature-based tour operators need? To answer these questions, twenty-four nature-based tour operators representing 20 different small and medium sized businesses in Juneau, Alaska were interviewed. The results show that many of Juneau's nature-based tour operators are observing, responding to, and in some cases, actively planning for further changes in the environment. The types of responses tended to vary depending on the participants' certainty in climate change and the perceived risks to their organization. Using these two factors, this study proposes a framework to classify climate change responses for the purpose of generating meaningful information and communication processes that promote adaptation and build adaptive capacity. During the course of the study, several other valuable lessons were learned about communicating about adaptation. The results of this study demonstrate that science communication research has an important place in the practice of promoting and fostering climate change adaptation. While the focus of this study was tour operators, the lessons learned may be valuable to other organizations striving to engage unique groups in climate change adaptation planning efforts and to social scientists trying to understanding of the role of communication in climate change adaptation.

  11. Combined Inter- and Intrafractional Plan Adaptation Using Fraction Partitioning in Magnetic Resonance-guided Radiotherapy Delivery.

    PubMed

    Lagerwaard, Frank; Bohoudi, Omar; Tetar, Shyama; Admiraal, Marjan A; Rosario, Tezontl S; Bruynzeel, Anna

    2018-04-05

    Magnetic resonance-guided radiation therapy (MRgRT) not only allows for superior soft-tissue setup and online MR-guidance during delivery but also for inter-fractional plan re-optimization or adaptation. This plan adaptation involves repeat MR imaging, organs at risk (OARs) re-contouring, plan prediction (i.e., recalculating the baseline plan on the anatomy of that moment), plan re-optimization, and plan quality assurance. In contrast, intrafractional plan adaptation cannot be simply performed by pausing delivery at any given moment, adjusting contours, and re-optimization because of the complex and composite nature of deformable dose accumulation. To overcome this limitation, we applied a practical workaround by partitioning treatment fractions, each with half the original fraction dose. In between successive deliveries, the patient remained in the treatment position and all steps of the initial plan adaptation were repeated. Thus, this second re-optimization served as an intrafractional plan adaptation at 50% of the total delivery. The practical feasibility of this partitioning approach was evaluated in a patient treated with MRgRT for locally advanced pancreatic cancer (LAPC). MRgRT was delivered in 40Gy in 10 fractions, with two fractions scheduled successively on each treatment day. The contoured gross tumor volume (GTV) was expanded by 3 mm, excluding parts of the OARs within this expansion to derive the planning target volume for daily re-optimization (PTV OPT ). The baseline GTVV 95%  achieved in this patient was 80.0% to adhere to the high-dose constraints for the duodenum, stomach, and bowel (V 33 Gy <1 cc and V 36 Gy <0.1 cc). Treatment was performed on the MRIdian (ViewRay Inc, Mountain View, USA) using video-assisted breath-hold in shallow inspiration. The dual plan adaptation resulted, for each partitioned fraction, in the generation of Plan PREDICTED1 , Plan RE-OPTIMIZED1  (inter-fractional adaptation), Plan PREDICTED2 , and Plan RE-OPTIMIZED2  (intrafractional adaptation). An offline analysis was performed to evaluate the benefit of inter-fractional versus intrafractional plan adaptation with respect to GTV coverage and high-dose OARs sparing for all five partitioned fractions. Interfractional changes in adjacent OARs were substantially larger than intrafractional changes. Mean GTV V 95% was 76.8 ± 1.8% (Plan PREDICTED1 ), 83.4 ± 5.7% (Plan RE-OPTIMIZED1 ), 82.5 ± 4.3% (Plan PREDICTED2 ),and 84.4 ± 4.4% (Plan RE-OPTIMIZED2 ). Both plan re-optimizations appeared important for correcting the inappropriately high duodenal V 33 Gy values of 3.6 cc (Plan PREDICTED1 ) and 3.9 cc (Plan PREDICTED2 ) to 0.2 cc for both re-optimizations. To a smaller extent, this improvement was also observed for V 25 Gy values. For the stomach, bowel, and all other OARs, high and intermediate doses were well below preset constraints, even without re-optimization. The mean delivery time of each daily treatment was 90 minutes. This study presents the clinical application of combined inter-fractional and intrafractional plan adaptation during MRgRT for LAPC using fraction partitioning with successive re-optimization. Whereas, in this study, interfractional plan adaptation appeared to benefit both GTV coverage and OARs sparing, intrafractional adaptation was particularly useful for high-dose OARs sparing. Although all necessary steps lead to a prolonged treatment duration, this may be applied in selected cases where high doses to adjacent OARs are regarded as critical.

  12. Combined Inter- and Intrafractional Plan Adaptation Using Fraction Partitioning in Magnetic Resonance-guided Radiotherapy Delivery

    PubMed Central

    Bohoudi, Omar; Tetar, Shyama; Admiraal, Marjan A; Rosario, Tezontl S; Bruynzeel, Anna

    2018-01-01

    Magnetic resonance-guided radiation therapy (MRgRT) not only allows for superior soft-tissue setup and online MR-guidance during delivery but also for inter-fractional plan re-optimization or adaptation. This plan adaptation involves repeat MR imaging, organs at risk (OARs) re-contouring, plan prediction (i.e., recalculating the baseline plan on the anatomy of that moment), plan re-optimization, and plan quality assurance. In contrast, intrafractional plan adaptation cannot be simply performed by pausing delivery at any given moment, adjusting contours, and re-optimization because of the complex and composite nature of deformable dose accumulation. To overcome this limitation, we applied a practical workaround by partitioning treatment fractions, each with half the original fraction dose. In between successive deliveries, the patient remained in the treatment position and all steps of the initial plan adaptation were repeated. Thus, this second re-optimization served as an intrafractional plan adaptation at 50% of the total delivery. The practical feasibility of this partitioning approach was evaluated in a patient treated with MRgRT for locally advanced pancreatic cancer (LAPC). MRgRT was delivered in 40Gy in 10 fractions, with two fractions scheduled successively on each treatment day. The contoured gross tumor volume (GTV) was expanded by 3 mm, excluding parts of the OARs within this expansion to derive the planning target volume for daily re-optimization (PTVOPT). The baseline GTVV95% achieved in this patient was 80.0% to adhere to the high-dose constraints for the duodenum, stomach, and bowel (V33 Gy <1 cc and V36 Gy <0.1 cc). Treatment was performed on the MRIdian (ViewRay Inc, Mountain View, USA) using video-assisted breath-hold in shallow inspiration. The dual plan adaptation resulted, for each partitioned fraction, in the generation of PlanPREDICTED1, PlanRE-OPTIMIZED1 (inter-fractional adaptation), PlanPREDICTED2, and PlanRE-OPTIMIZED2 (intrafractional adaptation). An offline analysis was performed to evaluate the benefit of inter-fractional versus intrafractional plan adaptation with respect to GTV coverage and high-dose OARs sparing for all five partitioned fractions. Interfractional changes in adjacent OARs were substantially larger than intrafractional changes. Mean GTV V95% was 76.8 ± 1.8% (PlanPREDICTED1), 83.4 ± 5.7% (PlanRE-OPTIMIZED1), 82.5 ± 4.3% (PlanPREDICTED2),and 84.4 ± 4.4% (PlanRE-OPTIMIZED2). Both plan re-optimizations appeared important for correcting the inappropriately high duodenal V33 Gy values of 3.6 cc (PlanPREDICTED1) and 3.9 cc (PlanPREDICTED2) to 0.2 cc for both re-optimizations. To a smaller extent, this improvement was also observed for V25 Gy values. For the stomach, bowel, and all other OARs, high and intermediate doses were well below preset constraints, even without re-optimization. The mean delivery time of each daily treatment was 90 minutes. This study presents the clinical application of combined inter-fractional and intrafractional plan adaptation during MRgRT for LAPC using fraction partitioning with successive re-optimization. Whereas, in this study, interfractional plan adaptation appeared to benefit both GTV coverage and OARs sparing, intrafractional adaptation was particularly useful for high-dose OARs sparing. Although all necessary steps lead to a prolonged treatment duration, this may be applied in selected cases where high doses to adjacent OARs are regarded as critical. PMID:29876156

  13. An ontology-based personalization of health-care knowledge to support clinical decisions for chronically ill patients.

    PubMed

    Riaño, David; Real, Francis; López-Vallverdú, Joan Albert; Campana, Fabio; Ercolani, Sara; Mecocci, Patrizia; Annicchiarico, Roberta; Caltagirone, Carlo

    2012-06-01

    Chronically ill patients are complex health care cases that require the coordinated interaction of multiple professionals. A correct intervention of these sort of patients entails the accurate analysis of the conditions of each concrete patient and the adaptation of evidence-based standard intervention plans to these conditions. There are some other clinical circumstances such as wrong diagnoses, unobserved comorbidities, missing information, unobserved related diseases or prevention, whose detection depends on the capacities of deduction of the professionals involved. In this paper, we introduce an ontology for the care of chronically ill patients and implement two personalization processes and a decision support tool. The first personalization process adapts the contents of the ontology to the particularities observed in the health-care record of a given concrete patient, automatically providing a personalized ontology containing only the clinical information that is relevant for health-care professionals to manage that patient. The second personalization process uses the personalized ontology of a patient to automatically transform intervention plans describing health-care general treatments into individual intervention plans. For comorbid patients, this process concludes with the semi-automatic integration of several individual plans into a single personalized plan. Finally, the ontology is also used as the knowledge base of a decision support tool that helps health-care professionals to detect anomalous circumstances such as wrong diagnoses, unobserved comorbidities, missing information, unobserved related diseases, or preventive actions. Seven health-care centers participating in the K4CARE project, together with the group SAGESA and the Local Health System in the town of Pollenza have served as the validation platform for these two processes and tool. Health-care professionals participating in the evaluation agree about the average quality 84% (5.9/7.0) and utility 90% (6.3/7.0) of the tools and also about the correct reasoning of the decision support tool, according to clinical standards. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Does a Measure of Support Needs Predict Funding Need Better Than a Measure of Adaptive and Maladaptive Behavior?

    PubMed

    Arnold, Samuel R C; Riches, Vivienne C; Stancliffe, Roger J

    2015-09-01

    Internationally, various approaches are used for the allocation of individualized funding. When using a databased approach, a key question is the predictive validity of adaptive behavior versus support needs assessment. This article reports on a subset of data from a larger project that allowed for a comparison of support needs and adaptive behavior assessments when predicting person-centered funding allocation. The first phase of the project involved a trial of the Inventory for Client and Agency Planning (ICAP) adaptive behavior and Instrument for the Classification and Assessment of Support Needs (I-CAN)-Brief Research version support needs assessments. Participants were in receipt of an individual support package allocated using a person-centered planning process, and were stable in their support arrangements. Regression analysis showed that the most useful items in predicting funding allocation came from the I-CAN-Brief Research. No additional variance could be explained by adding the ICAP, or using the ICAP alone. A further unique approach of including only items from the I-CAN-Brief Research marked as funded supports showed high predictive validity. It appears support need is more effective at determining resource need than adaptive behavior.

  15. Adaptive Sensing of Time Series with Application to Remote Exploration

    NASA Technical Reports Server (NTRS)

    Thompson, David R.; Cabrol, Nathalie A.; Furlong, Michael; Hardgrove, Craig; Low, Bryan K. H.; Moersch, Jeffrey; Wettergreen, David

    2013-01-01

    We address the problem of adaptive informationoptimal data collection in time series. Here a remote sensor or explorer agent throttles its sampling rate in order to track anomalous events while obeying constraints on time and power. This problem is challenging because the agent has limited visibility -- all collected datapoints lie in the past, but its resource allocation decisions require predicting far into the future. Our solution is to continually fit a Gaussian process model to the latest data and optimize the sampling plan on line to maximize information gain. We compare the performance characteristics of stationary and nonstationary Gaussian process models. We also describe an application based on geologic analysis during planetary rover exploration. Here adaptive sampling can improve coverage of localized anomalies and potentially benefit mission science yield of long autonomous traverses.

  16. Vulnerability Assessments and Resilience Planning at Federal Facilities. Preliminary Synthesis of Project

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

    Moss, R. H.; Blohm, A. J.; Delgado, A.

    2015-08-15

    U.S. government agencies are now directed to assess the vulnerability of their operations and facilities to climate change and to develop adaptation plans to increase their resilience. Specific guidance on methods is still evolving based on the many different available frameworks. Agencies have been experimenting with these frameworks and approaches. This technical paper synthesizes lessons and insights from a series of research case studies conducted by the investigators at facilities of the U.S. Department of Energy and the Department of Defense. The purpose of the paper is to solicit comments and feedback from interested program managers and analysts before finalmore » conclusions are published. The paper describes the characteristics of a systematic process for prioritizing needs for adaptation planning at individual facilities and examines requirements and methods needed. It then suggests a framework of steps for vulnerability assessments at Federal facilities and elaborates on three sets of methods required for assessments, regardless of the detailed framework used. In a concluding section, the paper suggests a roadmap to further develop methods to support agencies in preparing for climate change. The case studies point to several preliminary conclusions; (1) Vulnerability assessments are needed to translate potential changes in climate exposure to estimates of impacts and evaluation of their significance for operations and mission attainment, in other words into information that is related to and useful in ongoing planning, management, and decision-making processes; (2) To increase the relevance and utility of vulnerability assessments to site personnel, the assessment process needs to emphasize the characteristics of the site infrastructure, not just climate change; (3) A multi-tiered framework that includes screening, vulnerability assessments at the most vulnerable installations, and adaptation design will efficiently target high-risk sites and infrastructure; (4) Vulnerability assessments can be connected to efforts to improve facility resilience to motivate participation; and (5) Efficient, scalable methods for vulnerability assessment can be developed, but additional case studies and evaluation are required.« less

  17. Psychosocial drivers for change: Understanding and promoting stakeholder engagement in local adaptation to climate change in three European Mediterranean case studies.

    PubMed

    Luís, Sílvia; Lima, Maria Luísa; Roseta-Palma, Catarina; Rodrigues, Nuno; P Sousa, Lisa; Freitas, Fabiana; L Alves, Fátima; Lillebø, Ana I; Parrod, Camille; Jolivet, Vincent; Paramana, Theodora; Alexandrakis, George; Poulos, Serafim

    2018-06-18

    Stakeholder engagement in the processes of planning local adaptation to climate change faces many challenges. The goal of this work was to explore whether or not the intention of engaging could be understood (Study 1) and promoted (Study 2), by using an extension of the theory of planned behaviour. In Study 1, stakeholders from three European Mediterranean case studies were surveyed: Baixo Vouga Lagunar (Portugal), SCOT Provence Méditerranée (France), and the island of Crete (Greece) (N = 115). Stakeholders' intention of engaging was significantly predicted by subjective norm (which was predicted by injunctive normative beliefs towards policy-makers and stakeholders) and by perceived behavioural control (which was predicted by knowledge of policy and instruments). Study 2 was conducted in the Baixo Vouga Lagunar case study and consisted of a two-workshop intervention where issues on local and regional adaptation, policies, and engagement were presented and discussed. A within-participants comparison of initial survey results with results following the workshops (N T1  = 12, N T2  = 15, N T3  = 12) indicated that these were successful in increasing stakeholders' intention of engaging. This increase was paired with a) an increase in injunctive normative beliefs towards policy-makers and consequently in subjective norm, and to b) a decrease in perceived complexity of planning local adaptation and an increase in knowledge regarding adaptation to climate change. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Environmental Adaptations Improve Everyday Action in Schizophrenia.

    PubMed

    Kessler, Rachel K; Rhodes, Emma; Giovannetti, Tania

    2015-05-01

    Cognitive functioning, particularly executive functioning, is a strong predictor of functional outcomes in people with schizophrenia. Cognitive remediation has been shown to improve specific cognitive processes, but adjunctive interventions are required for meaningful gains in adaptive functioning, particularly in people with chronic illness. This study examined whether (and how) environmental adaptations, used without training, may circumvent cognitive difficulties and facilitate everyday task performance in individuals with chronic schizophrenia. Forty-two individuals with chronic schizophrenia/schizoaffective disorder were administered cognitive measures and two versions of the Naturalistic Action Test (NAT)-a standard version (ST-NAT), and a user-centered version (UC-NAT) that incorporated environmental adaptations designed to facilitate task performance. The NAT conditions were counterbalanced across participants. Analyses compared performance between the NAT versions and examined the cognitive correlates of each NAT condition. Individuals with schizophrenia made fewer errors on the UC-NAT as compared to the ST-NAT; this between-group difference was significant for all error types. Compared to the ST-NAT, the UC-NAT performance was not significantly associated with an executive function measure of planning. Environmental adaptations may be implemented without extensive training to improve everyday action in individuals with chronic schizophrenia. Environmental adaptations that reduce planning demands may be most effective in this population.

  19. A Decision Analysis Tool for Climate Impacts, Adaptations, and Vulnerabilities

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

    Omitaomu, Olufemi A; Parish, Esther S; Nugent, Philip J

    Climate change related extreme events (such as flooding, storms, and drought) are already impacting millions of people globally at a cost of billions of dollars annually. Hence, there are urgent needs for urban areas to develop adaptation strategies that will alleviate the impacts of these extreme events. However, lack of appropriate decision support tools that match local applications is limiting local planning efforts. In this paper, we present a quantitative analysis and optimization system with customized decision support modules built on geographic information system (GIS) platform to bridge this gap. This platform is called Urban Climate Adaptation Tool (Urban-CAT). Formore » all Urban-CAT models, we divide a city into a grid with tens of thousands of cells; then compute a list of metrics for each cell from the GIS data. These metrics are used as independent variables to predict climate impacts, compute vulnerability score, and evaluate adaptation options. Overall, the Urban-CAT system has three layers: data layer (that contains spatial data, socio-economic and environmental data, and analytic data), middle layer (that handles data processing, model management, and GIS operation), and application layer (that provides climate impacts forecast, adaptation optimization, and site evaluation). The Urban-CAT platform can guide city and county governments in identifying and planning for effective climate change adaptation strategies.« less

  20. MO-E-BRD-01: Adapt-A-Thon - Texas Hold’em Invitational

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

    Kessler, M; Brock, K; Pouliot, J

    2014-06-15

    Software tools for image-based adaptive radiotherapy such as deformable image registration, contour propagation and dose mapping have progressed beyond the research setting and are now commercial products available as part of both treatment planning systems and stand-alone applications. These software tools are used together to create clinical workflows to detect, track and evaluate changes in the patient and to accumulate dose. Deviations uncovered in this process are used to guide decisions about replanning/adaptation with the goal of keeping the delivery of prescribed dose “on target” throughout the entire course of radiotherapy. Since the output from one step of the adaptivemore » process is used as an input for another, it is essential to understand and document the uncertainty associated with each of the step and how these uncertainties are propagated. This in turn requires an understanding how the underlying tools work. Unfortunately, important details about the algorithms used to implement these tools are scarce or incomplete, too often for competitive reasons. This is in contrast to the situation involving other basic treatment planning algorithms such as dose calculations, where the medical physics community essentially requires vendors to provide physically important details about their underlying theory and clinical implementation. Vendors should adopt this same level of information sharing when it comes to the tools and techniques for image guided adaptive radiotherapy. The goal of this session is to start this process by inviting vendors and medical physicists to discuss and demonstrate the available tools and describe how they are intended to be used in clinical practice. The format of the session will involve a combination of formal presentations, interactive demonstrations, audience participation and some friendly “Texas style” competition. Learning Objectives: Understand the components of the image-based adaptive radiotherapy process. Understand the how these components are implemented in various commercial systems. Understand the different use cases and workflows currently supported these tools.« less

  1. Responding to Sea Level Rise: Does Short-Term Risk Reduction Inhibit Successful Long-Term Adaptation?

    NASA Astrophysics Data System (ADS)

    Keeler, A. G.; McNamara, D. E.; Irish, J. L.

    2018-04-01

    Most existing coastal climate-adaptation planning processes, and the research supporting them, tightly focus on how to use land use planning, policy tools, and infrastructure spending to reduce risks from rising seas and changing storm conditions. While central to community response to sea level rise, we argue that the exclusive nature of this focus biases against and delays decisions to take more discontinuous, yet proactive, actions to adapt—for example, relocation and aggressive individual protection investments. Public policies should anticipate real estate market responses to risk reduction to avoid large costs—social and financial—when and if sea level rise and other climate-related factors elevate the risks to such high levels that discontinuous responses become the least bad alternative.

  2. Evaluation of delivered dose for a clinical daily adaptive plan selection strategy for bladder cancer radiotherapy.

    PubMed

    Lutkenhaus, Lotte J; Visser, Jorrit; de Jong, Rianne; Hulshof, Maarten C C M; Bel, Arjan

    2015-07-01

    To account for variable bladder size during bladder cancer radiotherapy, a daily plan selection strategy was implemented. The aim of this study was to calculate the actually delivered dose using an adaptive strategy, compared to a non-adaptive approach. Ten patients were treated to the bladder and lymph nodes with an adaptive full bladder strategy. Interpolated delineations of bladder and tumor on a full and empty bladder CT scan resulted in five PTVs for which VMAT plans were created. Daily cone beam CT (CBCT) scans were used for plan selection. Bowel, rectum and target volumes were delineated on these CBCTs, and delivered dose for these was calculated using both the adaptive plan, and a non-adaptive plan. Target coverage for lymph nodes improved using an adaptive strategy. The full bladder strategy spared the healthy part of the bladder from a high dose. Average bowel cavity V30Gy and V40Gy significantly reduced with 60 and 69ml, respectively (p<0.01). Other parameters for bowel and rectum remained unchanged. Daily plan selection compared to a non-adaptive strategy yielded similar bladder coverage and improved coverage for lymph nodes, with a significant reduction in bowel cavity V30Gy and V40Gy only, while other sparing was limited. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. SU-F-J-110: MRI-Guided Single-Session Simulation, Online Adaptation, and Treatment

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

    Hill, P; Geurts, M; Mittauer, K

    Purpose: To develop a combined simulation and treatment workflow for MRI-guided radiation therapy using the ViewRay treatment planning and delivery system. Methods: Several features of the ViewRay MRIdian planning and treatment workflows are used to simulate and treat patients that require emergent radiotherapy. A simple “pre-plan” is created on diagnostic imaging retrieved from radiology PACS, where conformal fields are created to target a volume defined by a physician based on review of the diagnostic images and chart notes. After initial consult in radiation oncology, the patient is brought to the treatment room, immobilized, and imaged in treatment position with amore » volumetric MR. While the patient rests on the table, the pre-plan is applied to the treatment planning MR and dose is calculated in the treatment geometry. After physician review, modification of the plan may include updating the target definition, redefining fields, or re-balancing beam weights. Once an acceptable treatment plan is finalized and approved, the patient is treated. Results: Careful preparation and judicious choices in the online planning process allow conformal treatment plans to be created and delivered in a single, thirty-minute session. Several advantages have been identified using this process as compared to conventional urgent CT simulation and delivery. Efficiency gains are notable, as physicians appreciate the predictable time commitment and patient waiting time for treatment is decreased. MR guidance in a treatment position offers both enhanced contrast for target delineation and reduction of setup uncertainties. The MRIdian system tools designed for adaptive radiotherapy are particularly useful, enabling plan changes to be made in minutes. Finally, the resulting plans, typically 6 conformal beams, are delivered as quickly as more conventional AP/PA beam arrangements with comparatively superior dose distributions. Conclusion: The ViewRay treatment planning software and delivery system can accommodate a fast simulation and treatment workflow.« less

  4. The multidisciplinary treatment plan: a format for enhancing activity therapy department involvement.

    PubMed

    Lang, E; Mattson, M

    1985-01-01

    A structured, goal-oriented format for enhancing the involvement of activity therapy disciplines in the multidisciplinary treatment planning process has been developed in a large private psychiatric teaching hospital. The format, an adaptation of the problem-oriented record, encompasses formal procedures for identifying and recording relevant problems, goals, methods, and objectives for activity therapy treatment. The benefits of this approach include the development of specific, measurable, attainable functional goals; increased accountability in treatment planning and delivery; less time spent in documentation; and education of other staff about the role and function of activities therapy. Patients have a better understanding of their goals and the steps needed to achieve them and show increased participation in the therapy process.

  5. Cautious but committed: moving toward adaptive planning and operation strategies for renewable energy's wildlife implications.

    PubMed

    Köppel, Johann; Dahmen, Marie; Helfrich, Jennifer; Schuster, Eva; Bulling, Lea

    2014-10-01

    Wildlife planning for renewable energy must cope with the uncertainties of potential wildlife impacts. Unfortunately, the environmental policies which instigate renewable energy and those which protect wildlife are not coherently aligned-creating a green versus green dilemma. Thus, climate mitigation efforts trigger renewable energy development, but then face substantial barriers from biodiversity protection instruments and practices. This article briefly reviews wind energy and wildlife interactions, highlighting the lively debated effects on bats. Today, planning and siting of renewable energy are guided by the precautionary principle in an attempt to carefully address wildlife challenges. However, this planning attitude creates limitations as it struggles to negotiate the aforementioned green versus green dilemma. More adaptive planning and management strategies and practices hold the potential to reconcile these discrepancies to some degree. This adaptive approach is discussed using facets of case studies from policy, planning, siting, and operational stages of wind energy in Germany and the United States, with one case showing adaptive planning in action for solar energy as well. This article attempts to highlight the benefits of more adaptive approaches as well as the possible shortcomings, such as reduced planning security for renewable energy developers. In conclusion, these studies show that adaptive planning and operation strategies can be designed to supplement and enhance the precautionary principle in wildlife planning for green energy.

  6. Cautious but Committed: Moving Toward Adaptive Planning and Operation Strategies for Renewable Energy's Wildlife Implications

    NASA Astrophysics Data System (ADS)

    Köppel, Johann; Dahmen, Marie; Helfrich, Jennifer; Schuster, Eva; Bulling, Lea

    2014-10-01

    Wildlife planning for renewable energy must cope with the uncertainties of potential wildlife impacts. Unfortunately, the environmental policies which instigate renewable energy and those which protect wildlife are not coherently aligned—creating a green versus green dilemma. Thus, climate mitigation efforts trigger renewable energy development, but then face substantial barriers from biodiversity protection instruments and practices. This article briefly reviews wind energy and wildlife interactions, highlighting the lively debated effects on bats. Today, planning and siting of renewable energy are guided by the precautionary principle in an attempt to carefully address wildlife challenges. However, this planning attitude creates limitations as it struggles to negotiate the aforementioned green versus green dilemma. More adaptive planning and management strategies and practices hold the potential to reconcile these discrepancies to some degree. This adaptive approach is discussed using facets of case studies from policy, planning, siting, and operational stages of wind energy in Germany and the United States, with one case showing adaptive planning in action for solar energy as well. This article attempts to highlight the benefits of more adaptive approaches as well as the possible shortcomings, such as reduced planning security for renewable energy developers. In conclusion, these studies show that adaptive planning and operation strategies can be designed to supplement and enhance the precautionary principle in wildlife planning for green energy.

  7. Classroom Research in Accounting: Assessing for Learning.

    ERIC Educational Resources Information Center

    Cottell, Philip G., Jr.

    1991-01-01

    The use of several college classroom assessment techniques to evaluate the processes and products of accounting instruction through cooperative learning is described. The discussion looks at considerations in planning classroom assessment, choosing initial assessment techniques and adapting them, and blending cooperative learning structures with…

  8. 10 Steps for Implementing Change.

    ERIC Educational Resources Information Center

    Marsee, Jeff

    2002-01-01

    Offers steps for adapting the change process to institutional culture: align leadership style with organizational culture, don't overuse change missionaries, protect change agents, define the problem, maintain focus when the project drifts, identify and remove barriers before implementing action plans, assign responsibilities to individuals,…

  9. Using weather data to improve decision-making

    USDA-ARS?s Scientific Manuscript database

    Weather in the western United States is relatively dry and highly variable. The consequences of this variability can be effectively dealt with through the process of adaptive management which includes contingency planning for partial restoration success or restoration failure in any given year. Pr...

  10. Introducing an on-line adaptive procedure for prostate image guided intensity modulate proton therapy.

    PubMed

    Zhang, M; Westerly, D C; Mackie, T R

    2011-08-07

    With on-line image guidance (IG), prostate shifts relative to the bony anatomy can be corrected by realigning the patient with respect to the treatment fields. In image guided intensity modulated proton therapy (IG-IMPT), because the proton range is more sensitive to the material it travels through, the realignment may introduce large dose variations. This effect is studied in this work and an on-line adaptive procedure is proposed to restore the planned dose to the target. A 2D anthropomorphic phantom was constructed from a real prostate patient's CT image. Two-field laterally opposing spot 3D-modulation and 24-field full arc distal edge tracking (DET) plans were generated with a prescription of 70 Gy to the planning target volume. For the simulated delivery, we considered two types of procedures: the non-adaptive procedure and the on-line adaptive procedure. In the non-adaptive procedure, only patient realignment to match the prostate location in the planning CT was performed. In the on-line adaptive procedure, on top of the patient realignment, the kinetic energy for each individual proton pencil beam was re-determined from the on-line CT image acquired after the realignment and subsequently used for delivery. Dose distributions were re-calculated for individual fractions for different plans and different delivery procedures. The results show, without adaptive, that both the 3D-modulation and the DET plans experienced delivered dose degradation by having large cold or hot spots in the prostate. The DET plan had worse dose degradation than the 3D-modulation plan. The adaptive procedure effectively restored the planned dose distribution in the DET plan, with delivered prostate D(98%), D(50%) and D(2%) values less than 1% from the prescription. In the 3D-modulation plan, in certain cases the adaptive procedure was not effective to reduce the delivered dose degradation and yield similar results as the non-adaptive procedure. In conclusion, based on this 2D phantom study, by updating the proton pencil beam energy from the on-line image after realignment, this on-line adaptive procedure is necessary and effective for the DET-based IG-IMPT. Without dose re-calculation and re-optimization, it could be easily incorporated into the clinical workflow.

  11. Introducing an on-line adaptive procedure for prostate image guided intensity modulate proton therapy

    NASA Astrophysics Data System (ADS)

    Zhang, M.; Westerly, D. C.; Mackie, T. R.

    2011-08-01

    With on-line image guidance (IG), prostate shifts relative to the bony anatomy can be corrected by realigning the patient with respect to the treatment fields. In image guided intensity modulated proton therapy (IG-IMPT), because the proton range is more sensitive to the material it travels through, the realignment may introduce large dose variations. This effect is studied in this work and an on-line adaptive procedure is proposed to restore the planned dose to the target. A 2D anthropomorphic phantom was constructed from a real prostate patient's CT image. Two-field laterally opposing spot 3D-modulation and 24-field full arc distal edge tracking (DET) plans were generated with a prescription of 70 Gy to the planning target volume. For the simulated delivery, we considered two types of procedures: the non-adaptive procedure and the on-line adaptive procedure. In the non-adaptive procedure, only patient realignment to match the prostate location in the planning CT was performed. In the on-line adaptive procedure, on top of the patient realignment, the kinetic energy for each individual proton pencil beam was re-determined from the on-line CT image acquired after the realignment and subsequently used for delivery. Dose distributions were re-calculated for individual fractions for different plans and different delivery procedures. The results show, without adaptive, that both the 3D-modulation and the DET plans experienced delivered dose degradation by having large cold or hot spots in the prostate. The DET plan had worse dose degradation than the 3D-modulation plan. The adaptive procedure effectively restored the planned dose distribution in the DET plan, with delivered prostate D98%, D50% and D2% values less than 1% from the prescription. In the 3D-modulation plan, in certain cases the adaptive procedure was not effective to reduce the delivered dose degradation and yield similar results as the non-adaptive procedure. In conclusion, based on this 2D phantom study, by updating the proton pencil beam energy from the on-line image after realignment, this on-line adaptive procedure is necessary and effective for the DET-based IG-IMPT. Without dose re-calculation and re-optimization, it could be easily incorporated into the clinical workflow.

  12. The Automated System of the Rhythm Analysis of the Educational Process in a Higher Educational Institution on the Basis of Aprioristic Data

    ERIC Educational Resources Information Center

    Pelin, Nicolae; Mironov, Vladimir

    2008-01-01

    In this article the problems of functioning algorithms development for system of the automated analysis of educational process rhythm in a higher educational institution are considered. Using the device of experiment planning for conducting the scientific researches, adapted methodologies, received by authors in the dissertational works at the…

  13. Adaptive fractionated stereotactic Gamma Knife radiotherapy of meningioma using integrated stereotactic cone-beam-CT and adaptive re-planning (a-gkFSRT).

    PubMed

    Stieler, F; Wenz, F; Abo-Madyan, Y; Schweizer, B; Polednik, M; Herskind, C; Giordano, F A; Mai, S

    2016-11-01

    The Gamma Knife Icon (Elekta AB, Stockholm, Sweden) allows frameless stereotactic treatment using a combination of cone beam computer tomography (CBCT), a thermoplastic mask system, and an infrared-based high-definition motion management (HDMM) camera system for patient tracking during treatment. We report on the first patient with meningioma at the left petrous bone treated with adaptive fractionated stereotactic radiotherapy (a-gkFSRT). The first patient treated with Gamma Knife Icon at our institute received MR imaging for preplanning before treatment. For each treatment fraction, a daily CBCT was performed to verify the actual scull/tumor position. The system automatically adapted the planned shot positions to the daily position and recalculated the dose distribution (online adaptive planning). During treatment, the HDMM system recorded the intrafractional patient motion. Furthermore, the required times were recorded to define a clinical treatment slot. Total treatment time was around 20 min. Patient positioning needed 0.8 min, CBCT positioning plus acquisition 1.65 min, CT data processing and adaptive planning 2.66 min, and treatment 15.6 min. The differences for the five daily CBCTs compared to the reference are for rotation: -0.59 ± 0.49°/0.18 ± 0.20°/0.05 ± 0.36° and for translation: 0.94 ± 0.52 mm/-0.08 ± 0.08 mm/-1.13 ± 0.89 mm. Over all fractions, an intrafractional movement of 0.13 ± 0.04 mm was observed. The Gamma Knife Icon allows combining the accuracy of the stereotactic Gamma Knife system with the flexibility of fractionated treatment with the mask system and CBCT. Furthermore, the Icon system introduces a new online patient tracking system to the clinical routine. The interfractional accuracy of patient positioning was controlled with a thermoplastic mask and CBCT.

  14. Limitations to Thermoregulation and Acclimatization Challenge Human Adaptation to Global Warming.

    PubMed

    Hanna, Elizabeth G; Tait, Peter W

    2015-07-15

    Human thermoregulation and acclimatization are core components of the human coping mechanism for withstanding variations in environmental heat exposure. Amidst growing recognition that curtailing global warming to less than two degrees is becoming increasing improbable, human survival will require increasing reliance on these mechanisms. The projected several fold increase in extreme heat events suggests we need to recalibrate health protection policies and ratchet up adaptation efforts. Climate researchers, epidemiologists, and policy makers engaged in climate change adaptation and health protection are not commonly drawn from heat physiology backgrounds. Injecting a scholarly consideration of physiological limitations to human heat tolerance into the adaptation and policy literature allows for a broader understanding of heat health risks to support effective human adaptation and adaptation planning. This paper details the physiological and external environmental factors that determine human thermoregulation and acclimatization. We present a model to illustrate the interrelationship between elements that modulate the physiological process of thermoregulation. Limitations inherent in these processes, and the constraints imposed by differing exposure levels, and thermal comfort seeking on achieving acclimatization, are then described. Combined, these limitations will restrict the likely contribution that acclimatization can play in future human adaptation to global warming. We postulate that behavioral and technological adaptations will need to become the dominant means for human individual and societal adaptations as global warming progresses.

  15. Negotiating Risky Preferences in Nursing Homes: A Case Study of the Rothschild Person-Centered Care Planning Approach.

    PubMed

    Behrens, Liza; Van Haitsma, Kimberly; Brush, Jennifer; Boltz, Marie; Volpe, Donna; Kolanowski, Ann Marie

    2018-01-16

    Delivering person-centered care (PCC) is no longer an option for nursing homes (NH) that receive funding from the Centers for Medicare & Medicaid Services. NH staff need evidence-based protocols to guide efforts in honoring preferred choices of residents, especially those that are perceived to be risky. The Rothschild Care Planning Process for Resident Choice was created to honor such choices. The current article provides a case exemplar to demonstrate the use of the Rothschild Care Planning Process for Resident Choice with one NH resident who was perceived by staff to be making a risky choice. The scenario outlines six steps to the process, highlighting areas for focus and documentation that addresses complexities and best practices in delivering PCC. Three recommendations are offered to address residents' choices that carry risk: (a) adapt care community policies, (b) engage direct care staff in care planning, and (c) provide staff training in facilitating resident choice. [Journal of Gerontological Nursing, xx(x), xx-xx.]. Copyright 2018, SLACK Incorporated.

  16. Online Magnetic Resonance Image Guided Adaptive Radiation Therapy: First Clinical Applications

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

    Acharya, Sahaja; Fischer-Valuck, Benjamin W.; Kashani, Rojano

    Purpose: To demonstrate the feasibility of online adaptive magnetic resonance (MR) image guided radiation therapy (MR-IGRT) through reporting of our initial clinical experience and workflow considerations. Methods and Materials: The first clinically deployed online adaptive MR-IGRT system consisted of a split 0.35T MR scanner straddling a ring gantry with 3 multileaf collimator-equipped {sup 60}Co heads. The unit is supported by a Monte Carlo–based treatment planning system that allows real-time adaptive planning with the patient on the table. All patients undergo computed tomography and MR imaging (MRI) simulation for initial treatment planning. A volumetric MRI scan is acquired for each patient atmore » the daily treatment setup. Deformable registration is performed using the planning computed tomography data set, which allows for the transfer of the initial contours and the electron density map to the daily MRI scan. The deformed electron density map is then used to recalculate the original plan on the daily MRI scan for physician evaluation. Recontouring and plan reoptimization are performed when required, and patient-specific quality assurance (QA) is performed using an independent in-house software system. Results: The first online adaptive MR-IGRT treatments consisted of 5 patients with abdominopelvic malignancies. The clinical setting included neoadjuvant colorectal (n=3), unresectable gastric (n=1), and unresectable pheochromocytoma (n=1). Recontouring and reoptimization were deemed necessary for 3 of 5 patients, and the initial plan was deemed sufficient for 2 of the 5 patients. The reasons for plan adaptation included tumor progression or regression and a change in small bowel anatomy. In a subsequently expanded cohort of 170 fractions (20 patients), 52 fractions (30.6%) were reoptimized online, and 92 fractions (54.1%) were treated with an online-adapted or previously adapted plan. The median time for recontouring, reoptimization, and QA was 26 minutes. Conclusion: Online adaptive MR-IGRT has been successfully implemented with planning and QA workflow suitable for routine clinical application. Clinical trials are in development to formally evaluate adaptive treatments for a variety of disease sites.« less

  17. Data Sparsity Considerations in Climate Impact Analysis for the Water Sector (Invited)

    NASA Astrophysics Data System (ADS)

    Asante, K. O.; Khimsara, P.; Chan, A.

    2013-12-01

    Scientists and planners are helping governments and communities around the world to prepare for climate change by performing local impact studies and developing adaptation plans. Most studies begin by analyzing global climate models outputs to estimate the magnitude of projected change, assessing vulnerabilities and proposing adaptation measures. In these studies, climate projections from the Intergovernmental Panel on Climate Change (IPCC) Data Distribution Centre (DDC) are either used directly or downscaled using regional models. Since climate projections cover the entire global, climate change analysis can be performed for any location. However, selection of climate projections for use in historically data sparse regions presents special challenges. Key questions arise about the impact of historical data sparsity on quality of climate projections, spatial consistency of results and suitability for applications such as water resource planning. In this paper, a water-sector climate study conducted in a data-rich setting in California is compared to a similar study conducted a data-sparse setting in Mozambique. The challenges of selecting projections, performing analysis and interpreting the results for climate adaption planning are compared to illustrate the decision process and challenges encountered in these two very different settings.

  18. Salmon and Sagebrush: The Shoshone-Bannock Tribes Collaborative Approach to Adaptation Planning

    NASA Astrophysics Data System (ADS)

    Petersen, A.; Nasser, E.; Stone, D.; Krosby, M.; Whitley-Binder, L.; Morgan, H.; Rupp, D. E.; Dello, K.; Dalton, M. M.; Fox, M.; Rodgers, K.

    2017-12-01

    The Shoshone-Bannock Tribes reside in the Upper Snake River Watershed in southeast Idaho. Their lives and culture are intertwined with the lands where they live; lands which continue to sustain the Tribes cultural, spiritual, dietary and economic needs. Climate change presents a new threat to the region requiring innovative approaches to prepare for changes as well as to protect the natural resources within the region. As a critical first step in building climate resilience, the Tribes worked with Adaptation International, the University of Washington's Climate Impacts Group (CIG) and the Oregon Climate Change Research Institute (OCCRI) to complete a collaborative climate change vulnerability assessment and adaptation planning process. This presentation provides an overview of collaborative process, shares the results of the project, and includes a 3-minute video presentation. The project started with the identification of 34 plant and animal species to focus the vulnerability assessment. OCCRI analyzed detailed downscaled climate projections for two key climate scenarios (RCP 4.5 and RCP 8.5) and timescales (2050s and 2080s). CIG then used NatureServe's Climate Change Vulnerability Index (CCVI) to develop initial relative vulnerability results for these species. A core team of Tribal staff members from various departments refined these results, drawing upon and integrating rich local and traditional knowledges of the natural environmental and cultural resources. The adaptation planning phase of the project continued in a similar collaborative manner with the project team identifying promising adaptation actions and working directly with Tribal staff to refine and customize these strategies. Tailoring the actions to the local context provides a framework for action that the Tribes can continue to build on in the future. By engaging in these efforts to identify vulnerable species and adaptation strategies and actions to minimize the negative effects of climate change, the Tribes have demonstrated their continued commitment to protecting their vital natural resources. The Tribes will continue to implement projects across landscapes in the near term and utilize the information co-produced as part of this project to develop long-term strategies and projects to build resilience.

  19. Planning assistance for the NASA 30/20 GHz program. Network control architecture study.

    NASA Technical Reports Server (NTRS)

    Inukai, T.; Bonnelycke, B.; Strickland, S.

    1982-01-01

    Network Control Architecture for a 30/20 GHz flight experiment system operating in the Time Division Multiple Access (TDMA) was studied. Architecture development, identification of processing functions, and performance requirements for the Master Control Station (MCS), diversity trunking stations, and Customer Premises Service (CPS) stations are covered. Preliminary hardware and software processing requirements as well as budgetary cost estimates for the network control system are given. For the trunking system control, areas covered include on board SS-TDMA switch organization, frame structure, acquisition and synchronization, channel assignment, fade detection and adaptive power control, on board oscillator control, and terrestrial network timing. For the CPS control, they include on board processing and adaptive forward error correction control.

  20. Towards a Pragmatic Grammar of Teachers' Epistemic Networks.

    ERIC Educational Resources Information Center

    Tochon, Francois V.

    Possibilities of conceptual and pragmatic analysis exist for identifying epistemological processing in teacher thinking. These modes of organizing thought condition classroom planning, shape meaning from a virtual didactic knowledge-store, and scaffold further pedagogical interactions. The semio-cognitive grammar proposed is adapted to the…

  1. The Australian Natural Disaster Resilience Index

    NASA Astrophysics Data System (ADS)

    Thoms, Martin

    2016-04-01

    The Australian Natural Disaster Resilience Index Martin Thoms, Melissa Parsons, Phil Morley Bushfire and Natural Hazards Cooperative Research Centre, Geography and Planning, University of New England, Armidale NSW 2351, Australia. Natural hazard management policy directions in Australia - and indeed internationally - are increasingly being aligned to ideas of resilience. Resilience to natural hazards is the ability of individuals and communities to cope with disturbance and adversity and to maintain adaptive behaviour. Operationalizing the measurement and assessment of disaster resilience is often undertaken using a composite index, but this exercise is yet to be undertaken in Australia. The Australian Natural Disaster Resilience Index is a top-down, national scale assessment of the resilience of communities to natural hazards. Resilience is assessed based on two sets of capacities: coping and adaptive capacities. Coping capacity relates to the factors influencing the ability of a community to prepare for, absorb and recover from a natural hazard event. Adaptive capacity relates to the arrangements and processes that enable adjustment through learning, adaptation and transformation. Indicators are derived under themes of social character, economic capital, infrastructure and planning, emergency services, community capital, information and engagement and governance/leadership/policy, using existing data sets (e.g. census data) or evaluation of policy and procedure (e.g. disaster management planning). A composite index of disaster resilience is then computed for each spatial division, giving national scale coverage. The results of the Australian Natural Disaster Resilience Index will be reported in a State of Disaster Resilience report, due in 2018. The index is co-designed with emergency service agencies, and will support policy development, planning, community engagement and emergency management.

  2. A neural network prototyping package within IRAF

    NASA Technical Reports Server (NTRS)

    Bazell, D.; Bankman, I.

    1992-01-01

    We outline our plans for incorporating a Neural Network Prototyping Package into the IRAF environment. The package we are developing will allow the user to choose between different types of networks and to specify the details of the particular architecture chosen. Neural networks consist of a highly interconnected set of simple processing units. The strengths of the connections between units are determined by weights which are adaptively set as the network 'learns'. In some cases, learning can be a separate phase of the user cycle of the network while in other cases the network learns continuously. Neural networks have been found to be very useful in pattern recognition and image processing applications. They can form very general 'decision boundaries' to differentiate between objects in pattern space and they can be used for associative recall of patterns based on partial cures and for adaptive filtering. We discuss the different architectures we plan to use and give examples of what they can do.

  3. Putting people on the map through an approach that integrates social data in conservation planning.

    PubMed

    Stephanson, Sheri L; Mascia, Michael B

    2014-10-01

    Conservation planning is integral to strategic and effective operations of conservation organizations. Drawing upon biological sciences, conservation planning has historically made limited use of social data. We offer an approach for integrating data on social well-being into conservation planning that captures and places into context the spatial patterns and trends in human needs and capacities. This hierarchical approach provides a nested framework for characterizing and mapping data on social well-being in 5 domains: economic well-being, health, political empowerment, education, and culture. These 5 domains each have multiple attributes; each attribute may be characterized by one or more indicators. Through existing or novel data that display spatial and temporal heterogeneity in social well-being, conservation scientists, planners, and decision makers may measure, benchmark, map, and integrate these data within conservation planning processes. Selecting indicators and integrating these data into conservation planning is an iterative, participatory process tailored to the local context and planning goals. Social well-being data complement biophysical and threat-oriented social data within conservation planning processes to inform decisions regarding where and how to conserve biodiversity, provide a structure for exploring socioecological relationships, and to foster adaptive management. Building upon existing conservation planning methods and insights from multiple disciplines, this approach to putting people on the map can readily merge with current planning practices to facilitate more rigorous decision making. © 2014 Society for Conservation Biology.

  4. Adaptive Radiation Therapy for Localized Mesothelioma with Mediastinal Metastasis Using Helical Tomotherapy

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

    Renaud, James; Yartsev, Slav; Department of Oncology, University of Western Ontario, London, Ontario

    2009-10-01

    The purpose of this study was to compare 2 adaptive radiotherapy strategies with helical tomotherapy. A patient having mesothelioma with mediastinal nodes was treated using helical tomotherapy with pretreatment megavoltage CT (MVCT) imaging. Gross tumor volumes (GTVs) were outlined on every MVCT study. Two alternatives for adapting the treatment were investigated: (1) keeping the prescribed dose to the targets while reducing the dose to the OARs and (2) escalating the target dose while maintaining the original level of healthy tissue sparing. Intensity modulated radiotherapy (step-and-shoot IMRT) and 3D conformal radiotherapy (3DCRT) plans for the patient were generated and compared. Themore » primary lesion and nodal mass regressed by 16.2% and 32.5%, respectively. Adapted GTVs and reduced planning target volume (PTV) margins of 4 mm after 22 fractions decrease the planned mean lung dose by 19.4%. For dose escalation, the planned prescribed doses may be increased from 50.0 to 58.7 Gy in PTV{sub 1} and from 60.0 to 70.5 Gy in PTV{sub 2}. The step-and-shoot IMRT plan was better in sparing healthy tissue but did not provide target coverage as well as the helical tomotherapy plan. The 3DCRT plan resulted in a prohibitively high planned dose to the spinal cord. MVCT studies provide information both for setup correction and plan adaptation. Improved healthy tissue sparing and/or dose escalation can be achieved by adaptive planning.« less

  5. MO-E-BRC-03: Fast Online Replanning Techniques

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

    Li, X.

    Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled themore » implementation of ART in the clinic in the past couple of years. The introduction of these tools into routine clinical use requires many considerations and progressive knowledge to understand how processes that have historically taken hours/days to complete can now be done in less than 30 minutes. This session will discuss considerations to perform real time contouring, planning and patient specific QA, as well as a practical workflow and the required resources. Learning Objectives: To understand the difficulties, challenges and available technologies for online adaptive RT. To understand how to implement online adaptive therapy in a clinical environment and to understand the workflow and resources required. To understand the limitations and sources of uncertainty in the online adaptive process I have research funding from ViewRay Inc. and Philips Medical Systems.; R. Kashani, I have research funding from ViewRay Inc. and Philips Medical Systems.; X. Li, Research supported by Elekta Inc.« less

  6. Future planning and evaluation for automated adaptive minehunting: a roadmap for mine countermeasures theory modernization

    NASA Astrophysics Data System (ADS)

    Garcia, Gregory A.; Wettergren, Thomas A.

    2012-06-01

    This paper presents a discussion of U.S. naval mine countermeasures (MCM) theory modernization in light of advances in the areas of autonomy, tactics, and sensor processing. The unifying theme spanning these research areas concerns the capability for in situ adaptation of processing algorithms, plans, and vehicle behaviors enabled through run-time situation assessment and performance estimation. Independently, each of these technology developments impact the MCM Measures of Effectiveness1 [MOE(s)] of time and risk by improving one or more associated Measures of Performance2 [MOP(s)]; the contribution of this paper is to outline an integrated strategy for realizing the cumulative benefits of these technology enablers to the United States Navy's minehunting capability. An introduction to the MCM problem is provided to frame the importance of the foundational research and the ramifications of the proposed strategy on the MIW community. We then include an overview of current and future adaptive capability research in the aforementioned areas, highlighting a departure from the existing rigid assumption-based approaches while identifying anticipated technology acceptance issues. Consequently, the paper describes an incremental strategy for transitioning from the current minehunting paradigm where tactical decision aids rely on a priori intelligence and there is little to no in situ adaptation or feedback to a future vision where unmanned systems3, equipped with a representation of the commander's intent, are afforded the authority and ability to adapt to environmental perturbations with minimal human-in-the-loop supervision. The discussion concludes with an articulation of the science and technology issues which the MCM research community must continue to address.

  7. Risk Tradeoffs in Adaptive Ecosystem Management: The Case of the U.S. Forest Service

    NASA Astrophysics Data System (ADS)

    Stern, Marc J.; Martin, Caysie A.; Predmore, S. Andrew; Morse, Wayde C.

    2014-06-01

    Natural resource planning processes on public lands in the United States are driven in large part by the requirements of the National Environmental Policy Act (NEPA), which dictates general processes for analyzing and disclosing the likely impacts of proposed actions. The outcomes of these processes are the result of multiple factors, many related to the manifold smaller incremental decisions made by agency personnel directing the processes. Through interviews with decision makers, team leaders, and team members on five NEPA processes within the U.S. Forest Service, this study examines those incremental decisions. Risk, in particular external relationship risk, emerged as a dominant lens through which agency personnel weigh and make process-related decisions. We discuss the tradeoffs associated with agency actors' emphasis on this form of risk and their potential implications for adaptive ecosystem management and organizational performance.

  8. PEG spacer gel and adaptive planning vs single plan in external prostate radiotherapy—clinical dosimetry evaluation

    PubMed Central

    2015-01-01

    Objective: Spacer gel is used to reduce the rectal dose in prostate radiotherapy. It is injected to increase the distance between the prostate and rectum. During the course of external radiotherapy treatment, physiological changes in rectal volume exist. When using polyethylene glycol material, such as DuraSeal® (Covidien, Mansfield, MA), gel resorption also occurs. Together, these factors alter the original dose plan distribution. Methods: External dose planning and calculations were simulated using images acquired from 10 patients who were treated with brachytherapy and gel. The CT series was taken relative to gel injection: pre 1 day, post 1 day, post 1 month and post 2 months. Adaptive planning was compared with a single plan. Results: Adaptive planning shows better results compared with the single plan used in the total treatment course; however, the effect is minor. Conclusion: Gel usage is clearly favourable to rectal DVH. Using adaptive planning with gel improves rectal DVH but is not necessary according to this study. Advances in knowledge: Spacer gel is used in prostate radiotherapy to increase distance between the prostate and the rectum, thus reducing the rectal doses. During the treatment course, gel resorption exists which affects the rectal doses. The usefulness of adaptive planning to compensate this resorption effect has not been studied before. PMID:26370300

  9. Impact of the World Health Organization's Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran.

    PubMed

    Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E

    2014-04-01

    We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.

  10. Multiadaptive Plan (MAP) IMRT to Accommodate Independent Movement of the Prostate and Pelvic Lymph Nodes

    DTIC Science & Technology

    2013-06-01

    08-1-0358 TITLE: Multiadaptive Plan (MAP) IMRT to Accommodate Independent Movement of the Prostate and Pelvic Lymph Nodes PRINCIPAL...AND SUBTITLE Multi-Adaptive Plan (MAP) IMRT to Accommodate Independent 5a. CONTRACT NUMBER W81XWH-08-1-0358 Movement of the Prostate and...multi-adaptive plan (MAP) IMRT to accommodate independent movement of the two targeted tumor volumes. In this project, we evaluated two adaptive

  11. Study on Mine Emergency Mechanism based on TARP and ICS

    NASA Astrophysics Data System (ADS)

    Xi, Jian; Wu, Zongzhi

    2018-01-01

    By analyzing the experiences and practices of mine emergency in China and abroad, especially the United States and Australia, normative principle, risk management principle and adaptability principle of constructing mine emergency mechanism based on Trigger Action Response Plans (TARP) and Incident Command System (ICS) are summarized. Classification method, framework, flow and subject of TARP and ICS which are suitable for the actual situation of domestic mine emergency are proposed. The system dynamics model of TARP and ICS is established. The parameters such as evacuation ratio, response rate, per capita emergency capability and entry rate of rescuers are set up. By simulating the operation process of TARP and ICS, the impact of these parameters on the emergency process are analyzed, which could provide a reference and basis for building emergency capacity, formulating emergency plans and setting up action plans in the emergency process.

  12. Adaptive integration of habits into depth-limited planning defines a habitual-goal–directed spectrum

    PubMed Central

    Keramati, Mehdi; Smittenaar, Peter; Dolan, Raymond J.; Dayan, Peter

    2016-01-01

    Behavioral and neural evidence reveal a prospective goal-directed decision process that relies on mental simulation of the environment, and a retrospective habitual process that caches returns previously garnered from available choices. Artificial systems combine the two by simulating the environment up to some depth and then exploiting habitual values as proxies for consequences that may arise in the further future. Using a three-step task, we provide evidence that human subjects use such a normative plan-until-habit strategy, implying a spectrum of approaches that interpolates between habitual and goal-directed responding. We found that increasing time pressure led to shallower goal-directed planning, suggesting that a speed-accuracy tradeoff controls the depth of planning with deeper search leading to more accurate evaluation, at the cost of slower decision-making. We conclude that subjects integrate habit-based cached values directly into goal-directed evaluations in a normative manner. PMID:27791110

  13. Planning for the Future, a Look from Apollo to the Present

    NASA Technical Reports Server (NTRS)

    Segrera, David

    2008-01-01

    Future missions out of low Earth orbit, returning to the moon and Mars, will be some of the most complicated endeavors ever attempted by mankind. It will require the wealth of nations and the dedicated efforts of thousand of individuals working in a concerted effort to take man to the moon, Mars and beyond. These missions will require new equipment and new approaches to optimize our limited resources and time in space. This daily planning and optimization which currently is being performed by scores of people in MCC Houston and around the world will need to adapt to the challenges faced far from Earth. By studying the processes, methodologies, and tools employed from Apollo, Skylab, Shuttle, ISS, and other programs such as NEEMO, we can learn from the past to plan for the future. This paper will explore the planning process used from Apollo onward and will discuss their relevancy in future applications.

  14. Reconfigurable manufacturing execution system for pipe cutting

    NASA Astrophysics Data System (ADS)

    Yin, Y. H.; Xie, J. Y.

    2011-08-01

    This article presents a reconfigurable manufacturing execution system (RMES) filling the gap between enterprise resource planning and resource layer for pipe-cutting production with mass customisation and rapid adaptation to dynamic market, which consists of planning and scheduling layer and executive control layer. Starting from customer's task and process requirements, the cutting trajectories are planned under generalised mathematical model able to reconfigure in accordance with various intersecting types' joint, and all tasks are scheduled by nesting algorithm to maximise the utilisation rate of rough material. This RMES for pipe cutting has been effectively implemented in more than 100 companies.

  15. Where science meets practice: Olympic coaches' crafting of the tapering process.

    PubMed

    Ritchie, Darren; Allen, Justine B; Kirkland, Andrew

    2018-05-01

    Although there is research providing physiologically-based guidance for the content of the taper, this study was the first to examine how coaches actually implement the taper. The purpose of this study was to examine the taper planning and implementation processes of successful Olympic coaches leading up to major competitions and how they learned about tapering. Seven track and field coaches participated in semi-structured interviews exploring their tapering processes. To be considered for inclusion, coaches were required to have coached one or more athletes to an Olympic or Paralympic medal. Through a process of axial and open coding interview transcripts were analysed and lower and higher order themes developed describing the coaches' tapering processes. Our findings indicate that the strategies employed to achieve the desired physiological adaptions of the taper were consistent with research (e.g., reduction in volume whilst maintaining intensity and frequency). However, our findings also suggest that tapering is far from a straight forward "textbook" process. The taper was not restricted to physiological outcomes with coaches considering athletes' psychological as well as physical state. Coaches also involved the athlete in the process, adapted the taper to the athlete, continually monitored its progress, and adapted it further as required.

  16. Implementation of the first adaptive management plan for a European migratory waterbird population: The case of the Svalbard pink-footed goose Anser brachyrhynchus

    USGS Publications Warehouse

    Madsen, Jesper; Williams, James Henty; Johnson, Fred A.; Tombre, Ingunn M.; Dereliev, Sergey; Kuijken, Eckhart

    2017-01-01

    An International Species Management Plan for the Svalbard population of the pink-footed goose was adopted under the Agreement on the Conservation of African-Eurasian Migratory Waterbirds in 2012, the first case of adaptive management of a migratory waterbird population in Europe. An international working group (including statutory agencies, NGO representatives and experts) agreed on objectives and actions to maintain the population in favourable conservation status, while accounting for biodiversity, economic and recreational interests. Agreements include setting a population target to reduce agricultural conflicts and avoid tundra degradation, and using hunting in some range states to maintain stable population size. As part of the adaptive management procedures, adjustment to harvest is made annually subject to population status. This has required streamlining of monitoring and assessment activities. Three years after implementation, indicators suggest the attainment of management results. Dialogue, consensus-building and engagement among stakeholders represent the major process achievements.

  17. Climate Risk Informed Decision Analysis (CRIDA): A novel practical guidance for Climate Resilient Investments and Planning

    NASA Astrophysics Data System (ADS)

    Jeuken, Ad; Mendoza, Guillermo; Matthews, John; Ray, Patrick; Haasnoot, Marjolijn; Gilroy, Kristin; Olsen, Rolf; Kucharski, John; Stakhiv, Gene; Cushing, Janet; Brown, Casey

    2016-04-01

    Engineers and water managers have always incorporated uncertainty in water resources operations, design and planning. In recent years, concern has been growing concern that many of the fundamental principles to address uncertainty in planning and design are insufficient for coping with unprecedented shifts in climate, especially given the long lifetimes of water investments - spanning decades, even centuries. Can we design and operate new flood risk management, energy, water supply and sanitation, and agricultural projects that are robust to shifts over 20, 50, or more years? Since about 2009, better approaches to planning and designing under climate uncertainty have been gaining ground worldwide. The main challenge is to operationalize these approaches and bring them from science to practice, embed them within the existing decision-making processes of particular institutions, and shift from highly specialized "boutique" applications to methods that result in consistent, replicable outcomes accessible to water managers worldwide. With CRIDA a serious step is taken to achieve these goals. CRIDA is built on two innovative but complementary approaches that have developed in isolation across the Atlantic over the past seven years: diagnosing and assessing risk (decision scaling), and developing sequential decision steps to compensate for uncertainty within regulatory / performance standards (adaptation pathways). First, the decision scaling or "bottom up" framework to climate change adaptation was first conceptualized during the US/Canada Great Lakes regulation study and has recently been placed in a decision-making context for water-related investments published by the World Bank Second, the adaptation pathways approach was developed in the Netherlands to cope with the level of climate uncertainty we now face. Adaptation pathways is a tool for maintaining options and flexibility while meeting operational goals by envisioning how sequences of decisions can be navigated over time. They are part of the Dutch adaptive planning approach Adaptive Delta Management, executed and develop by the Dutch Delta program. Both decision scaling and adaptation pathways have been piloted in studies worldwide. The objective of CRIDA is to mainstream effective climate adaptation for professional water managers. The CRIDA publication, due in april 2016, follows the generic water design planning design cycle. At each step, CRIDA describes stepwise guidance for incorporating climate robustness: problem definition, stress test, alternatives formulation and recommendation, evaluation and selection. In the presentation the origin, goal, steps and practical tools available at each step of CRIDA will be explained. In two other abstracts ("Climate Risk Informed Decision Analysis: A Hypothetical Application to the Waas Region" by Gilroy et al., "The Application of Climate Risk Informed Decision Analysis to the Ioland Water Treatment Plant in Lusaka, Zambia, by Kucharski et al.), the application of CRIDA to cases is explained

  18. Mathematical Sciences Division 1992 Programs

    DTIC Science & Technology

    1992-10-01

    statistical theory that underlies modern signal analysis . There is a strong emphasis on stochastic processes and time series , particularly those which...include optimal resource planning and real- time scheduling of stochastic shop-floor processes. Scheduling systems will be developed that can adapt to...make forecasts for the length-of-service time series . Protocol analysis of these sessions will be used to idenify relevant contextual features and to

  19. Biological PET-guided adaptive radiotherapy for dose escalation in head and neck cancer: a systematic review.

    PubMed

    Hamming-Vrieze, Olga; Navran, Arash; Al-Mamgani, Abrahim; Vogel, Wouter V

    2018-06-04

    In recent years, the possibility of adapting radiotherapy to changes in biological tissue parameters has emerged. It is hypothesized that early identification of radio-resistant parts of the tumor during treatment provides the possibility to adjust the radiotherapy plan to improve outcome. The aim of this systematic literature review was to evaluate the current state of the art of biological PET-guided adaptive radiotherapy, focusing on dose escalation to radio-resistant tumor. A structured literature search was done to select clinical trials including patients with head and neck cancer of the oral cavity, oropharynx, hypopharynx or larynx, with a PET performed during treatment used to develop biological adaptive radiotherapy by i) delineation of sub-volumes suitable for adaptive re-planning, ii) in silico adaptive treatment planning or iii) treatment of patients with PET based dose escalated adaptive radiotherapy. Nineteen articles were selected, 12 articles analyzing molecular imaging signal during treatment and 7 articles focused on biological adaptive treatment planning, of which two were clinical trials. Studied biological pathways include metabolism (FDG), hypoxia (MISO, FAZA and HX4) and proliferation (FLT). In the development of biological dose adaptation in radiotherapy for head-neck tumors, many aspects of the procedure remain ambiguous. Patient selection, tracer selection for detection of the radio-resistant sub-volumes, timing of adaptive radiotherapy, workflow and treatment planning aspects are discussed in a clinical context.

  20. The Process of Residential Real Estate Development

    DTIC Science & Technology

    1993-01-01

    Having quality model homes and well planned home shows is important. The marketing strategy must be adaptable and flexible to changing market conditions...As the tastes of consumers change, so too does the success of many a project. The marketing strategy must incorporate these changes and provide the

  1. Diagnosing and Resolving Conflict Created by Strategic Plans: Where Outreach Strategies and Execution Meet at an Academic Health Center.

    PubMed

    Edwards, Robert L; Wollner, Samuel B; Weddle, Jessica; Zembrodt, James W; Birdwhistell, Mark D

    2017-01-01

    The imperative for strategic change at academic health centers has never been stronger. Underpinning the success of strategic change is an effective process to implement a strategy. Healthcare organizations, however, often fail to execute on strategy because they do not activate the requisite capabilities and management processes. The University of Kentucky HealthCare recently defined its 2020 strategic plan to adapt to emerging market conditions. The authors outline the strategic importance of strengthening partnership networks and the initial challenges faced in executing their strategy. The findings are a case study in how one academic health center has approached strategy implementation.

  2. Scenario Planning Provides a Framework for Climate Change Adaptation in the National Park Service

    NASA Astrophysics Data System (ADS)

    Welling, L. A.

    2012-12-01

    Resource management decisions must be based on future expectations. Abundant evidence suggests climate change will have highly consequential effects on the Nation's natural and cultural resources, but specific impacts are difficult to accurately predict. This situation of too much information but not enough specificity can often lead to either paralysis or denial for decision makers. Scenario planning is an emerging tool for climate change adaptation that provides a structured framework for identifying and exploring critical drivers of change and their uncertain outcomes. Since 2007, the National Park Service (NPS) has been working with its partners to develop and apply a scenario-based approach for adaptation planning that integrates quantitative, model-driven, climate change projections with qualitative, participatory exercises to explore management and policy options under a range of future conditions. Major outcomes of this work are (1) increased understanding of key scientific results and uncertainties, (2) incorporation of alternative perspectives into park and landscape level planning, (3) identification of "no brainer" and "no gainer" actions, (4) strengthening of regional science-management partnerships, and (5) overall improved capacity for flexible decision making. The basic approach employed by NPS for scenario planning follows a typical adaptive management process: define the focal question, assess the relevant science, explore plausible futures, identify effective strategies, prioritize and implement actions, and monitor results. Many science and management partners contributed to the process, including NOAA Regional Integrated Science and Assessment teams (RISAs) and Regional Climate Centers (RCCs), USGS Research Centers, and other university and government scientists. The Global Business Network, an internationally recognized leader in scenario development, provided expert facilitation and training techniques. Climate science input is provided through global and regional circulation models and downscaling to arrive at climate driver information that is relevant for parks and the landscapes within which they are found. Considerable effort is necessary to synthesize the information and to effectively communicate uncertainties about both values and trend (e.g. scientists have higher confidence in the trend of temperature over a given time period than the value). Drivers that are determined to be highly consequential and uncertain are used to create management-relevant scenarios using various techniques, including a structured 2X2 matrix approach, a succession of rapid combinations using multiple variables, and the development of a base, "least change" scenario from which alternatives are then constructed. Socio-economic factors are also considered as essential factors that define the full decision environment within which management and policy decisions are made. Resulting scenarios incorporate information about impacts to natural and cultural resources as well as facilities and visitor experience. The NPS conducted prototypes for scenario planning in each of seven regions and has begun to incorporate elements of the process into all planning requirements. A significant outcome of this work is managers and scientists alike understand climate and ecosystem models provide tools for exploring the future rather than predicting it.

  3. Water System Adaptation to Hydrological Changes: Module 10, Basic Principles of Incorporating Adaptation Science into Hydrologic Planning and Design

    EPA Science Inventory

    This course will introduce students to the fundamental principles of water system adaptation to hydrological changes, with emphasis on data analysis and interpretation, technical planning, and computational modeling. Starting with real-world scenarios and adaptation needs, the co...

  4. TU-H-CAMPUS-JeP3-01: Towards Robust Adaptive Radiation Therapy Strategies

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

    Boeck, M; KTH Royal Institute of Technology, Stockholm; Eriksson, K

    Purpose: To set up a framework combining robust treatment planning with adaptive reoptimization in order to maintain high treatment quality, to respond to interfractional variations and to identify those patients who will benefit the most from an adaptive fractionation schedule. Methods: We propose adaptive strategies based on stochastic minimax optimization for a series of simulated treatments on a one-dimensional patient phantom. The plan should be able to handle anticipated systematic and random errors and is applied during the first fractions. Information on the individual geometric variations is gathered at each fraction. At scheduled fractions, the impact of the measured errorsmore » on the delivered dose distribution is evaluated. For a patient that receives a dose that does not satisfy specified plan quality criteria, the plan is reoptimized based on these individual measurements using one of three different adaptive strategies. The reoptimized plan is then applied during future fractions until a new scheduled adaptation becomes necessary. In the first adaptive strategy the measured systematic and random error scenarios and their assigned probabilities are updated to guide the robust reoptimization. The focus of the second strategy lies on variation of the fraction of the worst scenarios taken into account during robust reoptimization. In the third strategy the uncertainty margins around the target are recalculated with the measured errors. Results: By studying the effect of the three adaptive strategies combined with various adaptation schedules on the same patient population, the group which benefits from adaptation is identified together with the most suitable strategy and schedule. Preliminary computational results indicate when and how best to adapt for the three different strategies. Conclusion: A workflow is presented that provides robust adaptation of the treatment plan throughout the course of treatment and useful measures to identify patients in need for an adaptive treatment strategy.« less

  5. An adaptive paradigm for human space settlement

    NASA Astrophysics Data System (ADS)

    Smith, Cameron M.

    2016-02-01

    Because permanent space settlement will be multigenerational it will have to be viable on ecological timescales so far unfamiliar to those planning space exploration. Long-term viability will require evolutionary and adaptive planning. Adaptations in the natural world provide many lessons for such planning, but implementing these lessons will require a new, evolutionary paradigm for envisioning and carrying out Earth-independent space settlement. I describe some of these adaptive lessons and propose some cognitive shifts required to implement them in a genuinely evolutionary approach to human space settlement.

  6. Planning an adaptive management process for biodiversity conservation and resource development in the Camisea River Basin.

    PubMed

    Dallmeier, Francisco; Alonso, Alfonso; Jones, Murray

    2002-05-01

    The Smithsonian Institution's Monitoring and Assessment of Biodiversity Program joined Shell Prospecting and Development Peru (SPDP) to protect biodiversity during a natural gas exploration project. Emphasis was on long-term societal and environmental benefits in addition to financial gain for the company. The systematic, cyclical adaptive management process was used to generate feedback for SPDP managers. Adaptive management enables ongoing improvement of management policies and practices based on lessons learned from operational activities. Previous to this study, very little information about the local biodiversity was available. Over a 2-year period, the team conducted biological assessments of six taxonomic groups at five sites located within 600 km2. A broad range of management options such as location, timing and technology were developed from the beginning of the project. They were considered in conjunction with emerging lessons from the biodiversity assessments. Critical decisions included location of a gas plant and the cost of helicopter access versus roads to service the full field development. Both of these decisions were evaluated to ensure that they were economically and environmentally feasible. Project design changes, addressed in the planning stage, were accepted once consensus was achieved. Stakeholders were apprised of the implications of the baseline biodiversity assessments.

  7. Science-society collaboration for robust adaptation planning in water management - The Maipo River Basin in Chile

    NASA Astrophysics Data System (ADS)

    Ocampo Melgar, Anahí; Vicuña, Sebastián; Gironás, Jorge

    2015-04-01

    The Metropolitan Region (M.R.) in Chile is populated by over 6 million people and supplied by the Maipo River and its large number of irrigation channels. Potential environmental alterations caused by global change will extremely affect managers and users of water resources in this semi-arid basin. These hydro-climatological impacts combined with demographic and economic changes will be particularly complex in the city of Santiago, due to the diverse, counterpoised and equally important existing activities and demands. These challenges and complexities request the implementation of flexible plans and actions to adapt policies, institutions, infrastructure and behaviors to a new future with climate change. Due to the inherent uncertainties in the future, a recent research project entitled MAPA (Maipo Adaptation Plan for its initials in Spanish) has formed a collaborative science-society platform to generate insights into the vulnerabilities, challenges and possible mitigation measures that would be necessary to deal with the potential changes in the M.R. This large stakeholder platform conformed by around 30 public, private and civil society organizations, both at the local and regional level and guided by a Robust Decision Making Framework (RDMF) has identified vulnerabilities, future scenarios, performance indicators and mitigation measures for the Maipo River basin. The RDMF used in this project is the XLRM framework (Lempert et al. 2006) that incorporates policy levers (L), exogenous uncertainties (X), measures of performance standards (M) and relationships (R) in an interlinked process. Both stakeholders' expertise and computational capabilities have been used to create hydrological models for the urban, rural and highland sectors supported also by the Water Evaluation and Planning system software (WEAP). The identification of uncertainties and land use transition trends was used to develop future development scenarios to explore possible water management challenges. Finally a collaborative process guided by the Water Security concept resulted in the identification of local-based performance indicators that will be used to evaluate scenarios and the need for adaptation measures. This collaborative approach has allowed capturing the general aspirations of different water users in this basin and identifying the main challenges and possible adaptation measures that will be necessary to explore if some of these scenarios become real. Furthermore, this science-society effort has formed the basis for a more extended and long-term collaboration for the implementation of adaptation measures to other unavoidable land-based changes in the Maipo river basin.

  8. Novice High School Science Teachers: Lesson Plan Adaptations

    ERIC Educational Resources Information Center

    Scharon, Aracelis Janelle

    2013-01-01

    The Next Generation Science Standards (NRC, 2013) positions teachers as responsible for necessary decision making about how their intended science lesson plan content supports continuous student science learning. Teachers interact with their instructional lesson plans in dynamic and constructive ways. Adapting lesson plans is complex. This process…

  9. Exploring factors influencing farmers' willingness to pay (WTP) for a planned adaptation programme to address climatic issues in agricultural sectors.

    PubMed

    Ahmed, Adeel; Masud, Muhammad Mehedi; Al-Amin, Abul Quasem; Yahaya, Siti Rohani Binti; Rahman, Mahfuzur; Akhtar, Rulia

    2015-06-01

    This study empirically estimates farmers' willingness to pay (WTP) for a planned adaptation programme for addressing climate issues in Pakistan's agricultural sectors. The contingent valuation method (CVM) was employed to determine a monetary valuation of farmers' preferences for a planned adaptation programme by ascertaining the value attached to address climatic issues. The survey was conducted by distributing structured questionnaires among Pakistani farmers. The study found that 67 % of respondents were willing to pay for a planned adaptation programme. However, several socioeconomic and motivational factors exert greater influence on their willingness to pay (WTP). This paper specifies the steps needed for all institutional bodies to better address issues in climate change. The outcomes of this paper will support attempts by policy makers to design an efficient adaptation framework for mitigating and adapting to the adverse impacts of climate change.

  10. Process and Product: Creating Stories with Deaf Students

    ERIC Educational Resources Information Center

    Enns, Catherine; Hall, Ricki; Isaac, Becky; MacDonald, Patricia

    2007-01-01

    This article describes the implementation of one element of an adapted language arts curriculum for Deaf students in a bilingual (American Sign Language and English) educational setting. It examines the implementation of writing workshops in three elementary classrooms in a school for Deaf students. The typical steps of preparing/planning,…

  11. The uncertainty of crop yield projections is reduced by improved temperature response functions

    USDA-ARS?s Scientific Manuscript database

    Increasing the accuracy of crop productivity estimates is a key Increasing the accuracy of crop productivity estimates is a key element in planning adaptation strategies to ensure global food security under climate change. Process-based crop models are effective means to project climate impact on cr...

  12. Teaching Economics: A Cooperative Learning Model.

    ERIC Educational Resources Information Center

    Caropreso, Edward J.; Haggerty, Mark

    2000-01-01

    Describes an alternative approach to introductory economics based on a cooperative learning model, "Learning Together." Discussion of issues in economics education and cooperative learning in higher education leads to explanation of how to adapt the Learning Together Model to lesson planning in economics. A flow chart illustrates the process for a…

  13. A Method to Assess Climate-Relevant Decisions: Application in the Chesapeake Bay (2010 External Review Draft)

    EPA Science Inventory

    The goal of this study is to formalize an approach to inventory and analyze management decisions in order to produce useful information targeted toward effective adaptation to climate change. The approach uses as its starting point ongoing planning processes and decisions geared ...

  14. Library Programs. Evaluating Federally Funded Public Library Programs.

    ERIC Educational Resources Information Center

    Office of Educational Research and Improvement (ED), Washington, DC.

    Following an introduction by Betty J. Turock, nine reports examine key issues in library evaluation: (1) "Output Measures and the Evaluation Process" (Nancy A. Van House) describes measurement as a concept to be understood in the larger context of planning and evaluation; (2) "Adapting Output Measures to Program Evaluation"…

  15. PM2006: a highly scalable urban planning management information system--Case study: Suzhou Urban Planning Bureau

    NASA Astrophysics Data System (ADS)

    Jing, Changfeng; Liang, Song; Ruan, Yong; Huang, Jie

    2008-10-01

    During the urbanization process, when facing complex requirements of city development, ever-growing urban data, rapid development of planning business and increasing planning complexity, a scalable, extensible urban planning management information system is needed urgently. PM2006 is such a system that can deal with these problems. In response to the status and problems in urban planning, the scalability and extensibility of PM2006 are introduced which can be seen as business-oriented workflow extensibility, scalability of DLL-based architecture, flexibility on platforms of GIS and database, scalability of data updating and maintenance and so on. It is verified that PM2006 system has good extensibility and scalability which can meet the requirements of all levels of administrative divisions and can adapt to ever-growing changes in urban planning business. At the end of this paper, the application of PM2006 in Urban Planning Bureau of Suzhou city is described.

  16. Using a modified intervention mapping approach to develop and refine a single-session motivational intervention for methamphetamine-using men who have sex with men.

    PubMed

    Zule, William A; Coomes, Curtis M; Karg, Rhonda; Harris, Jennie L; Orr, Alex; Wechsberg, Wendee M

    2010-05-14

    There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical.

  17. Limitations to Thermoregulation and Acclimatization Challenge Human Adaptation to Global Warming

    PubMed Central

    Hanna, Elizabeth G.; Tait, Peter W.

    2015-01-01

    Human thermoregulation and acclimatization are core components of the human coping mechanism for withstanding variations in environmental heat exposure. Amidst growing recognition that curtailing global warming to less than two degrees is becoming increasing improbable, human survival will require increasing reliance on these mechanisms. The projected several fold increase in extreme heat events suggests we need to recalibrate health protection policies and ratchet up adaptation efforts. Climate researchers, epidemiologists, and policy makers engaged in climate change adaptation and health protection are not commonly drawn from heat physiology backgrounds. Injecting a scholarly consideration of physiological limitations to human heat tolerance into the adaptation and policy literature allows for a broader understanding of heat health risks to support effective human adaptation and adaptation planning. This paper details the physiological and external environmental factors that determine human thermoregulation and acclimatization. We present a model to illustrate the interrelationship between elements that modulate the physiological process of thermoregulation. Limitations inherent in these processes, and the constraints imposed by differing exposure levels, and thermal comfort seeking on achieving acclimatization, are then described. Combined, these limitations will restrict the likely contribution that acclimatization can play in future human adaptation to global warming. We postulate that behavioral and technological adaptations will need to become the dominant means for human individual and societal adaptations as global warming progresses. PMID:26184272

  18. A Conceptual Framework for Planning Systemic Human Adaptation to Global Warming

    PubMed Central

    Tait, Peter W.; Hanna, Elizabeth G.

    2015-01-01

    Human activity is having multiple, inter-related effects on ecosystems. Greenhouse gas emissions persisting along current trajectories threaten to significantly alter human society. At 0.85 °C of anthropogenic warming, deleterious human impacts are acutely evident. Additional warming of 0.5 °C–1.0 °C from already emitted CO2 will further intensify extreme heat and damaging storm events. Failing to sufficiently address this trend will have a heavy human toll directly and indirectly on health. Along with mitigation efforts, societal adaptation to a warmer world is imperative. Adaptation efforts need to be significantly upscaled to prepare society to lessen the public health effects of rising temperatures. Modifying societal behaviour is inherently complex and presents a major policy challenge. We propose a social systems framework for conceptualizing adaptation that maps out three domains within the adaptation policy landscape: acclimatisation, behavioural adaptation and technological adaptation, which operate at societal and personal levels. We propose that overlaying this framework on a systems approach to societal change planning methods will enhance governments’ capacity and efficacy in strategic planning for adaptation. This conceptual framework provides a policy oriented planning assessment tool that will help planners match interventions to the behaviours being targeted for change. We provide illustrative examples to demonstrate the framework’s application as a planning tool. PMID:26334285

  19. A Conceptual Framework for Planning Systemic Human Adaptation to Global Warming.

    PubMed

    Tait, Peter W; Hanna, Elizabeth G

    2015-08-31

    Human activity is having multiple, inter-related effects on ecosystems. Greenhouse gas emissions persisting along current trajectories threaten to significantly alter human society. At 0.85 °C of anthropogenic warming, deleterious human impacts are acutely evident. Additional warming of 0.5 °C-1.0 °C from already emitted CO₂ will further intensify extreme heat and damaging storm events. Failing to sufficiently address this trend will have a heavy human toll directly and indirectly on health. Along with mitigation efforts, societal adaptation to a warmer world is imperative. Adaptation efforts need to be significantly upscaled to prepare society to lessen the public health effects of rising temperatures. Modifying societal behaviour is inherently complex and presents a major policy challenge. We propose a social systems framework for conceptualizing adaptation that maps out three domains within the adaptation policy landscape: acclimatisation, behavioural adaptation and technological adaptation, which operate at societal and personal levels. We propose that overlaying this framework on a systems approach to societal change planning methods will enhance governments' capacity and efficacy in strategic planning for adaptation. This conceptual framework provides a policy oriented planning assessment tool that will help planners match interventions to the behaviours being targeted for change. We provide illustrative examples to demonstrate the framework's application as a planning tool.

  20. Evaluation of online/offline image guidance/adaptation approaches for prostate cancer radiation therapy.

    PubMed

    Qin, An; Sun, Ying; Liang, Jian; Yan, Di

    2015-04-01

    To evaluate online/offline image-guided/adaptive treatment techniques for prostate cancer radiation therapy with daily cone-beam CT (CBCT) imaging. Three treatment techniques were evaluated retrospectively using daily pre- and posttreatment CBCT images on 22 prostate cancer patients. Prostate, seminal vesicles (SV), rectal wall, and bladder were delineated on all CBCT images. For each patient, a pretreatment intensity modulated radiation therapy plan with clinical target volume (CTV) = prostate + SV and planning target volume (PTV) = CTV + 3 mm was created. The 3 treatment techniques were as follows: (1) Daily Correction: The pretreatment intensity modulated radiation therapy plan was delivered after online CBCT imaging, and position correction; (2) Online Planning: Daily online inverse plans with 3-mm CTV-to-PTV margin were created using online CBCT images, and delivered; and (3) Hybrid Adaption: Daily Correction plus an offline adaptive inverse planning performed after the first week of treatment. The adaptive plan was delivered for all remaining 15 fractions. Treatment dose for each technique was constructed using the daily posttreatment CBCT images via deformable image registration. Evaluation was performed using treatment dose distribution in target and critical organs. Treatment equivalent uniform dose (EUD) for the CTV was within [85.6%, 100.8%] of the pretreatment planned target EUD for Daily Correction; [98.7%, 103.0%] for Online Planning; and [99.2%, 103.4%] for Hybrid Adaptation. Eighteen percent of the 22 patients in Daily Correction had a target dose deficiency >5%. For rectal wall, the mean ± SD of the normalized EUD was 102.6% ± 2.7% for Daily Correction, 99.9% ± 2.5% for Online Planning, and 100.6% ± 2.1% for Hybrid Adaptation. The mean ± SD of the normalized bladder EUD was 108.7% ± 8.2% for Daily Correction, 92.7% ± 8.6% for Online Planning, and 89.4% ± 10.8% for Hybrid Adaptation. Both Online Planning and Hybrid Adaptation can achieve comparable target coverage and normal tissue sparing and are superior to the Daily Correction technique. The Daily Correction technique using a 3-mm target margin in the pretreatment plan is not appropriate to compensate for residual variations in CBCT image-guided prostate cancer radiation therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Evaluation of Online/Offline Image Guidance/Adaptation Approaches for Prostate Cancer Radiation Therapy

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

    Qin, An; Sun, Ying; Liang, Jian

    Purpose: To evaluate online/offline image-guided/adaptive treatment techniques for prostate cancer radiation therapy with daily cone-beam CT (CBCT) imaging. Methods and Materials: Three treatment techniques were evaluated retrospectively using daily pre- and posttreatment CBCT images on 22 prostate cancer patients. Prostate, seminal vesicles (SV), rectal wall, and bladder were delineated on all CBCT images. For each patient, a pretreatment intensity modulated radiation therapy plan with clinical target volume (CTV) = prostate + SV and planning target volume (PTV) = CTV + 3 mm was created. The 3 treatment techniques were as follows: (1) Daily Correction: The pretreatment intensity modulated radiation therapy plan was delivered after online CBCT imaging, and positionmore » correction; (2) Online Planning: Daily online inverse plans with 3-mm CTV-to-PTV margin were created using online CBCT images, and delivered; and (3) Hybrid Adaption: Daily Correction plus an offline adaptive inverse planning performed after the first week of treatment. The adaptive plan was delivered for all remaining 15 fractions. Treatment dose for each technique was constructed using the daily posttreatment CBCT images via deformable image registration. Evaluation was performed using treatment dose distribution in target and critical organs. Results: Treatment equivalent uniform dose (EUD) for the CTV was within [85.6%, 100.8%] of the pretreatment planned target EUD for Daily Correction; [98.7%, 103.0%] for Online Planning; and [99.2%, 103.4%] for Hybrid Adaptation. Eighteen percent of the 22 patients in Daily Correction had a target dose deficiency >5%. For rectal wall, the mean ± SD of the normalized EUD was 102.6% ± 2.7% for Daily Correction, 99.9% ± 2.5% for Online Planning, and 100.6% ± 2.1% for Hybrid Adaptation. The mean ± SD of the normalized bladder EUD was 108.7% ± 8.2% for Daily Correction, 92.7% ± 8.6% for Online Planning, and 89.4% ± 10.8% for Hybrid Adaptation. Conclusions: Both Online Planning and Hybrid Adaptation can achieve comparable target coverage and normal tissue sparing and are superior to the Daily Correction technique. The Daily Correction technique using a 3-mm target margin in the pretreatment plan is not appropriate to compensate for residual variations in CBCT image-guided prostate cancer radiation therapy.« less

  2. Using Outreach and Engagement Efforts to Inform the Makah Tribe's Climate Adaptation Plan

    NASA Astrophysics Data System (ADS)

    Nelson, L. K.; Chang, M.; Howk, F.

    2017-12-01

    The Makah Tribe views climate change as one of the biggest challenges to their natural resource management, threatening their livelihoods, economy, and culture. As part of their work towards climate adaptation planning, the Makah Tribal Council and tribal natural resource managers prioritized early community outreach and engagement efforts in order to accomplish three goals: continually update and inform the tribal community about the Tribe's climate adaptation efforts; gather community input and priorities for the Makah Climate Adaptation Plan; and provide a series of targeted educational events to inform the tribal community about projected climate change impacts to our resources. Our first community climate event, the Makah Climate Change Awareness Dinner, was held on February 8, 2017. At this event, we provided an overview of the Makah Tribe's Climate Vulnerability Assessment and administered an initial climate survey that gathered information regarding community members' observed environmental changes, knowledge about climate change and impacts, and any concerns and priorities to include in the Tribe's adaptation plan. We developed a framework for incorporating community engagement into climate adaptation planning and used results of our community survey to ensure community concerns were being addressed in the plan in addition to risks identified in western science. We also used survey results to inform a series of educational events to address knowledge gaps in the community and requested topics. These are two of next steps that the Makah Tribe is pursuing towards climate adaptation planning.

  3. Urban Climate Map System for Dutch spatial planning

    NASA Astrophysics Data System (ADS)

    Ren, Chao; Spit, Tejo; Lenzholzer, Sanda; Yim, Hung Lam Steve; Heusinkveld, Bert; van Hove, Bert; Chen, Liang; Kupski, Sebastian; Burghardt, René; Katzschner, Lutz

    2012-08-01

    Facing climate change and global warming, outdoor climatic environment is an important consideration factor for planners and policy makers because improving it can greatly contribute to achieve citizen's thermal comfort and create a better urban living quality for adaptation. Thus, the climatic information must be assessed systematically and applied strategically into the planning process. This paper presents a tool named Urban Climate Map System (UCMS) that has proven capable of helping compact cities to incorporate climate effects in planning processes in a systematic way. UCMS is developed and presented in a Geographic Information System (GIS) platform in which the lessons learned and experience gained from interdisciplinary studies can be included. The methodology of UCMS of compact cities, the construction procedure, and the basic input factors - including the natural climate resources and planning data - are described. Some literatures that shed light on the applicability of UMCS are reported. The Municipality of Arnhem is one of Dutch compact urban areas and still under fast urban development and urban renewal. There is an urgent need for local planners and policy makers to protect local climate and open landscape resources and make climate change adaptation in urban construction. Thus, Arnhem is chosen to carry out a case study of UCMS. Although it is the first work of Urban Climatic Mapping in The Netherlands, it serves as a useful climatic information platform to local planners and policy makers for their daily on-going works. We attempt to use a quick method to collect available climatic and planning data and create an information platform for planning use. It relies mostly on literature and theoretical understanding that has been well practiced elsewhere. The effort here is to synergize the established understanding for a case at hand and demonstrate how useful guidance can still be made for planners and policy makers.

  4. Climate change adaptation frameworks: an evaluation of plans for coastal Suffolk, UK

    NASA Astrophysics Data System (ADS)

    Armstrong, J.; Wilby, R.; Nicholls, R. J.

    2015-11-01

    This paper asserts that three principal frameworks for climate change adaptation can be recognised in the literature: scenario-led (SL), vulnerability-led (VL) and decision-centric (DC) frameworks. A criterion is developed to differentiate these frameworks in recent adaptation projects. The criterion features six key hallmarks as follows: (1) use of climate model information; (2) analysis of metrics/units; (3) socio-economic knowledge; (4) stakeholder engagement; (5) adaptation of implementation mechanisms; (6) tier of adaptation implementation. The paper then tests the validity of this approach using adaptation projects on the Suffolk coast, UK. Fourteen adaptation plans were identified in an online survey. They were analysed in relation to the hallmarks outlined above and assigned to an adaptation framework. The results show that while some adaptation plans are primarily SL, VL or DC, the majority are hybrid, showing a mixture of DC/VL and DC/SL characteristics. Interestingly, the SL/VL combination is not observed, perhaps because the DC framework is intermediate and attempts to overcome weaknesses of both SL and VL approaches. The majority (57 %) of adaptation projects generated a risk assessment or advice notes. Further development of this type of framework analysis would allow better guidance on approaches for organisations when implementing climate change adaptation initiatives, and other similar proactive long-term planning.

  5. Climate change adaptation frameworks: an evaluation of plans for coastal, Suffolk, UK

    NASA Astrophysics Data System (ADS)

    Armstrong, J.; Wilby, R.; Nicholls, R. J.

    2015-06-01

    This paper asserts that three principal frameworks for climate change adaptation can be recognised in the literature: Scenario-Led (SL), Vulnerability-Led (VL) and Decision-Centric (DC) frameworks. A criterion is developed to differentiate these frameworks in recent adaptation projects. The criterion features six key hallmarks as follows: (1) use of climate model information; (2) analysis metrics/units; (3) socio-economic knowledge; (4) stakeholder engagement; (5) adaptation implementation mechanisms; (6) tier of adaptation implementation. The paper then tests the validity of this approach using adaptation projects on the Suffolk coast, UK. Fourteen adaptation plans were identified in an online survey. They were analysed in relation to the hallmarks outlined above and assigned to an adaptation framework. The results show that while some adaptation plans are primarily SL, VL or DC, the majority are hybrid showing a mixture of DC/VL and DC/SL characteristics. Interestingly, the SL/VL combination is not observed, perhaps because the DC framework is intermediate and attempts to overcome weaknesses of both SL and VL approaches. The majority (57 %) of adaptation projects generated a risk assessment or advice notes. Further development of this type of framework analysis would allow better guidance on approaches for organisations when implementing climate change adaptation initiatives, and other similar proactive long-term planning.

  6. Estuary ecosystem restoration: implementing and institutionalizing adaptive management: Institutionalizing adaptive management

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

    Ebberts, Blaine D.; Zelinsky, Ben D.; Karnezis, Jason P.

    We successfully implemented and institutionalized an adaptive management (AM) process for the Columbia Estuary Ecosystem Restoration Program, which is a large-scale restoration program focused on improving ecosystem conditions in the 234-km lower Columbia River and estuary. For our purpose, “institutionalized” means the AM process and restoration program are embedded in the work flow of the implementing agencies and affected parties. While plans outlining frameworks, processes, or approaches to AM of ecosystem restoration programs are commonplace, establishment for the long term is not. This paper presents the basic AM framework and explains how AM was implemented and institutionalized. Starting with amore » common goal, we pursued included a well-understood governance and decision-making structure, routine coordination and communication activities, data and information sharing, commitment from partners and upper agency management to the AM process, and meaningful cooperation among program managers and partners. The overall approach and steps to implement and institutionalize AM for ecosystem restoration explained here are applicable to situations where it has been less than successful or, as in our case, the restoration program is just getting started.« less

  7. Integrating Climate Change into Habitat Conservation Plans Under the U.S. Endangered Species Act

    NASA Astrophysics Data System (ADS)

    Bernazzani, Paola; Bradley, Bethany A.; Opperman, Jeffrey J.

    2012-06-01

    Habitat Conservation Plans (HCPs) under the Endangered Species Act (ESA) are an important mechanism for the acquisition of land and the management of terrestrial and aquatic ecosystems. HCPs have become a vital means of protecting endangered and threatened species and their habitats throughout the United States, particularly on private land. The scientific consensus that climate is changing and that these changes will impact the viability of species has not been incorporated into the conservation strategies of recent HCPs, rendering plans vulnerable biologically. In this paper we review the regulatory context for incorporating climate change into HCPs and analyze the extent to which climate change is linked to management actions in a subset of large HCPs. We conclude that most current plans do not incorporate climate change into conservation actions, and so we provide recommendations for integrating climate change into the process of HCP development and implementation. These recommendations are distilled from the published literature as well as the practice of conservation planning and are structured to the specific needs of HCP development and implementation. We offer nine recommendations for integrating climate change into the HCP process: (1) identify species at-risk from climate change, (2) explore new strategies for reserve design, (3) increase emphasis on corridors, linkages, and connectivity, (4) develop anticipatory adaptation measures, (5) manage for diversity, (6) consider assisted migration, (7) include climate change in scenarios of water management, (8) develop future-oriented management actions, and (9) increase linkages between the conservation strategy and adaptive management/monitoring programs.

  8. Integrating climate change into habitat conservation plans under the U.S. endangered species act.

    PubMed

    Bernazzani, Paola; Bradley, Bethany A; Opperman, Jeffrey J

    2012-06-01

    Habitat Conservation Plans (HCPs) under the Endangered Species Act (ESA) are an important mechanism for the acquisition of land and the management of terrestrial and aquatic ecosystems. HCPs have become a vital means of protecting endangered and threatened species and their habitats throughout the United States, particularly on private land. The scientific consensus that climate is changing and that these changes will impact the viability of species has not been incorporated into the conservation strategies of recent HCPs, rendering plans vulnerable biologically. In this paper we review the regulatory context for incorporating climate change into HCPs and analyze the extent to which climate change is linked to management actions in a subset of large HCPs. We conclude that most current plans do not incorporate climate change into conservation actions, and so we provide recommendations for integrating climate change into the process of HCP development and implementation. These recommendations are distilled from the published literature as well as the practice of conservation planning and are structured to the specific needs of HCP development and implementation. We offer nine recommendations for integrating climate change into the HCP process: (1) identify species at-risk from climate change, (2) explore new strategies for reserve design, (3) increase emphasis on corridors, linkages, and connectivity, (4) develop anticipatory adaptation measures, (5) manage for diversity, (6) consider assisted migration, (7) include climate change in scenarios of water management, (8) develop future-oriented management actions, and (9) increase linkages between the conservation strategy and adaptive management/monitoring programs.

  9. Being Prepared for Climate Change: A Workbook for Developing Risk-Based Adaptation Plans

    EPA Pesticide Factsheets

    This workbook is a guide for environmental professionals to construct a climate change adaptation plan based on identifying risks and their consequences. It incorporates watershed management, vulnerability assessments and action planning.

  10. A Health Impact Assessment Framework for Assessing Vulnerability and Adaptation Planning for Climate Change

    PubMed Central

    Brown, Helen; Spickett, Jeffery; Katscherian, Dianne

    2014-01-01

    This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA) framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru. PMID:25514146

  11. A health impact assessment framework for assessing vulnerability and adaptation planning for climate change.

    PubMed

    Brown, Helen; Spickett, Jeffery; Katscherian, Dianne

    2014-12-01

    This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA) framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru.

  12. Linking population, fertility, and family planning with adaptation to climate change: perspectives from Ethiopia.

    PubMed

    Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu

    2013-09-01

    Global climate change is felt disproportionately in the world's most economically disadvantaged countries. As adaption to an evolving climate becomes increasingly salient on national and global scales, it is important to assess how people at the local-level are already coping with changes. Understanding local responses to climate change is essential for helping countries to construct strategies to bolster resilience to current and future effects. This qualitative research investigated responses to climate change in Ethiopia; specifically, how communities react to and cope with climate variation, which groups are most vulnerable, and the role of family planning in increasing resilience. Participants were highly aware of changing climate effects, impacts of rapid population growth, and the need for increased access to voluntary family planning. Identification of family planning as an important adaptation strategy supports the inclusion of rights-based voluntary family planning and reproductive health into local and national climate change adaptation plans.

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

    Fraley, John J.; Marotz, Brian L.; DosSantos, Joseph M.

    In this document we present fisheries losses, mitigation alternatives, and recommendations to protect, mitigate, and enhance resident fish and aquatic habitat affected by the construction and operation of Hungry Horse Dam. This plan addresses six separate program measures in the 1987 Columbia Basin Fish and Wildlife Program. We designed the plan to be closely coordinated in terms of dam operations, funding, and activities with the Kerr Mitigation Plan presently before the Federal Energy Regulatory Commission. This document represents a mitigation plan for consideration by the Northwest Power Planning Council process; it is not an implementation plan. Flathead Lake is onemore » of the cleanest lakes of its size in the world. The exceptional water quality and unique native fisheries make the Flathead Lake/River system extremely valuable to the economy and quality of life in the basin. The recreational fishery in Flathead Lake has an estimated value of nearly eight million dollars annually. This mitigation process represents our best opportunity to reduce the impacts of hydropower in this valuable aquatic system and increase angling opportunity. We based loss estimates and mitigation alternatives on an extensive data base, agency reports, nationally and internationally peer-reviewed scientific articles, and an innovative biological model for Hungry Horse Reservoir and the Flathead River. We conducted an extensive, 14-month scoping and consultation process with agency representatives, representatives of citizen groups, and the general public. This consultation process helped identify issues, areas of agreement, areas of conflict, and advantages and disadvantages of mitigation alternatives. The results of the scoping and consultation process helped shape our mitigation plan. Our recommended plan is based firmly on principles of adaptive management and recognition of biological uncertainty. After we receive direction from the NPPC, we will add more detailed hypotheses and other features necessary for a long-term implementation plan.« less

  14. Life cycle assessment of stormwater management in the context of climate change adaptation.

    PubMed

    Brudler, Sarah; Arnbjerg-Nielsen, Karsten; Hauschild, Michael Zwicky; Rygaard, Martin

    2016-12-01

    Expected increases in pluvial flooding, due to climatic changes, require large investments in the retrofitting of cities to keep damage at an acceptable level. Many cities have investigated the possibility of implementing stormwater management (SWM) systems which are multi-functional and consist of different elements interacting to achieve desired safety levels. Typically, an economic assessment is carried out in the planning phase, while environmental sustainability is given little or no attention. In this paper, life cycle assessment is used to quantify environmental impacts of climate change adaptation strategies. The approach is tested using a climate change adaptation strategy for a catchment in Copenhagen, Denmark. A stormwater management system, using green infrastructure and local retention measures in combination with planned routing of stormwater on the surfaces to manage runoff, is compared to a traditional, sub-surface approach. Flood safety levels based on the Three Points Approach are defined as the functional unit to ensure comparability between systems. The adaptation plan has significantly lower impacts (3-18 person equivalents/year) than the traditional alternative (14-103 person equivalents/year) in all analysed impact categories. The main impacts are caused by managing rain events with return periods between 0.2 and 10 years. The impacts of handling smaller events with a return period of up to 0.2 years and extreme events with a return period of up to 100 years are lower in both alternatives. The uncertainty analysis shows the advantages of conducting an environmental assessment in the early stages of the planning process, when the design can still be optimised, but it also highlights the importance of detailed and site-specific data. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Managing the health effects of temperature in response to climate change: challenges ahead.

    PubMed

    Huang, Cunrui; Barnett, Adrian G; Xu, Zhiwei; Chu, Cordia; Wang, Xiaoming; Turner, Lyle R; Tong, Shilu

    2013-04-01

    Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion. We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public's health from heat events and climate change. Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified. The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions.

  16. Warm Season Storms, Floods, and Tributary Sand Inputs below Glen Canyon Dam: Investigating Salience to Adaptive Management in the Context of a 10-Year Long Controlled Flooding Experiment in Grand Canyon National Park, AZ, USA

    NASA Astrophysics Data System (ADS)

    Jain, S.; Melis, T. S.; Topping, D. J.; Pulwarty, R. S.; Eischeid, J.

    2013-12-01

    The planning and decision processes in the Glen Canyon Dam Adaptive Management Program (GCDAMP) strive to balance numerous, often competing, objectives, such as, water supply, hydropower generation, low flow maintenance, maximizing conservation of downstream tributary sand supply, endangered native fish, and other sociocultural resources of Glen Canyon National Recreation Area and Grand Canyon National Park. In this context, use of monitored and predictive information on the warm season floods (at point-to-regional scales) has been identified as lead-information for a new 10-year long controlled flooding experiment (termed the High-Flow Experiment Protocol) intended to determine management options for rebuilding and maintaining sandbars in Grand Canyon; an adaptive strategy that can potentially facilitate improved planning and dam operations. In this work, we focus on a key concern identified by the GCDAMP, related to the timing and volume of tributary sand input from the Paria and Little Colorado Rivers (located 26 and 124 km below the dam, respectively) into the Colorado River in Grand Canyon National Park. Episodic and intraseasonal variations (with links to equatorial and sub-tropical Pacific sea surface temperature variability) in the southwest hydroclimatology are investigated to understand the magnitude, timing and spatial scales of warm season floods from this relatively small, but prolific sand producing drainage of the semi-arid Colorado Plateau. The coupled variations of the flood-driven sediment input (magnitude and timing) from these two drainages into the Colorado River are also investigated. The physical processes, including diagnosis of storms and moisture sources, are mapped alongside the planning and decision processes for the ongoing experimental flood releases from the Glen Canyon Dam which are aimed at achieving restoration and maintenance of sandbars and instream ecology. The GCDAMP represents one of the most visible and widely recognized adaptive management efforts in the world to manage resources under growing environmental uncertainty as climate change and global warming continues.

  17. Fast and robust online adaptive planning in stereotactic MR-guided adaptive radiation therapy (SMART) for pancreatic cancer.

    PubMed

    Bohoudi, O; Bruynzeel, A M E; Senan, S; Cuijpers, J P; Slotman, B J; Lagerwaard, F J; Palacios, M A

    2017-12-01

    To implement a robust and fast stereotactic MR-guided adaptive radiation therapy (SMART) online strategy in locally advanced pancreatic cancer (LAPC). SMART strategy for plan adaptation was implemented with the MRIdian system (ViewRay Inc.). At each fraction, OAR (re-)contouring is done within a distance of 3cm from the PTV surface. Online plan re-optimization is based on robust prediction of OAR dose and optimization objectives, obtained by building an artificial neural network (ANN). Proposed limited re-contouring strategy for plan adaptation (SMART 3CM ) is evaluated by comparing 50 previously delivered fractions against a standard (re-)planning method using full-scale OAR (re-)contouring (FULLOAR). Plan quality was assessed using PTV coverage (V 95% , D mean , D 1cc ) and institutional OAR constraints (e.g. V 33Gy ). SMART 3CM required a significant lower number of optimizations than FULLOAR (4 vs 18 on average) to generate a plan meeting all objectives and institutional OAR constraints. PTV coverage with both strategies was identical (mean V 95% =89%). Adaptive plans with SMART 3CM exhibited significant lower intermediate and high doses to all OARs than FULLOAR, which also failed in 36% of the cases to adhere to the V 33Gy dose constraint. SMART 3CM approach for LAPC allows good OAR sparing and adequate target coverage while requiring only limited online (re-)contouring from clinicians. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Chandra mission scheduling on-orbit experience

    NASA Astrophysics Data System (ADS)

    Bucher, Sabina; Williams, Brent; Pendexter, Misty; Balke, David

    2008-07-01

    Scheduling observatory time to maximize both day-to-day science target integration time and the lifetime of the observatory is a formidable challenge. Furthermore, it is not a static problem. Of course, every schedule brings a new set of observations, but the boundaries of the problem change as well. As spacecraft ages, its capabilities may degrade. As in-flight experience grows, capabilities may expand. As observing programs are completed, the needs and expectations of the science community may evolve. Changes such as these impact the rules by which a mission scheduled. In eight years on orbit, the Chandra X-Ray Observatory Mission Planning process has adapted to meet the challenge of maximizing day-to-day and mission lifetime science return, despite a consistently evolving set of scheduling constraints. The success of the planning team has been achieved, not through the use of complex algorithms and optimization routines, but through processes and home grown tools that help individuals make smart short term and long term Mission Planning decisions. This paper walks through the processes and tools used to plan and produce mission schedules for the Chandra X-Ray Observatory. Nominal planning and scheduling, target of opportunity response, and recovery from on-board autonomous safing actions are all addressed. Evolution of tools and processes, best practices, and lessons learned are highlighted along the way.

  19. Software Testbed for Developing and Evaluating Integrated Autonomous Systems

    DTIC Science & Technology

    2015-03-01

    EUROPA planning system for plan generation. The adaptive controller executes the new plan, using augmented, hierarchical finite state machines to...using the Internet Communications Engine ( ICE ), an object-oriented toolkit for building distributed applications. TABLE OF CONTENTS 1...ANML model is translated into the New Domain Definition Language (NDDL) and sent to NASA???s EUROPA planning system for plan generation. The adaptive

  20. Climate risk index for Italy.

    PubMed

    Mysiak, Jaroslav; Torresan, Silvia; Bosello, Francesco; Mistry, Malcolm; Amadio, Mattia; Marzi, Sepehr; Furlan, Elisa; Sperotto, Anna

    2018-06-13

    We describe a climate risk index that has been developed to inform national climate adaptation planning in Italy and that is further elaborated in this paper. The index supports national authorities in designing adaptation policies and plans, guides the initial problem formulation phase, and identifies administrative areas with higher propensity to being adversely affected by climate change. The index combines (i) climate change-amplified hazards; (ii) high-resolution indicators of exposure of chosen economic, social, natural and built- or manufactured capital (MC) assets and (iii) vulnerability, which comprises both present sensitivity to climate-induced hazards and adaptive capacity. We use standardized anomalies of selected extreme climate indices derived from high-resolution regional climate model simulations of the EURO-CORDEX initiative as proxies of climate change-altered weather and climate-related hazards. The exposure and sensitivity assessment is based on indicators of manufactured, natural, social and economic capital assets exposed to and adversely affected by climate-related hazards. The MC refers to material goods or fixed assets which support the production process (e.g. industrial machines and buildings); Natural Capital comprises natural resources and processes (renewable and non-renewable) producing goods and services for well-being; Social Capital (SC) addressed factors at the individual (people's health, knowledge, skills) and collective (institutional) level (e.g. families, communities, organizations and schools); and Economic Capital (EC) includes owned and traded goods and services. The results of the climate risk analysis are used to rank the subnational administrative and statistical units according to the climate risk challenges, and possibly for financial resource allocation for climate adaptation.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Authors.

  1. Climate risk index for Italy

    NASA Astrophysics Data System (ADS)

    Mysiak, Jaroslav; Torresan, Silvia; Bosello, Francesco; Mistry, Malcolm; Amadio, Mattia; Marzi, Sepehr; Furlan, Elisa; Sperotto, Anna

    2018-06-01

    We describe a climate risk index that has been developed to inform national climate adaptation planning in Italy and that is further elaborated in this paper. The index supports national authorities in designing adaptation policies and plans, guides the initial problem formulation phase, and identifies administrative areas with higher propensity to being adversely affected by climate change. The index combines (i) climate change-amplified hazards; (ii) high-resolution indicators of exposure of chosen economic, social, natural and built- or manufactured capital (MC) assets and (iii) vulnerability, which comprises both present sensitivity to climate-induced hazards and adaptive capacity. We use standardized anomalies of selected extreme climate indices derived from high-resolution regional climate model simulations of the EURO-CORDEX initiative as proxies of climate change-altered weather and climate-related hazards. The exposure and sensitivity assessment is based on indicators of manufactured, natural, social and economic capital assets exposed to and adversely affected by climate-related hazards. The MC refers to material goods or fixed assets which support the production process (e.g. industrial machines and buildings); Natural Capital comprises natural resources and processes (renewable and non-renewable) producing goods and services for well-being; Social Capital (SC) addressed factors at the individual (people's health, knowledge, skills) and collective (institutional) level (e.g. families, communities, organizations and schools); and Economic Capital (EC) includes owned and traded goods and services. The results of the climate risk analysis are used to rank the subnational administrative and statistical units according to the climate risk challenges, and possibly for financial resource allocation for climate adaptation. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  2. Climate risk index for Italy

    PubMed Central

    Torresan, Silvia; Bosello, Francesco; Mistry, Malcolm; Amadio, Mattia; Marzi, Sepehr; Furlan, Elisa; Sperotto, Anna

    2018-01-01

    We describe a climate risk index that has been developed to inform national climate adaptation planning in Italy and that is further elaborated in this paper. The index supports national authorities in designing adaptation policies and plans, guides the initial problem formulation phase, and identifies administrative areas with higher propensity to being adversely affected by climate change. The index combines (i) climate change-amplified hazards; (ii) high-resolution indicators of exposure of chosen economic, social, natural and built- or manufactured capital (MC) assets and (iii) vulnerability, which comprises both present sensitivity to climate-induced hazards and adaptive capacity. We use standardized anomalies of selected extreme climate indices derived from high-resolution regional climate model simulations of the EURO-CORDEX initiative as proxies of climate change-altered weather and climate-related hazards. The exposure and sensitivity assessment is based on indicators of manufactured, natural, social and economic capital assets exposed to and adversely affected by climate-related hazards. The MC refers to material goods or fixed assets which support the production process (e.g. industrial machines and buildings); Natural Capital comprises natural resources and processes (renewable and non-renewable) producing goods and services for well-being; Social Capital (SC) addressed factors at the individual (people's health, knowledge, skills) and collective (institutional) level (e.g. families, communities, organizations and schools); and Economic Capital (EC) includes owned and traded goods and services. The results of the climate risk analysis are used to rank the subnational administrative and statistical units according to the climate risk challenges, and possibly for financial resource allocation for climate adaptation. This article is part of the theme issue ‘Advances in risk assessment for climate change adaptation policy’. PMID:29712797

  3. WE-H-207B-04: Strategies for Adaptive RT

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

    Green, O.

    2016-06-15

    In recent years, steady progress has been made towards the implementation of MRI in external beam radiation therapy for processes ranging from treatment simulation to in-room guidance. Novel procedures relying mostly on MR data are currently implemented in the clinic. This session will cover topics such as (a) commissioning and quality control of the MR in-room imagers and simulators specific to RT, (b) treatment planning requirements, constraints and challenges when dealing with various MR data, (c) quantification of organ motion with an emphasis on treatment delivery guidance, and (d) MR-driven strategies for adaptive RT workflows. The content of the sessionmore » was chosen to address both educational and practical key aspects of MR guidance. Learning Objectives: Good understanding of MR testing recommended for in-room MR imaging as well as image data validation for RT chain (e.g. image transfer, filtering for consistency, spatial accuracy, manipulation for task specific); Familiarity with MR-based planning procedures: motivation, core workflow requirements, current status, challenges; Overview of the current methods for the quantification of organ motion; Discussion on approaches for adaptive treatment planning and delivery. T. Stanescu - License agreement with Modus Medical Devices to develop a phantom for the quantification of MR image system-related distortions.; T. Stanescu, N/A.« less

  4. Assessment of the health impacts of climate change in Kiribati.

    PubMed

    McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven

    2014-05-14

    Kiribati-a low-lying, resource-poor Pacific atoll nation-is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health.

  5. Adaptive management of forest ecosystems: did some rubber hit the road?

    Treesearch

    B.T. Bormann; R.W. Haynes; J.R. Martin

    2007-01-01

    Although many scientists recommend adaptive management for large forest tracts, there is little evidence that its use has been effective at this scale. One exception is the 10-million-hectare Northwest Forest Plan, which explicitly included adaptive management in its design. Evidence from 10 years of implementing the plan suggests that formalizing adaptive steps and...

  6. Application of science-based restoration planning to a desert river system.

    PubMed

    Laub, Brian G; Jimenez, Justin; Budy, Phaedra

    2015-06-01

    Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

  7. Application of Science-Based Restoration Planning to a Desert River System

    NASA Astrophysics Data System (ADS)

    Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

    2015-06-01

    Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

  8. Application of science-based restoration planning to a desert river system

    USGS Publications Warehouse

    Laub, Brian G.; Jimenez, Justin; Budy, Phaedra

    2015-01-01

    Persistence of many desert river species is threatened by a suite of impacts linked to water infrastructure projects that provide human water security where water is scarce. Many desert rivers have undergone regime shifts from spatially and temporally dynamic ecosystems to more stable systems dominated by homogenous physical habitat. Restoration of desert river systems could aid in biodiversity conservation, but poses formidable challenges due to multiple threats and the infeasibility of recovery to pre-development conditions. The challenges faced in restoring desert rivers can be addressed by incorporating scientific recommendations into restoration planning efforts at multiple stages, as demonstrated here through an example restoration project. In particular, use of a watershed-scale planning process can identify data gaps and irreversible constraints, which aid in developing achievable restoration goals and objectives. Site-prioritization focuses limited the resources for restoration on areas with the greatest potential to improve populations of target organisms. Investment in research to understand causes of degradation, coupled with adoption of a guiding vision is critical for identifying feasible restoration actions that can enhance river processes. Setting monitoring as a project goal, developing hypotheses for expected outcomes, and implementing restoration as an experimental design will facilitate adaptive management and learning from project implementation. Involvement of scientists and managers during all planning stages is critical for developing process-based restoration actions and an implementation plan to maximize learning. The planning process developed here provides a roadmap for use of scientific recommendations in future efforts to recover dynamic processes in imperiled riverine ecosystems.

  9. Health Impacts of Climate Change in Vanuatu: An Assessment and Adaptation Action Plan

    PubMed Central

    Spickett, Jeffery T; Katscherian, Dianne; McIver, Lachlan

    2013-01-01

    Climate change is one of the greatest global challenges and Pacific island countries are particularly vulnerable due to, among other factors, their geography, demography and level of economic development. A Health Impact Assessment (HIA) framework was used as a basis for the consideration of the potential health impacts of changes in the climate on the population of Vanuatu, to assess the risks and propose a range of potential adaptive responses appropriate for Vanuatu. The HIA process involved the participation of a broad range of stakeholders including expert sector representatives in the areas of bio-physical, socio-economic, infrastructure, environmental diseases and food, who provided informed comment and input into the understanding of the potential health impacts and development of adaptation strategies. The risk associated with each of these impacts was assessed with the application of a qualitative process that considered both the consequences and the likelihood of each of the potential health impacts occurring. Potential adaptation strategies and actions were developed which could be used to mitigate the identified health impacts and provide responses which could be used by the various sectors in Vanuatu to contribute to future decision making processes associated with the health impacts of climate change. PMID:23618474

  10. Using Multi-Core Systems for Rover Autonomy

    NASA Technical Reports Server (NTRS)

    Clement, Brad; Estlin, Tara; Bornstein, Benjamin; Springer, Paul; Anderson, Robert C.

    2010-01-01

    Task Objectives are: (1) Develop and demonstrate key capabilities for rover long-range science operations using multi-core computing, (a) Adapt three rover technologies to execute on SOA multi-core processor (b) Illustrate performance improvements achieved (c) Demonstrate adapted capabilities with rover hardware, (2) Targeting three high-level autonomy technologies (a) Two for onboard data analysis (b) One for onboard command sequencing/planning, (3) Technologies identified as enabling for future missions, (4)Benefits will be measured along several metrics: (a) Execution time / Power requirements (b) Number of data products processed per unit time (c) Solution quality

  11. MORS Workshop on Improving Defense Analysis through Better Data Practices, held in Alexandria, Virginia on March 25, 26 and 27, 2003

    DTIC Science & Technology

    2004-12-03

    other process improvements could also enhance DoD data practices. These include the incorporation of library science techniques as well as processes to...coalition communities as well as adapting the approaches and lessons of the library science community. Second, there is a need to generate a plan of...Best Practices (2 of 2) - Processes - Incorporate library science techniques in repository design - Improve visibility and accessibility of DoD data

  12. Developments and potential of radiation processing in the Philippines

    NASA Astrophysics Data System (ADS)

    Singson, C.; Carmona, C.

    This paper describes the research and development activities in three areas of radiation processing, namely: food irradiation, medical product sterilization and wood plastic combination. Plans and efforts exerted to acquire a larger gamma source to augment our present 5,000 curie source are discussed. Cost estimates for a radiation facility is presented on the basis of the market potential of food irradiation and medical product sterilization. Existing local industries that can benefit from the adaptation of irradiation technology in their processing requirements is described.

  13. Analysis and Lessons Learned from an Online, Consultative Dialogue between Community Leaders and Climate Experts

    NASA Astrophysics Data System (ADS)

    Sylak-Glassman, E.; Clavin, C.

    2016-12-01

    Common approaches to climate resilience planning in the United States rely upon participatory planning approaches and dialogues between decision-makers, science translators, and subject matter experts. In an effort to explore alternative approaches support community climate resilience planning, a pilot of a public-private collaboration called the Resilience Dialogues was held in February and March of 2016. The Resilience Dialogues pilot was an online, asynchronous conversation between community leaders and climate experts, designed to help communities begin the process of climate resilience planning. In order to identify lessons learned from the pilot, we analyzed the discourse of the facilitated dialogues, administered surveys and conducted interviews with participants. Our analysis of the pilot suggests that participating community leaders found value in the consultative dialogue with climate experts, despite limited community-originated requests for climate information. Community leaders most often asked for advice regarding adaptation planning, including specific engineering guidance and advice on how to engage community members around the topic of resilience. Community leaders that had access to downscaled climate data asked experts about how to incorporate the data into their existing planning processes. The guidance sought by community leaders during the pilot shows a large range of hurdles that communities face in using climate information to inform their decision-making processes. Having a forum that connects community leaders with relevant experts and other community leaders who have familiarity with both climate impacts and municipal planning processes would likely help communities accelerate their resilience efforts.

  14. SU-C-202-02: A Comprehensive Evaluation of Adaptive Daily Planning for Cervical Cancer HDR Brachytherapy

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

    Meerschaert, R; Paul, A; Zhuang, L

    Purpose: To evaluate adaptive daily planning for cervical cancer patients who underwent high-dose-rate intra-cavitary brachytherapy (HDR-ICBT). Methods: This study included 22 cervical cancer patients who underwent 5 fractions of HDR ICBT. Regions of interest (ROIs) including high-risk clinical tumor volume (HR-CTV) and organs-at-risk (OARs) were manually contoured on daily CT images. All patients were treated with adaptive daily plans, which involved ROI delineation and dose optimization at each treatment fraction. Single treatment plans were retrospectively generated by applying the first treatment fraction’s dwell times adjusted for decay and dwell positions of the applicator to subsequent treatment fractions. Various existing similaritymore » metrics were calculated for the ROIs to quantify interfractional organ variations. A novel similarity score (JRARM) was established, which combined both volumetric overlap metrics (DSC, JSC, and RVD) and distance metrics (ASD, MSD, and RMSD). Linear regression was performed to determine a relationship between inter-fractional organ variations of various similarity metrics and D2cc variations from both plans. Wilcoxon Signed Rank Tests were used to assess adaptive daily plans and single plans by comparing EQD2 D2cc (α/β=3) for OARs. Results: For inter-fractional organ variations, the sigmoid demonstrated the greatest variations based on the JRARM and DSC similarity metrics. Comparisons between paired ROIs showed differences in JRARM scores and DSCs at each treatment fraction. RVD, MSD, and RMSD were found to be significantly correlated to D2cc variations for bladder and sigmoid. The comparison between plans found that adaptive daily planning provided lower EQD2 D2cc of OARs than single planning, specifically for the sigmoid (p=0.015). Conclusion: Substantial inter-fractional organ motion can occur during HDR-BT, which may significantly affect D2cc of OARs. Adaptive daily planning provides improved dose sparing for OARs compared to single planning.« less

  15. Integrating Collaboration, Adaptive Management, and Scenario-Planning to Address Rapid Change: Experiences at Las Cienegas National Conservation Area

    NASA Astrophysics Data System (ADS)

    Caves, J. K.; Bodner, G.; Simms, K.; Fisher, L.; Robertson, T.

    2012-12-01

    There is growing recognition that public lands cannot be managed as islands; rather, land management must address the ecological, social, and temporal complexity that often spans jurisdictions and traditional planning horizons. Collaborative decision-making and adaptive management (CAM) have been promoted as methods to reconcile competing societal demands and respond to complex ecosystem dynamics. We present the experiences of land managers and stakeholders in using CAM at Las Cienegas National Conservation Area (LCNCA), a highly valued site under the jurisdiction of the Bureau of Land Management (BLM). The CAM process at Las Cienegas is marked by strong stakeholder engagement, with four core elements: 1) shared watershed goals with measurable resource objectives; 2) mechanisms to incorporate new information into decision-making; 3) efforts to make information increasingly relevant and reliable; and 4) shared learning to improve both the process and management actions. The combination of stakeholder engagement and adaptive management has led to agreement on contentious issues, more innovative solutions, and more effective land management. Yet the region is now experiencing rapid changes outside managers' control—including climate change, human population growth, and reduced federal budgets—with large but unpredictable impacts on natural resources. While CAM experience provides a strong foundation for making the difficult and contentious management decisions that such changes are likely to require, neither collaboration nor adaptive management provides a sufficient structure for addressing uncontrollable and unpredictable change. As a result, LCNCA is exploring two specific modifications to CAM that may better address emerging challenges, including: 1) Creating nested resource objectives to distinguish between those objectives which may be crucial from those which may hinder a flexible response to climate change, and 2) Incorporating scenario planning into CAM to explore how climate change may interact with other drivers and alter options for the future, to identify robust management, and to prioritize ecological monitoring efforts. The experiences at LCNCA demonstrate how collaboration and adaptive management can be used to improve social and environmental outcomes and, with a few modifications, may help address the complexity and change that threatens to overwhelm even the best efforts to sustain public lands.

  16. Retrieval with Clustering in a Case-Based Reasoning System for Radiotherapy Treatment Planning

    NASA Astrophysics Data System (ADS)

    Khussainova, Gulmira; Petrovic, Sanja; Jagannathan, Rupa

    2015-05-01

    Radiotherapy treatment planning aims to deliver a sufficient radiation dose to cancerous tumour cells while sparing healthy organs in the tumour surrounding area. This is a trial and error process highly dependent on the medical staff's experience and knowledge. Case-Based Reasoning (CBR) is an artificial intelligence tool that uses past experiences to solve new problems. A CBR system has been developed to facilitate radiotherapy treatment planning for brain cancer. Given a new patient case the existing CBR system retrieves a similar case from an archive of successfully treated patient cases with the suggested treatment plan. The next step requires adaptation of the retrieved treatment plan to meet the specific demands of the new case. The CBR system was tested by medical physicists for the new patient cases. It was discovered that some of the retrieved cases were not suitable and could not be adapted for the new cases. This motivated us to revise the retrieval mechanism of the existing CBR system by adding a clustering stage that clusters cases based on their tumour positions. A number of well-known clustering methods were investigated and employed in the retrieval mechanism. Results using real world brain cancer patient cases have shown that the success rate of the new CBR retrieval is higher than that of the original system.

  17. Planning for Adaptation to Climate Change in the City of Chicago

    NASA Astrophysics Data System (ADS)

    Wuebbles, D. J.; Hayhoe, K.; Coffee, J.; McGraw, J.; Parzen, J.

    2008-12-01

    Under Mayor Richard M. Daley's leadership, the City of Chicago initiated the Chicago Climate Action Plan (CCAP) to better understand local implications of global climate change in both higher and lower emissions scenarios, reduce greenhouse gas emissions, and implement programs to build future climate change resilience. The City approached this work not only as a way to make Chicago more adaptable in the future, but also to improve Chicago's quality of life today. The Chicago Climate Action Plan adopted stresses the importance of both reducing greenhouse gas emissions in Chicago and preparing for climate changes that may be unavoidable. Building off of the City's significant environmental programs and projects, and based on our analyses of the climate effects and impacts that improved the scientific understanding of future climate change impacts on Chicago, the City then developed a set of climate change adaptation strategies, resulting in the City of Chicago Climate Change Adaptation Summary. This document includes prioritization of climate change adaptations based on relative risk as well as framework strategies for those tactics categorized as "must do/early action." In early 2008, The Mayor's Office asked five Commissioners from its Green Steering Committee to chair adaptation work groups including: extreme heat; extreme precipitation; buildings, infrastructure and equipment; ecosystems; and leadership, planning and communications. Working with staff from relevant departments, sister agencies and other stakeholders, these work groups developed 39 basic adaptation work plans, including plans for enhancing the City's existing projects and programs that relate to climate change adaptation. Climate change adaptation work will be on-going in City Departments under the Mayor's Office leadership. The City intends to continually monitor and improve its response to climate change, resulting in an improved quality of life for Chicago residents.

  18. Molecular PET imaging for biology-guided adaptive radiotherapy of head and neck cancer.

    PubMed

    Hoeben, Bianca A W; Bussink, Johan; Troost, Esther G C; Oyen, Wim J G; Kaanders, Johannes H A M

    2013-10-01

    Integration of molecular imaging PET techniques into therapy selection strategies and radiation treatment planning for head and neck squamous cell carcinoma (HNSCC) can serve several purposes. First, pre-treatment assessments can steer decisions about radiotherapy modifications or combinations with other modalities. Second, biology-based objective functions can be introduced to the radiation treatment planning process by co-registration of molecular imaging with planning computed tomography (CT) scans. Thus, customized heterogeneous dose distributions can be generated with escalated doses to tumor areas where radiotherapy resistance mechanisms are most prevalent. Third, monitoring of temporal and spatial variations in these radiotherapy resistance mechanisms early during the course of treatment can discriminate responders from non-responders. With such information available shortly after the start of treatment, modifications can be implemented or the radiation treatment plan can be adapted tailing the biological response pattern. Currently, these strategies are in various phases of clinical testing, mostly in single-center studies. Further validation in multicenter set-up is needed. Ultimately, this should result in availability for routine clinical practice requiring stable production and accessibility of tracers, reproducibility and standardization of imaging and analysis methods, as well as general availability of knowledge and expertise. Small studies employing adaptive radiotherapy based on functional dynamics and early response mechanisms demonstrate promising results. In this context, we focus this review on the widely used PET tracer (18)F-FDG and PET tracers depicting hypoxia and proliferation; two well-known radiation resistance mechanisms.

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

    Chen, Xiaojian; Qiao, Qiao; Department of Radiotherapy, First Hospital of China Medical University, Shenyang

    Purpose: To evaluate the efficiency of standard image-guided radiation therapy (IGRT) to account for lumpectomy cavity (LC) variation during whole-breast irradiation (WBI) and propose an adaptive strategy to improve dosimetry if IGRT fails to address the interfraction LC variations. Methods and Materials: Daily diagnostic-quality CT data acquired during IGRT in the boost stage using an in-room CT for 19 breast cancer patients treated with sequential boost after WBI in the prone position were retrospectively analyzed. Contours of the LC, treated breast, ipsilateral lung, and heart were generated by populating contours from planning CTs to boost fraction CTs using an auto-segmentationmore » tool with manual editing. Three plans were generated on each fraction CT: (1) a repositioning plan by applying the original boost plan with the shift determined by IGRT; (2) an adaptive plan by modifying the original plan according to a fraction CT; and (3) a reoptimization plan by a full-scale optimization. Results: Significant variations were observed in LC. The change in LC volume at the first boost fraction ranged from a 70% decrease to a 50% increase of that on the planning CT. The adaptive and reoptimization plans were comparable. Compared with the repositioning plans, the adaptive plans led to an improvement in target coverage for an increased LC case (1 of 19, 7.5% increase in planning target volume evaluation volume V{sub 95%}), and breast tissue sparing for an LC decrease larger than 35% (3 of 19, 7.5% decrease in breast evaluation volume V{sub 50%}; P=.008). Conclusion: Significant changes in LC shape and volume at the time of boost that deviate from the original plan for WBI with sequential boost can be addressed by adaptive replanning at the first boost fraction.« less

  20. The Generalization of Visuomotor Learning to Untrained Movements and Movement Sequences Based on Movement Vector and Goal Location Remapping

    PubMed Central

    Wu, Howard G.

    2013-01-01

    The planning of goal-directed movements is highly adaptable; however, the basic mechanisms underlying this adaptability are not well understood. Even the features of movement that drive adaptation are hotly debated, with some studies suggesting remapping of goal locations and others suggesting remapping of the movement vectors leading to goal locations. However, several previous motor learning studies and the multiplicity of the neural coding underlying visually guided reaching movements stand in contrast to this either/or debate on the modes of motor planning and adaptation. Here we hypothesize that, during visuomotor learning, the target location and movement vector of trained movements are separately remapped, and we propose a novel computational model for how motor plans based on these remappings are combined during the control of visually guided reaching in humans. To test this hypothesis, we designed a set of experimental manipulations that effectively dissociated the effects of remapping goal location and movement vector by examining the transfer of visuomotor adaptation to untrained movements and movement sequences throughout the workspace. The results reveal that (1) motor adaptation differentially remaps goal locations and movement vectors, and (2) separate motor plans based on these features are effectively averaged during motor execution. We then show that, without any free parameters, the computational model we developed for combining movement-vector-based and goal-location-based planning predicts nearly 90% of the variance in novel movement sequences, even when multiple attributes are simultaneously adapted, demonstrating for the first time the ability to predict how motor adaptation affects movement sequence planning. PMID:23804099

  1. Analysis of Existing Guidelines for the Systematic Planning Process of Clinical Registries.

    PubMed

    Löpprich, Martin; Knaup, Petra

    2016-01-01

    Clinical registries are a powerful method to observe the clinical practice and natural disease history. In contrast to clinical trials, where guidelines and standardized methods exist and are mandatory, only a few initiatives have published methodological guidelines for clinical registries. The objective of this paper was to review these guidelines and systematically assess their completeness, usability and feasibility according to a SWOT analysis. The results show that each guideline has its own strengths and weaknesses. While one supports the systematic planning process, the other discusses clinical registries in great detail. However, the feasibility was mostly limited and the special requirements of clinical registries, their flexible, expandable and adaptable technological structure was not addressed consistently.

  2. Health Aspects of Climate Change in Cities with Mediterranean Climate, and Local Adaptation Plans

    PubMed Central

    Paz, Shlomit; Negev, Maya; Clermont, Alexandra; Green, Manfred S.

    2016-01-01

    Cities with a Mediterranean-type climate (Med-cities) are particularly susceptible to health risks from climate change since they are located in biogeographical hot-spots that experience some of the strongest effects of the changing climate. The study aims to highlight health impacts of climate change in Med-cities, analyze local climate adaptation plans and make adaptation policy recommendations for the Med-city level. We identified five Med-cities with a climate change adaptation plan: Adelaide, Barcelona, Cape Town, Los Angeles and Santiago. Beyond their similar Med-climate features (although Santiago’s are slightly different), the cities have different socio-economic characteristics in various aspects. We analyzed each plan according to how it addresses climate change-related drivers of health impacts among city dwellers. For each driver, we identified the types of policy adaptation tools that address it in the urban climate adaptation plans. The surveyed cities address most of the fundamental climate change-related drivers of risks to human health, including rising temperatures, flooding and drought, but the policy measures to reduce negative impacts vary across cities. We suggest recommendations for Med-cities in various aspects, depending on their local needs and vulnerability challenges: assessment of health risks, extreme events management and long-term adaptation, among others. PMID:27110801

  3. Health Aspects of Climate Change in Cities with Mediterranean Climate, and Local Adaptation Plans.

    PubMed

    Paz, Shlomit; Negev, Maya; Clermont, Alexandra; Green, Manfred S

    2016-04-21

    Cities with a Mediterranean-type climate (Med-cities) are particularly susceptible to health risks from climate change since they are located in biogeographical hot-spots that experience some of the strongest effects of the changing climate. The study aims to highlight health impacts of climate change in Med-cities, analyze local climate adaptation plans and make adaptation policy recommendations for the Med-city level. We identified five Med-cities with a climate change adaptation plan: Adelaide, Barcelona, Cape Town, Los Angeles and Santiago. Beyond their similar Med-climate features (although Santiago's are slightly different), the cities have different socio-economic characteristics in various aspects. We analyzed each plan according to how it addresses climate change-related drivers of health impacts among city dwellers. For each driver, we identified the types of policy adaptation tools that address it in the urban climate adaptation plans. The surveyed cities address most of the fundamental climate change-related drivers of risks to human health, including rising temperatures, flooding and drought, but the policy measures to reduce negative impacts vary across cities. We suggest recommendations for Med-cities in various aspects, depending on their local needs and vulnerability challenges: assessment of health risks, extreme events management and long-term adaptation, among others.

  4. IT strategic planning in hospitals: from theory to practice.

    PubMed

    Jaana, Mirou; Teitelbaum, Mari; Roffey, Tyson

    2014-07-01

    To date, IT strategic planning has been mostly theory-based with limited information on "best practices" in this area. This study presents the process and outcomes of IT strategic planning undertaken at a pediatric hospital (PH) in Canada. A five-stage sequential and incremental process was adopted. Various tools / approaches were used including review of existing documentation, internal survey (n = 111), fifteen interviews, and twelve workshops. IT strategic planning was informed by 230 individuals (12 percent of hospital community) and revealed consistency in the themes and concerns raised by participants (e.g., slow IT projects delivery rate, lack of understanding of IT priorities, strained communication with IT staff). Mobile and remote access to patients' information, and an integrated EMR were identified as top priorities. The methodology and used approach revealed effective, improved internal relationships, and ensured commitment to the final IT strategic plan. Several lessons were learned including: maintaining a dynamic approach capable of adapting to the fast technology evolution; involving stakeholders and ensuring continuous communication; using effective research tools to support strategic planning; and grounding the process and final product in existing models. This study contributes to the development of "best practices" in IT strategic planning, and illustrates "how" to apply the theoretical principles in this area. This is especially important as IT leaders are encouraged to integrate evidence-based management into their decision making and practices. The methodology and lessons learned may inform practitioners in other hospitals planning to engage in IT strategic planning in the future.

  5. A Meta-Analysis of Urban Climate Change Adaptation Planning in the U.S.

    EPA Science Inventory

    The concentration of people, infrastructure, and ecosystem services in urban areas make them prime sites for climate change adaptation. While advances have been made in developing frameworks for adaptation planning and identifying both real and potential barriers to action, empir...

  6. Theoretical orientations in environmental planning: An inquiry into alternative approaches

    NASA Astrophysics Data System (ADS)

    Briassoulis, Helen

    1989-07-01

    In the process of devising courses of action to resolve problems arising at the society-environment interface, a variety of planning approaches are followed, whose adoption is influenced by—among other things—the characteristics of environmental problems, the nature of the decision-making context, and the intellectual traditions of the disciplines contributing to the study of these problems. This article provides a systematic analysis of six alternative environmental planning approaches—comprehensive/rational, incremental, adaptive, contingency, advocacy, and participatory/consensual. The relative influence of the abovementioned factors is examined, the occurrence of these approaches in real-world situations is noted, and their environmental soundness and political realism is evaluated. Because of the disparity between plan formulation and implementation and between theoretical form and empirical reality, a synthetic view of environmental planning approaches is taken and approaches in action are identified, which characterize the totality of the planning process from problem definition to plan implementation, as well as approaches in the becoming, which may be on the horizon of environmental planning of tomorrow. The suggested future research directions include case studies to verify and detail the presence of the approaches discussed, developing measures of success of a given approach in a given decision setting, and an intertemporal analysis of environmental planning approaches.

  7. Social marketing: the family planning experience.

    PubMed

    El-ansary, A I; Kramer Oe, J

    1973-07-01

    The authors explore social marketing applications in the Louisiana model of statewide program for family planning. The marketing concept has 4 major elements: 1) consumer orientation; 2) social process; 3) integrated effort; 4) profitable operation. Success of program and continued growth are the results of defining services needed by consumer; determining market target; taking services to customer; and emphasizing concept of selling family planning rather than giving free birth control method. Another important facet is the recognition of many participants--community agencies, the church, the American Medical Association, funding sources, and hospitals. This project used anyaltical marketing tools and defined services as human services rather than the narrow family planning services. It also extended activities to multinational environment and adapted the product offering to meet these needs.

  8. QA RESOURCE MATERIALS TO ASSIST IN DEVELOPING AND WRITING RESEARCH PLANS AT A USEPA OFFICE OF RESEARCH AND DEVELOPMENT DIVISION

    EPA Science Inventory

    In the process of adapting the Agency's Data Quality Objectives Workshop for presentation at an ORD Research Facility, ownership and consensus approval of the presentation by the Division's research staff was sought. Three groups of researchers, at various levels of responsibilit...

  9. Acculturation Process and Distress: Mediating Roles of Sociocultural Adaptation and Acculturative Stress

    ERIC Educational Resources Information Center

    Wu, Ellery K. Y.; Mak, Winnie W. S.

    2012-01-01

    The present study applied the theory of planned behavior (TPB) to unfold the social cognitive antecedents of acculturation and investigated the effects of acculturation on psychological distress using a longitudinal design. A total of 180 mainland Chinese university students studying in Hong Kong completed three sets of questionnaires every 2…

  10. Fit for Purpose: Self-Assessment for Small Providers.

    ERIC Educational Resources Information Center

    Ravenhall, Mark; Merrifield, Juliet; Gardener, Sue

    This booklet gives smaller adult and community learning (ACL) providers and their partners a practical insight into how to adapt current approaches to quality improvement for their own institutions. The first sections set out how they can do the following: plan the process; collect, collate, and analyze data; make value judgements and act upon…

  11. Adapting Creative and Relaxation Activities to Students with Cancer

    ERIC Educational Resources Information Center

    Jenko, Nika; Stopar, Mojca Lipec

    2015-01-01

    The team which forms a comprehensive treatment plan for students with cancer includes, among other experts, special educators. In cooperation with other team members, their role is to enable students to integrate in the educational process, having regard to their individual needs. In the present paper we introduce the study of specific methodical…

  12. 78 FR 65980 - Notice of Availability for Public Review and Comment: Draft EPA Climate Change Adaptation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-04

    ... Climate Change Adaptation Plan, many of the goals EPA is working to attain (e.g., clean air, safe drinking... health and the environment. It is essential therefore, that the EPA adapt to climate change in order to... of human health and the environment. Adaptation will involve anticipating and planning for changes in...

  13. Engineering of mechanical manufacturing from the cradle to cradle

    NASA Astrophysics Data System (ADS)

    Peralta, M. E.; Aguayo, F.; Lama, J. R.

    2012-04-01

    The sustainability of manufacturing processes lies in industrial planning and productive activity. Industrial plants are characterized by the management of resource (inputs and outputs), processing and conversion processes, which usually are organized in a linear system. Good planning will optimize the manufacturing and promoting the quality of the industrial system. Cradle to Cradle is a new paradigm for engineering and sustainable manufacturing that integrates projects (industrial parks, manufacturing plants, systems and products) in a framework consistent with the environment, adapted to the society and technology and economically viable. To carry it out, we implement this paradigm in the MGE2 (Genomic Model of Eco-innovation and Eco-design), as a methodology for designing and developing products and manufacturing systems with an approach from the cradle to cradle.

  14. Partnerships for Policy Development: A Case Study From Uganda’s Costed Implementation Plan for Family Planning

    PubMed Central

    Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

    2016-01-01

    ABSTRACT In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda’s CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda’s CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda’s CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

  15. Planning a multi-site, complex intervention for homeless people with mental illness: the relationships between the national team and local sites in Canada's At Home/Chez Soi project.

    PubMed

    Nelson, Geoffrey; Macnaughton, Eric; Goering, Paula; Dudley, Michael; O'Campo, Patricia; Patterson, Michelle; Piat, Myra; Prévost, Natasha; Strehlau, Verena; Vallée, Catherine

    2013-06-01

    This research focused on the relationships between a national team and five project sites across Canada in planning a complex, community intervention for homeless people with mental illness called At Home/Chez Soi, which is based on the Housing First model. The research addressed two questions: (a) what are the challenges in planning? and (b) what factors that helped or hindered moving project planning forward? Using qualitative methods, 149 national, provincial, and local stakeholders participated in key informant or focus group interviews. We found that planning entails not only intervention and research tasks, but also relational processes that occur within an ecology of time, local context, and values. More specifically, the relationships between the national team and the project sites can be conceptualized as a collaborative process in which national and local partners bring different agendas to the planning process and must therefore listen to, negotiate, discuss, and compromise with one another. A collaborative process that involves power-sharing and having project coordinators at each site helped to bridge the differences between these two stakeholder groups, to find common ground, and to accomplish planning tasks within a compressed time frame. While local context and culture pushed towards unique adaptations of Housing First, the principles of the Housing First model provided a foundation for a common approach across sites and interventions. The implications of the findings for future planning and research of multi-site, complex, community interventions are noted.

  16. Phase I trial of stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of oligometastatic or unresectable primary malignancies of the abdomen.

    PubMed

    Henke, Lauren; Kashani, Rojano; Robinson, Clifford; Curcuru, Austen; DeWees, Todd; Bradley, Jeffrey; Green, Olga; Michalski, Jeff; Mutic, Sasa; Parikh, Parag; Olsen, Jeffrey

    2018-03-01

    SBRT is used to treat oligometastatic or unresectable primary abdominal malignancies, although ablative dose delivery is limited by proximity of organs-at-risk (OAR). Stereotactic, magnetic resonance (MR)-guided online-adaptive radiotherapy (SMART) may improve SBRT's therapeutic ratio. This prospective Phase I trial assessed feasibility and potential advantages of SMART to treat abdominal malignancies. Twenty patients with oligometastatic or unresectable primary liver (n = 10) and non-liver (n = 10) abdominal malignancies underwent SMART. Initial plans prescribed 50 Gy/5 fractions (BED 100 Gy) with goal 95% PTV coverage by 95% of prescription, subject to hard OAR constraints. Daily real-time online-adaptive plans were created as needed, based on daily setup MR-image-set tumor/OAR "anatomy-of-the-day" to preserve hard OAR constraints, escalate PTV dose, or both. Treatment times, patient outcomes, and dosimetric comparisons between initial and adaptive plans were prospectively recorded. Online adaptive plans were created at time of treatment for 81/97 fractions, due to initial plan violation of OAR constraints (61/97) or observed opportunity for PTV dose escalation (20/97). Plan adaptation increased PTV coverage in 64/97 fractions. Zero Grade ≥ 3 acute (<6 months) treatment-related toxicities were observed. SMART is clinically deliverable and safe, allowing PTV dose escalation and/or simultaneous OAR sparing compared to non-adaptive abdominal SBRT. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Use of intervention mapping to adapt a health behavior change intervention for endometrial cancer survivors: the shape-up following cancer treatment program.

    PubMed

    Koutoukidis, Dimitrios A; Lopes, Sonia; Atkins, Lou; Croker, Helen; Knobf, M Tish; Lanceley, Anne; Beeken, Rebecca J

    2018-03-27

    About 80% of endometrial cancer survivors (ECS) are overweight or obese and have sedentary behaviors. Lifestyle behavior interventions are promising for improving dietary and physical activity behaviors, but the constructs associated with their effectiveness are often inadequately reported. The aim of this study was to systematically adapt an evidence-based behavior change program to improve healthy lifestyle behaviors in ECS. Following a review of the literature, focus groups and interviews were conducted with ECS (n = 16). An intervention mapping protocol was used for the program adaptation, which consisted of six steps: a needs assessment, formulation of matrices of change objectives, selection of theoretical methods and practical applications, program production, adoption and implementation planning, and evaluation planning. Social Cognitive Theory and Control Theory guided the adaptation of the intervention. The process consisted of eight 90-min group sessions focusing on shaping outcome expectations, knowledge, self-efficacy, and goals about healthy eating and physical activity. The adapted performance objectives included establishment of regular eating, balanced diet, and portion sizes, reduction in sedentary behaviors, increase in lifestyle and organized activities, formulation of a discrepancy-reducing feedback loop for all above behaviors, and trigger management. Information on managing fatigue and bowel issues unique to ECS were added. Systematic intervention mapping provided a framework to design a cancer survivor-centered lifestyle intervention. ECS welcomed the intervention and provided essential feedback for its adaptation. The program has been evaluated through a randomized controlled trial.

  18. Which Measures of Online Control Are Least Sensitive to Offline Processes?

    PubMed

    de Grosbois, John; Tremblay, Luc

    2018-02-28

    A major challenge to the measurement of online control is the contamination by offline, planning-based processes. The current study examined the sensitivity of four measures of online control to offline changes in reaching performance induced by prism adaptation and terminal feedback. These measures included the squared Z scores (Z 2 ) of correlations of limb position at 75% movement time versus movement end, variable error, time after peak velocity, and a frequency-domain analysis (pPower). The results indicated that variable error and time after peak velocity were sensitive to the prism adaptation. Furthermore, only the Z 2 values were biased by the terminal feedback. Ultimately, the current study has demonstrated the sensitivity of limb kinematic measures to offline control processes and that pPower analyses may yield the most suitable measure of online control.

  19. 50 CFR 216.275 - Requirements for monitoring and reporting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Navy shall complete an Integrated Comprehensive Monitoring Plan (ICMP) in 2009. This planning and adaptive management tool shall include: (1) A method for prioritizing monitoring projects that clearly... potentially modify subsequent monitoring and mitigation. (4) An adaptive management plan. (5) A method for...

  20. The predictive roles of neural oscillations in speech motor adaptability.

    PubMed

    Sengupta, Ranit; Nasir, Sazzad M

    2016-06-01

    The human speech system exhibits a remarkable flexibility by adapting to alterations in speaking environments. While it is believed that speech motor adaptation under altered sensory feedback involves rapid reorganization of speech motor networks, the mechanisms by which different brain regions communicate and coordinate their activity to mediate adaptation remain unknown, and explanations of outcome differences in adaption remain largely elusive. In this study, under the paradigm of altered auditory feedback with continuous EEG recordings, the differential roles of oscillatory neural processes in motor speech adaptability were investigated. The predictive capacities of different EEG frequency bands were assessed, and it was found that theta-, beta-, and gamma-band activities during speech planning and production contained significant and reliable information about motor speech adaptability. It was further observed that these bands do not work independently but interact with each other suggesting an underlying brain network operating across hierarchically organized frequency bands to support motor speech adaptation. These results provide novel insights into both learning and disorders of speech using time frequency analysis of neural oscillations. Copyright © 2016 the American Physiological Society.

  1. Robustness via Run-Time Adaptation of Contingent Plans

    NASA Technical Reports Server (NTRS)

    Bresina, John L.; Washington, Richard; Norvig, Peter (Technical Monitor)

    2000-01-01

    In this paper, we discuss our approach to making the behavior of planetary rovers more robust for the purpose of increased productivity. Due to the inherent uncertainty in rover exploration, the traditional approach to rover control is conservative, limiting the autonomous operation of the rover and sacrificing performance for safety. Our objective is to increase the science productivity possible within a single uplink by allowing the rover's behavior to be specified with flexible, contingent plans and by employing dynamic plan adaptation during execution. We have deployed a system exhibiting flexible, contingent execution; this paper concentrates on our ongoing efforts on plan adaptation, Plans can be revised in two ways: plan steps may be deleted, with execution continuing with the plan suffix; and the current plan may be merged with an "alternate plan" from an on-board library. The plan revision action is chosen to maximize the expected utility of the plan. Plan merging and action deletion constitute a more conservative general-purpose planning system; in return, our approach is more efficient and more easily verified, two important criteria for deployed rovers.

  2. SU-E-P-12: Pinnacle-Based Tool to Evaluate the Effect of Prostate Rotation as Determined by Calypso

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

    Narayanan, S; Velasco-Schmitz, R; Claeys, K

    Purpose: When the Calypso reports a large prostate rotation and one does not have the means to make corrections, it is helpful to quantify its dosimetric effects. We have devised a simple scheme to achieve this in Pinnacle TPS. If it is determined that the PTV margin is inadequate, an alternate larger-margin plan may be adapted for the day. Methods: A three-step process using the Pinnacle Image fusion module was formulated to analyze the clinical effect of prostate rotation. The process includes (1) translating the image set such that the rotational axis is about the isocenter, (2) performing 3D rotationsmore » of the structures of interest, and (3) restoring the coordinates associated with the plan. The rotated structures are imported and overlayed on the original plan for evaluation. The tool was applied to three prostate cancer patients with relatively large rotations (95 fractions total). Prostate rotations are primarily due to variations in bladder and rectal filling, which may also affect the seminal vesicles. It is difficult to estimate the perturbation of seminal vesicles for a given prostate rotation. Therefore, the Calypso-derived rotation matrix was applied only to CTV and PTV (CTV+5mm). Results: The rotations were predominantly in the pitch direction with an absolute value ranging from 0–29 degrees (Median = 10°, Average = 14.5°). For various magnitudes of rotation, the CTV V100 decreased from the original 100% to 99.6%/99%/95% for 10°/15°/29° rotations, respectively. Likewise, the PTV V100 diminished from 95% to 92%/89%/82%. Conclusion: A tool, consisting only of features within a TPS, was used to evaluate the dosimetric effect of prostate rotation. Our study shows that under large uncorrected rotations, the tumor coverage is degraded and may require intervention in the form of plan adaptation. To this end, alternate plans with variable margins can be generated in advance for daily adaption.« less

  3. Preparing strategic information management plans for hospitals: a practical guideline SIM plans for hospitals: a guideline.

    PubMed

    Brigl, B; Ammenwerth, E; Dujat, C; Gräber, S; Grosse, A; Häber, A; Jostes, C; Winter, A

    2005-01-01

    Systematic information management in hospitals demands for a strategic information management plan (SIM plan). As preparing a SIM plan is a considerable challenge we provide a practical guideline that is directly applicable when a SIM plan is going to be prepared. The guideline recommends a detailed structure of a SIM plan and gives advice about its content and the preparation process. It may be used as template, which can be adapted to the individual demands of any hospital. The guideline was used in several hospitals preparing a SIM plan. Experiences showed that the SIM plans could be prepared very efficiently and timely using the guideline, that the proposed SIM plan structure suited well, that the guideline offers enough flexibility to meet the requirements of the individual hospitals and that the specific recommendations of the guideline were very helpful. Nevertheless, we must strive for a more comprehensive theory of strategic information management planning which -- in the sense of enterprise architecture planning -- represents the intrinsic correlations of the different parts of a SIM plan to a greater extent.

  4. Managing for climate change on protected areas: An adaptive management decision making framework.

    PubMed

    Tanner-McAllister, Sherri L; Rhodes, Jonathan; Hockings, Marc

    2017-12-15

    Current protected area management is becoming more challenging with advancing climate change and current park management techniques may not be adequate to adapt for effective management into the future. The framework presented here provides an adaptive management decision making process to assist protected area managers with adapting on-park management to climate change. The framework sets out a 4 step process. One, a good understanding of the park's context within climate change. Secondly, a thorough understanding of the park management systems including governance, planning and management systems. Thirdly, a series of management options set out as an accept/prevent change style structure, including a systematic assessment of those options. The adaptive approaches are defined as acceptance of anthropogenic climate change impact and attempt to adapt to a new climatic environment or prevention of change and attempt to maintain current systems under new climatic variations. Last, implementation and monitoring of long term trends in response to ecological responses to management interventions and assessing management effectiveness. The framework addresses many issues currently with park management in dealing with climate change including the considerable amount of research focussing on 'off-reserve' strategies, and threats and stress focused in situ park management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Technical Note: DIRART – A software suite for deformable image registration and adaptive radiotherapy research

    PubMed Central

    Yang, Deshan; Brame, Scott; El Naqa, Issam; Aditya, Apte; Wu, Yu; Murty Goddu, S.; Mutic, Sasa; Deasy, Joseph O.; Low, Daniel A.

    2011-01-01

    Purpose: Recent years have witnessed tremendous progress in image guide radiotherapy technology and a growing interest in the possibilities for adapting treatment planning and delivery over the course of treatment. One obstacle faced by the research community has been the lack of a comprehensive open-source software toolkit dedicated for adaptive radiotherapy (ART). To address this need, the authors have developed a software suite called the Deformable Image Registration and Adaptive Radiotherapy Toolkit (DIRART). Methods:DIRART is an open-source toolkit developed in MATLAB. It is designed in an object-oriented style with focus on user-friendliness, features, and flexibility. It contains four classes of DIR algorithms, including the newer inverse consistency algorithms to provide consistent displacement vector field in both directions. It also contains common ART functions, an integrated graphical user interface, a variety of visualization and image-processing features, dose metric analysis functions, and interface routines. These interface routines make DIRART a powerful complement to the Computational Environment for Radiotherapy Research (CERR) and popular image-processing toolkits such as ITK. Results: DIRART provides a set of image processing∕registration algorithms and postprocessing functions to facilitate the development and testing of DIR algorithms. It also offers a good amount of options for DIR results visualization, evaluation, and validation. Conclusions: By exchanging data with treatment planning systems via DICOM-RT files and CERR, and by bringing image registration algorithms closer to radiotherapy applications, DIRART is potentially a convenient and flexible platform that may facilitate ART and DIR research. PMID:21361176

  6. Options for national parks and reserves for adapting to climate change.

    PubMed

    Baron, Jill S; Gunderson, Lance; Allen, Craig D; Fleishman, Erica; McKenzie, Donald; Meyerson, Laura A; Oropeza, Jill; Stephenson, Nate

    2009-12-01

    Past and present climate has shaped the valued ecosystems currently protected in parks and reserves, but future climate change will redefine these conditions. Continued conservation as climate changes will require thinking differently about resource management than we have in the past; we present some logical steps and tools for doing so. Three critical tenets underpin future management plans and activities: (1) climate patterns of the past will not be the climate patterns of the future; (2) climate defines the environment and influences future trajectories of the distributions of species and their habitats; (3) specific management actions may help increase the resilience of some natural resources, but fundamental changes in species and their environment may be inevitable. Science-based management will be necessary because past experience may not serve as a guide for novel future conditions. Identifying resources and processes at risk, defining thresholds and reference conditions, and establishing monitoring and assessment programs are among the types of scientific practices needed to support a broadened portfolio of management activities. In addition to the control and hedging management strategies commonly in use today, we recommend adaptive management wherever possible. Adaptive management increases our ability to address the multiple scales at which species and processes function, and increases the speed of knowledge transfer among scientists and managers. Scenario planning provides a broad forward-thinking framework from which the most appropriate management tools can be chosen. The scope of climate change effects will require a shared vision among regional partners. Preparing for and adapting to climate change is as much a cultural and intellectual challenge as an ecological challenge.

  7. Options for national parks and reserves for adapting to climate change

    USGS Publications Warehouse

    Baron, Jill S.; Gunderson, Lance; Allen, Craig D.; Fleishman, Erica; McKenzie, Donald; Meyerson, Laura A.; Oropeza, Jill; Stephenson, Nathan L.

    2009-01-01

    Past and present climate has shaped the valued ecosystems currently protected in parks and reserves, but future climate change will redefine these conditions. Continued conservation as climate changes will require thinking differently about resource management than we have in the past; we present some logical steps and tools for doing so. Three critical tenets underpin future management plans and activities: (1) climate patterns of the past will not be the climate patterns of the future; (2) climate defines the environment and influences future trajectories of the distributions of species and their habitats; (3) specific management actions may help increase the resilience of some natural resources, but fundamental changes in species and their environment may be inevitable. Science-based management will be necessary because past experience may not serve as a guide for novel future conditions. Identifying resources and processes at risk, defining thresholds and reference conditions, and establishing monitoring and assessment programs are among the types of scientific practices needed to support a broadened portfolio of management activities. In addition to the control and hedging management strategies commonly in use today, we recommend adaptive management wherever possible. Adaptive management increases our ability to address the multiple scales at which species and processes function, and increases the speed of knowledge transfer among scientists and managers. Scenario planning provides a broad forward-thinking framework from which the most appropriate management tools can be chosen. The scope of climate change effects will require a shared vision among regional partners. Preparing for and adapting to climate change is as much a cultural and intellectual challenge as an ecological challenge.

  8. Participatory Scenario Planning for the Cienega Watershed: Embracing Uncertainty in Public Lands Management in the U.S. Southwest

    NASA Astrophysics Data System (ADS)

    Hartmann, H.; Morino, K.; Bodner, G.; Markstein, A.; McFarlin, S.

    2013-12-01

    Land managers and communities struggle to sustain natural landscapes and the benefits they provide--especially in an era of rapid and unpredictable changes being driven by shifts in climate and other drivers that are largely outside the control of local managers and residents. The Cienega Watershed Partnership (CWP) is a long-standing multi-agency partnership involved in managing lands and resources over about 700,000 acres in southeast Arizona, surrounding the Bureau of Land Management's Las Cienegas National Conservation Area. The region forms a vital wildlife corridor connecting the diverse ecosystems of the Sonoran and Chihuahuan deserts and grasslands with the Sierra Madrean and Rocky Mountain forests and woodlands. The CWP has long-standing forums and relationships for considering complex issues and novel approaches for management, including practical implementation of adaptive management, development of monitoring programs and protocols, and the use of nested objectives to adjust management targets. However, current plans have objectives and strategies based on what is known or likely to become known about natural and socio-cultural systems; they do not incorporate uncertainties related to rapid changes in climate or have well developed feedback mechanisms for routinely reconsidering climate information. Since 2011, more than 50 individuals from over 20 federal and local governments, non-governmental organizations, and private landowners have participated in scenario planning for the Cienega Watershed. Scenario planning is an important tool for (1) managing risks in the face of high volatility, uncertainty, complexity, and ambiguity; (2) integrating quantitative climate projections, trend and impact assessments, and local expertise to develop qualitative scenario narratives that can inform decisions even by simply provoking insights; and (3) engaging jurisdictions having different missions, objectives, and planning processes. Participants are helping to extend and refine participatory scenario planning methods from the development of regional qualitative narratives to (1) development of scenario narratives that are relevant at the local management level, (2) creation and evaluation of portfolios of management options that can accommodate changes in management objectives, connect to formal agency planning processes, and that can be adjusted as the future evolves, and (3) explicit identification of the data and information that link qualitative narratives to quantitative scenario and adaptation assessments, which can be used to drive the timing and implementation of activities within the adaptation portfolios, and to prioritize monitoring and research activities to resolve near-term uncertainties. Project tasks are structured around four resource teams that focus on their specific management concerns (Montane, Riparian, Upland and Cultural), but that come together periodically to consider interaction and conflict among their scenarios or prospective adaptation. Participants are finding that embracing uncertainty enables them to approach climate change with a sense of empowerment rather than a sense of reacting to crises, and they appreciate the methods and opportunities for thinking differently and crossing boundaries that the scenario planning exercises provide.

  9. Designing monitoring programs in an adaptive management context for regional multiple species conservation plans

    USGS Publications Warehouse

    Atkinson, A.J.; Trenham, P.C.; Fisher, R.N.; Hathaway, S.A.; Johnson, B.S.; Torres, S.G.; Moore, Y.C.

    2004-01-01

    critical management uncertainties; and 3) implementing long-term monitoring and adaptive management. Ultimately, the success of regional conservation planning depends on the ability of monitoring programs to confront the challenges of adaptively managing and monitoring complex ecosystems and diverse arrays of sensitive species.

  10. Evaluation Plan for the Computerized Adaptive Vocational Aptitude Battery.

    ERIC Educational Resources Information Center

    Green, Bert F.; And Others

    The United States Armed Services are planning to introduce computerized adaptive testing (CAT) into the Armed Services Vocational Aptitude Battery (ASVAB), which is a major part of the present personnel assessment procedures. Adaptive testing will improve efficiency greatly by assessing each candidate's answers as the test progresses and posing…

  11. Drug delivery optimization through Bayesian networks.

    PubMed Central

    Bellazzi, R.

    1992-01-01

    This paper describes how Bayesian Networks can be used in combination with compartmental models to plan Recombinant Human Erythropoietin (r-HuEPO) delivery in the treatment of anemia of chronic uremic patients. Past measurements of hematocrit or hemoglobin concentration in a patient during the therapy can be exploited to adjust the parameters of a compartmental model of the erythropoiesis. This adaptive process allows more accurate patient-specific predictions, and hence a more rational dosage planning. We describe a drug delivery optimization protocol, based on our approach. Some results obtained on real data are presented. PMID:1482938

  12. Automation of Cassini Support Imaging Uplink Command Development

    NASA Technical Reports Server (NTRS)

    Ly-Hollins, Lisa; Breneman, Herbert H.; Brooks, Robert

    2010-01-01

    "Support imaging" is imagery requested by other Cassini science teams to aid in the interpretation of their data. The generation of the spacecraft command sequences for these images is performed by the Cassini Instrument Operations Team. The process initially established for doing this was very labor-intensive, tedious and prone to human error. Team management recognized this process as one that could easily benefit from automation. Team members were tasked to document the existing manual process, develop a plan and strategy to automate the process, implement the plan and strategy, test and validate the new automated process, and deliver the new software tools and documentation to Flight Operations for use during the Cassini extended mission. In addition to the goals of higher efficiency and lower risk in the processing of support imaging requests, an effort was made to maximize adaptability of the process to accommodate uplink procedure changes and the potential addition of new capabilities outside the scope of the initial effort.

  13. WE-AB-BRA-09: Sensitivity of Plan Re-Optimization to Errors in Deformable Image Registration in Online Adaptive Image-Guided Radiation Therapy

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

    McClain, B; Olsen, J; Green, O

    2015-06-15

    Purpose: Online adaptive therapy (ART) relies on auto-contouring using deformable image registration (DIR). DIR’s inherent uncertainties require user intervention and manual edits while the patient is on the table. We investigated the dosimetric impact of DIR errors on the quality of re-optimized plans, and used the findings to establish regions for focusing manual edits to where DIR errors can Result in clinically relevant dose differences. Methods: Our clinical implementation of online adaptive MR-IGRT involves using DIR to transfer contours from CT to daily MR, followed by a physicians’ edits. The plan is then re-optimized to meet the organs at riskmore » (OARs) constraints. Re-optimized abdomen and pelvis plans generated based on physician edited OARs were selected as the baseline for evaluation. Plans were then re-optimized on auto-deformed contours with manual edits limited to pre-defined uniform rings (0 to 5cm) around the PTV. A 0cm ring indicates that the auto-deformed OARs were used without editing. The magnitude of the variations caused by the non-deterministic optimizer was quantified by repeat re-optimizations on the same geometry to determine the mean and standard deviation (STD). For each re-optimized plan, various volumetric parameters for the PTV, the OARs were extracted along with DVH and isodose evaluation. A plan was deemed acceptable if the variation from the baseline plan was within one STD. Results: Initial results show that for abdomen and pancreas cases, a minimum of 5cm margin around the PTV is required for contour corrections, while for pelvic and liver cases a 2–3 cm margin is sufficient. Conclusion: Focusing manual contour edits to regions of dosimetric relevance can reduce contouring time in the online ART process while maintaining a clinically comparable plan. Future work will further refine the contouring region by evaluating the path along the beams, dose gradients near the target and OAR dose metrics.« less

  14. Climate Change Adaptation Activities at the NASA John F. Kennedy Space Center, FL., USA

    NASA Technical Reports Server (NTRS)

    Hall, Carlton; Phillips, Lynne

    2016-01-01

    In 2010, the Office of Strategic Infrastructure and Earth Sciences established the Climate Adaptation Science Investigators (CASI) program to integrate climate change forecasts and knowledge into sustainable management of infrastructure and operations needed for the NASA mission. NASA operates 10 field centers valued at $32 billion dollars, occupies 191,000 acres and employs 58,000 people. CASI climate change and sea-level rise forecasts focus on the 2050 and 2080 time periods. At the 140,000 acre Kennedy Space Center (KSC) data are used to simulate impacts on infrastructure, operations, and unique natural resources. KSC launch and processing facilities represent a valued national asset located in an area with high biodiversity including 33 species of special management concern. Numerical and advanced Bayesian and Monte Carlo statistical modeling is being conducted using LiDAR digital elevation models coupled with relevant GIS layers to assess potential future conditions. Results are provided to the Environmental Management Branch, Master Planning, Construction of Facilities, Engineering Construction Innovation Committee and our regional partners to support Spaceport development, management, and adaptation planning and design. Potential impacts to natural resources include conversion of 50% of the Center to open water, elevation of the surficial aquifer, alterations of rainfall and evapotranspiration patterns, conversion of salt marsh to mangrove forest, reductions in distribution and extent of upland habitats, overwash of the barrier island dune system, increases in heat stress days, and releases of chemicals from legacy contamination sites. CASI has proven successful in bringing climate change planning to KSC including recognition of the need to increase resiliency and development of a green managed shoreline retreat approach to maintain coastal ecosystem services while maximizing life expectancy of Center launch and payload processing resources.

  15. Incorporating geodiversity into conservation decisions.

    PubMed

    Comer, Patrick J; Pressey, Robert L; Hunter, Malcolm L; Schloss, Carrie A; Buttrick, Steven C; Heller, Nicole E; Tirpak, John M; Faith, Daniel P; Cross, Molly S; Shaffer, Mark L

    2015-06-01

    In a rapidly changing climate, conservation practitioners could better use geodiversity in a broad range of conservation decisions. We explored selected avenues through which this integration might improve decision making and organized them within the adaptive management cycle of assessment, planning, implementation, and monitoring. Geodiversity is seldom referenced in predominant environmental law and policy. With most natural resource agencies mandated to conserve certain categories of species, agency personnel are challenged to find ways to practically implement new directives aimed at coping with climate change while retaining their species-centered mandate. Ecoregions and ecological classifications provide clear mechanisms to consider geodiversity in plans or decisions, the inclusion of which will help foster the resilience of conservation to climate change. Methods for biodiversity assessment, such as gap analysis, climate change vulnerability analysis, and ecological process modeling, can readily accommodate inclusion of a geophysical component. We adapted others' approaches for characterizing landscapes along a continuum of climate change vulnerability for the biota they support from resistant, to resilient, to susceptible, and to sensitive and then summarized options for integrating geodiversity into planning in each landscape type. In landscapes that are relatively resistant to climate change, options exist to fully represent geodiversity while ensuring that dynamic ecological processes can change over time. In more susceptible landscapes, strategies aiming to maintain or restore ecosystem resilience and connectivity are paramount. Implementing actions on the ground requires understanding of geophysical constraints on species and an increasingly nimble approach to establishing management and restoration goals. Because decisions that are implemented today will be revisited and amended into the future, increasingly sophisticated forms of monitoring and adaptation will be required to ensure that conservation efforts fully consider the value of geodiversity for supporting biodiversity in the face of a changing climate. © 2015 Society for Conservation Biology.

  16. Climate Change Adaptation Activities at the NASA John F. Kennedy Space Center, Fl., USA

    NASA Astrophysics Data System (ADS)

    Hall, C. R.; Phillips, L. V.; Foster, T.; Stolen, E.; Duncan, B.; Hunt, D.; Schaub, R.

    2016-12-01

    In 2010, the Office of Strategic Infrastructure and Earth Sciences established the Climate Adaptation Science Investigators (CASI) program to integrate climate change forecasts and knowledge into sustainable management of infrastructure and operations needed for the NASA mission. NASA operates 10 field centers valued at $32 billion dollars, occupies 191,000 acres and employs 58,000 people. CASI climate change and sea-level rise forecasts focus on the 2050 and 2080 time periods. At the 140,000 acre Kennedy Space Center (KSC) data are used to simulate impacts on infrastructure, operations, and unique natural resources. KSC launch and processing facilities represent a valued national asset located in an area with high biodiversity including 33 species of special management concern. Numerical and advanced Bayesian and Monte Carlo statistical modeling is being conducted using LiDAR digital elevation models coupled with relevant GIS layers to assess potential future conditions. Results are provided to the Environmental Management Branch, Master Planning, Construction of Facilities, Engineering Construction Innovation Committee and our regional partners to support Spaceport development, management, and adaptation planning and design. Potential impacts to natural resources include conversion of 50% of the Center to open water, elevation of the surficial aquifer, alterations of rainfall and evapotranspiration patterns, conversion of salt marsh to mangrove forest, reductions in distribution and extent of upland habitats, overwash of the barrier island dune system, increases in heat stress days, and releases of chemicals from legacy contamination sites. CASI has proven successful in bringing climate change planning to KSC including recognition of the need to increase resiliency and development of a green managed shoreline retreat approach to maintain coastal ecosystem services while maximizing life expectancy of Center launch and payload processing resources.

  17. [An application of the strategy results cycle to HIV/AIDS strategic planning in Latin America].

    PubMed

    Rodríguez-García, Rosalía; Rosenberg, Hernán

    2013-07-01

    To describe the Strategy Results Cycle (SRC), a model that approaches planning as an ongoing cycle of seven phases that continually responds and adapts to existing evidence. Reliable sources were used for the preparation of databases and expenditure-costing data for resources needs analysis. The planning process 6-9 months to complete a national strategic plan that was informed by evidence, focused on results and costed. Knowledge transfer facilitated national leadership and stakeholders' participation. Between 2007 and 2011, 13 of 16 countries adopted the Strategy Results Cycle model. The evidence supported the identification of results and the expenditure-costing analysis improved budget allocation efficiency. The SRC facilitated purposeful participation and added value to previous planning approaches by connecting "thinking" and "doing" which resulted in national strategic plans that are designed by stakeholders, relevant to local conditions, and can guide implementation and resource mobilization.

  18. Managing the Health Effects of Temperature in Response to Climate Change: Challenges Ahead

    PubMed Central

    Barnett, Adrian G.; Xu, Zhiwei; Chu, Cordia; Wang, Xiaoming; Turner, Lyle R.; Tong, Shilu

    2013-01-01

    Background: Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion. Objectives: We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public’s health from heat events and climate change. Discussion: Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified. Conclusions: The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions. PMID:23407064

  19. 50 CFR 216.175 - Requirements for monitoring and reporting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... complete an Integrated Comprehensive Monitoring Plan (ICMP) in 2009. This planning and adaptive management... subsequent monitoring and mitigation. (4) An adaptive management plan. (5) A method for standardizing data... Report—The Navy shall submit a report annually on October 1 describing the implementation and results...

  20. Building the framework for climate change adaptation in the urban areas using participatory approach: the Czech Republic experience

    NASA Astrophysics Data System (ADS)

    Emmer, Adam; Hubatová, Marie; Lupač, Miroslav; Pondělíček, Michael; Šafařík, Miroslav; Šilhánková, Vladimíra; Vačkář, David

    2016-04-01

    The Czech Republic has experienced numerous extreme hydrometeorological / climatological events such as floods (significant ones in 1997, 2002, 2010, 2013), droughts (2013, 2015), heat waves (2015) and windstorms (2007) during past decades. These events are generally attributed to the ongoing climate change and caused loss of lives and significant material damages (up to several % of GDP in some years), especially in urban areas. To initiate the adaptation process of urban areas, the main objective was to prepare a framework for creating climate change adaptation strategies of individual cities reflecting physical-geographical and socioeconomical conditions of the Czech Republic. Three pilot cities (Hradec Králové, Žďár nad Sázavou, Dobru\\vska) were used to optimize entire procedure. Two sets of participatory seminars were organised in order to involve all key stakeholders (the city council, department of the environment, department of the crisis management, hydrometeorological institute, local experts, ...) into the process of creation of the adaptation strategy from its early stage. Lesson learned for the framework were related especially to its applicability on a local level, which is largely a matter of the understandability of the concept. Finally, this illustrative and widely applicable framework (so called 'road map to adaptation strategy') includes five steps: (i) analysis of existing strategies and plans on national, regional and local levels; (ii) analysing climate-change related hazards and key vulnerabilities; (iii) identification of adaptation needs, evaluation of existing adaptation capacity and formulation of future adaptation priorities; (iv) identification of limits and barriers for the adaptation (economical, environmental, ...); and (v) selection of specific types of adaptation measures reflecting identified adaptation needs and formulated adaptation priorities. Keywords: climate change adaptation (CCA); urban areas; participatory approach; road map

  1. Advance care planning in CKD/ESRD: an evolving process.

    PubMed

    Holley, Jean L

    2012-06-01

    Advance care planning was historically considered to be simply the completion of a proxy (health care surrogate designation) or instruction (living will) directive that resulted from a conversation between a patient and his or her physician. We now know that advance care planning is a much more comprehensive and dynamic patient-centered process used by patients and families to strengthen relationships, achieve control over medical care, prepare for death, and clarify goals of care. Some advance directives, notably designated health care proxy documents, remain appropriate expressions of advance care planning. Moreover, although physician orders, such as do-not-resuscitate orders and Physician Orders for Life-Sustaining Treatment, may not be strictly defined as advance directives, their completion, when appropriate, is an integral component of advance care planning. The changing health circumstances and illness trajectory characteristic of ESRD mandate that advance care planning discussions adapt to a patient's situation and therefore must be readdressed at appropriate times and intervals. The options of withholding and withdrawing dialysis add ESRD-specific issues to advance care planning in this population and are events each nephrologist will at some time confront. Advance care planning is important throughout the spectrum of ESRD and is a part of nephrology practice that can be rewarding to nephrologists and beneficial to patients and their families.

  2. Assessment of the Health Impacts of Climate Change in Kiribati

    PubMed Central

    McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven

    2014-01-01

    Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452

  3. Adaptive volumetric modulated arc treatment planning for esophageal cancers using cone beam computed tomography.

    PubMed

    Sriram, Padmanaban; Syamkumar, S A; Kumar, J Sam Deva; Prabakar, Sukumar; Dhanabalan, Rajasekaran; Vivekanandan, Nagarajan

    2012-10-01

    To assess the potential of cone beam CT (CBCT) derived adaptive RapidArc treatment for esophageal cancers in reducing the dose to organs at risk (OAR). Ten patients with esophageal cancer were CT scanned in free breathing pattern. The PTV is generated by adding a 3D margin of 1 cm to the CTV as per ICRU 62 recommendations. The double arc RapidArc plan (Clin_RA) was generated for the PTV. Patients were setup using kV orthogonal images and kV-CBCT scan was acquired daily during first week of therapy, then weekly. These images were exported to the Eclipse TPS. The adaptive CTV which includes tumor and involved nodes was delineated in each CBCT image set for the length of the PTV. The composite CTV from first week CBCT was generated using Boolean union operator and 5 mm margin was added circumferentially to generate adaptive PTV (PTV1). Adaptive RapidArc plan (Adap_RA) was generated. NTCP and DVH of the OARs of the two plans were compared. Similarly, PTV2 was generated from weekly CBCT. PTV2 was evaluated for the coverage of 95% isodose of Adap_RA plan. The PTV1 and PTV2 volumes covered by 95% isodose in adaptive plans were 93.51 ± 1.17% and 94.59 ± 1.43% respectively. The lung V(10Gy,)V(20Gy) and mean dose in Adap_RA plan was reduced by 17.43% (p = 0.0012), 34.64% (p = 0.0019) and 16.50% (p = 0.0002) respectively compared to Clin_RA. The Adap_RA plan reduces the heart D(35%) and mean dose by 17.35% (p = 0.0011) and 17.16% (p = 0.0012). No significant reduction in spinal cord and liver doses were observed. NTCP for the lung (0.42% vs. 0.08%) and heart (1.39% vs. 0.090%) was reduced significantly in adaptive plans. The adaptive re-planning strategy based on the first week CBCT dataset significantly reduces the doses and NTCP to OARs. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. Automating Mission Scheduling for Space-Based Observatories

    NASA Technical Reports Server (NTRS)

    Pell, Barney; Muscettola, Nicola; Hansson, Othar; Mohan, Sunil

    1998-01-01

    In this paper we describe the use of our planning and scheduling framework, HSTS, to reduce the complexity of science mission planning. This work is part of an overall project to enable a small team of scientists to control the operations of a spacecraft. The present process is highly labor intensive. Users (scientists and operators) rely on a non-codified understanding of the different spacecraft subsystems and of their operating constraints. They use a variety of software tools to support their decision making process. This paper considers the types of decision making that need to be supported/automated, the nature of the domain constraints and the capabilities needed to address them successfully, and the nature of external software systems with which the core planning/scheduling engine needs to interact. HSTS has been applied to science scheduling for EUVE and Cassini and is being adapted to support autonomous spacecraft operations in the New Millennium initiative.

  5. Public Health and Climate Change Adaptation at the Federal Level: One Agency’s Response to Executive Order 13514

    PubMed Central

    Schramm, Paul J.; Luber, George

    2014-01-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change. PMID:24432931

  6. Public health and climate change adaptation at the federal level: one agency's response to Executive Order 13514.

    PubMed

    Hess, Jeremy J; Schramm, Paul J; Luber, George

    2014-03-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change.

  7. Technical Note: A fast online adaptive replanning method for VMAT using flattening filter free beams

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

    Ates, Ozgur; Ahunbay, Ergun E.; Li, X. Allen, E-mail: ali@mcw.edu

    Purpose: To develop a fast replanning algorithm based on segment aperture morphing (SAM) for online replanning of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams. Methods: A software tool was developed to interface with a VMAT research planning system, which enables the input and output of beam and machine parameters of VMAT plans. The SAM algorithm was used to modify multileaf collimator positions for each segment aperture based on the changes of the target from the planning (CT/MR) to daily image [CT/CBCT/magnetic resonance imaging (MRI)]. The leaf travel distance was controlled for large shifts to prevent themore » increase of VMAT delivery time. The SAM algorithm was tested for 11 patient cases including prostate, pancreatic, and lung cancers. For each daily image set, three types of VMAT plans, image-guided radiation therapy (IGRT) repositioning, SAM adaptive, and full-scope reoptimization plans, were generated and compared. Results: The SAM adaptive plans were found to have improved the plan quality in target and/or critical organs when compared to the IGRT repositioning plans and were comparable to the reoptimization plans based on the data of planning target volume (PTV)-V100 (volume covered by 100% of prescription dose). For the cases studied, the average PTV-V100 was 98.85% ± 1.13%, 97.61% ± 1.45%, and 92.84% ± 1.61% with FFF beams for the reoptimization, SAM adaptive, and repositioning plans, respectively. The execution of the SAM algorithm takes less than 10 s using 16-CPU (2.6 GHz dual core) hardware. Conclusions: The SAM algorithm can generate adaptive VMAT plans using FFF beams with comparable plan qualities as those from the full-scope reoptimization plans based on daily CT/CBCT/MRI and can be used for online replanning to address interfractional variations.« less

  8. Reducing sick leave of Dutch vocational school students: adaptation of a sick leave protocol using the intervention mapping process.

    PubMed

    de Kroon, Marlou L A; Bulthuis, Jozien; Mulder, Wico; Schaafsma, Frederieke G; Anema, Johannes R

    2016-12-01

    Since the extent of sick leave and the problems of vocational school students are relatively large, we aimed to tailor a sick leave protocol at Dutch lower secondary education schools to the particular context of vocational schools. Four steps of the iterative process of Intervention Mapping (IM) to adapt this protocol were carried out: (1) performing a needs assessment and defining a program objective, (2) determining the performance and change objectives, (3) identifying theory-based methods and practical strategies and (4) developing a program plan. Interviews with students using structured questionnaires, in-depth interviews with relevant stakeholders, a literature research and, finally, a pilot implementation were carried out. A sick leave protocol was developed that was feasible and acceptable for all stakeholders. The main barriers for widespread implementation are time constraints in both monitoring and acting upon sick leave by school and youth health care. The iterative process of IM has shown its merits in the adaptation of the manual 'A quick return to school is much better' to a sick leave protocol for vocational school students.

  9. Lessons from the construction of a climate change adaptation plan: A Broads wetland case study.

    PubMed

    Turner, R Kerry; Palmieri, Maria Giovanna; Luisetti, Tiziana

    2016-10-01

    The dynamic nature of environmental change in coastal areas means that a flexible "learning by doing" management strategy has a number of advantages. This article lays out the principles of such a strategy and then assesses an actual planning and management process focused on climate change consequences for the Broads wetland on the East coast of England. The management strategy focused on the concept of ecosystem services (stocks and flows) provided by the coastal wetland and the threats and opportunities posed to the area by sea level rise and other climate change impacts. The analysis explores the process by which an adaptive management plan has been formulated and coproduced by a combination of centralized (vertical) and stakeholder social network (horizontal) arrangements. The process values where feasible the ecosystem services under threat and prioritizes response actions. Coastal management needs a careful balance between strategic requirements imposed at a national scale and local schemes that affect regional and/or local communities and social networks. These networks aided by electronic media have allowed groups to engage more rapidly and effectively with policy proposals. However, successful deliberation is conditioned by a range of context specific factors, including the type of social networks present and their relative competitive and/or complementary characteristics. The history of consultation and dialogue between official agencies and stakeholders also plays a part in contemporary deliberation processes and the success of their outcomes. Among the issues highlighted are the multiple dimensions of nature's value; the difficulty of quantifying some ecosystem service changes, especially for cultural services; and the problem of "stakeholder fatigue" complicating engagement arrangements. Integr Environ Assess Manag 2016;12:719-725. © 2016 SETAC. © 2016 SETAC.

  10. Nutrition and Menu Planning 9-3. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Army Quartermaster School, Ft. Lee, VA.

    This course, adapted from military curriculum materials for use in technical and vocational education, is of interest to food service personnel and to some food service supply personnel. Designed for independent study, the course includes the principles of nutrition, including nutrients and the effects of digestive processes on each individual's…

  11. Early Learning and Adaptive Behaviour in Toddlers with Down Syndrome: Evidence for an Emerging Behavioural Phenotype?

    ERIC Educational Resources Information Center

    Fidler, Deborah; Hepburn, Susan; Rogers, Sally

    2006-01-01

    Background: Though the Down syndrome behavioural phenotype has been described as involving relative strengths in visuo-spatial processing and sociability, and relative weaknesses in verbal skills and motor planning, the early emergence of this phenotypic pattern of strengths and weaknesses has not yet been fully explored. Method: In this study, we…

  12. Climate change health assessment: a novel approach for Alaska Native communities.

    PubMed

    Brubaker, Michael Y; Bell, Jacob N; Berner, James E; Warren, John A

    2011-06-01

    Develop a process for assessing climate change impacts on public health that identifies climate-health vulnerabilities and mechanisms and encourages adaptation. Multi-stakeholder, participatory, qualitative research. A Climate Change Health Assessment (CCHA) was developed that involved 4 steps: (1) scoping to describe local conditions and engage stakeholders; (2) surveying to collect descriptive and quantitative data; (3) analysis to evaluate the data; and (4) planning to communicate findings and explore appropriate actions with community members. The health effects related to extreme weather, thinning ice, erosion, flooding, thawing permafrost and changing conditions of water and food resources were considered. The CCHA process was developed and performed in north-west Arctic villages. Refinement of the process took place in Point Hope, a coastal Inupiat village that practices whaling and a variety of other traditional subsistence harvest practices. Local observers identified climate change impacts that resulted in damaged health infrastructure, compromised food and water security and increased risk of injury. Priority health issues included thawing traditional ice cellars, diminished quality of the community water source and increased safety issues related to sea ice change. The CCHA increased awareness about health vulnerability and encouraged informed planning and decision-making. A community-scale assessment process guided by observation-based data can identify climate health impacts, raise awareness and encourage adaptive actions, thereby improving the response capacity of communities vulnerable to climate change.

  13. Learning to manage a complex ecosystem: adaptive management and the Northwest Forest Plan.

    Treesearch

    George H. Stankey; Roger N. Clark; Bernard T. Bormann

    2006-01-01

    The Northwest Forest Plan (the Plan) identifies adaptive management as a central strategy for effective implementation. Despite this, there has been a lack of any systematic evaluation of its performance. This study is based on an extensive literature review, 50 interviews with resource managers and scientists involved with the Plan’s implementation, and a survey of...

  14. Adapted intervention mapping: a strategic planning process for increasing physical activity and healthy eating opportunities in schools via environment and policy change.

    PubMed

    Belansky, Elaine S; Cutforth, Nick; Chavez, Robert; Crane, Lori A; Waters, Emily; Marshall, Julie A

    2013-03-01

    School environment and policy changes have increased healthy eating and physical activity; however, there has been modest success in translating research findings to practice. The School Environment Project tested whether an adapted version of Intervention Mapping (AIM) resulted in school change. Using a pair randomized design, 10 rural elementary schools were assigned to AIM or the School Health Index (SHI). Baseline measures were collected fall 2005, AIM was conducted 2005-2006, and follow-up measures were collected fall 2006 and 2007. Outcome measures included number and type of effective environment and policy changes implemented; process measures included the extent to which 11 implementation steps were used. AIM schools made an average of 4.4 effective changes per school with 90% still in place a year later. SHI schools made an average of 0.6 effective changes with 66% in place a year later. Implementation steps distinguishing AIM from SHI included use of external, trained facilitators; principal involvement; explicitly stating the student behavior goals; identifying effective environment and policy changes; prioritizing potential changes based on importance and feasibility; and developing an action plan. The AIM process led to environment and policy changes known to increase healthy eating and physical activity. © 2013, American School Health Association.

  15. Situating Green Infrastructure in Context: A Framework for Adaptive Socio-Hydrology in Cities.

    PubMed

    Schifman, L A; Herrmann, D L; Shuster, W D; Ossola, A; Garmestani, A; Hopton, M E

    2017-12-01

    Management of urban hydrologic processes using green infrastructure (GI) has largely focused on stormwater management. Thus, design and implementation of GI usually rely on physical site characteristics and local rainfall patterns, and do not typically account for human or social dimensions. This traditional approach leads to highly centralized stormwater management in a disconnected urban landscape, and can deemphasize additional benefits that GI offers, such as increased property value, greenspace aesthetics, heat island amelioration, carbon sequestration, and habitat for biodiversity. We propose a Framework for Adaptive Socio-Hydrology (FrASH) in which GI planning and implementation moves from a purely hydrology-driven perspective to an integrated socio-hydrological approach. This allows for an iterative, multifaceted decision-making process that would enable a network of stakeholders to collaboratively set a dynamic, context-guided project plan for the installation of GI, rather than a 'one-size-fits-all' installation. We explain how different sectors (e.g., governance, non-governmental organizations, academia, and industry) can create a connected network of organizations that work towards a common goal. Through a graphical Chambered Nautilus model, FrASH is experimentally applied to contrasting GI case studies and shows that this multi-stakeholder, connected, de-centralized network with a co-evolving decision-making project plan results in enhanced multi-functionality, potentially allowing for the management of resilience in urban systems at multiple scales.

  16. Situating Green Infrastructure in Context: A Framework for Adaptive Socio-Hydrology in Cities

    NASA Astrophysics Data System (ADS)

    Schifman, L. A.; Herrmann, D. L.; Shuster, W. D.; Ossola, A.; Garmestani, A.; Hopton, M. E.

    2017-12-01

    Management of urban hydrologic processes using green infrastructure (GI) has largely focused on storm water management. Thus, design and implementation of GI usually rely on physical site characteristics and local rainfall patterns, and do not typically account for human or social dimensions. This traditional approach leads to highly centralized storm water management in a disconnected urban landscape and can deemphasize additional benefits that GI offers, such as increased property value, greenspace aesthetics, heat island amelioration, carbon sequestration, and habitat for biodiversity. We propose the Framework for Adaptive Socio-Hydrology (FrASH) in which GI planning and implementation moves from a purely hydrology-driven perspective to an integrated sociohydrological approach. This allows for an iterative, multifaceted decision-making process that would enable a network of stakeholders to collaboratively set a dynamic, context-guided project plan for the installation of GI, rather than a "one-size-fits-all" installation. We explain how different sectors (e.g., governance, nongovernmental organizations, communities, academia, and industry) can create a connected network of organizations that work toward a common goal. Through a graphical Chambered Nautilus model, FrASH is experimentally applied to contrasting GI case studies and shows that this multistakeholder, connected, decentralized network with a coevolving decision-making project plan results in enhanced multifunctionality, potentially allowing for the management of resilience in urban systems at multiple scales.

  17. The implementation of two stages clustering (k-means clustering and adaptive neuro fuzzy inference system) for prediction of medicine need based on medical data

    NASA Astrophysics Data System (ADS)

    Husein, A. M.; Harahap, M.; Aisyah, S.; Purba, W.; Muhazir, A.

    2018-03-01

    Medication planning aim to get types, amount of medicine according to needs, and avoid the emptiness medicine based on patterns of disease. In making the medicine planning is still rely on ability and leadership experience, this is due to take a long time, skill, difficult to obtain a definite disease data, need a good record keeping and reporting, and the dependence of the budget resulted in planning is not going well, and lead to frequent lack and excess of medicines. In this research, we propose Adaptive Neuro Fuzzy Inference System (ANFIS) method to predict medication needs in 2016 and 2017 based on medical data in 2015 and 2016 from two source of hospital. The framework of analysis using two approaches. The first phase is implementing ANFIS to a data source, while the second approach we keep using ANFIS, but after the process of clustering from K-Means algorithm, both approaches are calculated values of Root Mean Square Error (RMSE) for training and testing. From the testing result, the proposed method with better prediction rates based on the evaluation analysis of quantitative and qualitative compared with existing systems, however the implementation of K-Means Algorithm against ANFIS have an effect on the timing of the training process and provide a classification accuracy significantly better without clustering.

  18. Anatomical robust optimization to account for nasal cavity filling variation during intensity-modulated proton therapy: a comparison with conventional and adaptive planning strategies

    NASA Astrophysics Data System (ADS)

    van de Water, Steven; Albertini, Francesca; Weber, Damien C.; Heijmen, Ben J. M.; Hoogeman, Mischa S.; Lomax, Antony J.

    2018-01-01

    The aim of this study is to develop an anatomical robust optimization method for intensity-modulated proton therapy (IMPT) that accounts for interfraction variations in nasal cavity filling, and to compare it with conventional single-field uniform dose (SFUD) optimization and online plan adaptation. We included CT data of five patients with tumors in the sinonasal region. Using the planning CT, we generated for each patient 25 ‘synthetic’ CTs with varying nasal cavity filling. The robust optimization method available in our treatment planning system ‘Erasmus-iCycle’ was extended to also account for anatomical uncertainties by including (synthetic) CTs with varying patient anatomy as error scenarios in the inverse optimization. For each patient, we generated treatment plans using anatomical robust optimization and, for benchmarking, using SFUD optimization and online plan adaptation. Clinical target volume (CTV) and organ-at-risk (OAR) doses were assessed by recalculating the treatment plans on the synthetic CTs, evaluating dose distributions individually and accumulated over an entire fractionated 50 GyRBE treatment, assuming each synthetic CT to correspond to a 2 GyRBE fraction. Treatment plans were also evaluated using actual repeat CTs. Anatomical robust optimization resulted in adequate CTV doses (V95%  ⩾  98% and V107%  ⩽  2%) if at least three synthetic CTs were included in addition to the planning CT. These CTV requirements were also fulfilled for online plan adaptation, but not for the SFUD approach, even when applying a margin of 5 mm. Compared with anatomical robust optimization, OAR dose parameters for the accumulated dose distributions were on average 5.9 GyRBE (20%) higher when using SFUD optimization and on average 3.6 GyRBE (18%) lower for online plan adaptation. In conclusion, anatomical robust optimization effectively accounted for changes in nasal cavity filling during IMPT, providing substantially improved CTV and OAR doses compared with conventional SFUD optimization. OAR doses can be further reduced by using online plan adaptation.

  19. SU-F-T-100: Development and Implementation of a Treatment Planning Tracking System Into the Radiation Oncology Clinic

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

    Kabat, C; Cline, K; Li, Y

    Purpose: With increasing numbers of cancer patients being diagnosed and the complexity of radiotherapy treatments rising it’s paramount that patient plan development continues to stay fluid within the clinic. In order to maintain a high standard of care and clinical efficiency the establishment of a tracking system for patient plan development allows healthcare providers to view real time plan progression and drive clinical workflow. In addition, it provides statistical datasets which can further identify inefficiencies within the clinic. Methods: An application was developed utilizing Microsoft’s ODBC SQL database engine to track patient plan status throughout the treatment planning process whilemore » also managing key factors pertaining to the patient’s treatment. Pertinent information is accessible to staff in many locations, including tracking monitors within dosimetry, the clinic network for both computers and handheld devices, and through email notifications. Plans are initiated with a CT and continually tracked through planning stages until final approval by staff. Patient’s status is dynamically updated by the physicians, dosimetrists, and medical physicists based on the stage of the patient’s plan. Results: Our application has been running over a six month period with all patients being processed through the system. Modifications have been made to allow for new features to be implemented along with additional tracking parameters. Based on in-house feedback, the application has been supportive in streamlining patient plans through the treatment planning process and data has been accumulating to further improve procedures within the clinic. Conclusion: Over time the clinic will continue to track data with this application. As data accumulates the clinic will be able to highlight inefficiencies within the workflow and adapt accordingly. We will add in new features to help support the treatment planning process in the future.« less

  20. SU-E-J-206: Adaptive Radiotherapy for Gynecological Malignancies with MRIGuided Cobolt-60 Radiotherapy

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

    Lamb, J; Kamrava, M; Agazaryan, N

    Purpose: Even in the IMRT era, bowel toxicity and bone marrow irradiation remain concerns with pelvic irradiation. We examine the potential gain from an adaptive radiotherapy workflow for post-operative gynecological patients treated to pelvic targets including lymph nodes using MRI-guided Co-60 radiation therapy. Methods: An adaptive workflow was developed with the intent of minimizing time overhead of adaptive planning. A pilot study was performed using retrospectively analyzed images from one patient’s treatment. The patient’s treated plan was created using conventional PTV margins. Adaptive treatment was simulated on the patient’s first three fractions. The daily PTV was created by removing non-targetmore » tissue, including bone, muscle and bowel, from the initial PTV based on the daily MRI. The number of beams, beam angles, and optimization parameters were kept constant, and the plan was re-optimized. Normal tissue contours were not adjusted for the re-optimization, but were adjusted for evaluation of plan quality. Plan quality was evaluated based on PTV coverage and normal tissue DVH points per treatment protocol. Bowel was contoured as the entire bowel bag per protocol at our institution. Pelvic bone marrow was contoured per RTOG protocol 1203. Results: For the clinically treated plan, the volume of bowel receiving 45 Gy was 380 cc, 53% of the rectum received 30 Gy, 35% of the bladder received 45 Gy, and 28% of the pelvic bone marrow received 40 Gy. For the adaptive plans, the volume of bowel receiving 45 Gy was 175–201 cc, 55–62% of the rectum received 30 Gy, 21– 27% of the bladder received 45 Gy, and 13–17% of the pelvic bone marrow received 40 Gy. Conclusion: Adaptive planning led to a large reduction of bowel and bone marrow dose in this pilot study. Further study of on-line adaptive techniques for the radiotherapy of pelvic lymph nodes is warranted. Dr. Low is a member of the scientific advisory board of ViewRay, Inc.« less

  1. Family planning and family vision in mothers after diagnosis of a child with autism spectrum disorder

    PubMed Central

    Navot, Noa; Jorgenson, Alicia Grattan; Stoep, Ann Vander; Toth, Karen; Webb, Sara Jane

    2016-01-01

    The diagnosis of a child with autism has short- and long-term impacts on family functioning. With early diagnosis, the diagnostic process is likely to co-occur with family planning decisions, yet little is known about how parents navigate this process. This study explores family planning decision making process among mothers of young children with autism spectrum disorder in the United States, by understanding the transformation in family vision before and after the diagnosis. A total of 22 mothers of first born children, diagnosed with autism between 2 and 4 years of age, were interviewed about family vision prior to and after their child’s diagnosis. Grounded Theory method was used for data analysis. Findings indicated that coherence of early family vision, maternal cognitive flexibility, and maternal responses to diagnosis were highly influential in future family planning decisions. The decision to have additional children reflected a high level of adaptability built upon a solid internalized family model and a flexible approach to life. Decision to stop childrearing reflected a relatively less coherent family model and more rigid cognitive style followed by ongoing hardship managing life after the diagnosis. This report may be useful for health-care providers in enhancing therapeutic alliance and guiding family planning counseling. PMID:26395237

  2. Family planning and family vision in mothers after diagnosis of a child with autism spectrum disorder.

    PubMed

    Navot, Noa; Jorgenson, Alicia Grattan; Vander Stoep, Ann; Toth, Karen; Webb, Sara Jane

    2016-07-01

    The diagnosis of a child with autism has short- and long-term impacts on family functioning. With early diagnosis, the diagnostic process is likely to co-occur with family planning decisions, yet little is known about how parents navigate this process. This study explores family planning decision making process among mothers of young children with autism spectrum disorder in the United States, by understanding the transformation in family vision before and after the diagnosis. A total of 22 mothers of first born children, diagnosed with autism between 2 and 4 years of age, were interviewed about family vision prior to and after their child's diagnosis. Grounded Theory method was used for data analysis. Findings indicated that coherence of early family vision, maternal cognitive flexibility, and maternal responses to diagnosis were highly influential in future family planning decisions. The decision to have additional children reflected a high level of adaptability built upon a solid internalized family model and a flexible approach to life. Decision to stop childrearing reflected a relatively less coherent family model and more rigid cognitive style followed by ongoing hardship managing life after the diagnosis. This report may be useful for health-care providers in enhancing therapeutic alliance and guiding family planning counseling. © The Author(s) 2015.

  3. Dosimetric benefit of adaptive re-planning in pancreatic cancer stereotactic body radiotherapy

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

    Li, Yongbao; Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA; Department of Radiation Oncology, University of California San Diego, La Jolla, CA

    Stereotactic body radiotherapy (SBRT) shows promise in unresectable pancreatic cancer, though this treatment modality has high rates of normal tissue toxicity. This study explores the dosimetric utility of daily adaptive re-planning with pancreas SBRT. We used a previously developed supercomputing online re-planning environment (SCORE) to re-plan 10 patients with pancreas SBRT. Tumor and normal tissue contours were deformed from treatment planning computed tomographies (CTs) and transferred to daily cone-beam CT (CBCT) scans before re-optimizing each daily treatment plan. We compared the intended radiation dose, the actual radiation dose, and the optimized radiation dose for the pancreas tumor planning target volumemore » (PTV) and the duodenum. Treatment re-optimization improved coverage of the PTV and reduced dose to the duodenum. Within the PTV, the actual hot spot (volume receiving 110% of the prescription dose) decreased from 4.5% to 0.5% after daily adaptive re-planning. Within the duodenum, the volume receiving the prescription dose decreased from 0.9% to 0.3% after re-planning. It is noteworthy that variation in the amount of air within a patient's stomach substantially changed dose to the PTV. Adaptive re-planning with pancreas SBRT has the ability to improve dose to the tumor and decrease dose to the nearby duodenum, thereby reducing the risk of toxicity.« less

  4. Intelligent flight control systems

    NASA Technical Reports Server (NTRS)

    Stengel, Robert F.

    1993-01-01

    The capabilities of flight control systems can be enhanced by designing them to emulate functions of natural intelligence. Intelligent control functions fall in three categories. Declarative actions involve decision-making, providing models for system monitoring, goal planning, and system/scenario identification. Procedural actions concern skilled behavior and have parallels in guidance, navigation, and adaptation. Reflexive actions are spontaneous, inner-loop responses for control and estimation. Intelligent flight control systems learn knowledge of the aircraft and its mission and adapt to changes in the flight environment. Cognitive models form an efficient basis for integrating 'outer-loop/inner-loop' control functions and for developing robust parallel-processing algorithms.

  5. Revealing Adaptive Management of Environmental Flows

    NASA Astrophysics Data System (ADS)

    Allan, Catherine; Watts, Robyn J.

    2018-03-01

    Managers of land, water, and biodiversity are working with increasingly complex social ecological systems with high uncertainty. Adaptive management (learning from doing) is an ideal approach for working with this complexity. The competing social and environmental demands for water have prompted interest in freshwater adaptive management, but its success and uptake appear to be slow. Some of the perceived "failure" of adaptive management may reflect the way success is conceived and measured; learning, rarely used as an indicator of success, is narrowly defined when it is. In this paper, we document the process of adaptive flow management in the Edward-Wakool system in the southern Murray-Darling Basin, Australia. Data are from interviews with environmental water managers, document review, and the authors' structured reflection on their experiences of adaptive management and environmental flows. Substantial learning occurred in relation to the management of environmental flows in the Edward-Wakool system, with evidence found in planning documents, water-use reports, technical reports, stakeholder committee minutes, and refereed papers, while other evidence was anecdotal. Based on this case, we suggest it may be difficult for external observers to perceive the success of large adaptive management projects because evidence of learning is dispersed across multiple documents, and learning is not necessarily considered a measure of success. We suggest that documentation and sharing of new insights, and of the processes of learning, should be resourced to facilitate social learning within the water management sector, and to help demonstrate the successes of adaptive management.

  6. Revealing Adaptive Management of Environmental Flows.

    PubMed

    Allan, Catherine; Watts, Robyn J

    2018-03-01

    Managers of land, water, and biodiversity are working with increasingly complex social ecological systems with high uncertainty. Adaptive management (learning from doing) is an ideal approach for working with this complexity. The competing social and environmental demands for water have prompted interest in freshwater adaptive management, but its success and uptake appear to be slow. Some of the perceived "failure" of adaptive management may reflect the way success is conceived and measured; learning, rarely used as an indicator of success, is narrowly defined when it is. In this paper, we document the process of adaptive flow management in the Edward-Wakool system in the southern Murray-Darling Basin, Australia. Data are from interviews with environmental water managers, document review, and the authors' structured reflection on their experiences of adaptive management and environmental flows. Substantial learning occurred in relation to the management of environmental flows in the Edward-Wakool system, with evidence found in planning documents, water-use reports, technical reports, stakeholder committee minutes, and refereed papers, while other evidence was anecdotal. Based on this case, we suggest it may be difficult for external observers to perceive the success of large adaptive management projects because evidence of learning is dispersed across multiple documents, and learning is not necessarily considered a measure of success. We suggest that documentation and sharing of new insights, and of the processes of learning, should be resourced to facilitate social learning within the water management sector, and to help demonstrate the successes of adaptive management.

  7. Automated Data Processing as an AI Planning Problem

    NASA Technical Reports Server (NTRS)

    Golden, Keith; Pang, Wanlin; Nemani, Ramakrishna; Votava, Petr

    2003-01-01

    NASA s vision for Earth Science is to build a "sensor web"; an adaptive array of heterogeneous satellites and other sensors that will track important events, such as storms, and provide real-time information about the state of the Earth to a wide variety of customers. Achieving his vision will require automation not only in the scheduling of the observations but also in the processing af tee resulting data. Ta address this need, we have developed a planner-based agent to automatically generate and execute data-flow programs to produce the requested data products. Data processing domains are substantially different from other planning domains that have been explored, and this has led us to substantially different choices in terms of representation and algorithms. We discuss some of these differences and discuss the approach we have adopted.

  8. Gradient maintenance: A new algorithm for fast online replanning

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

    Ahunbay, Ergun E., E-mail: eahunbay@mcw.edu; Li, X. Allen

    2015-06-15

    Purpose: Clinical use of online adaptive replanning has been hampered by the unpractically long time required to delineate volumes based on the image of the day. The authors propose a new replanning algorithm, named gradient maintenance (GM), which does not require the delineation of organs at risk (OARs), and can enhance automation, drastically reducing planning time and improving consistency and throughput of online replanning. Methods: The proposed GM algorithm is based on the hypothesis that if the dose gradient toward each OAR in daily anatomy can be maintained the same as that in the original plan, the intended plan qualitymore » of the original plan would be preserved in the adaptive plan. The algorithm requires a series of partial concentric rings (PCRs) to be automatically generated around the target toward each OAR on the planning and the daily images. The PCRs are used in the daily optimization objective function. The PCR dose constraints are generated with dose–volume data extracted from the original plan. To demonstrate this idea, GM plans generated using daily images acquired using an in-room CT were compared to regular optimization and image guided radiation therapy repositioning plans for representative prostate and pancreatic cancer cases. Results: The adaptive replanning using the GM algorithm, requiring only the target contour from the CT of the day, can be completed within 5 min without using high-power hardware. The obtained adaptive plans were almost as good as the regular optimization plans and were better than the repositioning plans for the cases studied. Conclusions: The newly proposed GM replanning algorithm, requiring only target delineation, not full delineation of OARs, substantially increased planning speed for online adaptive replanning. The preliminary results indicate that the GM algorithm may be a solution to improve the ability for automation and may be especially suitable for sites with small-to-medium size targets surrounded by several critical structures.« less

  9. Using deliberative techniques to engage the community in policy development.

    PubMed

    Gregory, Judy; Hartz-Karp, Janette; Watson, Rebecca

    2008-07-16

    This paper examines work in deliberative approaches to community engagement used in Western Australia by the Department of Planning and Infrastructure and other planning and infrastructure agencies between 2001 and 2005, and considers whether the techniques could be applied to the development of health policy in Australia. Deliberative processes were used in WA to address specific planning and infrastructure problems. Using deliberative techniques, community participants contributed to joint decision making and policy development. Outcomes from deliberative processes were seriously considered by the Minister and used to influence policy decisions. In many cases, the recommendations generated through deliberative processes were fully adopted by the Minister. The experiences in WA demonstrate that deliberative engagement processes can be successfully implemented by government and can be used to guide policy. The techniques can be adapted to suit the context and issues experienced by a portfolio, and the skills required to conduct deliberative processes can be fostered amongst the portfolio's staff. Health policy makers may be able to learn from the experiences in WA, and adopt approaches to community engagement that allow for informed deliberation and debate in the community about the future of Australia's health system.

  10. Beyond Adapting to Climate Change: Embedding Adaptation in Responses to Multiple Threats and Stresses

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

    Wilbanks, Thomas J; Kates, Dr. Robert W.

    2010-01-01

    Climate change impacts are already being experienced in every region of the United States and every part of the world most severely in Arctic regions and adaptation is needed now. Although climate change adaptation research is still in its infancy, significant adaptation planning in the United States has already begun in a number of localities. This article seeks to broaden the adaptation effort by integrating it with broader frameworks of hazards research, sustainability science, and community and regional resilience. To extend the range of experience, we draw from ongoing case studies in the Southeastern United States and the environmental historymore » of New Orleans to consider the multiple threats and stresses that all communities and regions experience. Embedding climate adaptation in responses to multiple threats and stresses helps us to understand climate change impacts, themselves often products of multiple stresses, to achieve community acceptance of needed adaptations as co-benefits of addressing multiple threats, and to mainstream the process of climate adaptation through the larger envelope of social relationships, communication channels, and broad-based awareness of needs for risk management that accompany community resilience.« less

  11. Reconfigurable signal processor designs for advanced digital array radar systems

    NASA Astrophysics Data System (ADS)

    Suarez, Hernan; Zhang, Yan (Rockee); Yu, Xining

    2017-05-01

    The new challenges originated from Digital Array Radar (DAR) demands a new generation of reconfigurable backend processor in the system. The new FPGA devices can support much higher speed, more bandwidth and processing capabilities for the need of digital Line Replaceable Unit (LRU). This study focuses on using the latest Altera and Xilinx devices in an adaptive beamforming processor. The field reprogrammable RF devices from Analog Devices are used as analog front end transceivers. Different from other existing Software-Defined Radio transceivers on the market, this processor is designed for distributed adaptive beamforming in a networked environment. The following aspects of the novel radar processor will be presented: (1) A new system-on-chip architecture based on Altera's devices and adaptive processing module, especially for the adaptive beamforming and pulse compression, will be introduced, (2) Successful implementation of generation 2 serial RapidIO data links on FPGA, which supports VITA-49 radio packet format for large distributed DAR processing. (3) Demonstration of the feasibility and capabilities of the processor in a Micro-TCA based, SRIO switching backplane to support multichannel beamforming in real-time. (4) Application of this processor in ongoing radar system development projects, including OU's dual-polarized digital array radar, the planned new cylindrical array radars, and future airborne radars.

  12. Making evolutionary history count: biodiversity planning for coral reef fishes and the conservation of evolutionary processes

    NASA Astrophysics Data System (ADS)

    von der Heyden, Sophie

    2017-03-01

    Anthropogenic activities are having devastating impacts on marine systems with numerous knock-on effects on trophic functioning, species interactions and an accelerated loss of biodiversity. Establishing conservation areas can not only protect biodiversity, but also confer resilience against changes to coral reefs and their inhabitants. Planning for protection and conservation in marine systems is complex, but usually focuses on maintaining levels of biodiversity and protecting special and unique landscape features while avoiding negative impacts to socio-economic benefits. Conversely, the integration of evolutionary processes that have shaped extant species assemblages is rarely taken into account. However, it is as important to protect processes as it is to protect patterns for maintaining the evolutionary trajectories of populations and species. This review focuses on different approaches for integrating genetic analyses, such as phylogenetic diversity, phylogeography and the delineation of management units, temporal and spatial monitoring of genetic diversity and quantification of adaptive variation for protecting evolutionary resilience, into marine spatial planning, specifically for coral reef fishes. Many of these concepts are not yet readily applied to coral reef fish studies, but this synthesis highlights their potential and the importance of including historical processes into systematic biodiversity planning for conserving not only extant, but also future, biodiversity and its evolutionary potential.

  13. Remote mission specialist - A study in real-time, adaptive planning

    NASA Technical Reports Server (NTRS)

    Rokey, Mark J.

    1990-01-01

    A high-level planning architecture for robotic operations is presented. The remote mission specialist integrates high-level directives with low-level primitives executable by a run-time controller for command of autonomous servicing activities. The planner has been designed to address such issues as adaptive plan generation, real-time performance, and operator intervention.

  14. Climate Change Adaptation - Challenges and Opportunities

    DTIC Science & Technology

    2011-11-01

    Humans have been adapting to the vagaries of weather for millennia, sometimes successfully sometimes not. Today, the myriad of important federal laws that regulate the impacts of human activity in our natural environment not only complicates plans for climate change adaptation, but also act as a strong justification for proactive planning, engagement and action. The challenge of adaptation will result in increased opportunities for more effective interaction with other federal agencies, communities and scientific organizations to better

  15. Unpacking the 'information barrier': comparing perspectives on information as a barrier to climate change adaptation in the interior mountain West.

    PubMed

    Archie, Kelli M; Dilling, Lisa; Milford, Jana B; Pampel, Fred C

    2014-01-15

    Inadequate information has been repeatedly identified as a barrier to climate change adaptation planning and implementation. However less is known about how information functions as a barrier, and to what degree it prevents adaptation compared to other perceived barriers. In addition, the role of institutional context in mediating the demand for information in the context of adaptation has been less well studied. This paper helps to clarify the role that information plays in adaptation planning for two sectors of public employees working at similar scales, in similar locations, with similar challenges. We conducted surveys and semi-structured interviews to investigate the demand for information in support of adaptation implementation and planning from US federal public lands managers and municipal officials in the US interior West. We found that federal managers and municipal officials both consulted information frequently for decision making, and while both groups indicated that lack of information at relevant scales was a barrier to adaptation planning, this was seen as a much stronger barrier for federal managers than for communities. Uncertainty of information was raised as an issue, but results were mixed on whether or not this acted as a strong barrier. While peer-reviewed publications were seen as the "best available science," and correlated with adaptation planning, they were not accessed directly as frequently as other sources of information, including colleagues, the internet and reports. The strong connection between communities and adjacent federal lands may provide an opportunity for networking that could facilitate the flow of information relevant for adaptation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Adaptation and validation of the Tower of London test of planning and problem solving in people with intellectual disabilities.

    PubMed

    Masson, J D; Dagnan, D; Evans, J

    2010-05-01

    There is a need for validated, standardised tools for the assessment of executive functions in adults with intellectual disabilities (ID). This study examines the validity of a test of planning and problem solving (Tower of London) with adults with ID. Participants completed an adapted version of the Tower of London (ToL) while day-centre staff completed adaptive function (Adaptive Behaviour Scale - Residential and Community: Second Edition, modified version) and dysexecutive function (DEX-Independent Rater) questionnaires for each participant. Correlation analyses of test and questionnaire variables were undertaken. The adapted ToL has a robust structure and shows significant associations with independent living skills, challenging behaviour and behaviours related to dysexecutive function. The adapted ToL is a valid test for use with people with ID. However, there is also a need to develop other ecologically valid tools based on everyday planning tasks undertaken by people with ID.

  17. Estimating farmers' willingness to pay for climate change adaptation: the case of the Malaysian agricultural sector.

    PubMed

    Masud, Muhammad Mehedi; Junsheng, Ha; Akhtar, Rulia; Al-Amin, Abul Quasem; Kari, Fatimah Binti

    2015-02-01

    This paper estimates Malaysian farmers' willingness to pay (WTP) for a planned adaptation programme for addressing climate issues in the Malaysian agricultural sector. We used the contingent valuation method (CVM) for a monetary valuation of farmers' preferences for a planned adaptation programme by ascertaining the value attached to address climatic issues in the Malaysian agricultural sector. Structured questionnaires were distributed among the sampled farmers. The study found that 74 % of respondents were willing to pay for a planned adaptation programme and that several socioeconomic and motivation factors have greater influence on their WTP. This paper clearly specifies the steps needed for all institutional bodies to better address issues in climate change. The outcomes of this paper will support policy makers to better design an efficient adaptation framework for adapting to the adverse impacts of climate change.

  18. Effect of a care plan based on Roy adaptation model biological dimension on stroke patients' physiologic adaptation level.

    PubMed

    Alimohammadi, Nasrollah; Maleki, Bibi; Shahriari, Mohsen; Chitsaz, Ahmad

    2015-01-01

    Stroke is a stressful event with several functional, physical, psychological, social, and economic problems that affect individuals' different living balances. With coping strategies, patients try to control these problems and return to their natural life. The aim of this study is to investigate the effect of a care plan based on Roy adaptation model biological dimension on stroke patients' physiologic adaptation level. This study is a clinical trial in which 50 patients, affected by brain stroke and being admitted in the neurology ward of Kashani and Alzahra hospitals, were randomly assigned to control and study groups in Isfahan in 2013. Roy adaptation model care plan was administered in biological dimension in the form of four sessions and phone call follow-ups for 1 month. The forms related to Roy adaptation model were completed before and after intervention in the two groups. Chi-square test and t-test were used to analyze the data through SPSS 18. There was a significant difference in mean score of adaptation in physiological dimension in the study group after intervention (P < 0.001) compared to before intervention. Comparison of the mean scores of changes of adaptation in the patients affected by brain stroke in the study and control groups showed a significant increase in physiological dimension in the study group by 47.30 after intervention (P < 0.001). The results of study showed that Roy adaptation model biological dimension care plan can result in an increase in adaptation in patients with stroke in physiological dimension. Nurses can use this model for increasing patients' adaptation.

  19. Experiences and lessons learned for planning and supply of micronutrient powders interventions

    PubMed Central

    Schauer, Claudia; Sunley, Nigel; Nyhus Dhillon, Christina; Roca, Claudia; Tapia, Gustavo; Mathema, Pragya; Walton, Shelley; Situma, Ruth; Zlotkin, Stanley; DW Klemm, Rolf

    2017-01-01

    Abstract Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale‐up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale‐up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. PMID:28960875

  20. SU-E-J-67: Evaluation of Adaptive MLC Morphing for Online Correction of Prostate Cancer Radiotherapy

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

    Sandhu, R; Qin, A; Yan, D

    Purpose: Online adaptive MLC morphing is desirable over translational couch shifts to accommodate target position as well as anatomic changes. A reliable method of adaptive MLC segment to target during prostate cancer IMRT treatment is proposed and evaluated by comparison with daily online-image guidance (IGRT) correction and online-IMRT planning. Methods: The MLC adaptive algorithm involves following steps; move the MLC segments according to target translational shifts, and then morph the segment shape to maintain the spatial relationship between the planning-target contour and MLC segment. Efficacy of this method was evaluated retrospectively using daily-CBCT images on seven prostate patients treated withmore » seven-beam IMRT treatment to deliver 64Gy in 20 fractions. Daily modification was simulated with three approaches; daily-IGRT correction based on implanted radio-markers, adaptive MLC morphing, and online-IMRT planning, with no-residual variation. The selected dosimetric endpoints and nEUD (normalized equivalent uniform dose to online-IMRT planning) of each organ of interest were determined for evaluation and comparison. Results: For target(prostate), bladder and rectal-wall, the mean±sd of nEUD were 97.6%+3.2%, 103.9%±4.9% and 97.4%±1.1% for daily-IGRT correction; and 100.2%+0.2%, 108.9%±5.1% and 99.8%±1.2% for adaptive MLC morphing, respectively. For daily-IGRT correction, adaptive MLC morphing and online-IMRT planning, target D99 was <95% of the prescription dose in 30%, 0% and 0% of 140 fractions, respectively. For the rectal-wall, D5 exceeded 105% of the planned-D5 in 2.8%, 11.4% and 0% of 140 fractions, respectively. For the bladder, Dmax exceeded 105% of the planned-D5 in 2.8%, 5.6% and 0% of 140 fractions, respectively. D30 of bladder and rectal-wall were well within the planned-D30 for all three approaches. Conclusion: The proposed method of adaptive MLC morphing can be beneficial for the prostate patient population with large deformation and rotation. It is superior to the daily-IGRT correction, and comparable to the online-IMRT planning for dose to the target and rectal-wall.« less

  1. Closing the Certification Gaps in Adaptive Flight Control Software

    NASA Technical Reports Server (NTRS)

    Jacklin, Stephen A.

    2008-01-01

    Over the last five decades, extensive research has been performed to design and develop adaptive control systems for aerospace systems and other applications where the capability to change controller behavior at different operating conditions is highly desirable. Although adaptive flight control has been partially implemented through the use of gain-scheduled control, truly adaptive control systems using learning algorithms and on-line system identification methods have not seen commercial deployment. The reason is that the certification process for adaptive flight control software for use in national air space has not yet been decided. The purpose of this paper is to examine the gaps between the state-of-the-art methodologies used to certify conventional (i.e., non-adaptive) flight control system software and what will likely to be needed to satisfy FAA airworthiness requirements. These gaps include the lack of a certification plan or process guide, the need to develop verification and validation tools and methodologies to analyze adaptive controller stability and convergence, as well as the development of metrics to evaluate adaptive controller performance at off-nominal flight conditions. This paper presents the major certification gap areas, a description of the current state of the verification methodologies, and what further research efforts will likely be needed to close the gaps remaining in current certification practices. It is envisioned that closing the gap will require certain advances in simulation methods, comprehensive methods to determine learning algorithm stability and convergence rates, the development of performance metrics for adaptive controllers, the application of formal software assurance methods, the application of on-line software monitoring tools for adaptive controller health assessment, and the development of a certification case for adaptive system safety of flight.

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

    Benioff, R.; Ness, E.; Hirst, J.

    Under its Support for National Action Plans (SNAP) initiative, the U.S. Country Studies Program is providing financial and technical assistance to 18 countries for the development of climate change action plans. Although most of the countries have not yet completed their plans, the important lessons learned thus far are valuable and should be shared with other countries and international institutions that have an interest in the process of action plan development. This interim report describes the experience of 11 countries that are the furthest along in their planning activity and who have offered to share their results to date withmore » the larger community of interested nations. These action plans delineate specific mitigation and adaptation measures that the countries will implement and integrate into their ongoing development programs. This report focuses on the measures the countries have selected and the methods they used to prepare their action plans. This executive summary presents key lessons and common themes using a structure similar to that used in the individual country chapters.« less

  3. Preparing the Dutch delta for future droughts: model based support in the national Delta Programme

    NASA Astrophysics Data System (ADS)

    ter Maat, Judith; Haasnoot, Marjolijn; van der Vat, Marnix; Hunink, Joachim; Prinsen, Geert; Visser, Martijn

    2014-05-01

    Keywords: uncertainty, policymaking, adaptive policies, fresh water management, droughts, Netherlands, Dutch Deltaprogramme, physically-based complex model, theory-motivated meta-model To prepare the Dutch Delta for future droughts and water scarcity, a nation-wide 4-year project, called Delta Programme, is established to assess impacts of climate scenarios and socio-economic developments and to explore policy options. The results should contribute to a national adaptive plan that is able to adapt to future uncertain conditions, if necessary. For this purpose, we followed a model-based step-wise approach, wherein both physically-based complex models and theory-motivated meta-models were used. First step (2010-2011) was to make a quantitative problem description. This involved a sensitivity analysis of the water system for drought situations under current and future conditions. The comprehensive Dutch national hydrological instrument was used for this purpose and further developed. Secondly (2011-2012) our main focus was on making an inventory of potential actions together with stakeholders. We assessed efficacy, sell-by date of actions, and reassessed vulnerabilities and opportunities for the future water supply system if actions were (not) taken. A rapid assessment meta-model was made based on the complex model. The effects of all potential measures were included in the tool. Thirdly (2012-2013), with support of the rapid assessment model, we assessed the efficacy of policy actions over time for an ensemble of possible futures including sea level rise and climate and land use change. Last step (2013-2014) involves the selection of preferred actions from a set of promising actions that meet the defined objectives. These actions are all modeled and evaluated using the complex model. The outcome of the process will be an adaptive management plan. The adaptive plan describes a set of preferred policy pathways - sequences of policy actions - to achieve targets under changing conditions. The plan commits to short term actions, and identifies signpost indicators and trigger values to assess if next actions of the identified policy pathways need to be implemented or if reassessment of the plan is needed. For example, river discharges could be measured to monitor changes in low discharges as a result of climate change, and assess whether policy options such as diverting more water the main fresh water lake (IJsselmeer) need to be implemented sooner or later or not at all. The adaptive plan of the Delta Programme will be presented in 2014. First lessons of this part of the Delta Programme can already be drawn: Both the complex and meta-model had its own purpose in each phase. The meta-model was particularly useful for identifying promising policy options and for consultation of stakeholders due to the instant response. The complex model had much more opportunities to assess impacts of regional policy actions, and was supported by regional stakeholders that recognized their areas better in this model. Different sector impact assessment modules are also included in the workflow of the complex model. However, the complex model has a long runtime (i.e. three days for 1 year simulation or more than 100 days for 35 year time series simulation), which makes it less suitable to support the dynamic policy process on instant demand and interactively.

  4. Development of a technical assistance framework for building organizational capacity of health programs in resource-limited settings.

    PubMed

    Reyes, E Michael; Sharma, Anjali; Thomas, Kate K; Kuehn, Chuck; Morales, José Rafael

    2014-09-17

    Little information exists on the technical assistance needs of local indigenous organizations charged with managing HIV care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper describes the methods used to adapt the Primary Care Assessment Tool (PCAT) framework, which has successfully strengthened HIV primary care services in the US, into one that could strengthen the capacity of local partners to deliver priority health programs in resource-constrained settings by identifying their specific technical assistance needs. Qualitative methods and inductive reasoning approaches were used to conceptualize and adapt the new Clinical Assessment for Systems Strengthening (ClASS) framework. Stakeholder interviews, comparisons of existing assessment tools, and a pilot test helped determine the overall ClASS framework for use in low-resource settings. The framework was further refined one year post-ClASS implementation. Stakeholder interviews, assessment of existing tools, a pilot process and the one-year post- implementation assessment informed the adaptation of the ClASS framework for assessing and strengthening technical and managerial capacities of health programs at three levels: international partner, local indigenous partner, and local partner treatment facility. The PCAT focus on organizational strengths and systems strengthening was retained and implemented in the ClASS framework and approach. A modular format was chosen to allow the use of administrative, fiscal and clinical modules in any combination and to insert new modules as needed by programs. The pilot led to refined pre-visit planning, informed review team composition, increased visit duration, and restructured modules. A web-based toolkit was developed to capture three years of experiential learning; this kit can also be used for independent implementation of the ClASS framework. A systematic adaptation process has produced a qualitative framework that can inform implementation strategies in support of country led HIV care and treatment programs. The framework, as a well-received iterative process focused on technical assistance, may have broader utility in other global programs.

  5. Integrating interprofessional education into continuing education: a planning process for continuing interprofessional education programs.

    PubMed

    Owen, John A; Schmitt, Madeline H

    2013-01-01

    Informal continuing interprofessional education (CIPE) can be traced back decades in the United States; however, interest in formal CIPE is recent. Interprofessional education (IPE) now is recognized as an important component of new approaches to continuing education (CE) that are needed to increase health professionals' ability to improve outcomes of care. Although there are examples of CIPE programs that are being successfully implemented, a clearly articulated, step-by-step planning process to help guide educators in providing effective CIPE programs is lacking. This lack of guidance poses a significant barrier to increasing the number of CIPE programs in the United States. In this article, we describe a process for developing, implementing, and evaluating CIPE programs using the familiar systematic CE planning process. Limitations of traditional CE also are addressed, and the relationship between CIPE and other new approaches to CE is clarified. Four examples of CIPE programs are provided to illustrate how the planning process can be adapted to include IPE, while implementing recommended changes in traditional CE offerings. The article is concluded with a discussion of some of the challenges that will face CE educators in moving toward a new vision of CE integrated with IPE. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  6. SU-E-T-214: Intensity Modulated Proton Therapy (IMPT) Based On Passively Scattered Protons and Multi-Leaf Collimation: Prototype TPS and Dosimetry Study

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

    Sanchez-Parcerisa, D; Carabe-Fernandez, A

    2014-06-01

    Purpose. Intensity-modulated proton therapy is usually implemented with multi-field optimization of pencil-beam scanning (PBS) proton fields. However, at the view of the experience with photon-IMRT, proton facilities equipped with double-scattering (DS) delivery and multi-leaf collimation (MLC) could produce highly conformal dose distributions (and possibly eliminate the need for patient-specific compensators) with a clever use of their MLC field shaping, provided that an optimal inverse TPS is developed. Methods. A prototype TPS was developed in MATLAB. The dose calculation process was based on a fluence-dose algorithm on an adaptive divergent grid. A database of dose kernels was precalculated in order tomore » allow for fast variations of the field range and modulation during optimization. The inverse planning process was based on the adaptive simulated annealing approach, with direct aperture optimization of the MLC leaves. A dosimetry study was performed on a phantom formed by three concentrical semicylinders separated by 5 mm, of which the inner-most and outer-most were regarded as organs at risk (OARs), and the middle one as the PTV. We chose a concave target (which is not treatable with conventional DS fields) to show the potential of our technique. The optimizer was configured to minimize the mean dose to the OARs while keeping a good coverage of the target. Results. The plan produced by the prototype TPS achieved a conformity index of 1.34, with the mean doses to the OARs below 78% of the prescribed dose. This Result is hardly achievable with traditional conformal DS technique with compensators, and it compares to what can be obtained with PBS. Conclusion. It is certainly feasible to produce IMPT fields with MLC passive scattering fields. With a fully developed treatment planning system, the produced plans can be superior to traditional DS plans in terms of plan conformity and dose to organs at risk.« less

  7. Linking Climate Risk, Policy Networks and Adaptation Planning in Public Lands

    NASA Astrophysics Data System (ADS)

    Lubell, M.; Schwartz, M.; Peters, C.

    2014-12-01

    Federal public land management agencies in the United States have engaged a variety of planning efforts to address climate adaptation. A major goal of these efforts is to build policy networks that enable land managers to access information and expertise needed for responding to local climate risks. This paper investigates whether the perceived and modeled climate risk faced by different land managers is leading to larger networks or more participating in climate adaptation. In theory, the benefits of climate planning networks are larger when land managers are facing more potential changes. The basic hypothesis is tested with a survey of public land managers from hundreds of local and regional public lands management units in the Southwestern United States, as well as other stakeholders involved with climate adaptation planning. All survey respondents report their perceptions of climate risk along a variety of dimensions, as well as their participation in climate adaptation planning and information sharing networks. For a subset of respondents, we have spatially explicity GIS data about their location, which will be linked with downscaled climate model data. With the focus on climate change, the analysis is a subset of the overall idea of linking social and ecological systems.

  8. Adapting industry-style business model to academia in a system of Performance-based Incentive Compensation.

    PubMed

    Reece, E Albert; Nugent, Olan; Wheeler, Richard P; Smith, Charles W; Hough, Aubrey J; Winter, Charles

    2008-01-01

    Performance-Based Incentive Compensation (PBIC) plans currently prevail throughout industry and have repeatedly demonstrated effectiveness as powerful motivational tools for attracting and retaining top talent, enhancing key indicators, increasing employee productivity, and, ultimately, enhancing mission-based parameters. The University of Arkansas for Medical Sciences (UAMS) College of Medicine introduced its PBIC plan to further the transition of the college to a high-performing academic and clinical enterprise. A forward-thinking compensation plan was progressively implemented during a three-year period. After the introduction of an aggressive five-year vision plan in 2002, the college introduced a PBIC plan designed to ensure the retention and recruitment of high-quality faculty through the use of uncapped salaries that reflect each faculty member's clinical, research, and education duties. The PBIC plan was introduced with broad, schoolwide principles adaptable to each department and purposely flexible to allow for tailor-made algorithms to fit the specific approaches required by individual departments. As of July 2006, the college had begun to reap a variety of short-term benefits from Phase I of its PBIC program, including increases in revenue and faculty salaries, and increased faculty morale and satisfaction.Successful implementation of a PBIC plan depends on a host of factors, including the development of a process for evaluating performance that is considered fair and reliable to the entire faculty. The college has become more efficient and effective by adopting such a program, which has helped it to increase overall productivity. The PBIC program continues to challenge our faculty members to attain their highest potential while rewarding them accordingly.

  9. Efficient greedy algorithms for economic manpower shift planning

    NASA Astrophysics Data System (ADS)

    Nearchou, A. C.; Giannikos, I. C.; Lagodimos, A. G.

    2015-01-01

    Consideration is given to the economic manpower shift planning (EMSP) problem, an NP-hard capacity planning problem appearing in various industrial settings including the packing stage of production in process industries and maintenance operations. EMSP aims to determine the manpower needed in each available workday shift of a given planning horizon so as to complete a set of independent jobs at minimum cost. Three greedy heuristics are presented for the EMSP solution. These practically constitute adaptations of an existing algorithm for a simplified version of EMSP which had shown excellent performance in terms of solution quality and speed. Experimentation shows that the new algorithms perform very well in comparison to the results obtained by both the CPLEX optimizer and an existing metaheuristic. Statistical analysis is deployed to rank the algorithms in terms of their solution quality and to identify the effects that critical planning factors may have on their relative efficiency.

  10. Adaptation Planning for the National Estuary Program

    EPA Pesticide Factsheets

    This document is a resource for coastal communities to start planning to adapt to climate change. It describes elements, such as vulnerability assessments and stakeholder outreach, and provides examples as well as suggestions for additional resources.

  11. Selecting, adapting, and sustaining programs in health care systems

    PubMed Central

    Zullig, Leah L; Bosworth, Hayden B

    2015-01-01

    Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA) Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. PMID:25931825

  12. SU-F-J-108: TMR Correction Factor Based Online Adaptive Radiotherapy for Stereotactic Radiosurgery (SRS) of L-Spine Tumors Using Cone Beam CT

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

    Ghaffar, I; Balik, S; Zhuang, T

    Purpose: To investigate the feasibility of using TMR ratio correction factors for a fast online adaptive plan to compensate for anatomical changes in stereotactic radiosurgery (SRS) of L-spine tumors. Methods: Three coplanar treatment plans were made for 11 patients: Uniform (9 IMRT beams equally distributed around the patient); Posterior (IMRT with 9 posterior beams every 20 degree) and VMAT (2 360° arcs). For each patient, the external body and bowel gas were contoured on the planning CT and pre-treatment CBCT. After registering CBCT and the planning CT by aligning to the tumor, the CBCT contours were transferred to the planningmore » CT. To estimate the actual delivered dose while considering patient’s anatomy of the treatment day, a hybrid CT was created by overriding densities in planning CT using the differences between CT and CBCT external and bowel gas contours. Correction factors (CF) were calculated using the effective depth information obtained from the planning system using the hybrid CT: CF = TMR (delivery)/TMR (planning). The adaptive plan was generated by multiplying the planned Monitor Units with the CFs. Results: The mean absolute difference (MAD) in V16Gy of the target between planned and estimated delivery with and without TMR correction was 0.8 ± 0.7% vs. 2.4 ± 1.3% for Uniform and 1.0 ± 0.9% vs. 2.6 ± 1.3% for VMAT plans(p<0.05), respectively. For V12Gy of cauda-equina with and without TMR correction, MAD was 0.24 ± 0.19% vs. 1.2 ± 1.02% for Uniform and 0.23 ± 0.20% vs. 0.78 ± 0.79% for VMAT plans(p<0.05), respectively. The differences between adaptive and original plans were not significant for posterior plans. Conclusion: The online adaptive strategy using TMR ratios and pre-treatment CBCT information was feasible strategy to compensate for anatomical changes for the patients treated for L-spine tumors, particularly for equally spaced IMRT and VMAT plans.« less

  13. SU-E-J-135: Feasibility of Using Quantitative Cone Beam CT for Proton Adaptive Planning

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

    Jingqian, W; Wang, Q; Zhang, X

    2015-06-15

    Purpose: To investigate the feasibility of using scatter corrected cone beam CT (CBCT) for proton adaptive planning. Methods: Phantom study was used to evaluate the CT number difference between the planning CT (pCT), quantitative CBCT (qCBCT) with scatter correction and calibrated Hounsfield units using adaptive scatter kernel superposition (ASKS) technique, and raw CBCT (rCBCT). After confirming the CT number accuracy, prostate patients, each with a pCT and several sets of weekly CBCT, were investigated for this study. Spot scanning proton treatment plans were independently generated on pCT, qCBCT and rCBCT. The treatment plans were then recalculated on all images. Dose-volume-histogrammore » (DVH) parameters and gamma analysis were used to compare between dose distributions. Results: Phantom study suggested that Hounsfield unit accuracy for different materials are within 20 HU for qCBCT and over 250 HU for rCBCT. For prostate patients, proton dose could be calculated accurately on qCBCT but not on rCBCT. When the original plan was recalculated on qCBCT, tumor coverage was maintained when anatomy was consistent with pCT. However, large dose variance was observed when patient anatomy change. Adaptive plan using qCBCT was able to recover tumor coverage and reduce dose to normal tissue. Conclusion: It is feasible to use qu antitative CBCT (qCBCT) with scatter correction and calibrated Hounsfield units for proton dose calculation and adaptive planning in proton therapy. Partly supported by Varian Medical Systems.« less

  14. Surprise and opportunity for learning in Grand Canyon: the Glen Canyon Dam Adaptive Management Program

    USGS Publications Warehouse

    Melis, Theodore S.; Walters, Carl; Korman, Josh

    2015-01-01

    With a focus on resources of the Colorado River ecosystem below Glen Canyon Dam, the Glen Canyon Dam Adaptive Management Program has included a variety of experimental policy tests, ranging from manipulation of water releases from the dam to removal of non-native fish within Grand Canyon National Park. None of these field-scale experiments has yet produced unambiguous results in terms of management prescriptions. But there has been adaptive learning, mostly from unanticipated or surprising resource responses relative to predictions from ecosystem modeling. Surprise learning opportunities may often be viewed with dismay by some stakeholders who might not be clear about the purpose of science and modeling in adaptive management. However, the experimental results from the Glen Canyon Dam program actually represent scientific successes in terms of revealing new opportunities for developing better river management policies. A new long-term experimental management planning process for Glen Canyon Dam operations, started in 2011 by the U.S. Department of the Interior, provides an opportunity to refocus management objectives, identify and evaluate key uncertainties about the influence of dam releases, and refine monitoring for learning over the next several decades. Adaptive learning since 1995 is critical input to this long-term planning effort. Embracing uncertainty and surprise outcomes revealed by monitoring and ecosystem modeling will likely continue the advancement of resource objectives below the dam, and may also promote efficient learning in other complex programs.

  15. The adjustments experienced by persons with an ostomy: an integrative review of the literature.

    PubMed

    Torquato Lopes, Ana Patrícia Araujo; Decesaro, Maria das Neves

    2014-10-01

    The person with an ostomy may focus on the negative aspects of the stoma rather than its function to the detriment of self-image, acceptance of a new lifestyle, and ability to self-care. The purpose of this integrative literature review was to explore factors involved in the adaption process of persons with a gastrointestinal stoma with a focus on the role of nonspecialist professional nurses in the process. The authors searched the databases of the Virtual Health Library, the Latin American and Caribbean of Health Sciences Information System, the Scientific Electronic Library Online, the Spanish Bibliographic Index of Health Sciences, International Literature on Health Sciences (MEDLINE), and the Cochrane Library using the keywords ostomy, adaption, and nursing for full text articles in all languages published between 2008 and 2013. Of the 612 articles identified, 21 were not duplicates and met the inclusion criteria of availability of full text, published in the past 5 years, indexed, and covering the topic of stoma adaption; this literature was analyzed using Bardin's thematic analysis. Three categories emerged: experiences and adaption strategies employed by the person with a stoma, the role of the care provider, and education as a tool in healthcare. Persons with a stoma need time and support from caregivers, family, and friends to adjust to the changes and adapt to having a stoma. This includes the ability to overcome the stigma of appearance and activities involving social interaction. Caregivers and health professionals need to serve as information resources while encouraging care autonomy. The more informed the patient, the smoother the adaption process. The literature also suggests nursing education may affect caregiving. Further research to elucidate the adaption experienced by each person with an ostomy is needed to help the multidisciplinary team plan care appropriately.

  16. Sensorimotor adaptation of point-to-point arm movements after spaceflight: the role of internal representation of gravity force in trajectory planning.

    PubMed

    Gaveau, Jérémie; Paizis, Christos; Berret, Bastien; Pozzo, Thierry; Papaxanthis, Charalambos

    2011-08-01

    After an exposure to weightlessness, the central nervous system operates under new dynamic and sensory contexts. To find optimal solutions for rapid adaptation, cosmonauts have to decide whether parameters from the world or their body have changed and to estimate their properties. Here, we investigated sensorimotor adaptation after a spaceflight of 10 days. Five cosmonauts performed forward point-to-point arm movements in the sagittal plane 40 days before and 24 and 72 h after the spaceflight. We found that, whereas the shape of hand velocity profiles remained unaffected after the spaceflight, hand path curvature significantly increased 1 day after landing and returned to the preflight level on the third day. Control experiments, carried out by 10 subjects under normal gravity conditions, showed that loading the arm with varying loads (from 0.3 to 1.350 kg) did not affect path curvature. Therefore, changes in path curvature after spaceflight cannot be the outcome of a control process based on the subjective feeling that arm inertia was increased. By performing optimal control simulations, we found that arm kinematics after exposure to microgravity corresponded to a planning process that overestimated the gravity level and optimized movements in a hypergravity environment (∼1.4 g). With time and practice, the sensorimotor system was recalibrated to Earth's gravity conditions, and cosmonauts progressively generated accurate estimations of the body state, gravity level, and sensory consequences of the motor commands (72 h). These observations provide novel insights into how the central nervous system evaluates body (inertia) and environmental (gravity) states during sensorimotor adaptation of point-to-point arm movements after an exposure to weightlessness.

  17. An Integrated Framework to Analyze Local Decision Making and Adaptation to Sea-Level Rise in Coastal Regions in Santos-Brazil, Broward County-USA and Selsey-UK

    NASA Astrophysics Data System (ADS)

    Marengo, J. A.; Muller-Karger, F. E.; Pelling, M.; Reynolds, C. J.; Merril, S. B.; Nunes, L. H.; Paterson, S.; Gray, A.; Lockman, J. T.; Kartez, J.; Moreira, F.; Greco, R.; Harari, J.; Souza, C. G.; Alves, L. M.; Hosokawa, E.; Tabuchi, E.

    2016-12-01

    One of the clear signals of present climate change is sea level rise (SLR). There is mounting evidence of other changes, including warmer temperatures in many localities, and changes in the intensity and frequency of extreme meteorological events, including wind, rain, and waves. A rising sea level combined with these factors and tides is expected to affect coastal communities through a number of processes, including increased risk of flooding and contamination of water sources. An international collaboration between Brazil, the United Kingdom, and the United States was designed to evaluate local decision making processes and to open convening space for local urban managers to reflect on possible actions toward adaption to SLR and the constraints imposed by framing administrative and institutional structures. The overall goal of the project is to help coastal communities better understand factors that facilitate or hinder their intrinsic, local decision-making processes related to planning for adaptation to risk. The project carried out these tests in 2014 and 2015 in one coastal city in each partnering nation. The framework was designed by an interdisciplinary team that incorporated social and natural scientists from these three nations, and which included local government officials. To support the overall goal, this paper 1) discusses some aspects of adaptive capacity and participant survey research conducted through the project, 2) presents technical modelling results for adaptation options that may reduce the potential damages of SLR and storm surge in each location, and 3) identifies project design considerations for similar transnational adaptation projects.

  18. Best Practices in Military Design Teams

    DTIC Science & Technology

    2015-03-01

    this assessment. 10 metacognitive thinkers, and can reflect and comment on how the team is thinking about a particular topic. These findings...planning team employed a thorough and intentional selection process that included assessment instruments, several interviews, and a writing assignment...Myers-Briggs Type Indicator (MBTI), StrengthsFinder, and the Kirton Adaption-Innovation Inventory. • Writing samples and other examples of work

  19. Climate change and health effects in Northwest Alaska.

    PubMed

    Brubaker, Michael; Berner, James; Chavan, Raj; Warren, John

    2011-01-01

    This article provides examples of adverse health effects, including weather-related injury, food insecurity, mental health issues, and water infrastructure damage, and the responses to these effects that are currently being applied in two Northwest Alaska communities. In Northwest Alaska, warming is resulting in a broad range of unusual weather and environmental conditions, including delayed freeze-up, earlier breakup, storm surge, coastal erosion, and thawing permafrost. These are just some of the climate impacts that are driving concerns about weather-related injury, the spread of disease, mental health issues, infrastructure damage, and food and water security. Local leaders are challenged to identify appropriate adaptation strategies to address climate impacts and related health effects. IMPLEMENTATION PROCESS: The tribal health system is combining local observations, traditional knowledge, and western science to perform community-specific climate change health impact assessments. Local leaders are applying this information to develop adaptation responses. The Alaska Native Tribal Health Consortium will describe relationships between climate impacts and health effects and provide examples of community-scaled adaptation actions currently being applied in Northwest Alaska. Climate change is increasing vulnerability to injury, disease, mental stress, food insecurity, and water insecurity. Northwest communities are applying adaptation approaches that are both specific and appropriate. The health impact assessment process is effective in raising awareness, encouraging discussion, engaging partners, and implementing adaptation planning. With community-specific information, local leaders are applying health protective adaptation measures.

  20. Climate change and health effects in Northwest Alaska

    PubMed Central

    Brubaker, Michael; Berner, James; Chavan, Raj; Warren, John

    2011-01-01

    This article provides examples of adverse health effects, including weather-related injury, food insecurity, mental health issues, and water infrastructure damage, and the responses to these effects that are currently being applied in two Northwest Alaska communities. Background In Northwest Alaska, warming is resulting in a broad range of unusual weather and environmental conditions, including delayed freeze-up, earlier breakup, storm surge, coastal erosion, and thawing permafrost. These are just some of the climate impacts that are driving concerns about weather-related injury, the spread of disease, mental health issues, infrastructure damage, and food and water security. Local leaders are challenged to identify appropriate adaptation strategies to address climate impacts and related health effects. Implementation process The tribal health system is combining local observations, traditional knowledge, and western science to perform community-specific climate change health impact assessments. Local leaders are applying this information to develop adaptation responses. Objective The Alaska Native Tribal Health Consortium will describe relationships between climate impacts and health effects and provide examples of community-scaled adaptation actions currently being applied in Northwest Alaska. Findings Climate change is increasing vulnerability to injury, disease, mental stress, food insecurity, and water insecurity. Northwest communities are applying adaptation approaches that are both specific and appropriate. Conclusion The health impact assessment process is effective in raising awareness, encouraging discussion, engaging partners, and implementing adaptation planning. With community-specific information, local leaders are applying health protective adaptation measures. PMID:22022304

  1. Policy improvement by a model-free Dyna architecture.

    PubMed

    Hwang, Kao-Shing; Lo, Chia-Yue

    2013-05-01

    The objective of this paper is to accelerate the process of policy improvement in reinforcement learning. The proposed Dyna-style system combines two learning schemes, one of which utilizes a temporal difference method for direct learning; the other uses relative values for indirect learning in planning between two successive direct learning cycles. Instead of establishing a complicated world model, the approach introduces a simple predictor of average rewards to actor-critic architecture in the simulation (planning) mode. The relative value of a state, defined as the accumulated differences between immediate reward and average reward, is used to steer the improvement process in the right direction. The proposed learning scheme is applied to control a pendulum system for tracking a desired trajectory to demonstrate its adaptability and robustness. Through reinforcement signals from the environment, the system takes the appropriate action to drive an unknown dynamic to track desired outputs in few learning cycles. Comparisons are made between the proposed model-free method, a connectionist adaptive heuristic critic, and an advanced method of Dyna-Q learning in the experiments of labyrinth exploration. The proposed method outperforms its counterparts in terms of elapsed time and convergence rate.

  2. Deep Impact Sequence Planning Using Multi-Mission Adaptable Planning Tools With Integrated Spacecraft Models

    NASA Technical Reports Server (NTRS)

    Wissler, Steven S.; Maldague, Pierre; Rocca, Jennifer; Seybold, Calina

    2006-01-01

    The Deep Impact mission was ambitious and challenging. JPL's well proven, easily adaptable multi-mission sequence planning tools combined with integrated spacecraft subsystem models enabled a small operations team to develop, validate, and execute extremely complex sequence-based activities within very short development times. This paper focuses on the core planning tool used in the mission, APGEN. It shows how the multi-mission design and adaptability of APGEN made it possible to model spacecraft subsystems as well as ground assets throughout the lifecycle of the Deep Impact project, starting with models of initial, high-level mission objectives, and culminating in detailed predictions of spacecraft behavior during mission-critical activities.

  3. Environmental Assessment for Integrated Natural Resources Management Plan Activities at Eglin Air Force Base, Florida

    DTIC Science & Technology

    2013-01-28

    and coordination services by planning for and adapting to a rapidly changing military mission. 2. Restore the longleaf pine ecosystem and recover...success by supporting the Eglin AFB NRS adaptive management efforts through statistically sound, scientifically based monitoring of community...conservation targets, including sandhills, flatwoods, steepheads, seepage slopes, and stream habitats. Ecological monitoring supports adaptive

  4. A Climate Change Adaptation Strategy for Management of ...

    EPA Pesticide Factsheets

    Sea level rise is causing shoreline erosion, increased coastal flooding, and marsh vulnerability to the impact of storms. Coastal marshes provide flood abatement, carbon and nutrient sequestration, water quality maintenance, and habitat for fish, shellfish, and wildlife, including species of concern, such as the saltmarsh sparrow (Ammodramus caudacutus). We present a climate change adaptation strategy (CCAS) adopted by scientific, management, and policy stakeholders for managing coastal marshes and enhancing system resiliency. A common adaptive management approach previously used for restoration projects was modified to identify climate-related vulnerabilities and plan climate change adaptive actions. As an example of implementation of the CCAS, we describe the stakeholder plans and management actions the US Fish and Wildlife Service and partners developed to build coastal resiliency in the Narrow River Estuary, RI, in the aftermath of Superstorm Sandy. When possible, an experimental BACI (before-after, control-impact) design, described as pre- and post-sampling at the impact site and one or more control sites, was incorporated into the climate change adaptation and implementation plans. Specific climate change adaptive actions and monitoring plans are described and include shoreline stabilization, restoring marsh drainage, increasing marsh elevation, and enabling upland marsh migration. The CCAS provides a framework and methodology for successfully managing coa

  5. A review of plan library approaches in adaptive radiotherapy of bladder cancer.

    PubMed

    Collins, Shane D; Leech, Michelle M

    2018-05-01

    Large variations in the shape and size of the bladder volume are commonly observed in bladder cancer radiotherapy (RT). The clinical target volume (CTV) is therefore frequently inadequately treated and large isotropic margins are inappropriate in terms of dose to organs at risk (OAR); thereby making adaptive radiotherapy (ART) attractive for this tumour site. There are various methods of ART delivery, however, for bladder cancer, plan libraries are frequently used. A review of published studies on plan libraries for bladder cancer using four databases (Pubmed, Science Direct, Embase and Cochrane Library) was conducted. The endpoints selected were accuracy and feasibility of initiation of a plan library strategy into a RT department. Twenty-four articles were included in this review. The majority of studies reported improvement in accuracy with 10 studies showing an improvement in planning target volume (PTV) and CTV coverage with plan libraries, some by up to 24%. Seventeen studies showed a dose reduction to OARs, particularly the small bowel V45Gy, V40Gy, V30Gy and V10Gy, and the rectal V30Gy. However, the occurrence of no suitable plan was reported in six studies, with three studies showing no significant difference between adaptive and non-adaptive strategies in terms of target coverage. In addition, inter-observer variability in plan selection appears to remain problematic. The additional resources, education and technology required for the initiation of plan library selection for bladder cancer may hinder its routine clinical implementation, with eight studies illustrating increased treatment time required. While there is a growing body of evidence in support of plan libraries for bladder RT, many studies differed in their delivery approach. The advent of the clinical use of the MRI-linear accelerator will provide RT departments with the opportunity to consider daily online adaption for bladder cancer as an alternate to plan library approaches.

  6. An adaptive framework to differentiate receiving water quality impacts on a multi-scale level.

    PubMed

    Blumensaat, F; Tränckner, J; Helm, B; Kroll, S; Dirckx, G; Krebs, P

    2013-01-01

    The paradigm shift in recent years towards sustainable and coherent water resources management on a river basin scale has changed the subject of investigations to a multi-scale problem representing a great challenge for all actors participating in the management process. In this regard, planning engineers often face an inherent conflict to provide reliable decision support for complex questions with a minimum of effort. This trend inevitably increases the risk to base decisions upon uncertain and unverified conclusions. This paper proposes an adaptive framework for integral planning that combines several concepts (flow balancing, water quality monitoring, process modelling, multi-objective assessment) to systematically evaluate management strategies for water quality improvement. As key element, an S/P matrix is introduced to structure the differentiation of relevant 'pressures' in affected regions, i.e. 'spatial units', which helps in handling complexity. The framework is applied to a small, but typical, catchment in Flanders, Belgium. The application to the real-life case shows: (1) the proposed approach is adaptive, covers problems of different spatial and temporal scale, efficiently reduces complexity and finally leads to a transparent solution; and (2) water quality and emission-based performance evaluation must be done jointly as an emission-based performance improvement does not necessarily lead to an improved water quality status, and an assessment solely focusing on water quality criteria may mask non-compliance with emission-based standards. Recommendations derived from the theoretical analysis have been put into practice.

  7. Designing an evaluation framework for WFME basic standards for medical education.

    PubMed

    Tackett, Sean; Grant, Janet; Mmari, Kristin

    2016-01-01

    To create an evaluation plan for the World Federation for Medical Education (WFME) accreditation standards for basic medical education. We conceptualized the 100 basic standards from "Basic Medical Education: WFME Global Standards for Quality Improvement: The 2012 Revision" as medical education program objectives. Standards were simplified into evaluable items, which were then categorized as inputs, processes, outputs and/or outcomes to generate a logic model and corresponding plan for data collection. WFME standards posed significant challenges to evaluation due to complex wording, inconsistent formatting and lack of existing assessment tools. Our resulting logic model contained 244 items. Standard B 5.1.1 separated into 24 items, the most for any single standard. A large proportion of items (40%) required evaluation of more than one input, process, output and/or outcome. Only one standard (B 3.2.2) was interpreted as requiring evaluation of a program outcome. Current WFME standards are difficult to use for evaluation planning. Our analysis may guide adaptation and revision of standards to make them more evaluable. Our logic model and data collection plan may be useful to medical schools planning an institutional self-review and to accrediting authorities wanting to provide guidance to schools under their purview.

  8. Colleges and universities: survival in the information age

    NASA Astrophysics Data System (ADS)

    Huff, Warren D.

    2000-07-01

    Coping with information technology (IT) planning is one of the more important, expensive, time-consuming and potentially disastrous exercises an academic institution can undertake. Those institutions that are successful in establishing administrative and academic frameworks within which rapid technological change and adaptation can occur will survive and those who stubbornly adhere to archaic styles of management and decision-making will not. IT strategies, priorities and plans must be driven by and integrated with on-going academic planning. Cross-department/unit collaboration must be encouraged and facilitated by university resources and processes. Long-range planning and identification of reasonable and attainable goals requires a leadership and governance structure in which all major stakeholders participate in setting information technology strategies, priorities, plans, standards and performance measures. A successful technology funding strategy must ensure budgeting for adequate network facilities, including assets and the people and processes to support them. Accompanying these administrative procedures should be an open dialogue on the issues brought about by apparent conflicts between University wide standardization of basic policy, procedures and technologies and the pedagogical and research initiatives which address unique collegiate or departmental needs. Network capabilities should be integrated, timely, accurate, secure and easily accessible to all who need it.

  9. Robust path planning for flexible needle insertion using Markov decision processes.

    PubMed

    Tan, Xiaoyu; Yu, Pengqian; Lim, Kah-Bin; Chui, Chee-Kong

    2018-05-11

    Flexible needle has the potential to accurately navigate to a treatment region in the least invasive manner. We propose a new planning method using Markov decision processes (MDPs) for flexible needle navigation that can perform robust path planning and steering under the circumstance of complex tissue-needle interactions. This method enhances the robustness of flexible needle steering from three different perspectives. First, the method considers the problem caused by soft tissue deformation. The method then resolves the common needle penetration failure caused by patterns of targets, while the last solution addresses the uncertainty issues in flexible needle motion due to complex and unpredictable tissue-needle interaction. Computer simulation and phantom experimental results show that the proposed method can perform robust planning and generate a secure control policy for flexible needle steering. Compared with a traditional method using MDPs, the proposed method achieves higher accuracy and probability of success in avoiding obstacles under complicated and uncertain tissue-needle interactions. Future work will involve experiment with biological tissue in vivo. The proposed robust path planning method can securely steer flexible needle within soft phantom tissues and achieve high adaptability in computer simulation.

  10. Coastal Adaptation: The Case of Ocean Beach, San Francisco

    NASA Astrophysics Data System (ADS)

    Cheong, S.

    2012-12-01

    Coastal erosion, storms, sea-level rise, and tsunamis all lead to inundation that puts people and communities at risk. Adapting to these coastal hazards has gained increasing attention with climate change. Instead of promoting one particular strategy such as seawalls or defending against one type of hazard, scholars and practitioners encourage a combination of existing methods and strategies to promote synergistic effects. The recently published Intergovernmental Panel on Climate Change (IPCC) Special Report on climate extremes reflects this trend in the integration of disaster risk management and climate change adaptation. This paper focuses on the roles, compatibilities, and synergies of three coastal adaptation options - engineering, vegetation, and policy - in the case of Ocean Beach in San Francisco. Traditionally engineering approach and ecosystem conservation often have stood in opposition as hard shoreline structures destroy coastal habitats, worsen coastal erosion, divert ocean currents, and prevent the natural migration of shores. A natural migration of shores without structure translates into the abandonment of properties in the coastal zone, and is at odds with property rights and development. For example, policies of relocation, retreat, and insurance may not be popular given the concerns of infrastructure and coastal access. As such, engineering, natural defense, and policy can be more conflictual than complementary. Nonetheless, all these responses are used in combination in many locations. Complementarities and compatibilities, therefore, must be assessed when considering the necessity of engineering responses, natural defense capabilities, and policy options. In this light, the question is how to resolve the problem of mixed responses and short- and long-term interests and values, identify compatibilities, and generate synergies. In the case of Ocean Beach, recent erosions that endangered San Francisco's wastewater treatment system acted as major stimuli in coastal adaptation initiatives and resulted in the Ocean Beach Master Plan. Investigation into the planning processes involving multiple stakeholder engagement such as San Francisco (SF) Public Utilities Commission, California Coastal Commission, National Park Service, SF Department of Public Works, SF Recreation and Park Department, SF Planning Department, and the U.S. Army Corps of Engineers can shed light on trade-offs and synergies of different adaptation responses. The role of the coordinator - SF Planning and Urban Research Commission - as a mediator between different stakeholder interests and priorities, a realistic assessment of current hazard management practices specific to local contexts, and the necessity of combining hazard mitigation policies with coastal management and community management are the key findings of this research. They help inform policy formulation and decision-making in climate change adaptation, and provide a valuable case study that can be transferred to other locations.

  11. Comparative evaluation of ERTS-A imagery for resource inventory in land-use planning

    NASA Technical Reports Server (NTRS)

    Simonson, G. H. (Principal Investigator)

    1972-01-01

    There are no author-identified significant results in this report. The overall objectives of this program are: (1) use of multidiscipline team approach to determine features that can be successfully monitored by ERTS-1 imagery for resource inventory, planning, land use zoning, and resource development; and (2) using carefully selected sample areas, develop a comprehensive resource inventory mapping system for use in planning, zoning, and resource development. Progress has included compilation and organization of ground truth data and observations in the primary study area of Crook County; resource inventory legend development; assembly and testing of color enhancement equipment; development and adaption of programs for digital data processing; and quick-look evaluations of initial ERTS-1 imagery for Oregon.

  12. Skirting Saturn's Rings and Skimming Its Cloud Tops: Planning Cassini's End of Mission

    NASA Technical Reports Server (NTRS)

    Manor-Chapman, Emily; Magee, Kari; Brooks, Shawn; Edgington, Scott; Heventhal, William; Sturm, Erick

    2014-01-01

    In October 2010, the Cassini spacecraft embarked on the seven-year Solstice Mission. The mission will culminate with a spectacular series of orbits that bring Cassini between Saturn's innermost ring, the D ring, and the cloud tops of the planet. The spacecraft will make its closest passages ever to the planet allowing for unprecedented science to be collected on Saturn and its rings. These final orbits will expose the spacecraft to new environments, which presents a number of challenges to planning the final mission phase. While these challenges will require adaptations to planning processes and operations, they are not insurmountable. This paper describes the challenges identified and the steps taken to mitigate them to enable collection of unique Saturn system science.

  13. Cracking the egg: virtual embryogenesis of real robots.

    PubMed

    Cussat-Blanc, Sylvain; Pollack, Jordan

    2014-01-01

    All multicellular living beings are created from a single cell. A developmental process, called embryogenesis, takes this first fertilized cell down a complex path of reproduction, migration, and specialization into a complex organism adapted to its environment. In most cases, the first steps of the embryogenesis take place in a protected environment such as in an egg or in utero. Starting from this observation, we propose a new approach to the generation of real robots, strongly inspired by living systems. Our robots are composed of tens of specialized cells, grown from a single cell using a bio-inspired virtual developmental process. Virtual cells, controlled by gene regulatory networks, divide, migrate, and specialize to produce the robot's body plan (morphology), and then the robot is manually built from this plan. Because the robot is as easy to assemble as Lego, the building process could be easily automated.

  14. On-line Adaptive Radiation Treatment of Prostate Cancer

    DTIC Science & Technology

    2009-01-01

    12]. For intensity modulated radiation therapy (IMRT) plans , the beamlet weight can be re-optimized on a daily basis to mini- mize the dose to the OAR...Thongphiew D, Wang Z, Mathayomchan B, Chankong V, Yoo S, et al. On-line re-optimization of prostate IMRT plans for adaptive radiation therapy . Phys Med Biol...time. The treatment planning method for VMAT however is not mature. We are developing a robust VMAT treatment planning method which incorporates

  15. Statistical control process to compare and rank treatment plans in radiation oncology: impact of heterogeneity correction on treatment planning in lung cancer.

    PubMed

    Chaikh, Abdulhamid; Balosso, Jacques

    2016-12-01

    This study proposes a statistical process to compare different treatment plans issued from different irradiation techniques or different treatment phases. This approach aims to provide arguments for discussion about the impact on clinical results of any condition able to significantly alter dosimetric or ballistic related data. The principles of the statistical investigation are presented in the framework of a clinical example based on 40 fields of radiotherapy for lung cancers. Two treatment plans were generated for each patient making a change of dose distribution due to variation of lung density correction. The data from 2D gamma index (γ) including the pixels having γ≤1 were used to determine the capability index (Cp) and the acceptability index (Cpk) of the process. To measure the strength of the relationship between the γ passing rates and the Cp and Cpk indices, the Spearman's rank non-parametric test was used to calculate P values. The comparison between reference and tested plans showed that 95% of pixels have γ≤1 with criteria (6%, 6 mm). The values of the Cp and Cpk indices were lower than one showing a significant dose difference. The data showed a strong correlation between γ passing rates and the indices with P>0.8. The statistical analysis using Cp and Cpk, show the significance of dose differences resulting from two plans in radiotherapy. These indices can be used for adaptive radiotherapy to measure the difference between initial plan and daily delivered plan. The significant changes of dose distribution could raise the question about the continuity to treat the patient with the initial plan or the need for adjustments.

  16. Changes in Regional Ventilation During Treatment and Dosimetric Advantages of CT Ventilation Image Guided Radiation Therapy for Locally Advanced Lung Cancer.

    PubMed

    Yamamoto, Tokihiro; Kabus, Sven; Bal, Matthieu; Bzdusek, Karl; Keall, Paul J; Wright, Cari; Benedict, Stanley H; Daly, Megan E

    2018-05-04

    Lung functional image guided radiation therapy (RT) that avoids irradiating highly functional regions has potential to reduce pulmonary toxicity following RT. Tumor regression during RT is common, leading to recovery of lung function. We hypothesized that computed tomography (CT) ventilation image-guided treatment planning reduces the functional lung dose compared to standard anatomic image-guided planning in 2 different scenarios with or without plan adaptation. CT scans were acquired before RT and during RT at 2 time points (16-20 Gy and 30-34 Gy) for 14 patients with locally advanced lung cancer. Ventilation images were calculated by deformable image registration of four-dimensional CT image data sets and image analysis. We created 4 treatment plans at each time point for each patient: functional adapted, anatomic adapted, functional unadapted, and anatomic unadapted plans. Adaptation was performed at 2 time points. Deformable image registration was used for accumulating dose and calculating a composite of dose-weighted ventilation used to quantify the lung accumulated dose-function metrics. The functional plans were compared with the anatomic plans for each scenario separately to investigate the hypothesis at a significance level of 0.05. Tumor volume was significantly reduced by 20% after 16 to 20 Gy (P = .02) and by 32% after 30 to 34 Gy (P < .01) on average. In both scenarios, the lung accumulated dose-function metrics were significantly lower in the functional plans than in the anatomic plans without compromising target volume coverage and adherence to constraints to critical structures. For example, functional planning significantly reduced the functional mean lung dose by 5.0% (P < .01) compared to anatomic planning in the adapted scenario and by 3.6% (P = .03) in the unadapted scenario. This study demonstrated significant reductions in the accumulated dose to the functional lung with CT ventilation image-guided planning compared to anatomic image-guided planning for patients showing tumor regression and changes in regional ventilation during RT. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. VirSSPA- a virtual reality tool for surgical planning workflow.

    PubMed

    Suárez, C; Acha, B; Serrano, C; Parra, C; Gómez, T

    2009-03-01

    A virtual reality tool, called VirSSPA, was developed to optimize the planning of surgical processes. Segmentation algorithms for Computed Tomography (CT) images: a region growing procedure was used for soft tissues and a thresholding algorithm was implemented to segment bones. The algorithms operate semiautomati- cally since they only need seed selection with the mouse on each tissue segmented by the user. The novelty of the paper is the adaptation of an enhancement method based on histogram thresholding applied to CT images for surgical planning, which simplifies subsequent segmentation. A substantial improvement of the virtual reality tool VirSSPA was obtained with these algorithms. VirSSPA was used to optimize surgical planning, to decrease the time spent on surgical planning and to improve operative results. The success rate increases due to surgeons being able to see the exact extent of the patient's ailment. This tool can decrease operating room time, thus resulting in reduced costs. Virtual simulation was effective for optimizing surgical planning, which could, consequently, result in improved outcomes with reduced costs.

  18. "I'm still here": Exploring what matters to people with intellectual disability during advance care planning.

    PubMed

    McKenzie, Nicola; Mirfin-Veitch, Brigit; Conder, Jennifer; Brandford, Sharon

    2017-11-01

    This study sought to identify, from the perspective of people with intellectual disabilities and life limiting conditions, the factors that strengthened and inhibited their Advance Care Planning. This in depth qualitative study explored the experiences of four people with intellectual disability and life limiting conditions, through interviews and documentation reviews. There was strong agreement across all participants about what positively influenced Advance Care Planning, namely; going at my pace; supporting me to make my own choices; adapting the process to suit me, and, most importantly; continuing to support and plan the life I'm still living. With the exception of being comfortable/skilled in end-of-life support, the skills required of facilitators were similar to those required for all forms of person-centred planning. The findings are encouraging and demonstrate that Advance Care Planning is a useful tool in ensuring that people with intellectual disability have control and choice over their lives, right to the end. © 2017 John Wiley & Sons Ltd.

  19. Climate change adaptation in a highly urbanized snowmelt dominated basin in Central Chile

    NASA Astrophysics Data System (ADS)

    Vicuna, S.; Bustos, E.; Merino, P.; Henriquez Dole, L. E.; Jansen, S.; Gil, M.; Ocampo, A.; Poblete, D.; Tosoni, D.; Meza, F. J.; Donoso, G.; Melo, O.

    2015-12-01

    The Maipo river basin holds 40% of Chile's total population and produces almost half of the country's Gross Domestic Product. The basin is located in the semiarid and snowmelt dominated central region of the country and, aside from the typical pressures of growth in developing country basins, the Maipo river basin faces climate change impacts associated with a reduction in total runoff and changes in its seasonality. Surface water is the main water source for human settlements, natural ecosystems, and economic activities including agriculture, mining and hydropower production. In 2012 a research project, called MAPA (Maipo Plan de Adaptacion), began with the objective of articulating a climate variability and climate change adaptation plan for the Maipo river basin. The project engaged at the beginning a group of relevant water and land use stakeholders which allowed for a good representation of critical aspects of an adaptation plan such as the definition of objectives and performance indicators, future land use scenarios, modeling of the different components of the system and design of adaptation strategies. The presentation will highlight the main results of the research project with a special focus on the upper catchments of the basin. These results include the assessment of impacts associated with future climate and land use scenarios on key components of the hydrologic cycle including snowmelt and glacier contribution to runoff and subsequent impacts on water availability for the operation of hydropower facilities, satisfaction of instream (recreation and aquatic ecosystem) uses and provision of water for the city of Santiago (7 million people) and to irrigate more than 100,000 hectares of high value crops. The integrative approach followed in this project including different perspectives on the use of water in the basin provides a good opportunity to test the varying degree of impacts that could be associated with a given future scenario and also understand the challenges and opportunities that exist in the process of designing and implementing adaptation strategies.

  20. A new adaptive videogame for training attention and executive functions: design principles and initial validation.

    PubMed

    Montani, Veronica; De Filippo De Grazia, Michele; Zorzi, Marco

    2014-01-01

    A growing body of evidence suggests that action videogames could enhance a variety of cognitive skills and more specifically attention skills. The aim of this study was to develop a novel adaptive videogame to support the rehabilitation of the most common consequences of traumatic brain injury (TBI), that is the impairment of attention and executive functions. TBI patients can be affected by psychomotor slowness and by difficulties in dealing with distraction, maintain a cognitive set for a long time, processing different simultaneously presented stimuli, and planning purposeful behavior. Accordingly, we designed a videogame that was specifically conceived to activate those functions. Playing involves visuospatial planning and selective attention, active maintenance of the cognitive set representing the goal, and error monitoring. Moreover, different game trials require to alternate between two tasks (i.e., task switching) or to perform the two tasks simultaneously (i.e., divided attention/dual-tasking). The videogame is controlled by a multidimensional adaptive algorithm that calibrates task difficulty on-line based on a model of user performance that is updated on a trial-by-trial basis. We report simulations of user performance designed to test the adaptive game as well as a validation study with healthy participants engaged in a training protocol. The results confirmed the involvement of the cognitive abilities that the game is supposed to enhance and suggested that training improved attentional control during play.

  1. A new adaptive videogame for training attention and executive functions: design principles and initial validation

    PubMed Central

    Montani, Veronica; De Filippo De Grazia, Michele; Zorzi, Marco

    2014-01-01

    A growing body of evidence suggests that action videogames could enhance a variety of cognitive skills and more specifically attention skills. The aim of this study was to develop a novel adaptive videogame to support the rehabilitation of the most common consequences of traumatic brain injury (TBI), that is the impairment of attention and executive functions. TBI patients can be affected by psychomotor slowness and by difficulties in dealing with distraction, maintain a cognitive set for a long time, processing different simultaneously presented stimuli, and planning purposeful behavior. Accordingly, we designed a videogame that was specifically conceived to activate those functions. Playing involves visuospatial planning and selective attention, active maintenance of the cognitive set representing the goal, and error monitoring. Moreover, different game trials require to alternate between two tasks (i.e., task switching) or to perform the two tasks simultaneously (i.e., divided attention/dual-tasking). The videogame is controlled by a multidimensional adaptive algorithm that calibrates task difficulty on-line based on a model of user performance that is updated on a trial-by-trial basis. We report simulations of user performance designed to test the adaptive game as well as a validation study with healthy participants engaged in a training protocol. The results confirmed the involvement of the cognitive abilities that the game is supposed to enhance and suggested that training improved attentional control during play. PMID:24860529

  2. Self-determination, control, and reactions to changes in workload: a work simulation.

    PubMed

    Parker, Stacey L; Jimmieson, Nerina L; Amiot, Catherine E

    2013-04-01

    The objective of this experimental study is to capture the dynamic temporal processes that occur in changing work settings and to test how work control and individuals' motivational predispositions interact to predict reactions to these changes. To this aim, we examine the moderating effects of global self-determined and non-self-determined motivation, at different levels of work control, on participants' adaptation and stress reactivity to changes in workload during four trials of an inbox activity. Workload was increased or decreased at Trial 3, and adaptation to this change was examined via fluctuations in anxiety, coping, motivation, and performance. In support of the hypotheses, results revealed that, for non-self-determined individuals, low work control was stress-buffering and high work control was stress-exacerbating when predicting anxiety and intrinsic motivation. In contrast, for self-determined individuals, high work control facilitated the adaptive use of planning coping in response to a change in workload. Overall, this pattern of results demonstrates that, while high work control was anxiety-provoking and demotivating for non-self-determined individuals, self-determined individuals used high work control to implement an adaptive antecedent-focused emotion regulation strategy (i.e., planning coping) to meet situational demands. Other interactive effects of global motivation emerged on anxiety, active coping, and task performance. These results and their practical implications are discussed.

  3. Incorporating climate change into systematic conservation planning

    USGS Publications Warehouse

    Groves, Craig R.; Game, Edward T.; Anderson, Mark G.; Cross, Molly; Enquist, Carolyn; Ferdana, Zach; Girvetz, Evan; Gondor, Anne; Hall, Kimberly R.; Higgins, Jonathan; Marshall, Rob; Popper, Ken; Schill, Steve; Shafer, Sarah L.

    2012-01-01

    The principles of systematic conservation planning are now widely used by governments and non-government organizations alike to develop biodiversity conservation plans for countries, states, regions, and ecoregions. Many of the species and ecosystems these plans were designed to conserve are now being affected by climate change, and there is a critical need to incorporate new and complementary approaches into these plans that will aid species and ecosystems in adjusting to potential climate change impacts. We propose five approaches to climate change adaptation that can be integrated into existing or new biodiversity conservation plans: (1) conserving the geophysical stage, (2) protecting climatic refugia, (3) enhancing regional connectivity, (4) sustaining ecosystem process and function, and (5) capitalizing on opportunities emerging in response to climate change. We discuss both key assumptions behind each approach and the trade-offs involved in using the approach for conservation planning. We also summarize additional data beyond those typically used in systematic conservation plans required to implement these approaches. A major strength of these approaches is that they are largely robust to the uncertainty in how climate impacts may manifest in any given region.

  4. Building a Framework in Improving Drought Monitoring and Early Warning Systems in Africa

    NASA Astrophysics Data System (ADS)

    Tadesse, T.; Wall, N.; Haigh, T.; Shiferaw, A. S.; Beyene, S.; Demisse, G. B.; Zaitchik, B.

    2015-12-01

    Decision makers need a basic understanding of the prediction models and products of hydro-climatic extremes and their suitability in time and space for strategic resource and development planning to develop mitigation and adaptation strategies. Advances in our ability to assess and predict climate extremes (e.g., droughts and floods) under evolving climate change suggest opportunity to improve management of climatic/hydrologic risk in agriculture and water resources. In the NASA funded project entitled, "Seasonal Prediction of Hydro-Climatic Extremes in the Greater Horn of Africa (GHA) under Evolving Climate Conditions to Support Adaptation Strategies," we are attempting to develop a framework that uses dialogue between managers and scientists on how to enhance the use of models' outputs and prediction products in the GHA as well as improve the delivery of this information in ways that can be easily utilized by managers. This process is expected to help our multidisciplinary research team obtain feedback on the models and forecast products. In addition, engaging decision makers is essential in evaluating the use of drought and flood prediction models and products for decision-making processes in drought and flood management. Through this study, we plan to assess information requirements to implement a robust Early Warning Systems (EWS) by engaging decision makers in the process. This participatory process could also help the existing EWSs in Africa and to develop new local and regional EWSs. In this presentation, we report the progress made in the past two years of the NASA project.

  5. To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England.

    PubMed

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2012-01-01

    The success of the International Classification of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and reflective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, field notes and a reflective diary. Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. The empirical findings demonstrate how to make the ICF classification a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians.

  6. Learning from conservation planning for the U.S. National Wildlife Refuges.

    PubMed

    Meretsky, Vicky J; Fischman, Robert L

    2014-10-01

    The U.S. National Wildlife Refuge System has nearly completed its first round of unit-level, comprehensive conservation plans (CCPs) and will soon begin required revisions. Laws and policies governing refuge planning emphasize ecological integrity, landscape-scale conservation, and adaptive management. We evaluated 185 CCPs completed during 2005-2011, which cover 324 of 555 national wildlife refuges. We reviewed CCP prescriptions addressing 5 common conservation issues (habitat and game, nongame, imperiled, and invasive species) and 3 specialized topics (landscape-scale conservation, climate change, and environmental quality). Common conservation issues received prescriptions in >90% of CCPs. Specialized topics received more variable treatment. Prescriptions for aquatic connectivity, water quantity, and climate-change impacts increased over the study period. Except for climate change, direct actions were the most common type of management prescription, followed by plans or studies. Most CCPs stated a commitment to adaptive management and prescribed monitoring for common conservation objectives; other aspects of planning for adaptive management were often lacking, despite strong support for adaptive management in the conservation planning literature. To better address refuge-specific threats, we recommend that revised plans explicitly match identified refuge issues with prescriptions, particularly for under-represented concerns such as novel pests and pathogens. We recommend incorporating triggers into monitoring frameworks and specifying actions that will occur when threshold values are reached to improve support for adaptive management. Revised CCPs should better reflect work that refuges already undertake to extend conservation objectives beyond their borders and better engage with regional conservation efforts to continue this work. More thorough landscape-scale threat assessments and explicit prioritization of planned actions would further improve conservation effectiveness. Excellent examples of all recommended practices exist within the CCPs we examined; sharing best planning practices would improve planning efficiency within the refuge system. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

  7. Framework for culturally competent decisionmaking in child welfare.

    PubMed

    Cohen, Elena P

    2003-01-01

    This article provides a framework to understand the cultural, social, political, and economic factors that affect decisionmaking when working with ethnically and racially diverse families in the child welfare system. The article describes external factors affecting the decisionmaking process, including community environment, agency structure, and family characteristics. It then reviews the core stages of the casework process, describing key decisions during intake, assessment, service planning, implementation, evaluation, and closure. Although the framework is based on casework process in the child welfare system, it can be adapted to other child-serving systems, including education, mental health, and juvenile justice.

  8. A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking.

    PubMed

    Colvill, Emma; Booth, Jeremy; Nill, Simeon; Fast, Martin; Bedford, James; Oelfke, Uwe; Nakamura, Mitsuhiro; Poulsen, Per; Worm, Esben; Hansen, Rune; Ravkilde, Thomas; Scherman Rydhög, Jonas; Pommer, Tobias; Munck Af Rosenschold, Per; Lang, Stephanie; Guckenberger, Matthias; Groh, Christian; Herrmann, Christian; Verellen, Dirk; Poels, Kenneth; Wang, Lei; Hadsell, Michael; Sothmann, Thilo; Blanck, Oliver; Keall, Paul

    2016-04-01

    A study of real-time adaptive radiotherapy systems was performed to test the hypothesis that, across delivery systems and institutions, the dosimetric accuracy is improved with adaptive treatments over non-adaptive radiotherapy in the presence of patient-measured tumor motion. Ten institutions with robotic(2), gimbaled(2), MLC(4) or couch tracking(2) used common materials including CT and structure sets, motion traces and planning protocols to create a lung and a prostate plan. For each motion trace, the plan was delivered twice to a moving dosimeter; with and without real-time adaptation. Each measurement was compared to a static measurement and the percentage of failed points for γ-tests recorded. For all lung traces all measurement sets show improved dose accuracy with a mean 2%/2mm γ-fail rate of 1.6% with adaptation and 15.2% without adaptation (p<0.001). For all prostate the mean 2%/2mm γ-fail rate was 1.4% with adaptation and 17.3% without adaptation (p<0.001). The difference between the four systems was small with an average 2%/2mm γ-fail rate of <3% for all systems with adaptation for lung and prostate. The investigated systems all accounted for realistic tumor motion accurately and performed to a similar high standard, with real-time adaptation significantly outperforming non-adaptive delivery methods. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  9. Multi-objective Optimization for the Robust Performance of Drinking Water Treatment Plants under Climate Change and Climate Extremes

    NASA Astrophysics Data System (ADS)

    Raseman, W. J.; Kasprzyk, J. R.; Rosario-Ortiz, F.; Summers, R. S.; Stewart, J.; Livneh, B.

    2016-12-01

    To promote public health, the United States Environmental Protection Agency (US EPA), and similar entities around the world enact strict laws to regulate drinking water quality. These laws, such as the Stage 1 and 2 Disinfectants and Disinfection Byproducts (D/DBP) Rules, come at a cost to water treatment plants (WTPs) which must alter their operations and designs to meet more stringent standards and the regulation of new contaminants of concern. Moreover, external factors such as changing influent water quality due to climate extremes and climate change, may force WTPs to adapt their treatment methods. To grapple with these issues, decision support systems (DSSs) have been developed to aid WTP operation and planning. However, there is a critical need to better address long-term decision making for WTPs. In this poster, we propose a DSS framework for WTPs for long-term planning, which improves upon the current treatment of deep uncertainties within the overall potable water system including the impact of climate on influent water quality and uncertainties in treatment process efficiencies. We present preliminary results exploring how a multi-objective evolutionary algorithm (MOEA) search can be coupled with models of WTP processes to identify high-performing plans for their design and operation. This coupled simulation-optimization technique uses Borg MOEA, an auto-adaptive algorithm, and the Water Treatment Plant Model, a simulation model developed by the US EPA to assist in creating the D/DBP Rules. Additionally, Monte Carlo sampling methods were used to study the impact of uncertainty of influent water quality on WTP decision-making and generate plans for robust WTP performance.

  10. Advanced optical manufacturing digital integrated system

    NASA Astrophysics Data System (ADS)

    Tao, Yizheng; Li, Xinglan; Li, Wei; Tang, Dingyong

    2012-10-01

    It is necessarily to adapt development of advanced optical manufacturing technology with modern science technology development. To solved these problems which low of ration, ratio of finished product, repetition, consistent in big size and high precision in advanced optical component manufacturing. Applied business driven and method of Rational Unified Process, this paper has researched advanced optical manufacturing process flow, requirement of Advanced Optical Manufacturing integrated System, and put forward architecture and key technology of it. Designed Optical component core and Manufacturing process driven of Advanced Optical Manufacturing Digital Integrated System. the result displayed effective well, realized dynamic planning Manufacturing process, information integration improved ratio of production manufactory.

  11. Implementing an organised cervical screening programme in the Republic of Moldova-Stakeholder identification and engagement.

    PubMed

    Davies, Philip; Valuta, Diana; Cojohari, Natalia; Sancho-Garnier, Helene

    2017-10-01

    Successfully implementing cervical screening programmes requires them to be adapted to the local context and have broad stakeholder support. This can be achieved by actively engaging local stakeholders in planning as well as implementing the programmes. The Moldovan government started implementing an organised cervical screening programme in 2010 with the first step being stakeholder identification and engagement. This process started by contacting easily identified stakeholders with each asked to recommend others and the process continued until no new ones were identified. Stakeholders were then involved in a series of individual and group meetings over a 2-year period to build confidence and encourage progressively greater engagement. In total, 87 individuals from 46 organisations were identified. Over the 2-year process, the individual and group meetings facilitated a change in stakeholder attitudes from disinterest, to acceptance and finally to active cooperation in designing the screening programme and preparing an implementation plan that were both well adapted to the Moldovan context. Developing the broad support needed to implement cervical screening programmes required ongoing interaction with stakeholders over an extended period. This interaction allowed stakeholder concerns to be identified and addressed, progress to be demonstrated, and stakeholders to be educated about organised screening programmes so they had the knowledge to progressively take greater responsibility and ownership. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Spot Weight Adaptation for Moving Target in Spot Scanning Proton Therapy.

    PubMed

    Morel, Paul; Wu, Xiaodong; Blin, Guillaume; Vialette, Stéphane; Flynn, Ryan; Hyer, Daniel; Wang, Dongxu

    2015-01-01

    This study describes a real-time spot weight adaptation method in spot-scanning proton therapy for moving target or moving patient, so that the resultant dose distribution closely matches the planned dose distribution. The method proposed in this study adapts the weight (MU) of the delivering pencil beam to that of the target spot; it will actually hit during patient/target motion. The target spot that a certain delivering pencil beam may hit relies on patient monitoring and/or motion modeling using four-dimensional (4D) CT. After the adapted delivery, the required total weight [Monitor Unit (MU)] for this target spot is then subtracted from the planned value. With continuous patient motion and continuous spot scanning, the planned doses to all target spots will eventually be all fulfilled. In a proof-of-principle test, a lung case was presented with realistic temporal and motion parameters; the resultant dose distribution using spot weight adaptation was compared to that without using this method. The impact of the real-time patient/target position tracking or prediction was also investigated. For moderate motion (i.e., mean amplitude 0.5 cm), D95% to the planning target volume (PTV) was only 81.5% of the prescription (RX) dose; with spot weight adaptation PTV D95% achieves 97.7% RX. For large motion amplitude (i.e., 1.5 cm), without spot weight adaptation PTV D95% is only 42.9% of RX; with spot weight adaptation, PTV D95% achieves 97.7% RX. Larger errors in patient/target position tracking or prediction led to worse final target coverage; an error of 3 mm or smaller in patient/target position tracking is preferred. The proposed spot weight adaptation method was able to deliver the planned dose distribution and maintain target coverage when patient motion was involved. The successful implementation of this method would rely on accurate monitoring or prediction of patient/target motion.

  13. Urban adaptation to mega-drought: Anticipatory water modeling, policy, and planning in Phoenix

    NASA Astrophysics Data System (ADS)

    Gober, P.; Sampson, D. A.; Quay, R.; White, D. D.; Chow, W.

    2016-12-01

    There is increasing interest in using the results of water models for long-term planning and policy analysis. Achieving this goal requires more effective integration of human dimensions into water modeling and a paradigm shift in the way models are developed and used. A user-defined focus argues in favor of models that are designed to foster public debate and engagement about the difficult trade-offs that are inevitable in managing complex water systems. These models also emphasize decision making under uncertainty and anticipatory planning, and are developed through a collaborative and iterative process. This paper demonstrates the use of anticipatory modeling for long-term drought planning in Phoenix, one of the largest and fastest growing urban areas in the southwestern USA. WaterSim 5, an anticipatory water policy and planning model, was used to explore groundwater sustainability outcomes for mega-drought conditions across a range of policies, including population growth management, water conservation, water banking, direct reuse of RO reclaimed water, and water augmentation. Results revealed that business-as-usual population growth, per capita use trends, and management strategies may not be sustainable over the long term, even without mega-drought conditions as years of available groundwater supply decline over the simulation period from 2000 to 2060. Adding mega-drought increases the decline in aquifer levels and increases the variability in flows and uncertainty about future groundwater supplies. Simulations that combine drought management policies can return the region to sustainable. Results demonstrate the value of long-term planning and policy analysis for anticipating and adapting to environmental change.

  14. Experiences and lessons learned for planning and supply of micronutrient powders interventions.

    PubMed

    Schauer, Claudia; Sunley, Nigel; Hubbell Melgarejo, Carrie; Nyhus Dhillon, Christina; Roca, Claudia; Tapia, Gustavo; Mathema, Pragya; Walton, Shelley; Situma, Ruth; Zlotkin, Stanley; Dw Klemm, Rolf

    2017-09-01

    Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of "The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance," 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale-up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale-up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

  15. Neural mechanisms of planning: A computational analysis using event-related fMRI

    PubMed Central

    Fincham, Jon M.; Carter, Cameron S.; van Veen, Vincent; Stenger, V. Andrew; Anderson, John R.

    2002-01-01

    To investigate the neural mechanisms of planning, we used a novel adaptation of the Tower of Hanoi (TOH) task and event-related functional MRI. Participants were trained in applying a specific strategy to an isomorph of the five-disk TOH task. After training, participants solved novel problems during event-related functional MRI. A computational cognitive model of the task was used to generate a reference time series representing the expected blood oxygen level-dependent response in brain areas involved in the manipulation and planning of goals. This time series was used as one term within a general linear modeling framework to identify brain areas in which the time course of activity varied as a function of goal-processing events. Two distinct time courses of activation were identified, one in which activation varied parametrically with goal-processing operations, and the other in which activation became pronounced only during goal-processing intensive trials. Regions showing the parametric relationship comprised a frontoparietal system and include right dorsolateral prefrontal cortex [Brodmann's area (BA 9)], bilateral parietal (BA 40/7), and bilateral premotor (BA 6) areas. Regions preferentially engaged only during goal-intensive processing include left inferior frontal gyrus (BA 44). The implications of these results for the current model, as well as for our understanding of the neural mechanisms of planning and functional specialization of the prefrontal cortex, are discussed. PMID:11880658

  16. Quality Control Analysis of Selected Aspects of Programs Administered by the Bureau of Student Financial Assistance. Task 1 and Quality Control Sample; Error-Prone Modeling Analysis Plan.

    ERIC Educational Resources Information Center

    Saavedra, Pedro; And Others

    Parameters and procedures for developing an error-prone model (EPM) to predict financial aid applicants who are likely to misreport on Basic Educational Opportunity Grant (BEOG) applications are introduced. Specifications to adapt these general parameters to secondary data analysis of the Validation, Edits, and Applications Processing Systems…

  17. 3. Photocopy of 1934 building plan adapted for use at ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. Photocopy of 1934 building plan adapted for use at the Hornet Ranger Station. Original is on file with the Payette National Forest, Supervisor's Office, McCall, Idaho. Photograph is 8'x 10', enlarged from a 4'x 5' negative. PLAN R-4 #11, FOUR HORSE BARN, 1934. - Hornet Ranger Station, Four Horse Barn, Forest Service Road No. 50002, Council, Adams County, ID

  18. Deciphering Paria and Little Colorado River flood regimes and their significance in multi-objective adaptive management strategies for Colorado River resources in Grand Canyon

    NASA Astrophysics Data System (ADS)

    Jain, S.; Topping, D. J.; Melis, T. S.

    2014-12-01

    Planning and decision processes in the Glen Canyon Dam Adaptive Management Program (GCDAMP) strive to balance numerous, often competing, objectives, such as, water supply, hydropower generation, low flow maintenance, sandbars, recreational trout angling, endangered native fish, whitewater rafting, and other sociocultural resources of Glen Canyon National Recreation Area and Grand Canyon National Park. In this context, use of monitored and predictive information on warm-season Paria River floods (JUL-OCT, at point-to-regional scales) has been identified as lead information for a new 10-year long controlled flooding experiment (termed the High-Flow Experiment Protocol) intended to determine management options for rebuilding and maintaining sandbars below Glen Canyon Dam; an adaptive strategy that can potentially facilitate improved planning and dam operations. In this work, we focus on a key concern identified by the GCDAMP, related to the timing and volume of warm season tributary sand input from the Paria River into the Colorado River in Grand Canyon National Park. The Little Colorado River is an important secondary source of sand inputs to Grand Canyon, but its lower segment is also critical spawning habitat for the endangered humpback chub. Fish biologists have reported increased abundance of chub juveniles in this key tributary in summers following cool-season flooding (DEC-FEB), but little is known about chub spawning substrates and behavior or the role that flood frequency in this tributary may play in native fish population dynamics in Grand Canyon. Episodic and intraseasonal variations (with links to equatorial and sub-tropical Pacific sea surface temperature variability) in southwest hydroclimatology are investigated to understand the magnitude, timing and spatial scales of warm- and cool-season floods from these two important tributaries of the semi-arid Colorado Plateau. Coupled variations of floods (magnitude and timing) from these rivers are also investigated. The physical processes, including diagnosis of storms and moisture sources, are mapped alongside the planning and decision processes for the ongoing experimental flood releases from the dam which are aimed at improving sandbars and instream ecology of native fish.

  19. Adaptive Radiotherapy Planning on Decreasing Gross Tumor Volumes as Seen on Megavoltage Computed Tomography Images

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

    Woodford, Curtis; Yartsev, Slav; Dar, A. Rashid

    2007-11-15

    Purpose: To evaluate gross tumor volume (GTV) changes for patients with non-small-cell lung cancer by using daily megavoltage (MV) computed tomography (CT) studies acquired before each treatment fraction on helical tomotherapy and to relate the potential benefit of adaptive image-guided radiotherapy to changes in GTV. Methods and Materials: Seventeen patients were prescribed 30 fractions of radiotherapy on helical tomotherapy for non-small-cell lung cancer at London Regional Cancer Program from Dec 2005 to March 2007. The GTV was contoured on the daily MVCT studies of each patient. Adapted plans were created using merged MVCT-kilovoltage CT image sets to investigate the advantagesmore » of replanning for patients with differing GTV regression characteristics. Results: Average GTV change observed over 30 fractions was -38%, ranging from -12 to -87%. No significant correlation was observed between GTV change and patient's physical or tumor features. Patterns of GTV changes in the 17 patients could be divided broadly into three groups with distinctive potential for benefit from adaptive planning. Conclusions: Changes in GTV are difficult to predict quantitatively based on patient or tumor characteristics. If changes occur, there are points in time during the treatment course when it may be appropriate to adapt the plan to improve sparing of normal tissues. If GTV decreases by greater than 30% at any point in the first 20 fractions of treatment, adaptive planning is appropriate to further improve the therapeutic ratio.« less

  20. Evaluation of the deformation and corresponding dosimetric implications in prostate cancer treatment

    NASA Astrophysics Data System (ADS)

    Wen, Ning; Glide-Hurst, Carri; Nurushev, Teamour; Xing, Lei; Kim, Jinkoo; Zhong, Hualiang; Liu, Dezhi; Liu, Manju; Burmeister, Jay; Movsas, Benjamin; Chetty, Indrin J.

    2012-09-01

    The cone-beam computed tomography (CBCT) imaging modality is an integral component of image-guided adaptive radiation therapy (IGART), which uses patient-specific dynamic/temporal information for potential treatment plan modification. In this study, an offline process for the integral component IGART framework has been implemented that consists of deformable image registration (DIR) and its validation, dose reconstruction, dose accumulation and dose verification. This study compares the differences between planned and estimated delivered doses under an IGART framework of five patients undergoing prostate cancer radiation therapy. The dose calculation accuracy on CBCT was verified by measurements made in a Rando pelvic phantom. The accuracy of DIR on patient image sets was evaluated in three ways: landmark matching with fiducial markers, visual image evaluation and unbalanced energy (UE); UE has been previously demonstrated to be a feasible method for the validation of DIR accuracy at a voxel level. The dose calculated on each CBCT image set was reconstructed and accumulated over all fractions to reflect the ‘actual dose’ delivered to the patient. The deformably accumulated (delivered) plans were then compared to the original (static) plans to evaluate tumor and normal tissue dose discrepancies. The results support the utility of adaptive planning, which can be used to fully elucidate the dosimetric impact based on the simulated delivered dose to achieve the desired tumor control and normal tissue sparing, which may be of particular importance in the context of hypofractionated radiotherapy regimens.

  1. Career Preparation: A Longitudinal, Process-Oriented Examination

    PubMed Central

    Stringer, Kate; Kerpelman, Jennifer; Skorikov, Vladimir

    2011-01-01

    Preparing for an adult career through careful planning, choosing a career, and gaining confidence to achieve career goals is a primary task during adolescence and early adulthood. The current study bridged identity process literature and career construction theory (Savickas, 2005) by examining the commitment component of career adaptability, career preparation (i.e., career planning, career decision-making, and career confidence), from an identity process perspective (Luyckx, Goossens, & Soenens, 2006). Research has suggested that career preparation dimensions are interrelated during adolescence and early adulthood; however, what remains to be known is how each dimension changes over time and the interrelationships among the dimensions during the transition from high school. Drawing parallels between career preparation and identity development dimensions, the current study addressed these questions by examining the patterns of change in each career preparation dimension and parallel process models that tested associations among the slopes and intercepts of the career preparation dimensions. Results showed that the career preparation dimensions were not developing similarly over time, although each dimension was associated cross-sectionally and longitudinally with the other dimensions. Results also suggested that career planning and decision-making precede career confidence. The results of the current study supported career construction theory and showed similarities between the processes of career preparation and identity development. PMID:21804641

  2. Career Preparation: A Longitudinal, Process-Oriented Examination.

    PubMed

    Stringer, Kate; Kerpelman, Jennifer; Skorikov, Vladimir

    2011-08-01

    Preparing for an adult career through careful planning, choosing a career, and gaining confidence to achieve career goals is a primary task during adolescence and early adulthood. The current study bridged identity process literature and career construction theory (Savickas, 2005) by examining the commitment component of career adaptability, career preparation (i.e., career planning, career decision-making, and career confidence), from an identity process perspective (Luyckx, Goossens, & Soenens, 2006). Research has suggested that career preparation dimensions are interrelated during adolescence and early adulthood; however, what remains to be known is how each dimension changes over time and the interrelationships among the dimensions during the transition from high school. Drawing parallels between career preparation and identity development dimensions, the current study addressed these questions by examining the patterns of change in each career preparation dimension and parallel process models that tested associations among the slopes and intercepts of the career preparation dimensions. Results showed that the career preparation dimensions were not developing similarly over time, although each dimension was associated cross-sectionally and longitudinally with the other dimensions. Results also suggested that career planning and decision-making precede career confidence. The results of the current study supported career construction theory and showed similarities between the processes of career preparation and identity development.

  3. Climate Adaptation and Resiliency Planning : Agency Roles and Workforce Development Needs.

    DOT National Transportation Integrated Search

    2017-10-01

    This report is one of two NCST Research Reports produced as part of a project to evaluate the state of practice and adequacy of technical tools for resiliency and adaptation planning. A companion report, Network Requirements for Assessing Criticality...

  4. Transportation Network Data Requirements for Assessing Criticality for Resiliency and Adaptation Planning

    DOT National Transportation Integrated Search

    2017-11-01

    This report is one of two NCST Research Report documents produced as part of a project to advance the technical modeling tools for resiliency and adaptation planning, especially those used for criticality rankings. The official final technical report...

  5. Climate Adaptation and Resiliency Planning : Agency Roles and Workforce Development Needs

    DOT National Transportation Integrated Search

    2017-10-01

    This report is one of two NCST Research Reports produced as part of a project to evaluate the state of practice and adequacy of technical tools for resiliency and adaptation planning. A companion report, Network Requirements for Assessing Criticality...

  6. Adapting practice-based intervention research to electronic environments: opportunities and complexities at two institutions.

    PubMed

    Stille, Christopher J; Lockhart, Steven A; Maertens, Julie A; Madden, Christi A; Darden, Paul M

    2015-01-01

    Primary care practice-based research has become more complex with increased use of electronic health records (EHRs). Little has been reported about changes in study planning and execution that are required as practices change from paper-based to electronic-based environments. We describe the evolution of a pediatric practice-based intervention study as it was adapted for use in the electronic environment, to enable other practice-based researchers to plan efficient, effective studies. We adapted a paper-based pediatric office-level intervention to enhance parent-provider communication about subspecialty referrals for use in two practice-based research networks (PBRNs) with partially and fully electronic environments. We documented the process of adaptation and its effect on study feasibility and efficiency, resource use, and administrative and regulatory complexities, as the study was implemented in the two networks. Considerable time and money was required to adapt the paper-based study to the electronic environment, requiring extra meetings with institutional EHR-, regulatory-, and administrative teams, and increased practice training. Institutional unfamiliarity with using EHRs in practice-based research, and the consequent need to develop new policies, were major contributors to delays. Adapting intervention tools to the EHR and minimizing practice disruptions was challenging, but resulted in several efficiencies as compared with a paper-based project. In particular, recruitment and tracking of subjects and data collection were easier and more efficient. Practice-based intervention research in an electronic environment adds considerable cost and time at the outset of a study, especially for centers unfamiliar with such research. Efficiencies generated have the potential of easing the work of study enrollment, subject tracking, and data collection.

  7. Ecologically-Relevant Maps of Landforms and Physiographic Diversity for Climate Adaptation Planning

    PubMed Central

    Theobald, David M.; Harrison-Atlas, Dylan; Monahan, William B.; Albano, Christine M.

    2015-01-01

    Key to understanding the implications of climate and land use change on biodiversity and natural resources is to incorporate the physiographic platform on which changes in ecological systems unfold. Here, we advance a detailed classification and high-resolution map of physiography, built by combining landforms and lithology (soil parent material) at multiple spatial scales. We used only relatively static abiotic variables (i.e., excluded climatic and biotic factors) to prevent confounding current ecological patterns and processes with enduring landscape features, and to make the physiographic classification more interpretable for climate adaptation planning. We generated novel spatial databases for 15 landform and 269 physiographic types across the conterminous United States of America. We examined their potential use by natural resource managers by placing them within a contemporary climate change adaptation framework, and found our physiographic databases could play key roles in four of seven general adaptation strategies. We also calculated correlations with common empirical measures of biodiversity to examine the degree to which the physiographic setting explains various aspects of current biodiversity patterns. Additionally, we evaluated the relationship between landform diversity and measures of climate change to explore how changes may unfold across a geophysical template. We found landform types are particularly sensitive to spatial scale, and so we recommend using high-resolution datasets when possible, as well as generating metrics using multiple neighborhood sizes to both minimize and characterize potential unknown biases. We illustrate how our work can inform current strategies for climate change adaptation. The analytical framework and classification of landforms and parent material are easily extendable to other geographies and may be used to promote climate change adaptation in other settings. PMID:26641818

  8. Dosimetric and geometric evaluation of a hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy

    PubMed Central

    Liu, Han; Wu, Qiuwen

    2011-01-01

    For prostate cancer patients, online image-guided (IG) radiotherapy has been widely used in clinic to correct the translational inter-fractional motion at each treatment fraction. For uncertainties that cannot be corrected online, such as rotation and deformation of the target volume, margins are still required to be added to the clinical target volume (CTV) for the treatment planning. Offline adaptive radiotherapy has been implemented to optimize the treatment for each individual patient based on the measurements at early stages of treatment process. It has been shown that offline adaptive radiotherapy can effectively reduce the required margin. Recently a hybrid strategy of offline adaptive replanning and online IG was proposed and the geometric evaluation was performed. It was found that the planning margins can be further reduced by 1–2 mm compared to online IG only strategy. The purpose of this study was to investigate the dosimetric benefits of such hybrid strategy on the target and organs at risk (OARs). A total of 420 repeated helical computed tomography (HCT) scans from 28 patients were included in the study. Both low-risk patients (LRP, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles, SV) were included in the simulation. Two registration methods, based on center-of-mass (COM) shift of prostate only and prostate plus SV, were performed for IRP. The intensity modulated radiotherapy (IMRT) was used in the simulation. Criteria on both cumulative dose and fractional doses were evaluated. Furthermore, the geometric evaluation was extended to investigate the optimal number of fractions necessary to construct the internal target volume (ITV) for the hybrid strategy. The dosimetric margin improvement was smaller than its geometric counterpart and was in the range of 0 mm to 1 mm. The optimal number of fractions necessary for the ITV construction is 2 for LRP and 3–4 for IRP in a hypofractionation protocol. A new cumulative index of target volume (CITV) was proposed for the evaluation of adaptive radiotherapy strategies, and it was found that it had the advantages over other indices in evaluating different adaptive radiotherapy strategies. PMID:21772083

  9. Dosimetric and geometric evaluation of a hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy.

    PubMed

    Liu, Han; Wu, Qiuwen

    2011-08-07

    For prostate cancer patients, online image-guided (IG) radiotherapy has been widely used in clinic to correct the translational inter-fractional motion at each treatment fraction. For uncertainties that cannot be corrected online, such as rotation and deformation of the target volume, margins are still required to be added to the clinical target volume (CTV) for the treatment planning. Offline adaptive radiotherapy has been implemented to optimize the treatment for each individual patient based on the measurements at early stages of treatment process. It has been shown that offline adaptive radiotherapy can effectively reduce the required margin. Recently a hybrid strategy of offline adaptive replanning and online IG was proposed and the geometric evaluation was performed. It was found that the planning margins can further be reduced by 1-2 mm compared to online IG only strategy. The purpose of this study was to investigate the dosimetric benefits of such a hybrid strategy on the target and organs at risk. A total of 420 repeated helical computed tomography scans from 28 patients were included in the study. Both low-risk patients (LRP, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles, SV) were included in the simulation. Two registration methods, based on center-of-mass shift of prostate only and prostate plus SV, were performed for IRP. The intensity-modulated radiotherapy was used in the simulation. Criteria on both cumulative and fractional doses were evaluated. Furthermore, the geometric evaluation was extended to investigate the optimal number of fractions necessary to construct the internal target volume (ITV) for the hybrid strategy. The dosimetric margin improvement was smaller than its geometric counterpart and was in the range of 0-1 mm. The optimal number of fractions necessary for the ITV construction is 2 for LRPs and 3-4 for IRPs in a hypofractionation protocol. A new cumulative index of target volume was proposed for the evaluation of adaptive radiotherapy strategies, and it was found that it had the advantages over other indices in evaluating different adaptive radiotherapy strategies.

  10. Significant and Basic Innovations in Urban Planning

    NASA Astrophysics Data System (ADS)

    Kolyasnikov, V. A.

    2017-11-01

    The article considers the development features of the innovative urban planning in the USSR and Russia in XVIII - XX centuries. Innovative urban planning is defined as an activity on innovations creation and their implementation to obtain a socio-economic, political, environmental or other effect. In the course of urban development history this activity represents a cyclic wave process in which there are phases of rise and fall. The study of cyclic waves in the development of innovative urban planning uses the concept of basic and epochal innovations selection. This concept was developed by scientists for the study of cyclic wave processes in economics. Its adaptation to the conditions of innovative urban planning development allows one to introduce the concept of “basic innovation” and “significant innovation” in the theory and practice of settlement formation and their systems as well as to identify opportunities to highlight these innovations in the history of Russian urban planning. From these positions, six innovation waves committed to the urban development over the past 300 years are being investigated. The observed basic innovations in the domestic urban area show that urban development is a vital area for ensuring the country’s geopolitical security. Basic innovations are translated in time and modernized under new conditions of urban planning development. In this regard, we can predict the development of four basic innovations in post-Soviet Russia.

  11. A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

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

    Jensen, Alexandra D., E-mail: Alexandra.Jensen@med.uni-heidelberg.de; Nill, Simeon; Huber, Peter E.

    Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on themore » basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online correction methods, this approach allows significant improvement of target volume coverage and continuous parotid sparing without treatment delays.« less

  12. A clinical concept for interfractional adaptive radiation therapy in the treatment of head and neck cancer.

    PubMed

    Jensen, Alexandra D; Nill, Simeon; Huber, Peter E; Bendl, Rolf; Debus, Jürgen; Münter, Marc W

    2012-02-01

    To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online correction methods, this approach allows significant improvement of target volume coverage and continuous parotid sparing without treatment delays. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. The BUMP model of response planning: intermittent predictive control accounts for 10 Hz physiological tremor.

    PubMed

    Bye, Robin T; Neilson, Peter D

    2010-10-01

    Physiological tremor during movement is characterized by ∼10 Hz oscillation observed both in the electromyogram activity and in the velocity profile. We propose that this particular rhythm occurs as the direct consequence of a movement response planning system that acts as an intermittent predictive controller operating at discrete intervals of ∼100 ms. The BUMP model of response planning describes such a system. It forms the kernel of Adaptive Model Theory which defines, in computational terms, a basic unit of motor production or BUMP. Each BUMP consists of three processes: (1) analyzing sensory information, (2) planning a desired optimal response, and (3) execution of that response. These processes operate in parallel across successive sequential BUMPs. The response planning process requires a discrete-time interval in which to generate a minimum acceleration trajectory to connect the actual response with the predicted future state of the target and compensate for executional error. We have shown previously that a response planning time of 100 ms accounts for the intermittency observed experimentally in visual tracking studies and for the psychological refractory period observed in double stimulation reaction time studies. We have also shown that simulations of aimed movement, using this same planning interval, reproduce experimentally observed speed-accuracy tradeoffs and movement velocity profiles. Here we show, by means of a simulation study of constant velocity tracking movements, that employing a 100 ms planning interval closely reproduces the measurement discontinuities and power spectra of electromyograms, joint-angles, and angular velocities of physiological tremor reported experimentally. We conclude that intermittent predictive control through sequential operation of BUMPs is a fundamental mechanism of 10 Hz physiological tremor in movement. Copyright © 2010 Elsevier B.V. All rights reserved.

  14. U.S. Forest Service Leads Climate Change Adaptation in the Western United States

    NASA Astrophysics Data System (ADS)

    Halofsky, J.; Peterson, D. L.

    2014-12-01

    Effective climate change engagement on public lands is characterized by (1) an enduring science-management partnership, (2) involvement of key stakeholders, (3) consideration of broad landscapes with multiple landowners, (4) science-based, peer-reviewed assessments of sensitivity of natural resources to climate change, (5) adaptation strategies and tactics developed by resource managers, (6) leadership and a workforce motivated to implement climate-smart practices in resource planning and project management. Using this approach, the U.S. Forest Service, in partnership with other organizations, has developed climate change vulnerability assessments and adaptation plans for diverse ecosystems and multiple resources in national forests and other lands in the western United States, although implementation (step 6) has been slow in some cases. Hundreds of meetings, strategies, plans, and panels have focused on climate change adaptation over the past decade, but only direct engagement between scientists and resource managers (less research, less planning, more action) has resulted in substantive outcomes and increased organizational capacity for climate-smart management.

  15. Nordic couples' decision-making processes during assisted reproduction treatments.

    PubMed

    Sol Olafsdottir, Helga; Wikland, Matts; Möller, Anders

    2013-06-01

    To study couples' perceptions of their decision-making process during the first three years of infertility treatments. This study is a part of a larger project studying the decision-making processes of 22 infertile heterosexual couples, recruited from fertility clinics in all five Nordic countries, over a three year period. A descriptive qualitative method was used. Process of decision-making during assisted reproduction treatments. Seventeen couples had succeeded in becoming parents after approximately three years. Our study suggests that the decision-making process during fertility treatments has three phases: (i) recognizing the decisions to be made, with subcategories; the driving force, mutual project, (ii) gathering knowledge and experience about the options, with subcategories; trust, patient competence, personalized support, and (iii) adapting decisions to possible options, with subcategories; strategic planning, adaption. The core category was "maintaining control in a situation of uncertainty." Two parallel processes affect couples' decision-making process, one within themselves and their relationship, and the other in their contact with the fertility clinic. Couples struggle to make decisions, trusting clinic personnel for guidance, knowledge, and understanding. Nevertheless, couples expressed disappointment with the clinics' reactions to their requests for shared decision-making. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Combined online and offline adaptive radiation therapy: a dosimetric feasibility study.

    PubMed

    Yang, Chengliang; Liu, Feng; Ahunbay, Ergun; Chang, Yu-Wen; Lawton, Colleen; Schultz, Christopher; Wang, Dian; Firat, Selim; Erickson, Beth; Li, X Allen

    2014-01-01

    The purpose of this work is to explore a new adaptive radiation therapy (ART) strategy, combined "online and offline" ART, that can fully account for interfraction variations similar to the existing online ART but with substantially reduced online effort. The concept for the combined ART is to perform online ART only for the fractions with obvious interfraction variations and to deliver the ART plan for that online fraction as well as the subsequent fractions until the next online fraction needs to be adapted. To demonstrate the idea, the daily computed tomographic (CT) data acquired during image guided radiation therapy (IGRT) with an in-room CT (CTVision, Siemens Healthcare, Amarillo, TX) for 6 representative patients (including 2 prostate, 1 head-and-neck, and 1 pancreatic cancer, 1 adrenal carcinoma, and 1 craniopharyngioma patients) were analyzed. Three types of plans were generated based on the following selected daily CTs: (1) IGRT repositioning plan, generated by applying the repositioning shifts to the original plan (representing the current IGRT practice); (2) Re-Opt plan, generated with full-scope optimization; and (3) ART plan, either online ART plan generated with an online ART tool (RealArt, Prowess Inc, Concord, CA) or offline ART plan generated with shifts from the online ART plan. Various dose-volume parameters were compared with measure dosimetric benefits of the ART plans based on daily dose distributions and the cumulative dose maps obtained with deformable image registration. In general, for all the cases studied, the ART (with 3-5 online ART) and Re-Opt plans provide comparable plan quality and offer significantly better target coverage and normal tissue sparing when compared with the repositioning plans. This improvement is statistically significant. The combined online and offline ART is dosimetrically equivalent to the online ART but with substantially reduced online effort, and enables immediate delivery of the adaptive plan when an obvious anatomic change is observed. Copyright © 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  17. Experiences with an adaptive design for a dose-finding study in patients with osteoarthritis.

    PubMed

    Miller, Frank; Björnsson, Marcus; Svensson, Ola; Karlsten, Rolf

    2014-03-01

    Dose-finding studies in non-oncology areas are usually conducted in Phase II of the development process of a new potential medicine and it is key to choose a good design for such a study, as the results will decide if and how to proceed to Phase III. The present article has focus on the design of a dose-finding study for pain in osteoarthritis patients treated with the TRPV1 antagonist AZD1386. We describe different design alternatives in the planning of this study, the reasoning for choosing the adaptive design and experiences with conduct and interim analysis. Three alternatives were proposed: one single dose-finding study with parallel design, a programme with a smaller Phase IIa study followed by a Phase IIb dose-finding study, and an adaptive dose-finding study. We describe these alternatives in detail and explain why the adaptive design was chosen for the study. We give insights in design aspects of the adaptive study, which need to be pre-planned, like interim decision criteria, statistical analysis method and setup of a Data Monitoring Committee. Based on the interim analysis it was recommended to stop the study for futility since AZD1386 showed no significant pain decrease based on the primary variable. We discuss results and experiences from the conduct of the study with the novel design approach. Huge cost savings have been done compared to if the option with one dose-finding design for Phase II had been chosen. However, we point out several challenges with this approach. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Designing for flexible interaction between humans and automation: delegation interfaces for supervisory control.

    PubMed

    Miller, Christopher A; Parasuraman, Raja

    2007-02-01

    To develop a method enabling human-like, flexible supervisory control via delegation to automation. Real-time supervisory relationships with automation are rarely as flexible as human task delegation to other humans. Flexibility in human-adaptable automation can provide important benefits, including improved situation awareness, more accurate automation usage, more balanced mental workload, increased user acceptance, and improved overall performance. We review problems with static and adaptive (as opposed to "adaptable") automation; contrast these approaches with human-human task delegation, which can mitigate many of the problems; and revise the concept of a "level of automation" as a pattern of task-based roles and authorizations. We argue that delegation requires a shared hierarchical task model between supervisor and subordinates, used to delegate tasks at various levels, and offer instruction on performing them. A prototype implementation called Playbook is described. On the basis of these analyses, we propose methods for supporting human-machine delegation interactions that parallel human-human delegation in important respects. We develop an architecture for machine-based delegation systems based on the metaphor of a sports team's "playbook." Finally, we describe a prototype implementation of this architecture, with an accompanying user interface and usage scenario, for mission planning for uninhabited air vehicles. Delegation offers a viable method for flexible, multilevel human-automation interaction to enhance system performance while maintaining user workload at a manageable level. Most applications of adaptive automation (aviation, air traffic control, robotics, process control, etc.) are potential avenues for the adaptable, delegation approach we advocate. We present an extended example for uninhabited air vehicle mission planning.

  19. Adaptive remote sensing technology for feature recognition and tracking

    NASA Technical Reports Server (NTRS)

    Wilson, R. G.; Sivertson, W. E., Jr.; Bullock, G. F.

    1979-01-01

    A technology development plan designed to reduce the data load and data-management problems associated with global study and monitoring missions is described with a heavy emphasis placed on developing mission capabilities to eliminate the collection of unnecessary data. Improved data selectivity can be achieved through sensor automation correlated with the real-time needs of data users. The first phase of the plan includes the Feature Identification and Location Experiment (FILE) which is scheduled for the 1980 Shuttle flight. The FILE experiment is described with attention given to technology needs, development plan, feature recognition and classification, and cloud-snow detection/discrimination. Pointing, tracking and navigation received particular consideration, and it is concluded that this technology plan is viewed as an alternative to approaches to real-time acquisition that are based on extensive onboard format and inventory processing and reliance upon global-satellite-system navigation data.

  20. Study of optical techniques for the Ames unitary wind tunnel, part 7

    NASA Technical Reports Server (NTRS)

    Lee, George

    1993-01-01

    A summary of optical techniques for the Ames Unitary Plan wind tunnels are discussed. Six optical techniques were studied: Schlieren, light sheet and laser vapor screen, angle of attack, model deformation, infrared imagery, and digital image processing. The study includes surveys and reviews of wind tunnel optical techniques, some conceptual designs, and recommendations for use of optical methods in the Ames Unitary Plan wind tunnels. Particular emphasis was placed on searching for systems developed for wind tunnel use and on commercial systems which could be readily adapted for wind tunnels. This final report is to summarize the major results and recommendations.

  1. Adaptive Signal Processing Testbed: VME-based DSP board market survey

    NASA Astrophysics Data System (ADS)

    Ingram, Rick E.

    1992-04-01

    The Adaptive Signal Processing Testbed (ASPT) is a real-time multiprocessor system utilizing digital signal processor technology on VMEbus based printed circuit boards installed on a Sun workstation. The ASPT has specific requirements, particularly as regards to the signal excision application, with respect to interfacing with current and planned data generation equipment, processing of the data, storage to disk of final and intermediate results, and the development tools for applications development and integration into the overall EW/COM computing environment. A prototype ASPT was implemented using three VME-C-30 boards from Applied Silicon. Experience gained during the prototype development led to the conclusions that interprocessor communications capability is the most significant contributor to overall ASPT performance. In addition, the host involvement should be minimized. Boards using different processors were evaluated with respect to the ASPT system requirements, pricing, and availability. Specific recommendations based on various priorities are made as well as recommendations concerning the integration and interaction of various tools developed during the prototype implementation.

  2. Land-use evaluation for sustainable construction in a protected area: A case of Sara mountain national park.

    PubMed

    Ristić, Vladica; Maksin, Marija; Nenković-Riznić, Marina; Basarić, Jelena

    2018-01-15

    The process of making decisions on sustainable development and construction begins in spatial and urban planning when defining the suitability of using land for sustainable construction in a protected area (PA) and its immediate and regional surroundings. The aim of this research is to propose and assess a model for evaluating land-use suitability for sustainable construction in a PA and its surroundings. The methodological approach of Multi-Criteria Decision Analysis was used in the formation of this model and adapted for the research; it was combined with the adapted Analytical hierarchy process and the Delphi process, and supported by a geographical information system (GIS) within the framework of ESRI ArcGIS software - Spatial analyst. The model is applied to the case study of Sara mountain National Park in Kosovo. The result of the model is a "map of integrated assessment of land-use suitability for sustainable construction in a PA for the natural factor". Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Galileo mission planning for Low Gain Antenna based operations

    NASA Technical Reports Server (NTRS)

    Gershman, R.; Buxbaum, K. L.; Ludwinski, J. M.; Paczkowski, B. G.

    1994-01-01

    The Galileo mission operations concept is undergoing substantial redesign, necessitated by the deployment failure of the High Gain Antenna, while the spacecraft is on its way to Jupiter. The new design applies state-of-the-art technology and processes to increase the telemetry rate available through the Low Gain Antenna and to increase the information density of the telemetry. This paper describes the mission planning process being developed as part of this redesign. Principal topics include a brief description of the new mission concept and anticipated science return (these have been covered more extensively in earlier papers), identification of key drivers on the mission planning process, a description of the process and its implementation schedule, a discussion of the application of automated mission planning tool to the process, and a status report on mission planning work to date. Galileo enhancements include extensive reprogramming of on-board computers and substantial hard ware and software upgrades for the Deep Space Network (DSN). The principal mode of operation will be onboard recording of science data followed by extended playback periods. A variety of techniques will be used to compress and edit the data both before recording and during playback. A highly-compressed real-time science data stream will also be important. The telemetry rate will be increased using advanced coding techniques and advanced receivers. Galileo mission planning for orbital operations now involves partitioning of several scarce resources. Particularly difficult are division of the telemetry among the many users (eleven instruments, radio science, engineering monitoring, and navigation) and allocation of space on the tape recorder at each of the ten satellite encounters. The planning process is complicated by uncertainty in forecast performance of the DSN modifications and the non-deterministic nature of the new data compression schemes. Key mission planning steps include quantifying resource or capabilities to be allocated, prioritizing science observations and estimating resource needs for each, working inter-and intra-orbit trades of these resources among the Project elements, and planning real-time science activity. The first major mission planning activity, a high level, orbit-by-orbit allocation of resources among science objectives, has already been completed; and results are illustrated in the paper. To make efficient use of limited resources, Galileo mission planning will rely on automated mission planning tools capable of dealing with interactions among time-varying downlink capability, real-time science and engineering data transmission, and playback of recorded data. A new generic mission planning tool is being adapted for this purpose.

  4. Galileo mission planning for Low Gain Antenna based operations

    NASA Astrophysics Data System (ADS)

    Gershman, R.; Buxbaum, K. L.; Ludwinski, J. M.; Paczkowski, B. G.

    1994-11-01

    The Galileo mission operations concept is undergoing substantial redesign, necessitated by the deployment failure of the High Gain Antenna, while the spacecraft is on its way to Jupiter. The new design applies state-of-the-art technology and processes to increase the telemetry rate available through the Low Gain Antenna and to increase the information density of the telemetry. This paper describes the mission planning process being developed as part of this redesign. Principal topics include a brief description of the new mission concept and anticipated science return (these have been covered more extensively in earlier papers), identification of key drivers on the mission planning process, a description of the process and its implementation schedule, a discussion of the application of automated mission planning tool to the process, and a status report on mission planning work to date. Galileo enhancements include extensive reprogramming of on-board computers and substantial hard ware and software upgrades for the Deep Space Network (DSN). The principal mode of operation will be onboard recording of science data followed by extended playback periods. A variety of techniques will be used to compress and edit the data both before recording and during playback. A highly-compressed real-time science data stream will also be important. The telemetry rate will be increased using advanced coding techniques and advanced receivers. Galileo mission planning for orbital operations now involves partitioning of several scarce resources. Particularly difficult are division of the telemetry among the many users (eleven instruments, radio science, engineering monitoring, and navigation) and allocation of space on the tape recorder at each of the ten satellite encounters. The planning process is complicated by uncertainty in forecast performance of the DSN modifications and the non-deterministic nature of the new data compression schemes. Key mission planning steps include quantifying resource or capabilities to be allocated, prioritizing science observations and estimating resource needs for each, working inter-and intra-orbit trades of these resources among the Project elements, and planning real-time science activity. The first major mission planning activity, a high level, orbit-by-orbit allocation of resources among science objectives, has already been completed; and results are illustrated in the paper. To make efficient use of limited resources, Galileo mission planning will rely on automated mission planning tools capable of dealing with interactions among time-varying downlink capability, real-time science and engineering data transmission, and playback of recorded data. A new generic mission planning tool is being adapted for this purpose.

  5. Implementation and Testing of VLBI Software Correlation at the USNO

    NASA Technical Reports Server (NTRS)

    Fey, Alan; Ojha, Roopesh; Boboltz, Dave; Geiger, Nicole; Kingham, Kerry; Hall, David; Gaume, Ralph; Johnston, Ken

    2010-01-01

    The Washington Correlator (WACO) at the U.S. Naval Observatory (USNO) is a dedicated VLBI processor based on dedicated hardware of ASIC design. The WACO is currently over 10 years old and is nearing the end of its expected lifetime. Plans for implementation and testing of software correlation at the USNO are currently being considered. The VLBI correlation process is, by its very nature, well suited to a parallelized computing environment. Commercial off-the-shelf computer hardware has advanced in processing power to the point where software correlation is now both economically and technologically feasible. The advantages of software correlation are manifold but include flexibility, scalability, and easy adaptability to changing environments and requirements. We discuss our experience with and plans for use of software correlation at USNO with emphasis on the use of the DiFX software correlator.

  6. Public Health Policy and Experience of the 2009 H1N1 Influenza Pandemic in Pune, India

    PubMed Central

    Purohit, Vidula; Kudale, Abhay; Sundaram, Neisha; Joseph, Saju; Schaetti, Christian; Weiss, Mitchell G.

    2018-01-01

    Background: Prior experience and the persisting threat of influenza pandemic indicate the need for global and local preparedness and public health response capacity. The pandemic of 2009 highlighted the importance of such planning and the value of prior efforts at all levels. Our review of the public health response to this pandemic in Pune, India, considers the challenges of integrating global and national strategies in local programmes and lessons learned for influenza pandemic preparedness. Methods: Global, national and local pandemic preparedness and response plans have been reviewed. In-depth interviews were undertaken with district health policy-makers and administrators who coordinated the pandemic response in Pune. Results: In the absence of a comprehensive district-level pandemic preparedness plan, the response had to be improvised. Media reporting of the influenza pandemic and inaccurate information that was reported at times contributed to anxiety in the general public and to widespread fear and panic. Additional challenges included inadequate public health services and reluctance of private healthcare providers to treat people with flu-like symptoms. Policy-makers developed a response strategy that they referred to as the Pune plan, which relied on powers sanctioned by the Epidemic Act of 1897 and resources made available by the union health ministry, state health department and a government diagnostic laboratory in Pune. Conclusion: The World Health Organization’s (WHO’s) global strategy for pandemic control focuses on national planning, but state-level and local experience in a large nation like India shows how national planning may be adapted and implemented. The priority of local experience and requirements does not negate the need for higher level planning. It does, however, indicate the importance of local adaptability as an essential feature of the planning process. Experience and the implicit Pune plan that emerged are relevant for pandemic preparedness and other public health emergencies. PMID:29524939

  7. Adaptable mission planning for kino-dynamic systems

    NASA Astrophysics Data System (ADS)

    Bush, Lawrence A. M.; Jimenez, Tony R.; Williams, Brian C.

    Autonomous systems can perform tasks that are dangerous, monotonous, or even impossible for humans. To approach the problem of planning for Unmanned Aerial Vehicles (UAVs) we present a hierarchical method that combines a high-level planner with a low-level planner. We pose the problem of high-level planning as a Selective Traveling Salesman Problem (STSP) and select the order in which to visit our science sites. We then use a kino-dynamic path planner to create a large number of intermediate waypoints. This is a complete system that combines high and low level planning to achieve a goal. This paper demonstrates the benefits gained by adaptable high-level plans versus static and greedy plans.

  8. Adaptive governance and institutional strategies for climate-induced community relocations in Alaska.

    PubMed

    Bronen, Robin; Chapin, F Stuart

    2013-06-04

    This article presents governance and institutional strategies for climate-induced community relocations. In Alaska, repeated extreme weather events coupled with climate change-induced coastal erosion impact the habitability of entire communities. Community residents and government agencies concur that relocation is the only adaptation strategy that can protect lives and infrastructure. Community relocation stretches the financial and institutional capacity of existing governance institutions. Based on a comparative analysis of three Alaskan communities, Kivalina, Newtok, and Shishmaref, which have chosen to relocate, we examine the institutional constraints to relocation in the United States. We identify policy changes and components of a toolkit that can facilitate community-based adaptation when environmental events threaten people's lives and protection in place is not possible. Policy changes include amendment of the Stafford Act to include gradual geophysical processes, such as erosion, in the statutory definition of disaster and the creation of an adaptive governance framework to allow communities a continuum of responses from protection in place to community relocation. Key components of the toolkit are local leadership and integration of social and ecological well-being into adaptation planning.

  9. TU-AB-303-01: A Feasibility Study for Dynamic Adaptive Therapy of Non-Small Cell Lung Cancer

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

    Kim, M; Phillips, M

    2015-06-15

    Purpose: To compare plans for NSCLC optimized using Dynamic Adaptive Therapy (DAT) with conventional IMRT optimization. DAT adapts plans based on changes in the target volume by using dynamic programing techniques to consider expected changes into the optimization process. Information gathered during treatment, e.g. from CBCT, is incorporated into the optimization. Methods and materials: DAT is formulated using stochastic control formalism, which minimizes the total expected number of tumor cells at the end of a treatment course subject to uncertainty inherent in the tumor response and organs-at-risk (OAR) dose constraints. This formulation allows for non-stationary dose distribution as well asmore » non-stationary fractional dose as needed to achieve a series of optimal plans that are conformal to tumor over time. Sixteen phantom cases with various sizes and locations of tumors, and OAR geometries were generated. Each case was planned with DAT and conventional IMRT (60Gy/30fx). Tumor volume change over time was obtained by using, daily MVCT-based, two-level cell population model. Monte Carlo simulations have been performed for each treatment course to account for uncertainty in tumor response. Same OAR dose constraints were applied for both methods. The frequency of plan modification was varied to 1, 2, 5 (weekly), and 29 (daily). The final average tumor dose and OAR doses have been compared to quantify the potential benefit of DAT. Results: The average tumor max, min, mean, and D95 resulted from DAT were 124.0–125.2%, 102.1–114.7%, 113.7–123.4%, and 102.0–115.9% (range dependent on the frequency of plan modification) of those from conventional IMRT. Cord max, esophagus max, lung mean, heart mean, and unspecified tissue D05 resulted from AT were 84–102.4%, 99.8–106.9%, 66.9–85.6%, 58.2–78.8%, and 85.2–94.0% of those from conventional IMRT. Conclusions: Significant tumor dose increase and OAR dose reduction, especially with parallel OAR with mean or dose-volume constraints, can be achieved using DAT.« less

  10. An Enduring Investment for Global Stability: Establishing Professional Values as the Foundation of Building Partnership Capacity in a Fiscally Constrained 21st Century

    DTIC Science & Technology

    2013-05-01

    partnership between U.S. and Colombian forces. This approach requires introspection, understanding, and adaptation across the U.S. national security...status. Not all national militaries focus on external threats. Some environmental or national capacity circumstances require military professionals...desired impact, outcomes, and outputs through a strategic planning process providing direction, consultation with stakeholders, and environmentally driven

  11. Humanitarian Assistance: Adapting the Process to Meet the Military’s Evolving Role in Non-Traditional Missions

    DTIC Science & Technology

    1993-12-01

    action to support humanitarian relief and democratic movements " (Towell, 1992, p. 3761). The U.S. 2 led coalition, from December 1992 through May...similar to planning and executing the movement phase of wartime contingencies. Therefore, these activities in humanitarian relief missions also serve...DISASTZR _ CATUGORIZS ORIGINS ZXARPLUS NATURAL METEOROLOGICAL STORMS, DROUGHTS TOPOLOGICAL FLOODS, LANDSLIDES TELLURIC /TECTONIC EARTHQUAKES BIOLOGICAL

  12. Safe Operations of Unmanned Systems for Reconnaissance in Complex Environments Army Technology Objective (SOURCE ATO)

    DTIC Science & Technology

    2011-04-25

    must adapt its planning to vehicle size, shape, wheelbase, wheel and axle configuration, the specific obstacle-crossing capabilities of the vehicle...scalability of the ANS is a consequence of making each sensing modality capable of performing reasonable perception tasks while allowing a wider...autonomous system design achieves flexibility by exploiting redundant sensing modalities where possible, and by a decision-making process that

  13. Simulation Based Evaluation of Integrated Adaptive Control and Flight Planning Technologies

    NASA Technical Reports Server (NTRS)

    Campbell, Stefan Forrest; Kaneshige, John T.

    2008-01-01

    The objective of this work is to leverage NASA resources to enable effective evaluation of resilient aircraft technologies through simulation. This includes examining strengths and weaknesses of adaptive controllers, emergency flight planning algorithms, and flight envelope determination algorithms both individually and as an integrated package.

  14. Extending Volunteer Programs in Schools.

    ERIC Educational Resources Information Center

    Hedges, Henry G.

    Documented here is a project involving three extensions or adaptations for using volunteers in schools. The first adaptation involves a plan for meeting certain major needs of a secondary school with volunteer help. This plan includes components designed to reorganize the secondary school curriculum to allow some of the students to study aspects…

  15. Graphing Important People

    ERIC Educational Resources Information Center

    Reading Teacher, 2012

    2012-01-01

    The "Toolbox" column features content adapted from ReadWriteThink.org lesson plans and provides practical tools for classroom teachers. This issue's column features a lesson plan adapted from "Graphing Plot and Character in a Novel" by Lisa Storm Fink and "Bio-graph: Graphing Life Events" by Susan Spangler. Students retell biographic events…

  16. Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

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

    Li, Taoran, E-mail: taoran.li.duke@gmail.com; Wu, Qiuwen; Yang, Yun

    Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system wasmore » designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery. Results: Online adapted plans were found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system’s ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. Conclusions: The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy.« less

  17. Quality assurance for online adapted treatment plans: benchmarking and delivery monitoring simulation.

    PubMed

    Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q

    2015-01-01

    An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system's performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery. Online adapted plans were found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system's ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy.

  18. Climate Change Adaptation Practices in Various Countries

    NASA Astrophysics Data System (ADS)

    Tanik, A.; Tekten, D.

    2017-08-01

    The paper will be a review work on the recent strategies of EU in general, and will underline the inspected sectoral based adaptation practices and action plans of 7 countries; namely Germany, France, Spain, Italy, Denmark, USA and Kenya from Africa continent. Although every countries’ action plan have some similarities on sectoral analysis, each country in accordance with the specific nature of the problem seems to create its own sectoral analysis. Within this context, green and white documents of EU adaptation to climate change, EU strategy on climate change, EU targets of 2020 on climate change and EU adaptation support tools are investigated.

  19. A new methodology for inter- and intrafraction plan adaptation for the MR-linac

    NASA Astrophysics Data System (ADS)

    Kontaxis, C.; Bol, G. H.; Lagendijk, J. J. W.; Raaymakers, B. W.

    2015-10-01

    The new era of hybrid MRI and linear accelerator machines, including the MR-linac currently being installed in the University Medical Center Utrecht (Utrecht, The Netherlands), will be able to provide the actual anatomy and real-time anatomy changes of the patient’s target(s) and organ(s) at risk (OARs) during radiation delivery. In order to be able to take advantage of this input, a new generation of treatment planning systems is needed, that will allow plan adaptation to the latest anatomy state in an online regime. In this paper, we present a treatment planning algorithm for intensity-modulated radiotherapy (IMRT), which is able to compensate for patient anatomy changes. The system consists of an iterative sequencing loop open to anatomy updates and an inter- and intrafraction adaptation scheme that enables convergence to the ideal dose distribution without the need of a final segment weight optimization (SWO). The ability of the system to take into account organ motion and adapt the plan to the latest anatomy state is illustrated using artificial baseline shifts created for three different kidney cases. Firstly, for two kidney cases of different target volumes, we show that the system can account for intrafraction motion, delivering the intended dose to the target with minimal dose deposition to the surroundings compared to conventional plans. Secondly, for a third kidney case we show that our algorithm combined with the interfraction scheme can be used to deliver the prescribed dose while adapting to the changing anatomy during multi-fraction treatments without performing a final SWO.

  20. The Influence of Drivers and Barriers on Urban Adaptation and Mitigation Plans-An Empirical Analysis of European Cities.

    PubMed

    Reckien, Diana; Flacke, Johannes; Olazabal, Marta; Heidrich, Oliver

    2015-01-01

    Cities are recognised as key players in global adaptation and mitigation efforts because the majority of people live in cities. However, in Europe, which is highly urbanized and one of the most advanced regions in terms of environmental policies, there is considerable diversity in the regional distribution, ambition and scope of climate change responses. This paper explores potential factors contributing to such diversity in 200 large and medium-sized cities across 11 European countries. We statistically investigate institutional, socio-economic, environmental and vulnerability characteristics of cities as potential drivers of or barriers to the development of urban climate change plans. Our results show that factors such as membership of climate networks, population size, GDP per capita and adaptive capacity act as drivers of mitigation and adaptation plans. By contrast, factors such as the unemployment rate, warmer summers, proximity to the coast and projected exposure to future climate impacts act as barriers. We see that, overall, it is predominantly large and prosperous cities that engage in climate planning, while vulnerable cities and those at risk of severe climate impacts in the future are less active. Our analysis suggests that climate change planning in European cities is not proactive, i.e. not significantly influenced by anticipated future impacts. Instead, we found that the current adaptive capacity of a city significantly relates to climate planning. Along with the need to further explore these relations, we see a need for more economic and institutional support for smaller and less resourceful cities and those at high risk from climate change impacts in the future.

  1. Argentine adaptation of the Quality of Life Indicators guide for organizations that support people with autistic spectrum disorders.

    PubMed

    Cuesta Gómez, José L; Manzone, Luisa A

    2018-04-01

    This article describes the adaptation process of the Quality of Life Indicators guide for organizations that support people with autistic spectrum disorders which has taken place in Argentina (Cuesta, J. L., 2009) using the Delphi method, and with the participation of a group of autism-related experts from different fields and domestic institutions. The result is an instrument based on a quality-of-life model which is adjusted to the Argentine setting, helps planning and assessing centers and programs for people with autistic spectrum disorders, and responds to the increasing number of specific services which cover the needs of this population. Sociedad Argentina de Pediatría.

  2. A discussion of nursing students' experiences of culture shock during an international clinical placement and the clinical facilitators' role.

    PubMed

    Maginnis, Cathy; Anderson, Judith

    2017-06-01

    This paper examines the meaning and experience of culture shock for nursing students undertaking an international clinical placement (ICP) and the role of the clinical facilitator. Oberg's four stages of adapting to culture shock were aligned to anecdotal conversations with nursing students on an ICP. All four stages were identified in anecdotal conversations with the students. Support by the accompanying clinical facilitator is pivotalin overcoming culture shock and maximising the learning experience. It is essential that students are prepared for the change in cultural norms and are supported by the academic staff to work through the processes required to adapt to culture shock. Planning and preparation prior to departure is essential to assist with managing culture shock with an emphasis on the inclusion of cultural norms and beliefs. The role of the facilitator is crucial to guide and support the students through the culture shock process.

  3. Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

    PubMed Central

    Somme, Dominique; Trouvé, Hélène; Perisset, Catherine; Corvol, Aline; Ankri, Joël; Saint-Jean, Olivier; de Stampa, Matthieu

    2014-01-01

    Introduction Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion. Discussion The approaching end of the president's term led to the method's institutionalization (2011–2012), before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein) have, nonetheless, ‘found’ some key lessons. Key lessons/conclusion It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level. PMID:24959112

  4. Paradigms for adaptive statistical information designs: practical experiences and strategies.

    PubMed

    Wang, Sue-Jane; Hung, H M James; O'Neill, Robert

    2012-11-10

    In the last decade or so, interest in adaptive design clinical trials has gradually been directed towards their use in regulatory submissions by pharmaceutical drug sponsors to evaluate investigational new drugs. Methodological advances of adaptive designs are abundant in the statistical literature since the 1970s. The adaptive design paradigm has been enthusiastically perceived to increase the efficiency and to be more cost-effective than the fixed design paradigm for drug development. Much interest in adaptive designs is in those studies with two-stages, where stage 1 is exploratory and stage 2 depends upon stage 1 results, but where the data of both stages will be combined to yield statistical evidence for use as that of a pivotal registration trial. It was not until the recent release of the US Food and Drug Administration Draft Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics (2010) that the boundaries of flexibility for adaptive designs were specifically considered for regulatory purposes, including what are exploratory goals, and what are the goals of adequate and well-controlled (A&WC) trials (2002). The guidance carefully described these distinctions in an attempt to minimize the confusion between the goals of preliminary learning phases of drug development, which are inherently substantially uncertain, and the definitive inference-based phases of drug development. In this paper, in addition to discussing some aspects of adaptive designs in a confirmatory study setting, we underscore the value of adaptive designs when used in exploratory trials to improve planning of subsequent A&WC trials. One type of adaptation that is receiving attention is the re-estimation of the sample size during the course of the trial. We refer to this type of adaptation as an adaptive statistical information design. Specifically, a case example is used to illustrate how challenging it is to plan a confirmatory adaptive statistical information design. We highlight the substantial risk of planning the sample size for confirmatory trials when information is very uninformative and stipulate the advantages of adaptive statistical information designs for planning exploratory trials. Practical experiences and strategies as lessons learned from more recent adaptive design proposals will be discussed to pinpoint the improved utilities of adaptive design clinical trials and their potential to increase the chance of a successful drug development. Published 2012. This article is a US Government work and is in the public domain in the USA.

  5. TH-E-BRE-04: An Online Replanning Algorithm for VMAT

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

    Ahunbay, E; Li, X; Moreau, M

    2014-06-15

    Purpose: To develop a fast replanning algorithm based on segment aperture morphing (SAM) for online replanning of volumetric modulated arc therapy (VMAT) with flattening filtered (FF) and flattening filter free (FFF) beams. Methods: A software tool was developed to interface with a VMAT planning system ((Monaco, Elekta), enabling the output of detailed beam/machine parameters of original VMAT plans generated based on planning CTs for FF or FFF beams. A SAM algorithm, previously developed for fixed-beam IMRT, was modified to allow the algorithm to correct for interfractional variations (e.g., setup error, organ motion and deformation) by morphing apertures based on themore » geometric relationship between the beam's eye view of the anatomy from the planning CT and that from the daily CT for each control point. The algorithm was tested using daily CTs acquired using an in-room CT during daily IGRT for representative prostate cancer cases along with their planning CTs. The algorithm allows for restricted MLC leaf travel distance between control points of the VMAT delivery to prevent SAM from increasing leaf travel, and therefore treatment delivery time. Results: The VMAT plans adapted to the daily CT by SAM were found to improve the dosimetry relative to the IGRT repositioning plans for both FF and FFF beams. For the adaptive plans, the changes in leaf travel distance between control points were < 1cm for 80% of the control points with no restriction. When restricted to the original plans' maximum travel distance, the dosimetric effect was minimal. The adaptive plans were delivered successfully with similar delivery times as the original plans. The execution of the SAM algorithm was < 10 seconds. Conclusion: The SAM algorithm can quickly generate deliverable online-adaptive VMAT plans based on the anatomy of the day for both FF and FFF beams.« less

  6. Vulnerability Assessment, Climate Change Impacts and Adaptation Measures in Slovenia

    NASA Astrophysics Data System (ADS)

    Cegnar, T.

    2010-09-01

    In relation to the priority tasks of the climate change measures, the Republic of Slovenia estimates that special attention needs to be devoted to the following sectors in general: - sectors that currently indicate a strong vulnerability for the current climate variability (for instance, agriculture), - sectors where the vulnerability for climate change is increased by current trends (for instance, urban development, use of space), - sectors where the adaptation time is the longest and the subsequent development changes are connected with the highest costs (for instance, use of space, infrastructural objects, forestry, urban development, building stock). Considering the views of Slovenia to the climate change problem in Europe and Slovenia, priority measures and emphasis on future adaptation to climate change, the Republic of Slovenia has especially exposed the following action areas: - sustainable and integrated management of water sources for water power production, prevention of floods, provision of water for the enrichment of low flow rates, and preservation of environmental function as well as provision of water for other needs; - sustainable management of forest ecosystems, adjusted to changes, for the provision of their environmental function as well as being a source of biomass, wood for products for the conservation of carbon, and carbon sinks; - spatial planning as one of the important preventive instruments for the adaptation to climate change through the processes of integral planning of spatial and urban development; - sustainable use and preservation of natural wealth and the preservation of biodiversity as well as ecosystem services with measures and policies that enable an enhanced resistance of ecosystems to climate change, and the role of biological diversity in integral adaptation measures; - informing and awareness on the consequences of climate change and adaptation possibilities. For years, the most endangered sectors have been agriculture and forestry; therefore, they are also the only sectors for which a national adaptation strategy was adopted.

  7. Spatial Learning and Action Planning in a Prefrontal Cortical Network Model

    PubMed Central

    Martinet, Louis-Emmanuel; Sheynikhovich, Denis; Benchenane, Karim; Arleo, Angelo

    2011-01-01

    The interplay between hippocampus and prefrontal cortex (PFC) is fundamental to spatial cognition. Complementing hippocampal place coding, prefrontal representations provide more abstract and hierarchically organized memories suitable for decision making. We model a prefrontal network mediating distributed information processing for spatial learning and action planning. Specific connectivity and synaptic adaptation principles shape the recurrent dynamics of the network arranged in cortical minicolumns. We show how the PFC columnar organization is suitable for learning sparse topological-metrical representations from redundant hippocampal inputs. The recurrent nature of the network supports multilevel spatial processing, allowing structural features of the environment to be encoded. An activation diffusion mechanism spreads the neural activity through the column population leading to trajectory planning. The model provides a functional framework for interpreting the activity of PFC neurons recorded during navigation tasks. We illustrate the link from single unit activity to behavioral responses. The results suggest plausible neural mechanisms subserving the cognitive “insight” capability originally attributed to rodents by Tolman & Honzik. Our time course analysis of neural responses shows how the interaction between hippocampus and PFC can yield the encoding of manifold information pertinent to spatial planning, including prospective coding and distance-to-goal correlates. PMID:21625569

  8. Climate change vulnerability assessments as catalysts for social learning: four case studies in south-eastern Australia

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

    Preston, Benjamin L

    2012-01-01

    Technical assessments of vulnerability and/or risk are increasingly being undertaken to assess the impacts of climate change. Underlying this is the belief that they will bring clarity to questions regarding the scale of institutional investments required, plausible adaptation policies and measures, and the timing of their implementation. Despite the perceived importance of technical assessments in 'evidence-based' decision environments, assessments cannot be undertaken independent of values and politics, nor are they capable of eliminating the uncertainty that clouds decision-making on climate adaptation As such, assessments can trigger as many questions as they answer, leaving practitioners and stakeholders to question their value.more » This paper explores the value of vulnerability/risk assessments in climate change adaptation planning processes as a catalyst for learning in four case studies in Southeastern Australia. Data were collected using qualitative interviews with stakeholders involved in the assessments and analysed using a social learning framework. This analysis revealed that detailed and tangible strategies or actions often do not emerge directly from technical assessments. However, it also revealed that the assessments became important platforms for social learning. In providing these platforms, assessments present opportunities to question initial assumptions, explore multiple framings of an issue, generate new information, and galvanise support for collective actions. This study highlights the need for more explicit recognition and understanding of the important role social learning plays in climate change vulnerability assessments and adaptation planning more broadly.« less

  9. Multi-disciplinary assessments of climate change impacts on agriculture to support adaptation decision making in developing countries

    NASA Astrophysics Data System (ADS)

    Fujisawa, Mariko; Kanamaru, Hideki

    2016-04-01

    Many existing climate change impact studies, carried out by academic researchers, are disconnected from decision making processes of stakeholders. On the other hand many climate change adaptation projects in developing countries lack a solid evidence base of current and future climate impacts as well as vulnerabilities assessment at different scales. In order to fill this information gap, FAO has developed and implemented a tool "MOSAICC (Modelling System for Agricultural Impacts of Climate Change)" in several developing countries such as Morocco, the Philippines and Peru, and recently in Malawi and Zambia. MOSAICC employs a multi-disciplinary assessment approach to addressing climate change impacts and adaptation planning in the agriculture and food security sectors, and integrates five components from different academic disciplines: 1. Statistical downscaling of climate change projections, 2. Yield simulation of major crops at regional scale under climate change, 3. Surface hydrology simulation model, 4. Macroeconomic model, and 5. Forestry model. Furthermore MOSAICC has been developed as a capacity development tool for the national scientists so that they can conduct the country assessment themselves, using their own data, and reflect the outcome into the national adaptation policies. The outputs are nation-wide coverage, disaggregated at sub-national level to support strategic planning, investments and decisions by national policy makers. MOSAICC is designed in such a way to promote stakeholders' participation and strengthen technical capacities in developing countries. The paper presents MOSAICC and projects that used MOSAICC as a tool with case studies from countries.

  10. Interactive Dose Shaping - efficient strategies for CPU-based real-time treatment planning

    NASA Astrophysics Data System (ADS)

    Ziegenhein, P.; Kamerling, C. P.; Oelfke, U.

    2014-03-01

    Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

  11. Flexible Early Warning Systems with Workflows and Decision Tables

    NASA Astrophysics Data System (ADS)

    Riedel, F.; Chaves, F.; Zeiner, H.

    2012-04-01

    An essential part of early warning systems and systems for crisis management are decision support systems that facilitate communication and collaboration. Often official policies specify how different organizations collaborate and what information is communicated to whom. For early warning systems it is crucial that information is exchanged dynamically in a timely manner and all participants get exactly the information they need to fulfil their role in the crisis management process. Information technology obviously lends itself to automate parts of the process. We have experienced however that in current operational systems the information logistics processes are hard-coded, even though they are subject to change. In addition, systems are tailored to the policies and requirements of a certain organization and changes can require major software refactoring. We seek to develop a system that can be deployed and adapted to multiple organizations with different dynamic runtime policies. A major requirement for such a system is that changes can be applied locally without affecting larger parts of the system. In addition to the flexibility regarding changes in policies and processes, the system needs to be able to evolve; when new information sources become available, it should be possible to integrate and use these in the decision process. In general, this kind of flexibility comes with a significant increase in complexity. This implies that only IT professionals can maintain a system that can be reconfigured and adapted; end-users are unable to utilise the provided flexibility. In the business world similar problems arise and previous work suggested using business process management systems (BPMS) or workflow management systems (WfMS) to guide and automate early warning processes or crisis management plans. However, the usability and flexibility of current WfMS are limited, because current notations and user interfaces are still not suitable for end-users, and workflows are usually only suited for rigid processes. We show how improvements can be achieved by using decision tables and rule-based adaptive workflows. Decision tables have been shown to be an intuitive tool that can be used by domain experts to express rule sets that can be interpreted automatically at runtime. Adaptive workflows use a rule-based approach to increase the flexibility of workflows by providing mechanisms to adapt workflows based on context changes, human intervention and availability of services. The combination of workflows, decision tables and rule-based adaption creates a framework that opens up new possibilities for flexible and adaptable workflows, especially, for use in early warning and crisis management systems.

  12. Conducting health survey research in a deep rural South African community: challenges and adaptive strategies.

    PubMed

    Casale, Marisa; Lane, Tyler; Sello, Lebo; Kuo, Caroline; Cluver, Lucie

    2013-04-24

    In many parts of the developing world, rural health requires focused policy attention, informed by reliable, representative health data. Yet there is surprisingly little published material to guide health researchers who face the unique set of hurdles associated with conducting field research in remote rural areas. In this paper we provide a detailed description of the key challenges encountered during health survey field research carried out in 2010 in a deep rural site in KwaZulu-Natal, South Africa. The aim of the field research was to collect data on the health of children aged 10 to 17 years old, and their primary adult caregivers, as part of a larger national health survey; the research was a collaboration between several South African and foreign universities, South African national government departments, and various NGO partners. In presenting each of the four fieldwork challenges encountered on this site, we describe the initial planning decisions made, the difficulties faced when implementing these in the field, and the adaptive strategies we used to respond to these challenges. We reflect on learnings of potential relevance for the research community. Our four key fieldwork challenges were scarce research capacity, staff relocation tensions, logistical constraints, and difficulties related to community buy-in. Addressing each of these obstacles required timely assessment of the situation and adaptation of field plans, in collaboration with our local NGO partner. Adaptive strategies included a greater use of local knowledge; the adoption of tribal authority boundaries as the smallest geopolitical units for sampling; a creative developmental approach to capacity building; and planned, on-going engagement with multiple community representatives. We argue that in order to maintain high scientific standards of research and manage to 'get the job done' on the ground, it is necessary to respond to fieldwork challenges that arise as a cohesive team, with timely, locally-relevant, and often creative, solutions. Budgeting sufficient time and project resources for capacity building and community buy-in processes is also essential when working in remote communities unaccustomed to research. Documenting and sharing field experiences can provide valuable information for other researchers planning to conduct fieldwork in similar contexts.

  13. Exploring Crisis Management in U.S. Small Businesses

    NASA Astrophysics Data System (ADS)

    Williams, Jon

    As a critical infrastructure, the US electricity grid supplies electricity to 340 million people within eight separate regions. The power infrastructure is vulnerable to many types of disasters capable of severing supplies of electricity. The impact on the employees and communities when small- and medium-size enterprises are shut down due to disasters can be severe. The purpose of the quantitative comparative study was to explore small- and medium-size enterprises crisis management strategies in the case of power infrastructure vulnerabilities. Perceptions of small business leaders were probed about crisis management planning relevant to three secondary factors: prior experience of crises, threat perceptions, and planning self-efficacy. Participants completed an adapted questionnaire instrument based on a five-point Likert scale for six sub-factors including resilience through planning, financial impact, operational crisis management, the perfect storm, the aftermath of survival, and atrophy. The instrument also measured three additional factors to include, prior experience of crises, threat perceptions, and planning self-efficacy, across seven types of crises. The results of this study indicated that of the 276 respondents, 104 had no crisis plans, but 172 did have crisis plans. Of those who had implemented crisis plans, 19% had specific provisions to address power outages or attacks on the electrical grid. Of the respondents who had not planned for power outages nor experienced significant losses of power, a statistically significant number acknowledged an external threat to their business. The majority of respondents indicated that long-term planning was related to resilience; however, the migration of crisis understanding into the planning process or implementation was not implemented. This heightened awareness of potential crises without the corresponding development and implementation of mitigation crisis plans requires additional research to understand drivers effecting the decision making process with crisis managers.

  14. Health-sector responses to address the impacts of climate change in Nepal.

    PubMed

    Dhimal, Meghnath; Dhimal, Mandira Lamichhane; Pote-Shrestha, Raja Ram; Groneberg, David A; Kuch, Ulrich

    2017-09-01

    Nepal is highly vulnerable to global climate change, despite its negligible emission of global greenhouse gases. The vulnerable climate-sensitive sectors identified in Nepal's National Adaptation Programme of Action (NAPA) to Climate Change 2010 include agriculture, forestry, water, energy, public health, urbanization and infrastructure, and climate-induced disasters. In addition, analyses carried out as part of the NAPA process have indicated that the impacts of climate change in Nepal are not gender neutral. Vector-borne diseases, diarrhoeal diseases including cholera, malnutrition, cardiorespiratory diseases, psychological stress, and health effects and injuries related to extreme weather are major climate-sensitive health risks in the country. In recent years, research has been done in Nepal in order to understand the changing epidemiology of diseases and generate evidence for decision-making. Based on this evidence, the experience of programme managers, and regular surveillance data, the Government of Nepal has mainstreamed issues related to climate change in development plans, policies and programmes. In particular, the Government of Nepal has addressed climate-sensitive health risks. In addition to the NAPA report, several policy documents have been launched, including the Climate Change Policy 2011; the Nepal Health Sector Programme - Implementation Plan II (NHSP-IP 2) 2010-2015; the National Health Policy 2014; the National Health Sector Strategy 2015-2020 and its implementation plan (2016-2021); and the Health National Adaptation Plan (H-NAP): climate change and health strategy and action plan (2016-2020). However, the translation of these policies and plans of action into tangible action on the ground is still in its infancy in Nepal. Despite this, the health sector's response to addressing the impact of climate change in Nepal may be taken as a good example for other low- and middle-income countries.

  15. Path Planning Algorithms for the Adaptive Sensor Fleet

    NASA Technical Reports Server (NTRS)

    Stoneking, Eric; Hosler, Jeff

    2005-01-01

    The Adaptive Sensor Fleet (ASF) is a general purpose fleet management and planning system being developed by NASA in coordination with NOAA. The current mission of ASF is to provide the capability for autonomous cooperative survey and sampling of dynamic oceanographic phenomena such as current systems and algae blooms. Each ASF vessel is a software model that represents a real world platform that carries a variety of sensors. The OASIS platform will provide the first physical vessel, outfitted with the systems and payloads necessary to execute the oceanographic observations described in this paper. The ASF architecture is being designed for extensibility to accommodate heterogenous fleet elements, and is not limited to using the OASIS platform to acquire data. This paper describes the path planning algorithms developed for the acquisition phase of a typical ASF task. Given a polygonal target region to be surveyed, the region is subdivided according to the number of vessels in the fleet. The subdivision algorithm seeks a solution in which all subregions have equal area and minimum mean radius. Once the subregions are defined, a dynamic programming method is used to find a minimum-time path for each vessel from its initial position to its assigned region. This path plan includes the effects of water currents as well as avoidance of known obstacles. A fleet-level planning algorithm then shuffles the individual vessel assignments to find the overall solution which puts all vessels in their assigned regions in the minimum time. This shuffle algorithm may be described as a process of elimination on the sorted list of permutations of a cost matrix. All these path planning algorithms are facilitated by discretizing the region of interest onto a hexagonal tiling.

  16. Roll and pitch set-up errors during volumetric modulated arc delivery: can adapting gantry and collimator angles compensate?

    PubMed

    Hoffmans-Holtzer, Nienke A; Hoffmans, Daan; Dahele, Max; Slotman, Ben J; Verbakel, Wilko F A R

    2015-03-01

    The purpose of this work was to investigate whether adapting gantry and collimator angles can compensate for roll and pitch setup errors during volumetric modulated arc therapy (VMAT) delivery. Previously delivered clinical plans for locally advanced head-and-neck (H&N) cancer (n = 5), localized prostate cancer (n = 2), and whole brain with simultaneous integrated boost to 5 metastases (WB + 5M, n = 1) were used for this study. Known rigid rotations were introduced in the planning CT scans. To compensate for these, in-house software was used to adapt gantry and collimator angles in the plan. Doses to planning target volumes (PTV) and critical organs at risk (OAR) were calculated with and without compensation and compared with the original clinical plan. Measurements in the sagittal plane in a polystyrene phantom using radiochromic film were compared by gamma (γ) evaluation for 2 H&N cancer patients. For H&N plans, the introduction of 2°-roll and 3°-pitch rotations reduced mean PTV coverage from 98.7 to 96.3%. This improved to 98.1% with gantry and collimator compensation. For prostate plans respective figures were 98.4, 97.5, and 98.4%. For WB + 5M, compensation worked less well, especially for smaller volumes and volumes farther from the isocenter. Mean comparative γ evaluation (3%, 1 mm) between original and pitched plans resulted in 86% γ < 1. The corrected plan restored the mean comparison to 96% γ < 1. Preliminary data suggest that adapting gantry and collimator angles is a promising way to correct roll and pitch set-up errors of < 3° during VMAT for H&N and prostate cancer.

  17. Simulated Online Adaptive MR-Guided SBRT for the Treatment of Oligometastatic Disease of the Abdomen and Central Thorax: Characterization of Potential Advantages

    PubMed Central

    Henke, Lauren; Kashani, Rojano; Yang, Deshan; Zhao, Tianyu; Green, Olga; Olsen, Lindsey; Rodriguez, Vivian; Wooten, H. Omar; Li, H. Harold; Hu, Yanle; Bradley, Jeffrey; Robinson, Clifford; Parikh, Parag; Michalski, Jeff; Mutic, Sasa; Olsen, Jeffrey

    2017-01-01

    Purpose/Objectives Stereotactic body radiotherapy (SBRT) is increasingly used to treat oligometastatic or unresectable primary malignancy, although proximity of organs-at-risk (OAR) may limit delivery of sufficiently ablative dose. Magnetic resonance (MR)-based online-adaptive radiotherapy (ART) has potential to improve SBRT’s therapeutic ratio. This study characterizes potential advantages of online-adaptive MR-guided SBRT to treat oligometastatic disease of the non-liver abdomen and central thorax. Materials/Methods Ten patients treated with RT for unresectable primary or oligometastatic disease of the non-liver abdomen (n=5) or central thorax (n=5) underwent imaging throughout treatment on a clinical MR-IGRT system. SBRT plans were created based on tumor/OAR anatomy at initial CT simulation (PI) and simulated adaptive plans were created based on observed MR-image set tumor/OAR “anatomy-of-the-day” (PA). Each PA was planned under workflow constraints to simulate online-ART. Prescribed dose was 50Gy/5fractions with goal coverage of 95% PTV by 95% of the prescription, subject to hard OAR constraints. PI was applied to each MR dataset and compared to PA to evaluate changes in dose delivered to tumor/OARs, with dose escalation when possible. Results Hard OAR constraints were met for all PI based on anatomy from initial CT simulation, and all PA based on anatomy from each daily MR-image set. Application of the PI to anatomy-of-the-day caused OAR constraint violation in 19/30 cases. Adaptive planning increased PTV coverage in 21/30 cases, including 14 cases where hard OAR constraints were violated by the non-adaptive plan. For 9 PA cases, decreased PTV coverage was required to meet hard OAR constraints that would have been violated in a non-adaptive setting. Conclusions Online-adaptive MRI-guided SBRT may allow PTV dose escalation and/or simultaneous OAR sparing compared to non-adaptive SBRT. A prospective clinical trial is underway at our institution to evaluate clinical outcomes of this technique. PMID:27742541

  18. Searching for signposts: Adaptive planning thresholds in long-term water supply projections for the Western U.S.

    NASA Astrophysics Data System (ADS)

    Robinson, B.; Herman, J. D.

    2017-12-01

    Long-term water supply planning is challenged by highly uncertain streamflow projections across climate models and emissions scenarios. Recent studies have devised infrastructure and policy responses that can withstand or adapt to an ensemble of scenarios, particularly those outside the envelope of historical variability. An important aspect of this process is whether the proposed thresholds for adaptation (i.e., observations that trigger a response) truly represent a trend toward future change. Here we propose an approach to connect observations of annual mean streamflow with long-term projections by filtering GCM-based streamflow ensembles. Visualizations are developed to investigate whether observed changes in mean annual streamflow can be linked to projected changes in end-of-century mean and variance relative to the full ensemble. A key focus is identifying thresholds that point to significant long-term changes in the distribution of streamflow (+/- 20% or greater) as early as possible. The analysis is performed on 87 sites in the Western United States, using streamflow ensembles through 2100 from a recent study by the U.S. Bureau of Reclamation. Results focus on three primary questions: (1) how many years of observed data are needed to identify the most extreme scenarios, and by what year can they be identified? (2) are these features different between sites? and (3) using this analysis, do observed flows to date at each site point to significant long-term changes? This study addresses the challenge of severe uncertainty in long-term streamflow projections by identifying key thresholds that can be observed to support water supply planning.

  19. Public Health Adaptation to Climate Change in OECD Countries.

    PubMed

    Austin, Stephanie E; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D; Parker, Stephen; Fleury, Manon D

    2016-09-07

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will-or should-include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation-cross-sectoral collaboration, vertical coordination and national health adaptation planning-and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning.

  20. The Colorado Climate Preparedness Project: A Systematic Approach to Assessing Efforts Supporting State-Level Adaptation

    NASA Astrophysics Data System (ADS)

    Klein, R.; Gordon, E.

    2010-12-01

    Scholars and policy analysts often contend that an effective climate adaptation strategy must entail "mainstreaming," or incorporating responses to possible climate impacts into existing planning and management decision frameworks. Such an approach, however, makes it difficult to assess the degree to which decisionmaking entities are engaging in adaptive activities that may or may not be explicitly framed around a changing climate. For example, a drought management plan may not explicitly address climate change, but the activities and strategies outlined in it may reduce vulnerabilities posed by a variable and changing climate. Consequently, to generate a strategic climate adaptation plan requires identifying the entire suite of activities that are implicitly linked to climate and may affect adaptive capacity within the system. Here we outline a novel, two-pronged approach, leveraging social science methods, to understanding adaptation throughout state government in Colorado. First, we conducted a series of interviews with key actors in state and federal government agencies, non-governmental organizations, universities, and other entities engaged in state issues. The purpose of these interviews was to elicit information about current activities that may affect the state’s adaptive capacity and to identify future climate-related needs across the state. Second, we have developed an interactive database cataloging organizations, products, projects, and people actively engaged in adaptive planning and policymaking that are relevant to the state of Colorado. The database includes a wiki interface, helping create a dynamic component that will enable frequent updating as climate-relevant information emerges. The results of this project are intended to paint a clear picture of sectors and agencies with higher and lower levels of adaptation awareness and to provide a roadmap for the next gubernatorial administration to pursue a more sophisticated climate adaptation agenda. Project results can also inform numerous other ongoing database efforts connected to the U.S. National Assessment of Climate Change.

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